- Fire and Rescue Services (FRSs) have wide-ranging skills and capabilities which can be deployed to deal with non-fire threats to health.
- There has been a sustained reduction in the incidence of fire, which cannot safely be matched by a reduction in FRS capacity.
- Therefore, there is scope to expand the FRSs’ role formally to encompass a wider range of tasks, in particular to support the NHS.
- There is broad consensus between the FRSs and the NHS about the value of this, but implementing it will need close partnership with relevant trade unions. There may in particular be implications for firefighters’ pay and conditions, and for public-sector workforce relationships more generally.
FRS capability and capacity
- The FRS has long been concerned with more than fighting fires. The Fire and Rescue Services Act 2004 created new duties to promote fire safety and to respond to road accidents. We have since added duties to respond to major disasters (in 2007) and incidents involving flooding and inland bodies of water (in 2017). The latter expansion of the Service’s role is unique in the UK.
- As a result, the Service’s skills and capabilities have also expanded. Firefighters now routinely assess and advise on fire risks in people’s homes. They attend a wide range of emergency incidents, and are all trained in immediate trauma care. All front-line fire appliances also carry equipment for dealing with certain medical emergencies, including defibrillators.
- The number of incidents to which the FRS responds is nonetheless in sustained and long-term decline: fires in particular have fallen by around half since responsibility was devolved in 2005. This appears partly due to the focus on fire safety and prevention, and is probably also attributable to societal changes such as a reduced incidence of smoking. However, the reduction in fires has not been matched by an equivalent reduction in FRS capacity, nor could it be. The Service still needs to respond to any fire at any time, and major incidents still require the deployment of all available FRS resources over a wide area.
- This has meant that the Service’s workload has changed and reduced, although the extent and effect of this varies across Wales. Larger towns and cities are served by wholetime firefighters whereas elsewhere, the Service relies on “retained” firefighters who are called in from work or home as needed, and paid for the incidents they attend. Overall, there is a broad consensus among both FRS management and unions around the potential to take on a broader role, accepting this would vary across Wales and between wholetime and the retained workforce.
Possible components of a broader role
- There are already several initiatives to make use of this capacity in providing a broader range of services, particularly in terms of providing support to the NHS. Most obviously, this could include FRS crews responding to certain medical emergencies. In Mid and West Wales, 36 fire stations already provide this service on behalf of Welsh Ambulances Services Trust (WAST). This includes both immediately life threatening “Red” calls and serious but not immediately life-threatening “Amber” calls. Mid and West Wales FRS estimates that this generally amounts to between 2,000 and 3,000 calls per year; and that, since 2015, its crews have directly saved over 200 lives in cases of cardiac arrest alone.
- This initiative in Mid and West Wales is a well-developed example of the concept of FRS emergency medical response (EMR). EMR was also the subject of UK-wide trials between 2015 and 2017, by agreement between employers and unions. An evaluation of those trials by the University of Hertfordshire showed clear benefits in terms of patient outcomes, as well as savings to the NHS and care providers in the order of £4.40 for each £1 spent on EMR. These gains arose largely because FRS crews are less likely to be affected by health system-wide pressures and were often able to arrive sooner than the nearest ambulance. That quicker response led to less need for extended hospitalisation, or reliance on long-term care.
- There is also potential for firefighters to respond to cases of people who have fallen at home and who are uninjured and do not need hospitalisation, but are unable to self-recover. These are a relatively low priority for WAST as there is no immediate threat to life, nor usually any clinical need for paramedics to attend. However, such individuals can become distressed and/or require hospitalisation if they do not receive a prompt response. North Wales FRS provided this service between 2016 and 2018; it responded to 1,203 cases that would otherwise have required WAST attendance and/or admission to hospital. NWFRS employed non-firefighters for this programme, so it is not directly relevant to a broader role. However, there is no obvious reason why firefighters could not carry out this work too. Indeed, we have invested £80,875 to purchase 75 units of lifting equipment to support FRS response to non-injured falls in Mid and West Wales. That will commence when MWWFRS has agreed a detailed memorandum of understanding with WAST.
- The greatest potential benefit may lie in expanding the FRSs’ preventative work. We already have by far the most extensive programme of home fire safety advice in the UK, which has probably contributed much to the sustained reduction in dwelling fires – although visits have had to be restricted during the pandemic. In principle, it would be straightforward to extend a typical home fire safety visit to include other domestic hazards, particularly tripping and falling. Pre-pandemic, falls at home typically account for around 1,000 admissions to hospital every month in Wales, and many of those so admitted may never recover enough to return to their own home. Yet domestic hazards of this type are generally easy to detect and resolve; and many people at high risk of falling at home are also at high risk of fire. There is a genuine opportunity here to adopt a preventative approach which would significantly improve outcomes while reducing costs. Our initial exchanges with local health boards have shown strong interest in this area, and it should be among the main priorities for a broader role.
