Delivering change through emergency service collaboration

Partners from six emergency services in Surrey and Sussex have been working together for nearly two years to co-design the way services are delivered. Linda Wood, programme manager of the Emergency Services Collaboration Programme, talks to PSE about some of the benefits already being felt across the region.

As PSE went to press the government was consulting on whether there should be a legal duty to collaborate for the three emergency services: police, fire & rescue and the ambulance service.

We caught up with the Emergency Services Collaboration Programme, which is ahead of the game with its aim to improve the way emergency services are delivered in Surrey and Sussex while reducing costs for local taxpayers.

The programme, which started back in 2013, consists of a number of initiatives and involves six partners – Surrey Police, Sussex Police, Surrey Fire & Rescue, East Sussex Fire & Rescue, West Sussex Fire & Rescue and South East Coast Ambulance (SECAmb).

Over the last two years, the partners have worked together to co-design the way services are delivered across the region.

Linda Wood, programme manager of the Emergency Services Collaboration Programme, told PSE: “We have a clear vision, design principles in areas around improving services to the public, reducing cost, increasing resilience, less overlap and aligning our resources across the piece to better meet demand.”

Wood’s own recent background is in senior local authority roles, including at the London boroughs of Croydon and Sutton. She is now based at both Surrey County Council and SECAmb.

Looking at the national picture, she highlighted that across the country fire services are generally attending fewer fires due to the prevention work that has been put in place. But police and ambulance demand has continued to rise by between 4% and 10% year-on-year – while budgets have gone the other way.

“A lot of what we have delivered early is about the fire and rescue service assisting one of the other services,” she said. “This is helping to balance the demand, without impacting on the fire service’s main purpose of responding to fires.”

Quick wins

An early example of this work relates to gaining entry. Back in December 2014, Surrey Fire & Rescue became the lead authority to gain or force entry to premises on behalf of SECAmb when there is a concern for an individual’s safety.

Wood explained that before this transfer of responsibilities, the ambulance service would contact the police for this type of help, but sometimes a lack of available resources or nearby specialised teams caused a time lag between calls being made and attendance in these ‘time critical’ situations.

However, after going live with the project, the fire service has helped significantly reduce the time taken to attend these incidents. This frees us police resources, which can be deployed to other priorities.

“In the first eight months of 2015 there were 409 requests from the ambulance service and they [the fire service] got there, on average, in around eight minutes – which is equivalent to the Red 1 emergency timeframe. It was a lot quicker than the estimated police service time,” said Wood.

“Additionally, out of the 409 incidents the fire service has only called on the boarding-up contract 26 times. We can’t do a direct comparison because the old data doesn’t allow that, but everybody accepts that is a huge reduction because they are often able to gain entry while doing less damage.”

Another area where the fire service aims to alleviate pressure on other services is with firefighters taking on greater responsibility for some health emergencies.

As part of a pilot scheme, which started at the end of September, Surrey firefighters will respond to life-threatening emergencies such as cardiac arrests and choking.

The firefighters involved have had immediate emergency care responder training, which has now been provided to about 300 people, with a similar number to be trained over the next year. Defibrillators have been installed in every fire engine, officer car and on the outside of every fire station in Surrey.

Qualified ambulance crews will always be assigned at the same time as the firefighters, who will respond in fire engines or in fire service cars. “It is not a case of ‘instead of’ as there will be the need for further clinical assessment and intervention and a need to transfer people to another service, such as a hospital,” she said.

“Gradually this is going to be expanded across Surrey and we will have cover in every part of the county, 24/7. It is an amazing additional resource as it really boosts what is possible to be deployed by the ambulance service.”

Joining up services

The projects that have progressed so far have mainly been Surrey-centric, but delivered in a way that the Sussex partners can adapt and take on-board.

Some of the longer-term projects involve the partners developing a Multi-Agency Information Transfer (MAIT) hub, which will enable an electronic connection between existing command and control systems, reducing the current four minutes it can take to transfer information by phone between the emergency services to just a few seconds. This could save an estimated 7,500 operator hours per year.

“We have procured a system where incidents can be transferred within seconds between services, saving the cost and time of making calls between services. We are now creating all the technical links to make it work,” said Wood.

There are lots of places with single-way links between services, but the MAIT hub will be a first in England with multiple partners engaged.

“It is a shared intelligence really, because anything a partner gets as extra information might change the deployment decisions of another,” PSE was told. “That will be a major step forward for the project and we hope it will be live early in the next financial year.”

The partnership is also examining the possibility of a joint contact and control centre, but this is at an early stage and considerable preliminary work needs to be done before firm proposals can be made to amalgamate existing centres.

The way forward

Wood said an important step in the development of the programme, and the building of the relationships between the partners, is that it is okay for partners to put boundaries and constraints around certain things. For instance, the ambulance service has been clear that its NHS pathways triage system is very different from the way other partners handle 999 calls and that won’t change. The ambulance service can’t see a time where there would be one generic multi-tasked person who would take all types of calls.

Talking about the government’s collaboration consultation, Wood added that these new methods of working could be supported by a strong mandate from government, with funding, to support delivery of the changes.

“If it is ingrained in new legislation, which looks like it might be on the cards, we’ll hopefully be ahead of the game,” she said. The long-term ambitions of this type of working “should be the way to go – it’s public money, so let’s use it wisely”.

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