MAP update: Scheduling medical co-response training

  Posted on 16th September 2020 by Nick Cottrell in UFBA blog, UFBA News

MAP update: Scheduling medical co-response training

Members have been in touch with us through our Membership Advisory Panel (MAP) to raise their concerns about the current scheduling of medical co-response training and first aid training.

There are two clear issues, one is around the operational response status of brigade members and the other the reasonableness of a Saturday training format.

This matter isn’t straightforward, and we appreciate that responses to medical emergencies to assist ambulance services and vehicle accidents are a significant part of the emergency response profile of a large number of Volunteer Fire Brigades. We also appreciate that brigades recognise the importance of maintaining first aid and medical response qualifications to provide service to their communities.

We raised these concerns with Fire and Emergency staff.

A grace period for training has been given

In March, Fire and Emergency released information about operational skills maintenance lights monitoring first aid refresher skills turning red for some individuals. Fire and Emergency cancelled training until further notice and extended the grace period out to five months. This means personnel who have a red light will remain current in terms of delivering this capability. There should be no change to personnel using first aid at, or co responding to, incidents due to a red OSM light.

Changes to training are planned

We understand that Fire and Emergency plans to offer online medical/first aid training for both co-response and first response brigades. In this way, those doing the training can complete the online module at a time that works for them before attending a half day practical session. Volunteers will not be required to give up a full day to maintain this crucial skill set.

This training is likely to be piloted from mid-2021 leaving brigades with the current training option for one more refresher, depending on when they last participated in training.

Fire and Emergency will promote the recognition of prior learning with St John for personnel who are current volunteer or paid St John paramedics.

A contract with St John for the delivery of training

Fire and Emergency NZ have a contract with St John for the delivery of the medical co-response training. The contract provides for one-day training costing approximately $1200 per session. Splitting the course over two sessions adds an extra $700 plus the St John instructor’s travel and expenses.

Fire and Emergency have identified three risks to splitting the course over two days:

Recognition of current competence

One member has put forward the idea of recognition of current competence as a way of reducing the time spent by volunteers on training.

Volunteers regularly respond alongside their St John partners, could the frequency of response, and the skills maintained, be enough to recognise current competency reducing the requirement for refreshers?
Reports could be run through SMS medical response events to check who responded.  A matrix could be used that analyses the number of calls each individual attended.  A threshold minimum number could be applied to ensure that each person reaches that threshold to recognise current competency.

Recognition of current competence won’t be suitable for all volunteers.

The UFBA’s take on this

We understand that these are significant concerns for many brigades. We appreciate the risks Fire and Emergency raises in relation to splitting training and are very pleased to note that online training will be offered.

We ask Fire and Emergency to continue to cover the cost of splitting training across two weekday evenings until online training is available. We believe that this cost is less than the cost to volunteers who might reasonably expect to spend their Saturdays with family and friends, particularly in these uncertain times.

We also request that Fire and Emergency considers recognition of current competence as suggested here.

We will continue to work with Fire and Emergency staff to find a resolution to this situation.

2 Comments

Nick Cottrell
18 Sep 20

Comment posted on behalf of Simon O’Neill, National Park VFB

I think that the UFBA has contributed to this situation. We all know COVID has had effects across the board and St John resources have been particularly hard hit. The UFBA put up a very good submission on the new MOU with St John in February 2019 but backed away from this after Josh Derby’s paper alleging a connection between medical response and firefighter self-harm. Josh’s paper is a good read but hasn’t been peer-reviewed – certainly not before organisations began reacting to it – and has a few logical disconnects and process errors. He may be right but the paper as currently writ doesn’t establish that.

