Since April 1, Community First Responders (CFR) have not been able to use blue lights and sirens on their vehicles while travelling to emergencies – and “enhanced” CFRs are now unable to carry drugs they were previously able to.
Community leaders and residents across Staffordshire spoke out against the changes before they were brought in. And on Monday, members of a Staffordshire County Council scrutiny committee continued to voice concerns – as did two members of the CFR scheme who spoke of their experiences.
Jane White, a CFR and area co-ordinator based in Fulford who has also served as a Special Constable with West Midlands Police, told the committee: “Enhanced CFRs were able to administer a range of pain relief analgesic drugs but that was withdrawn on April 1. Conversely St John Ambulance, Mountain Rescue and the RNLI (Royal National Lifeboat Institution) carry Entonox, an analgesic medical gas.
“One of my colleagues spent 45 minutes with an elderly patient who had broken her hip in a fall and that responder was not able to give that poor lady any analgesia until the ambulance arrived.
“During the last 10 months there was no communication with the First Responder groups, no communication with the enhanced CFRs who were going to be de-skilled on a specific date.
“The first we knew of it was when it was announced in the weekly briefing circulated across the ambulance service staff – after that we were invited to a meeting where we were told it was a done deal and it was all driven by the requirements of the legislation. But it’s not – the removal of the controlled drugs is not legislative.
“One example I can give you is sitting on standby at the windmill in Meir Heath, when a serious road traffic collision had occurred on the A50 just down by Blythe Bridge. That was less than two miles away and we were not dispatched to it.
“We came across it two or three hours later while the police were still at the scene because sadly that accident turned into a fatal event. When we spoke to the paramedic a few weeks later he said ‘where were you the night I needed you because I was trying to lift a van off a motorcyclist with two passers-by and I couldn’t get this guy out’.”
“But we weren’t sent – we were sat doing nothing. Those hours that we give up of our own time to respond are not recorded – the only time they’re recorded is when we’re actually on the clock, running to an incident to deal with a patient.”
The Healthy Staffordshire Select Committee meeting was also told that 37 CFRs had left the scheme in Staffordshire since April.
Vivek Khashu, strategy and engagement director at West Midlands Ambulance Service, said: “That is due to a mix of things; no doubt some of those would have been related to the changes that were introduced. Some will be related to just leaving, some will be related to Covid and shielding.
“What we’ve also done is open up the recruitment process and we have had 92 applicants shortlisted for our CFR scheme. We would hope as we move forward we will actually have a net increase in the voluntary colleagues supporting us.
“There is a two-year training programme that is going to kick off from February and that first tranche of 48 is full. That is part of a nationally-accredited programme, so the training and development is well under way and we think there is a significant recruitment process under way.
“The changes since April have brought our CFR scheme into line with all the others nationally. From our perspective that’s a good thing in terms of governance for both patients and our responders.
“We know that our back-up response times have improved. We also know that in line with those changes the amount of provision in the area in terms of cars have been directly replaced by ambulances.”
Committee member Councillor Paul Northcott described the 37 departures as “quite a significant amount”. He added: “These 37 people who leave us have gone through extensive training and are quite skilled.
“I wondered what had been done in terms of supporting them and what had been done to encourage them not to leave, or to re-join in the future. Is the standardised training an up-skilling or a down-skilling?”
Mark Docherty, executive director of nursing and clinical commissioning at WMAS, responded: “We have tried to articulate a vision of lots of First Responders who are trained to a level that saves lives but doesn’t replace the need for a paramedic. We see the First Responder as the person who keeps the patient alive while we get there.
“What we’ve found from feedback from First Responders is there are a lot of people who want to be a First Responder if only it was a little more straightforward. Once you start introducing lots of complicated drugs it reduces the number of people that are wanting to be First Responders.
“What we want to focus on is the real things that save lives immediately, like early defibrillation and airway management, but also focus on getting backup to the patient with a qualified paramedic as quickly as possible.
“If we believe there is something we need to be in the repertoire of responses of First Responders we will review that. But we believe at the moment we have got the balance right.
“We haven’t got any evidence that we have been made aware of that as a result of any of the drugs being removed there has been patient harm. If there’s evidence that a patient would have benefitted from a drug that the CFRs were not able to administer I would be very keen to hear of that.”