Objections to National Uniformity?

Reasons why various people have said uniformity is not going to work

The cost to replace CFR uniforms being between £500,000 to £1,000,000 – This would be mostly irrelevant, the first point is that that vast majority of CFRs provide their own uniforms. The second point is that if uniform were to be provided by the trust and replaced, this would be done gradually as it used and wears out, in much the same way that legacy uniforms were replaced in ‘County’ Ambulance services, when they were regionalised. This would be similar to the way in which school uniform is normally replaced; with legacy uniforms being acceptable for extended periods and parents buying the new uniform as and when.

National governance would not be possible – Why? National governance exists for retained firefighters, special constables, the RNLI, mountain rescue and lowland search and rescue (ALSAR), not to mention dozens of other national volunteer associations not linked to emergency response; why not for CFR’s? Are trusts concerned that a national governance would take something away from them? In reality national governance would remove some barriers and paperwork, and would pave the way for interoperability and would not lead to the loss of experience and volunteer hours caused when some CFRs move house.

‘Basic’ training is already the same for CFRs – As has been collated by a CFR Facebook group, there are massive differences between ‘basic’ CFR training. Some trusts offer FAW or something similar or their own trust specific training without reference to any recognised qualification(s), some offer FPOS Basic, some offer FPOS Intermediate, St John’s do their own. As a simple example, if each locality of CFR were to answer the question “Would you be sent to a 7 year old who was not breathing?” that would get a very wide range of answers, some of which would probably include “depends…”. This is not what we as the NACFR want, or as CFRs in general. We are here to preserve life, BLS and defib is our bread and butter, so to speak. If we were to look at it from the side of the 7 year olds family, would you care who turns up? Most likely the answer would be an emphatic ‘No!’ You just want someone there fast, who is going to do ‘something’. Whether that is a responder who is trained in paediatrics or a responder who is not, who applies adult BLS protocols with a few modifications. The adult BLS protocol will not be the best treatment, but it will be some treatment with the aim of preserving life until a more qualified clinician arrives.

Driving & Blue Lights – The NACFR has no position at this moment on blue lights. Some CFR schemes/groups are allowed to drive on blue lights, some are not. At the moment, we are not looking in to this. There are many other aspects of Community first response to standardise before this comes onto the agenda.

CAD and PRF differences – This will vary from trust to trust, any Paramedic or Technician that moves to a different trust will have to do an induction to their trust specific elements such as PRFs, CAD terminology and usage. This is not something that we are looking to push for standardisation on. In fact we would advocate the opposite – there should always be an induction to trust specific aspects of the role.

Dispatch criteria – This is very different within trusts, never mind comparing one trust to another. This is mostly based on the level of training that responders have. If training were to be more standardised across the country, then dispatch protocols would naturally become more standardised. As with the question of the 7 year old child who is not breathing. Will the parents care who responds as long as someone is there quickly and does ‘something’ in the interim prior to the arrival of a more qualified clinician? Actually, looking at the training of paediatric BLS, once adult BLS has been covered on a course, it doesn’t take long to look at the few adjustments for lay responder BLS. We are not talking about medical professionals with a duty to respond.

Equipment standardisation – Lots of CFRs and groups will have different pieces of kit for taking oxygen saturations, as an example, with some trusts not allowing their CFRs to do it at all. This piece of kit could be standardised over time, with the power of bulk buying, this could be made a lot cheaper for everyone. There is no reason this cannot be done with planning and time. The same idea could then be rolled out to other pieces of equipment. This would mean equipment being cheaper for groups and therefore means that the fundraising money groups have access to could be spent more effectively.

Value of CFRs – We were told by a couple of different CFRs at the Emergency Services Show that EMAS had recently published that they had valued their CFRs at saving the trust approximately £5,500,000 annually. We are of course looking to verify this, so would be interested to know if any CFRs have evidence of this or if any other trusts have done a similar thing.