Fire Crews Take On Paramedic Role

Firefighters are acting as stand-in paramedics to take seriously ill patients to hospital as the Welsh Ambulance Service is beset by delays. Ambulances have taken so long to reach emergencies that firefighters have been forced to take casualties to hospital themselves in fire engines.

The Western Mail has learned that South Wales Fire and Rescue Service has issued advice to its stations about what to do when ambulances are delayed in responding to an emergency call.

The service has said it will support fire crews who decide to transport a patient to hospital from the scene of an accident if no ambulance is available. Delayed ambulance responses have happened on an increasing basis over the past three years.

And it is understood that on at least three occasions this year either the fire service or the police in South Wales have had to take seriously ill patients to Accident and Emergency departments because an ambulance did not arrive quickly enough.

The revelation will come as a further blow to the Welsh Ambulance Service’s reputation, which is still suffering from having the worst response times to 999 emergency calls in Britain.

And it emphasises the scale of modernisation needed within the service to ensure that all Welsh patients receive the expert care they need in a life-or-death emergency.

Dave Galligan, head of health for Unison, which represents ambulance staff, said, “The fire service has many skills which are often akin to some of the basic life-saving techniques of the ambulance service. But they are not paramedics in disguise.

“I do recognise that this may be a case of needs-must, but the reality of this is that only one of those journeys needs to go wrong to send everyone running for cover.

“It really is a frightening scenario and it is being planned as an eventuality.

“We should be going that extra mile to ensure that this doesn’t become a reality.”

Nigel Williamson, brigade chair of the Fire Brigades’ Union for South Wales, said, “We do have concerns as we are not paramedics – we have first-aid training.

“We have raised these concerns with employers, especially that if this continues it will be seen as the introduction of a co- responding scheme through the back door.

“Management has explained its intent is to offer clarity and support to those who find themselves in the dynamic situation where they have to put a patient on the back of a fire engine to save someone’s life.”

The memo to fire stations, which includes advice about how to decide whether a patient needs to be taken to hospital immediately, does not state that fire engines and other vehicles will be used as replacements for ambulances.

Nor will the fire service be used to respond to ambulance-only emergencies.

But if crews are attending a 999 call, such as a road traffic accident, where a patient needs emergency hospital treatment but the ambulance will not get there in time, the fire service could step in.

A spokeswoman for South Wales Fire and Rescue Service, said, “It is an instinct in the fire and rescue service that if someone is in trouble then they will be there to save their life.

“If a patient has a life-threatening illness or injury and our crews are aware that there will be an extended response time by the ambulance, this memo advises that there are steps we have to take to save that person’s life.

“We would have to consider whether the injuries are critical, whether there is a delay to the ambulance, how far from A&E and what other transport options there are, including the use of police vehicles.”

In one such incident, the fire service’s special rescue unit was used to transport a woman with back injuries to hospital because of ambulance delays.

The unit had been called to Barry in December last year after the woman had fallen from a first floor window sill.

She was placed on a spinal board in the back of the vehicle, as the fire crew was concerned she would go into shock.

The ambulance met the vehicle at Culverhouse Cross roundabout and the patient was transferred and taken to the University Hospital of Wales.

The drastic action by South Wales Fire and Rescue Service comes amid mounting concern about the ambulance service’s response times.

The last official figures, which were published in May, revealed that only 56.7% of ambulances responded to a Category A 999 call within eight minutes in Wales.

In South East Wales the figure is just 52.4%.

South Wales Fire and Rescue Service has also experienced a growing number of occasions when an ambulance has been delayed arriving at the scene.

In the past 10 months there have been 21 occasions when the fire service experienced an “extended response time” from the ambulance service, according to figures presented to the South Wales Fire Authority.

Between July 2004 and December 2005 there were five such incidences and between September 1999 and June 2004, there were just two.

Alan Murray, chief executive of the Welsh Ambulance Services NHS Trust, said, “We have been working closely with the fire service to ensure that, should it be necessary for its staff to have to deal with casualties needing urgent medical attention whilst waiting for an ambulance, that access to clinical advice is available from ambulance officers.

“The trust is currently working hard to improve performance throughout Wales and is putting in measures now to improve its response to life-threatening emergencies with particular focus on South East Wales where we are aware of concerns.

“There is no doubt that meeting the eight-minute response time remains a huge challenge but we are undertaking a fundamental review of the way in which we provide and deliver services.”