NHS and Fire Service join forces to help vulnerable

NHS and Fire Service sign new consensus to help vulnerable and reduce winter pressures

Firefighters have joined forces with the NHS in a new health partnership to tackle health and social problems and reduce winter pressures.

Today, five organisations signed a new ‘Consensus' - NHS England, Public Health England, the Fire and Rescue Service, Age UK and the Local Government Association - promising to work together to make changes throughout their workforce.

The new 'Consensus' sets out how the organisations can work together to encourage local action to prevent or minimise service demand and improve the quality of life of people with long term conditions.

It means fire fighters across the country will aim to carry out more ‘Safe and Well' checks in people's homes when they visit.

The fire fighters will aim to extend the 670,000 home safety checks already carried out each year into a ‘Safe and Well' visit to help particularly the vulnerable and those with complex conditions.

As well as reducing the risks of a fire, they will aim to reduce health risks such as falls, loneliness and isolation which will also reduce visits to A&E, broken hips and depression.

The ‘Consensus' was launched on today's national Older People's Day at a World Health Organisation conference and Simon Stevens, NHS England CEO, said: "Fire service home visits already prevent fires, and now will help prevent falls, accidents and trips to casualty. It's great to see two of the most trusted public services getting creative about jointly supporting vulnerable people to stay healthy and independent."

The fire fighters may for example quickly install a handrail, notice and change falls hazards such as loose rugs, spot hazards such as piled up papers or signpost people to local groups for help, support or company.

Evidence shows that a high percentage of people will allow firefighters into their home due to the high level of trust they have making it easier for them to give simple advice which could save or change a life.

Some areas are already doing this joined up work but the ‘Consensus' now pledges a drive to roll it out across the country.

In Manchester for example, the fire fighters work with Community Response Intervention Teams who provide a rapid response to avoid people going into hospital and to facilitate early discharge.

Paul Hancock, President of the Chief Fire Officers Association, said: "By working in partnership with health professionals we can help to protect some of our most vulnerable residents, while improving people's quality of life. The Safe and Well checks will help to identify issues at an early stage, which could reduce the likelihood of older people being admitted to hospital by focusing on prevention measures. Firefighters carrying out these checks already have a high level of trust from the people they are visiting and will be able to give help and advice on a wide range of issues, while helping to keep our older residents safer."

Duncan Selbie, Chief Executive of Public Health England, said: "Saving peoples' lives is the most important thing for firefighters. They have already had astonishing success in reducing deaths from fires and can now bring this experience to bear more widely. They are perfectly placed to spot the dangers facing the most vulnerable when making their hundreds of thousands of visits each year to homes across the country.

"This agreement will help ensure older people, and those with complex needs, get the care and support they need to live healthier, more independent lives."

A ‘practical guide to healthy ageing' was also re-launched today by NHSE in partnership with Age UK. The guide is currently being distributed through Age UK shops, FRS home safety visits, GP practices, pharmacies, housing associations and many more.

Pam Creaven, Services Director at Age UK, said: "We're delighted to be part of the Consensus and believe that Local Age UKs and local fire services working together can really make a difference, helping older people stay healthy and independent in their own home

"It is terrific for Age UK to be joining NHS England in launching this new practical guide for people living with frailty. It is clear that having access to the right information and advice at the right time and knowing where to go for support can really enhance older people's lives."

Dr Martin McShane, NHS England's director for long term conditions, said: "This is translating the Five Year Forward View into reality. There are 670,000 home visits a year by the Fire Service for people with the sort of risk factors we recognize in healthcare.

"The fire service has reduced domestic fires by 35 per cent with pro-active interventions. Working together will help us to provide a good deal for the taxpayer and an even better deal for people at risk."

Cllr Jeremy Hilton, Chair of the LGA's Fire Services Management Committee, said: "Over the last decade fire and rescue services have halved instances of fire, both through their responses to emergencies and their extensive programme of prevention work. They are now looking to be just as effective in improving the public's health by providing critical interventions, promoting health messages and referring to appropriate services.

"Over half of all fire related deaths and injuries in the home happen to people over 60 and we know that impairment and disability increase the risk of harm from fires and other hazards too. This work means that not only can we prevent fires and other emergencies, but action can be taken to help people who may not even realise that they need extra help."

-ENDS-

Notes to editors

For further interviews or to arrange filming please call NHS England press office on 07900 715 132.

Read a day in the life blog on the frontline at a current pilot scheme.

Additional information

 Over 65 - over 50% of dwelling fire deaths are in the over 65 group.

Significant risk factors include: 

• Living alone
• Mental health issues
• Adult social care needs
• Lone parents
• Smoker
• Alcohol, drugs or substance misuse

Evidence from fire investigations and case studies suggests that ‘cognitive impairment' such as Dementia or alcohol related brain damage is a very common underlying or contributory factor in many fires and resultant fire casualties. An ageing population means this is more likely to become an even more important risk factor.

There is a significant overlap with risk factors for use of health services (including mental health) and potentially other services such as police and housing.

Manchester case study

Greater Manchester Fire and Rescue Service (GMFRS) has implemented a new approach in partnership with other blue light services and health and social care to identify and reduce risk for people living with risk factors that increase their risk of fire and lead to them regularly using health and other services. This new approach uses a ‘Safe and Well' visit that includes an assessment of fire, falls, health and wellbeing, the fitting of risk reduction equipment and referrals. This is being delivered by Community Risk Intervention Teams (CRIT).

As an example, CRIT recently responded to a man in his 60s, suffering from cancer, who had fallen while getting out of bed. He had previously refused any assistance from Local Authority Social Care and his house had no falls or other risk reduction equipment fitted.

CRIT helped him back into bed using specialist lifting equipment and persuaded him to accept help from ourselves and other agencies. He was admitted to hospital.

Whist in hospital CRIT fitted simple falls risk reduction equipment in his house, re-abling it and facilitating the gentleman coming out of hospital two days later. Re-abling someone's home usually takes a number of weeks, during which time a patient is rarely discharged from hospital.

The impact the CRIT made on the quality of life of this gentleman is immeasurable. And by re-abling his home in a significantly shorter time, the cost of secondary care has been significantly reduced.

Highlights

In six months, with only three CRIT teams, 2,500 activities including response to emergencies and ‘Safe and Well' visits have been provided.

A qualitative evaluation is being conducted by Salford University the first interim report is already highlighting the positive benefits.

An initial cost benefit analysis based on the work of three teams over less than six months has already shown approximately £1.25million of benefits from the preventative work alone. This takes no account of the benefits from responses, or societal and other quality of life benefits.

Conclusion

The use of ‘Safe and Well' visits are proving successful through the existing teams with significant financial and other benefits being derived through the current approach using CRIT.

The qualitative evaluation and cost benefit analysis highlight the value that this preventative approach can make.

The joint development of national policy and support material based on current and emerging evidence and best practice examples will enable this way of working to be rolled out across the country in order to transform care, achieve better outcomes for local people and better value for the money spent on public services.