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Fallen at home? Firefighter service eases pressure on ambulances


It’s 9.30am on a sunny spring day in Wolverhampton. Three firefighters are in the mess at one of the city’s fire stations when a screeching alarm pierces the air. The team jumps up and leaps into a kitted-out 4×4. Instead of speeding down roads with blaring sirens and lights, however, they travel to their destination without breaking the speed limit. And when they arrive at the house, there’s no fire to put out.

Inside, they find a woman in her 90s who has fallen out of bed and can’t get up. She is scared and distraught. She pleads with them not to take her to hospital. One of them reassures her while the others assess her surroundings and whether they need to call an ambulance. They help her up, make sure she’s OK and leave.

This additional part of their work is the result of a new scheme in the area – the mobile responder service – which sees the fire department working with Wolverhampton council to reduce pressure on the ambulance service and help avoid unnecessary hospital admissions.

Gwen Nuttall, chief operating officer at Royal Wolverhampton NHS trust, can see the benefits: “This new development where the fire service goes out and does initial assessments can prevent an ambulance being called. It helps the ambulance service as much as it helps us on the acute side. It’s a win-win.”

The mobile responder service steps into action when an alert is raised via a pendant or a sensor activating in someone’s home. The alarm unit calls through to the control center that triages the call. If there is no answer, or the person says they have fallen and there is no medical emergency, the fire department is contacted. The crew enter the property via a key code, assess the situation, carry out basic checks, lift the person using specialist equipment, and if necessary contact an ambulance. A report is filed to the council following every callout and any issues are looked into.

More than 5,000 clients – the majority aged over 75 – have been set up with the telecare service since its launch in April 2016. Patients who require a social care package on leaving hospital are automatically signed up. Social care professionals can also refer service users; individuals looking for something to keep them safe or family members seeking support for a relative can apply to the council for the service. In the last year there have been 2,037 call-outs attended by the fire service, of which 57% were fall related. Only 14% of all callouts required ambulance intervention.

There are 21,500 people aged 75 and over in Wolverhampton. Based on those figures, 17.25% of those over 75 are supported by telecare through the council service. John Williams, 84, is one of them. He lives with his wife, Janet, and has had a stroke; she has had a hip replacement. When her husband falls, she cannot pick him up.

“I can’t handle John, he’s quite hefty… Before I had no choice but to call the paramedics [when he fell]. Most of the time, he just needs lifting and it was [a waste of time] to call them out,” she says. “This new service has been a godsend… I felt really housebound and trapped. It’s given me a new lease of life.”

For Williams, meanwhile, it has renewed his sense of confidence. He says: “It gives you the confidence that someone’s going to come. [Falling] can be terrible. You’ve got to sort yourself out. The first time I slipped, I thought, ‘What am I going to do now?’ Now I’ve got some help all the time.”

The partnership is also reaping benefits for the fire brigade, another public service plagued by cuts, which gets paid by the council for every call out. David Baker, group commander of West Midlands fire service, says: “It’s a way of providing extra funding and providing the best service to people. The money goes to keeping staff on and the future funding of the fire service.” The scheme also allows them to monitor and assess a number of older people and spot any fire hazards. Baker adds: “Vulnerable individuals are also at risk of fire. The majority of our fatal fire deaths are [people] aged over 65.”

Having the fire service on board has been a huge positive for the council and the NHS trust. Linda Sanders, strategic director for people at Wolverhampton council, recognizes that the fire service is a trusted brand. She says: “In terms of training, they are better equipped. If someone’s on the floor, they know the checks to do and have the right equipment… they are a trusted public service.”

Variations of this model are already working in East Yorkshire where Humberside fire and rescue has been commissioned by the local clinical commissioning group to reduce the load on ambulance services, and in Gloucestershire. Could more telecare-based solutions be effective in future?

Nathan Downing, a telecare consultant who developed the partnership, believes so. “In my opinion, telecare is the best kept secret,” he says.

Saunders adds of the partnership: “It’s one area that truly works. It helps people remain longer at home, fewer people have to be admitted to hospital. It makes better use of resources… Any area that doesn’t have a well developed telecare offer is letting the public down.”

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