1. What we can learn together
Vij Randeniya
President, Chief Fire Officers Association
Ambulance Leadership Forum
Chesford Grange, Kenilworth
May 22nd 2013

2. Ambulance Leadership Forum – May 22nd
Fire and Ambulance
Ambulance and Fire have a long history of working together – every day in the UK ambulance and fire crews work together to save lives at RTCs, fires, chemical incidents etc.
Similarly, CFOA and AACE, the two bodies representing the professional voice of Fire and Ambulance, work closely together to ensure we are both able to undertake our roles more effectively to deliver the best possible service to the community, which is after all what we are all here to do.
Ambulance Leadership Forum – May 22nd

3. Ambulance Leadership Forum – May 22nd
This is not a land grab!
I want to be clear – this is not a “land grab” by fire for ambulance. Last time this topic was discussed publicly there was some animosity. We are not seeking to take over ambulance – I’m sure you’d tell me we couldn’t even if we wanted to! We recognise that they are very different services, and we benefit from being separate.
Nonetheless, the public and the government will expect us both to make significant savings and changes in the coming years and we’d be better off working together to overcome them than becoming insular and seeking to protect our own. Realistically, we have to accept that the man or woman on the street does not care how our services are organised or who is in charge. They want to see the white van or the red truck arrive when they call it, as quickly as possible with the best people on board.
Ambulance Leadership Forum – May 22nd

4. CLG’s Efficiency Review
Many of you will have seen the recently published report by Sir Ken Knight on improving the efficiency and effectiveness of the Fire and Rescue Service. CFOA disagrees with a number of specific points within the report, but this is perhaps not the venue to voice those. However, we welcome the report in general, as we enjoy the opportunity to discuss and debate the future of the service and we are pleased that so much attention is being focused on the Fire and Rescue Service.
Collaboration and joint working between fire services and other agencies, not least ambulance and fire, features prominently in the report. I believe that we are already in a strong position in this regard, and in many ways we just need to continue building on the successes we’ve already had. However, the government is looking closely at these recommendation, some of which would involve huge changes, and we must be sure to have a considered and joint response in place, and be willing to consider more fundamental reforms.

5. Ambulance Leadership Forum – May 22nd
Co-locating
Co-locating is one step that services are taking to work more closely and produce efficiencies. It is not suitable everywhere and in every situation, but it seems clear that some areas are further advanced with this than others. This is a “quick win” and could work both ways.
It is a visible indication of our joint working which the public can clearly see – appearances are important, even if the savings are negligible. In his report, Sir Ken is clear that;
“I believe that there is significant opportunity to expand on this and rationalise the public sector estate.”
Ambulance Leadership Forum – May 22nd

6. Ambulance Leadership Forum – May 22nd
Co-responding
Co responding is a controversial area, but a vitally important one. Your calls are growing year on year which means you are struggling to meet your response times We all know that “more money” is not an option. The government will not be paying for more ambulances – so to continue providing the same service requires a rethink.
Fire Services conversely have driven down calls, but still face pressures caused by rapidly reducing budgets (20% in four years). Nevertheless Fire Services have significant latent capacity as a result of our deployment on the basis of risk. We must also maintain a geographical spread that means our appliances are situated in more isolated areas where normally the ambulance and even police are not.
We also know that in many places a fire appliance will be on scene significantly before an ambulance – so it is just commons sense to have firefighters capable of treating injuries.
I understand that having a paramedic on scene will remain the best option but this is not always possible. Firefighters are now trained in trauma first aid, not just the basics.
The Fire Service faces a challenge around this as the FBU are not supportive unless contractual changes are made, something that is unlikely in the current climate. So far only some services have been able to introduce it. There are pockets of excellence but we must look to introduce it more widely.
Ambulance Leadership Forum – May 22nd

7. Ambulance Leadership Forum – May 22nd
Training
Many services now undertake joint training – a particularly good example being HART teams. We both gain from this, and it can produce savings too.
Joint exercising is important too, allowing us to effectively test ourselves, our procedures and identify issues. For fire, this is becoming a particularly important area, as the volume of calls reduce but their complexity grow, we are more reliant upon training to fill the gap left by reduced operational experience.
Ambulance Leadership Forum – May 22nd

8. Ambulance Leadership Forum – May 22nd
JESIP
The Joint Emergency Services Programme has strong support from central government, and it is great to see that all three emergency services, and others, are so committed to it. Already a number of advances have been made in terms of equipment, operational doctrine, training and comms.
Some of this is very simple, others more fundamental.
Key areas for JESIP:
Challenges with initial command, control and coordination activities on arrival at scene (sometimes called the “Golden Hour”)
A requirement for common joint operational and command procedures
Role of others, especially specialist resources and the reasons for their deployment, not well understood between services
Misunderstandings when sharing incident information and differing risk thresholds not understood
Difficulties with communication between control rooms and the incident ground
Issues with use of radio channels
Acronyms, jargon and differing call signs resulting in hampered communications
Ambulance Leadership Forum – May 22nd

9. Next steps to closer working
I’ve highlighted some of the ways we are already working closely together, at a local level, regional level and nationally between CFOA and AACE.
If we are to continue to improve we will need support – CFOA have made it clear to our Minister that the Department of Communities and Local Government needs to work closely with the Department of Health.
We do, however, have to recognise that we can do more. Ambulance could learn lessons from us on prevention, we need to look at keep developing skills of our firefighters so they can support your teams on scene most effectively.
There are a number of further questions we can ask ourselves.
Sir Ken asks whether Hazardous Area teams should be merged given the joint training and similar roles?
Should we be looking at control functions – could these be more closely aligned? Gloucestershire has made the most progress on this already.
The difference in size between 10 ambulance trusts and 46 fire services raises questions. Should we be bigger? Are you to big?
In all these instances there are already pockets of excellence but this needs to be expanded country-wide.
Ambulance Leadership Forum – May 22nd

10. Questions?