Merge Fire and Ambulance?

CaseyRyback

As posted in the news section Peter Holland, president of the Chief Fire Officers Association (CFOA) in Britain, says letting the Fire service run the Ambulance, effectively merging both services, could save money and improve the service with faster response times. It works for DFB, could it work in general? Is there a need for a separate fire and ambulance service?

Fire brigade proposal to run England's ambulance service


The fire and rescue service in England has proposed taking over and running the ambulance service.


The CFOA says the ambulance service is struggling to meet its response targets of dealing with 75% of life-threatening calls within eight minutes. But an ambulance official says the idea would not be workable. Mr Holland says: "We are calling on the Department of Health (DoH) and the Department for Communities and Local Government (DCLG) to review this idea. By basing fire and ambulance stations together we could generate savings for the future."


Figures for 2009 to 2010 show that five out of the 12 ambulance services in England are not meeting the 75% target. The CFOA believes it could respond to life-threatening calls within eight minutes 90% of the time. The fire service is only interested in running the emergency response section of the ambulance service, suggesting the patient transport service could be left with the NHS or run privately on the open market. Chief fire officers will be making the case to run the ambulance service at the Conservative party conference in Birmingham next week.

The Ambulance Service Network says emergency response times are improving. It is unlikely to go down well with unions. Jim Petter from the College of Paramedics, the ambulance service professional body, says:

"Culturally the two services are very different. I just can't see how it would work. The ambulance service went through a massive reorganisation in 2006 when the 29 ambulance services in England were cut to 12. Changing it again would only be damaging."


Jo Webber, director of the Ambulance Service Network - representing the services, says: "It is hard to see how the fire and rescue service think they could improve things. We deal with a huge number of calls compared to the calls to the fire service. We are already improving response times by building up a big network of community paramedics based in doctor's surgeries. This idea would mean a massive reorganisation which I just don't think would be workable."


The Ambulance Service Network also believes the move could be motivated by fears over fire service funding, which comes from the DCLG. A paper leaked to BBC Radio 4's You and Yours says: "While spending in the Department of Health has been ring-fenced from Treasury spending cuts, the Department of Communities and Local Government is facing cuts of between 25 and 40%".


A DoH spokesman said: "The department has had discussions with DCLG about options for operational efficiency in each service but there are currently no plans for any kind of merger."



http://www.bbc.co.uk/news/uk-11444927

Actual Paramedic

Think John Kidd of the IFESU wants the same here, don't see it happening.

Bang Bang

This topic has been done to death here.
Try the search function and you should find the many debates for and against this idea.

source

3 words, retained fire stations.....These would have to be made full time costing more money. coupled with purchasing ambulances and extra staff costs. It works in Dublin because the stations are nearly all 24 hour.

resus

As I have a small advisory roll across the waters, the ONLY thing the Fire & Rescue Services in UK are looking to take on is Trauma and nothing else. They are doing so for a raft of financial reasons. DOH pleading at the moment for them to take on cardiac arrest, but this is being actively opposed.

ivabiggon

it doesn't just work well in Dublin, but alot in the states and in other European countries eg: belgium , states, hong kong, canada dublin, there is loads of examples

http://en.wikipedia.org/wiki/Paris_Fire_Brigade#Mission



http://en.wikipedia.org/wiki/Hong_Kong_Fire_Services_Department#Ambulance_services

EMSCHAP

Anyone think of doing it the other way round? The NAS running a nationalised fire service?

ivabiggon

yeah sure they couldn't do any worse than some of the fire chiefs around the country!!!:o

Zuppy

EMSCHAP wrote: »

Anyone think of doing it the other way round? The NAS running a nationalised fire service?

I can't think of too many places where the ambulance runs the fire service. Plenty of examples international of the fire service running the frontline ambulance service. And even the police running the fire service or parts of it (USA).

CaseyRyback

ivabiggon wrote: »

it doesn't just work well in Dublin, but alot in the states and in other European countries eg: belgium , states, hong kong, canada dublin, there is loads of examples

http://en.wikipedia.org/wiki/Paris_Fire_Brigade#Mission



http://en.wikipedia.org/wiki/Hong_Kong_Fire_Services_Department#Ambulance_services

FDNY, like DFB are a good model.

Tango Alpha 51

For all the examples given of fire based ems, there is equally the same arguments/models for standalone ems ie Boston EMS, NSW Ambulance in Austrailia etc. The Dublin situation is quite unique.

CaseyRyback

buzzman wrote: »

For all the examples given of fire based ems, there is equally the same arguments/models for standalone ems ie Boston EMS, NSW Ambulance in Austrailia etc. The Dublin situation is quite unique.

