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Prevent, Protect, Respond: handling more than just fires
NHS England’s National Clinical Director for Long Term Conditions spent a day looking at a fascinating new partnership between the NHS and the Fire Service, and the new Safe and Well checks our 999 colleagues are carrying out:
I started writing this on the train home from Manchester. I arrived in the morning to spend a day with the Greater Manchester Fire and Rescue Service (GMFRS). I wasn’t sure what to expect, which is just as well as any expectations would have been exceeded.
On arrival, Peter O’Reilly, County Chief Fire Officer – or ‘the Boss’ – introduced me to Kerrie and Paul and we set off to our first home visit of the day: a referral from social services to the GMFRS Community Response Intervention Team.
While Kerrie went through a ‘safe and well visit’ with the person who had been referred, Paul set about installing grab rails that had been requested to prevent falls and assessed the house for fire risk.
I watched and listened as they worked efficiently and effectively as a team to identify, advise and signpost help for warmth, loneliness, food, care and support. They even supplied a fire retardant duvet and blanket there and then.
As a doctor I recognised the complex medical problems the individual had but also that it was more than medicine that was going to keep her safe and as well as possible, and the liaison following this visit was going to complement the work of health and social care services.
Back at the station I sat down over a cup of tea for a chat with the team on watch. I never got the tea. I did get to talk with two of the watch in the back of a tender heading into central Manchester on a “shout” or call out.
Stood down – an alarm fault in a shop – the tender carried on through Manchester and Ben and Ian set about doing their first safe and well visit.
We visited another lady, who is in her 90s and still goes dancing, despite her visual impairment. I could not fault Ian’s consultation skills despite this being the first time he used the structured assessment he had been trained to follow.
As Ben checked the smoke alarms, fire risks and personal security, Ian gave advice to the recipient of all this attention on what to do in the event of a fire, or if she was worried about her personal safety. They also tested her community alarm system was working and confirmed she’d had a flu jab.
Once again it all seemed familiar to me as an erstwhile GP but I missed what a fireman spotted. As the house stairs turned left near the top, to the landing, the handrail stopped. Ben suggested that getting a subsidiary rail in place might prevent a fall. Pretty important, as she still bore the bruises from a recent misadventure on the lower steps. Action will be taken.
Back at the station I listened in as ‘the Boss’ held one of his regular question and answer sessions with frontline staff.
The GMFRS are now providing cardiac arrest first responder in alliance with the ambulance service, safe and well visits and community intervention, as well as their traditional fire service.
The challenges faced and change sought would be familiar to all in public service. As I sat and listened to a room full of consummate professionals, who patently take immense pride in their work, it confirmed a belief that public services need to learn from each other and work with each other if we are to make best use of the limited resources available.
Before he left, Peter introduced me to three inspiring young people working with the Fire service. The stories I heard from Community Safety Adviser Apprentice Carys Thompson, Business Safety Apprentice, Rahul Ahmed and Salford Integrated Prevention Hub Youth Engagement Coordinator Anthony Maunder, were clear evidence of how the Fire Service engages with and supports the community it serves.
All three had all started off with the Princes Trust which is co-located with GMFRS. After a three month course they were equipped with skills and confidence that helped them make the next step – to enrol in a 12 month apprenticeship learning about community and business safety but also engaging with peers. Anthony had progressed further and is now employed in his coordinator role.
The suite of youth engagement programmes developed by GMFRS reaches out to those not in education employment or training (NEET). Every pound invested, research estimates, returns almost £3 in social value.
They talked passionately about how their mental health first aid training had helped them spot friends with problems and how they were able to advise and support them. Building community assets has added to the astonishing success the FRS has had in reducing domestic fires.
Having been there and experienced on the ground what potential the Fire Service has as a health asset I am proud to be part of a team that is raising awareness and supporting collaborative working across the country.
The consensus statement and design principles for Safe and Well visits are there to help local CCGs and Fire Services work together as a public service team. The impact is tangible.
Martin. You are absolutely right to raise the profile and potential of this nationally. This morning I had the Oxfordshire Chief Fire Officer and his deputy join my directors and our clinical directors at our monthly meeting. The big discussion was about community safety and how we can work together. We are taking this forward. The next practical step will be to second one of the fire officers to work with the Ccg and get this work shaped.
David smith, chief executive.