Why do we need a national standard/consistency?
CFR Groups are dependent on their local NHS Ambulance Service for their establishment, training, clinical protocols and equipment they carry and also to what type of emergency they are tasked to attend.
Thus the title of Community First Responder can be simply an individual who is trained to respond with a defibrillator to a cardiac arrest or an individual who is trained up to he equivalent of an NHS Emergency Medical Technician standard, is able to hold similar equipment and who can attend any emergency call. Indeed there are many CFRs who are medically qualified Doctors, Nurses or Paramedics who are members of CFR Groups. There are many variations in training, equipment and ability to respond in between these two extremes.
There is now a national accepted standard of training, overseen by the Royal College of Surgeons in England for the First Person on Scene (FPOS) which offers a three tier level of training – Basic, Intermediate and Enhanced which many CFR Groups are following and which many areas of commerce are adopting as a necessary first aid training for their employees.
Other volunteers for the Fire, Police, RNLI, Mountain Rescue have agreed national training and are therefore expected to be able to provide an accepted level of response and support.
With the growth of the Community First Responder throughout the UK there is a need to agree a common qualification, a level of equipment, medical supplies and drugs with which they should equipped and a clear definition of the level of support they should be capable of providing. A National Organisation would be essential to ensure that such measures were agreed and applicable to all Groups.
The Healthcare Commission, now the Care Quality Commission, Report of 2007, entitled “The role and management of community first responders” stated that
“This survey has shown that CFRs are used widely, that they are seen as being beneficial to outcomes for patients, and that over time ambulance services have developed the CFR model to different degrees. The development of this service requires the NHS to ensure that it is properly managed, supported and audited by those responsible for the provision of emergency services in England. In light of the variation in the role and management of CFRs across England, we recommend that the appropriate body should develop national guidance for ambulance services, to ensure that a more consistent approach is taken in the management, governance and development of this valuable service.”
This was 7 years ago, with no progress appearing to be made.
CFR Groups are established by individuals to support their local community. They are not established for the benefit of NHS Ambulance Services to achieve response time targets. It should be for each community to decide how they wish their group to develop the services it can provide far beyond the response to life threatening emergencies.
Fire and Police services are recognizing the value of CFRs and some see value in such CFRs also responding to some of the low risk Police and Fire emergencies.
The Chief Executive of the NHS has stated that he foresees a greater role for communities in helping the NHS deliver health and social care in the future to keep vulnerable people safely at home and out of hospital or full time care.
It would be a major task for each individual CFR Group to liaise with the emergency, the health and social care services supporting their area if they wished to extend the “first response” care they could provide to their communities. A National Association, could agree approval, training and protocols for such expansion on a national basis with the organisations concerned.
Establishing a CFR Group is a major cost, maintaining a Group’s equipment and vehicles and insurance are substantial annual costs which have to be met from local fundraising.
A National Association should be able to obtain grants from National Funds and Charities to assist with the initial set up costs. The association should be able to obtain vehicles, equipment, uniforms and insurance at more economical rates than individual Groups.
Finally, CFRs are participants and observers at emergency incidents and as such they develop a very accurate impression of the quality of emergency ambulance support available to their community. This has been recognised by the Care Quality Commission who intend to meet with as many CFRs as possible before they inspect each NHS Ambulance Service. Collectively, CFRs would be a very important Group to monitor Ambulance Service performance, development and to argue, where appropriate for national levels of emergency pre-hospital care.