Can you shed any light as to why DFB are a unique case and the model wasn't adopted in other cities?

999nobody

buzzman wrote: »

For all the examples given of fire based ems, there is equally the same arguments/models for standalone ems ie Boston EMS, NSW Ambulance in Austrailia etc. The Dublin situation is quite unique.

Why do you say that Dublin is unique, there are many similar models.

http://cityofpetaluma.net/firedept/home.html

for example

Zuppy

FDNY
San Fran.
Koln
Bonn
Berlin
Dusseldorf

Those are the ones off the top of my head which the Fire service run the ambulance. Cork used to have an Ambulance, I don't think Limerick ever did but I can't be certain.

civdef

Chicago Fire Dept also provides EMS, with all firefighters trained to EMT-B, who also man BLS ambulances; with ALS ambulances manned by EMT-Ps.

alentejo

I note that in the FG manifesto, under health and ambulance service, FG want review fire EMS involvement in the provision of ambulance services (hedging bets for the manifesto).

However, if you examine NYFD, in reality the fire and ems are separate with different ****s and dedicated paramedics on ambulance appliances.

I think the fire/ems model works well, however I have a gut feeling that there should be a re-orginisation of how the model is delivered in Dublin. I think DFB have a good product, however I suspect that it could be delivered more efficiently.

CaseyRyback

alentejo wrote: »

however I have a gut feeling that there should be a re-orginisation of how the model is delivered in Dublin. I think DFB have a good product, however I suspect that it could be delivered more efficiently.

This thread really isn't about picking the bones out of DFB. If that's where you're coming from perhaps a new thread might be the way forward?

But yes, in response to your brief point FDNY fire and medics are two separate roles yet under the same banner.

gem112

The fire service in this country is a distaster....there are 25 odd CFO's... With god only knows how many ACFO's... For 4million people is a bit of a joke....there are 3 different fire authorities in Louth the smallest county in Ireland...... They really need to sort out there own house before they even look at anyone elses

civdef

Compared to where?

ivabiggon

civdef wrote: »

Compared to where?

compared to london for instance, 5800 operational staff and one chief

"V" ireland- 2500 firefighter, 34 chiefs...what a joke

gem112

Dfb look after approx 1.4 million people.... 1 CFO.....33 CFO's for 3 odd million in the rest of the country...... London 16million odd people....1 CFO lads the maths don't add up..............

Think of the saving that could be made by reducing the number of CFO's to one

civdef

You're not comparing like with like there though.

http://www.london-fire.gov.uk/OurOrganisation.asp

London has a large and complicated management structure, with commissioner, deputy commissioners, assistant commissioners, deputy assistant commissioners, group managers etc etc etc, not to mention a myriad of administrative departments and staff. There would be no equivalents for these in Irish Brigades. The job of CFO in an Irish brigade and Commissioner of LFB are very different.

Furthermore, LFB has no Building Control role, which is what least a third of senior officers are assisgned to here, as well as emergency planning which is what a fifth of senior officers are assigned to. These are separate departments of the local authority in the UK.

The comparison of Irish fire service management structures to their UK counterparts is often trotted out, without a fair analysis of what the comparison actually involves.

gem112

I take ur point that london has its differences but Can u not see 33 CFO's To many to look after 3 odd million and 1 to look after 1.5 million as a waste of money.......34 CFO's on apron 90/100k a year......dont see the logic in that....

ivabiggon

gem112 wrote: »

I take ur point that london has its differences but Can u not see 33 CFO's To many to look after 3 odd million and 1 to look after 1.5 million as a waste of money.......34 CFO's on apron 90/100k a year......dont see the logic in that....

not to mention their assistant chiefs and secretaries and admin staff to go with ALL those chiefs, along with their offices and transport.
also the minimal buying power one local authority has in comparison to one large purchasing dept if it was national service for buying ppe and vehicles, and the duplication of specialist vehicles that every local authority wants on their wish list but their neighboring county might already have, but can't use, and remember these specialist vehicles have a shelf life and a service requirement weather they're used or not. what a waste of money

EMSCHAP

ZuppyLurk wrote: »

FDNY
San Fran.
Koln
Bonn
Berlin
Dusseldorf

Those are the ones off the top of my head which the Fire service run the ambulance. Cork used to have an Ambulance, I don't think Limerick ever did but I can't be certain.

Yep, Limerick did, back in the day!

civdef

I'd wager that once you factored in the range of different grades and the range of extra responsibilities such as building control undertaken by the fire service here, that fire service management costs are less in Ireland.