Workforce related matters
- Any changes to firefighters’ roles would naturally need to be reflected in their terms and conditions, and quite possibly their pay. These matters are all currently negotiated at a UK level by the National Joint Council for Fire and Rescue Services (NJC), a bilateral body covering employers and unions. No government is involved and there is no statutory control. It could be possible to agree a different package for Wales through the NJC, although this would be a novel approach that would present challenges. I would be reluctant to move outside the NJC machinery, as that could be seen as undermining collective bargaining.
- Most firefighters in Wales are members of the Fire Brigades Union (FBU). The FBU’s formal position supports a broader role, both as an end in itself and as a means of safeguarding jobs. However, it has expressed concern about the need for clarity and certainty in defining that role. In particular it would oppose firefighters being used as unskilled labour, or performing tasks like personal care for which they are unqualified. The FBU has also been clear that it would expect a substantial pay increase in return for additional duties.
- In February of this year, FBU members in Scotland voted to reject an offer from the Scottish FRS of a 14% rise in pay over four years, allied to a broader role. There appear to have been several reasons for that rejection, but a lack of clarity around the details of the broader role figured strongly.
- Since then, many firefighters have undertaken broader duties during the first wave of COVID-19, under a UK-wide agreement between employers, the FBU and the National Fire Chiefs Council. In Wales, for instance, some 450 firefighters volunteered to drive ambulances – although very few were ultimately needed in this role. Some such duties attracted extra payment if they were undertaken on days off, but there was no change to basic pay rates. It would, of course not be appropriate to take advantage of actions during the pandemic as a pretext for wider change. However, this has demonstrated the feasibility for firefighters to take on a broader role without jeopardising their core functions and by agreement.
- I have had regular discussions with the FBU on this and related issues. Those have shown a continued willingness to engage; and the FBU’s leadership has also re-initiated contact with the Scottish Government with a view to renewed negotiations there. On the other hand, it is very likely that the FBU’s reservations and expectations remain to an extent. We can be more certain that to make progress we will need a clear and detailed specification, agreed by the FRS and NHS, of a broader role. That is necessary both to assuage the FBU’s concerns and to demonstrate the public value of what we propose.
- There is a further important workforce angle. Recruiting retained firefighters has become challenging, especially in rural areas where incident numbers are very low. In time, this may well jeopardise the sustainability of the FRS in such areas if we do not act. One obvious course is to broaden the role, which could make the role of a retained firefighter more financially and personally rewarding. There is some evidence from Mid and West Wales of this, in that recruitment and retention tends to be much easier at those stations which undertake EMR.
- WAST similarly experiences challenges in delivering equity of service in rural areas, where it is difficult to predict the focus of demand, and where topography can impact on journey times. WAST is reliant on support from community first responders and fire co-response to ensure a timely response to urgent calls in the community.
- Following internal discussions and engagement with the Social Partnership Team, we have convened a working group of senior FRS and NHS officials, and the WLGA. This will draw up a specification for a broader role and assess the likely costs and benefits both for the FRS and NHS, and for patients and other service-users. At the same time, I and my officials are maintaining regular dialogue with the FBU. We will also explore appropriate means of engagement with the relevant Trade Unions. If Cabinet agrees, we will look to complete this work in the New Year, in the form of a clear proposal to put to the FBU and NJC.
- I strongly support a social partnership approach to changes in this area, but I do not propose becoming directly involved in any subsequent NJC negotiations about pay and conditions, which are and should remain bilateral. However, it is likely that the employing Fire and Rescue Authorities would look to us to support any substantial increase in pay, not least because the immediate beneficiary would be the NHS. The Annex to this paper considers this issue more fully, but I would look to secure further collective agreement with Cabinet colleagues (whether via a further Cabinet discussion or otherwise) before giving any firm funding commitments in this area.
- Our programme for government commitments include supporting closer collaboration between the emergency services, and in particular supporting the FRS to assist with medical response. The proposals in this paper would allow us to carry out and build on those commitments.
- The basic aim is to maximise the public value of our firefighters. The exact benefits of doing so would depend on the detail of a broader role; they could, though, include:
- swifter response to some medical emergencies leading to a saving of life or less need for hospital treatment and/or long-term care;
- prevention of domestic accidents leading to reduced hospital admissions following falls in the home;
- less pressure on NHS and social care capacity and resources as a result of the above;
- facilitating the recruitment and retention of on-call firefighters, thus helping to secure a sustainable future for the Service in communities across Wales.