Anyone want to check the numbers?

civdef

http://www.merseyfire.gov.uk/aspx/pages/reports/pdf/Standard_response_to_pay_queries_re_ELT.pdf
http://www.thisisbristol.co.uk/news/Firefighters-union-criticises-Bristol-chief-s-163-170-000-year-salary/article-2498077-detail/article.html


Just some backup that there's a bit of an apples / oranges thing going on here:

An area manager (DO here) in the UK will be earning more than an ACFO here. They also get a very nice deal on lease cars for flexi duty (similar to RSFO here).

An ACFO in the UK will be on a lot more than a CFO here (plus the car thing).

http://www.cheshirefire.gov.uk/Assets/seniormanagementteamjul10.pdf
http://www.leicestershire-fire.gov.uk/documents/organisational-structure.pdf

Organisational structures in the UK tend to be much more complex. Here outside the cities, the fire service management structure will be something like:

1 x CFO, 2-3 x SACFO, 2-3 x ACFO, Clerical Officer 1-3, 1 x fitter mechanic. That would be for a retained service with 6-10 stations.

Bearing mind this includes the staffing to provide emergency planning and building control services, which would be separate local authority departments in the UK.

The whole procurement sharing thing can be overblown. They recently cancelled the Firebuy project in the UK which was meant to save millions through common procurement, but ended up costing more than it saved. I'm not sure we're paying a whole lot more for stuff here than other places, especially given that tenders are EU wide known and it's so easy to see what other people are paying for things.

Tango Alpha 51

What I meant by unique is that Dublin is the only city to have a F&R service in Ireland providing ems. In my opinion it would be cost prohibitive for the rest of the country to try this. As has been pointed out the stations in Dublin are 24/7. Trying to get local authority managers to agree to this in light of the fact that their trying to reduce their costs is a non runner. The problem in the rest of the country lies in the fact that the NAS is massively under resourced. The HSE gave back over 100million euro out of it's budget last year. The waste in the HSE is astronomical. If it was a private business it would have closed years ago. If you compare the NAS with the NIAS, up north you have 6 counties, 2 control rooms, 46 ambulance stations, excess of 1100 staff & over 300 vehicles whereas down here for 26 counties, we have 93 ambulance stations, alittle over 1800 staff & 160 vehicles. We cover a bigger area with less vehicles & stations & therein lies the problem.

If F&R were to do this, the cost would be huge & you couldn't cherry pick just doing 999 work, Gp calls & PTS work would have to be carried out too

Zuppy

On cherry picking ambulance calls. Why not? Some german states operate a two tier ambulance system. Admittedly the don't have an emergency dept as we understand it but treat and triage in the field with a notartzt (emergency doctor).

First line of paramedic staffed ambulances for cat 1 calls and EMT staffed ambulances for transports, gp calls and the out of hours gp services along with being back up to the tier one ambulance at peak times. Private ambulances tied into the second tier system.

Not unworkable but even with what I consider limited resources the NAS at the moment does not seem to be the bottle neck in the emergency care system.

ivabiggon

just two quick point on this, as i'm gonna leave it as i've already hilighted my views on this in another thread and it can be looked up.

1) the retained fire service in this country is run on a shoe string, and for that the public get local lads with local knowledge turning out within..something like 5 mins and on the road in 6.. this could easily applied to an local emergency ambulance service in a very rural area were the nearest ambulance is probably 20-30 min away, strictly emergency calls and transport or 2 man crewed first responder car with equipment, leaving the fire truck still available for calls.
only paying them for the time on the road. this is very sucessful in rural town in the states were they do it on a voluntary basis and transport also.

2) the ambulance service and particularly the personnel in this country is barely recognised by their employers as anything but ambulance drivers, cardiac trained general operative, and this is shameful when clerks are startong at a higher grade and as a result, if they can get away with keeping you down there with the minions they will, it is not the ambulance service that is the bottle neck it the people up top who count beans and expect alot for nothing... how many time have crews spent hours waiting for a trolley while the radio is screaming for ambulances.

a national emergency service is the way to go, all services under the one umbrella, fire ambo rescue and coast gaurd, and then take the voluntary services under their wing for major emergencies. and leave the local authorities and health services to do what they do best. waste money and fix roads..

sorry but i have another issue on board.ie that i have to pursue now.

just sort it

http://www.ambulanceleadershipforum.org/news_resources/forum_updates/?n_id=39

Here's an artlicle by professor Woollard on the amalgamation issue. Just click the link on the webpage to open a pdf of the article printed in the Journal of Paramedic Practice.