At the same time, there could be potential costs and obstacles, including the cost of any enhanced pay settlement for firefighters and possible changes to working practices needed to sustain a broader role; and the complexity of agreeing that through UK-level negotiating arrangements. That could in turn have implications for workforce relationships in other sectors, and for public sector pay more generally. A significant pay increase for firefighters, albeit in return for a broader role, would quite possibly prompt calls for parity from other groups of public-sector workers. However, the potential gains from broadening the role of firefighters are considerable: there is a genuine opportunity here to deliver improved outcomes while reducing pressure on existing resources. That suggests we should pursue the potential in this area as far as we can.
Communications and publication
- This paper essentially seeks a mandate to undertake detailed development work towards a broader role. I would propose to make an announcement about that once the work is concluded and we have a clear and detailed proposal, probably in the New Year.
- This paper can be published six weeks after the Cabinet meeting.
- agrees that we should continue to work in partnership to develop proposals for a broader role for firefighters in Wales, in particular to support the NHS and the delivery of health outcomes; and
- Notes the potential implications for public-sector pay and workforce relationships more generally.
Hannah Blythyn MS
Deputy Minister for Housing and Local Government
Annex A – Statutory, Finance, Legal and Governance matters
There are no specific statutory requirements relating to the proposals in this paper. Any likely activities forming part of a broader role could rely on Fire and Rescue Authorities’ existing broad powers in sections 5A and 11 of the Fire and Rescue Services Act 2004. We could issue appropriate guidance to FRAs in the next iteration of the National Framework for Fire and Rescue Services, under section 21 of the same Act.
The proposal to broaden the role of firefighters would be consistent with the five ways of working under the Well-being of Future Generations (Wales) Act. In particular, likely elements of a broader role would entail collaboration between the FRSs and NHS bodies and integration of their well-being goals. They could also involve a clear preventative approach in the sense of removing hazards which could lead to admission to hospital.
Fire and the risk of fire disproportionately affect people with certain protected characteristics, for instance those who are old and/or have sensory or mobility impairments. The same is probably true of some of the other hazards which a broader role might encompass, such as falling at home. While a detailed equality impact assessment would have to await the development of a full proposal for a broader role, there are likely to be benefits for people with such characteristics.
The proposals in this paper would have no impact on the Welsh language or on children’s rights.
Finance requirements and governance implications
The current funding arrangements for FRAs involve them levying contributions on their constituent local authorities; they do not receive core funding from the Welsh Government. Contribution rates are at each FRA’s discretion and neither we nor local authorities have any control over their decisions.
As noted in the main paper, a proposal for a broader role may well lead the FBU to press for a significant increase in pay. At present, the total annual pay bill across the FRAs is around £100 million, including employers’ pension contributions and other on-costs. Each 1% increase in pay thus costs in the order of £1 million per year.
Once any pay rise had been applied, the direct cost of wholetime firefighters undertaking a wider role would be very limited. Attending a wider range of incidents would, for instance, only incur higher fuel costs for appliances and the like. There would, though, be direct costs to FRAs if on-call firefighters responded to more incidents. Those costs depend on the duration of each incident, so cannot be reliably predicted.
In the normal course of business, payroll costs would fall to be met by the FRAs from their core resources. However, a broader role which would primarily yield benefits to the NHS would probably lead the FRAs, the WLGA and the FBU, to press for Welsh Government financial support. Certainly, it would not be right for such costs effectively to fall on local authorities. Previous Ministers have given undertakings at least to consider providing financial support, subject to the terms of the broader role. Such commitments would, though, be unfunded within current budgets and would clearly need to be carefully considered in light of COVID-19 and other pressures. We also need to consider the context that the UK Government’s forthcoming spending review will only be covering the financial year 2021-22 which means we have a great deal of uncertainty surrounding the shape of future budgets. Any additional costs incurred by future proposals would need to be considered as part of the Welsh Government’s future budget planning process.
Therefore, I do not propose to give any firm commitments about funding at this stage. Before going further, I and the Minister for Health and Social Services would need to be assured of the deliverability and timing of a broader role, and the likely benefits to the NHS and others in cash and non-cash terms. We would also need to refer to the Minister for Finance and Trefnydd given the potential coordinating role between portfolios. We and colleagues would also need to consider affordability within the envelope for public spending as well as the value for money of any pay proposal made by the FRAs or unions in return for such a role, and the possible impact on public sector pay more generally. Once the detail of new roles and the potential pay implications are known further advice will be provided to Cabinet.
There are no particular governance issues arising from this paper. This paper has been cleared by the EPS Operations Team EPS/HB/41/20.
This paper has been cleared by Health and Social Services Finance GH2020/7723.
Strategic Budgeting have seen and cleared this paper: SB1252/5
Research and statistics
The statistics in the main paper have been verified by the Knowledge and Analytical Services Division KAS 27/2020.
Joined up working
The Minister for Health and Social Services and his officials have contributed to and agreed this paper, as has the Social Partnership and Fair Work Team.