By backing away from its original position on the MOU – see the note in the 2019 annual report – the UFBA has unintentionally reinforced the ‘not real firefighting’ view of medical response for many firefighters, probably mainly the ones that enjoy good local support from other agencies. Asking around at last year’s conference, it would appear that those brigades without a local ambulance station or one in close (10-15 minutes) proximity, were more likely to support medical response as another way that they supported and helped their communities. Without the UFBA maintaining pressure on the need to sustain the medical co-response output, IMHO FENZ has not been motivated to push back when St John – which has numerous groups that don’t like the competition, again mainly in the better supported urban area – used its resourcing crisis as a reason to withdraw refresher training from FENZ brigades. Whether it’s for medical co-response or for internal brigade safety, maintaining these core first aid skills for firefighters is a vital capability. Anyone who thinks that there will always be an ambulance handy let alone first arriving is in Lalaland…all too often, it is the first arriving FENZ appliance that has to deal with the situation until more specialised support arrives. For us, that might be 60-90 minutes from Taupo is closer ambulance resources are already committed.

Further many firefighters lack confidence in their medical skills often because refresher opportunities on training nights may be few and far between depending on brigade training priorities and focus, lack of opportunity to train elsewhere and limited opportunities to actual apply the skills on jobs depending on the number of jobs and roles assigned on arrival. This is even more reason for FENZ to have pretty much demanded that St John meet its obligation for training under the MOU. For St John, this pressure, had it been applied, would have strengthened its case to Government for more and more assured funding. But medical co-response isn’t real firefighting so that didn’t happen.

A lot of ambulance staff are aware of the situation and very concerned about it. In smaller, more isolated areas that’s an element of self-interest because we know that we won’t always be available to get to every job before or instead of the closest brigade: big rural area, could be 90 minutes away on the other side of the district as could the trucks from the two southern stations. It’s not just wanting a good medical response for the community; it’s not wanting our firefighter mates to be stressed by situation they don’t feel confident in as well.

Nick Cottrell
18 Sep 20

So, enough with the problems…a couple of things that we have been discussing to address this locally for those firefighters that want to play…

My first year in FENZ, I volunteered with St John as a firefighter – the days of single crews, doing what an EMA does now – so that I could build up experience in medical situations and my chief was all in favour because that experience came directly back to the brigade. After a year, St John convinced me to sign up – nothing really changed except the uniform from blue to green and more training. I was probably averaging an ambulance shift a week and more jobs than I was getting as a pure firefighter – great experience and confidence building + spin-offs in relationships and networking with other brigades, ambos, rescue helis, Police, etc. This is something that we are looking at – pending territory manger sign-off – offering to local brigades, for some firefighters to regularly ride three-up with St John crews. I was lucky to be in a district where they appreciated the assistance and allowed me to ride as often as I wanted. Sadly other station were firefighters tried the same often only offered a coupler of observer shift and then it was “sign up or go away” very much a lose/lose for St John and FENZ.

The second thing we are looking at doing is working with firefighters who want more medical training certainly while the current hold on formal refresher training is in place. This could include anything from a chat around various scenarios, fam on Ambulance equipment and where stuff is on ambulances, CPR, or areas of special focus i.e. where confidence might be low…this would be on a volunteer basis as it’s pretty certain that St John won’t spring for it but it’s all about community in the end.

The big challenge is building firefighter confidence in their medical skills. The Firefighter First Aid course is pretty good and so are the refreshers but many brigades don’t do much in between or rely operationally on those with extra skills and experience e.g. St John and other medically-experienced/qualified staff who are also firefighters.

Adopting a system where selected firefighters (there has to be a ‘fit’ element) can regularly ride three-up with St John front-line crews would help build this confidence.

Allowing St John staff to deliver training to firefighters on a volunteer basis would help fill the current training gap and address the confidence issue.

The UFBA pressuring FENZ to press forward with the MOU as proposed in February 2019 so that the new rules and obligations are clear would also be significant progress towards addressing the issues around medical co-response capability maintenance. The UFBA should also be pressuring FENZ to put up or shut up re the Derby paper: to either validate its claims (and then address them) or put it to bed and get on with it.

The UFBA should also be leading to dispel the belief that there are somethings that are ‘real firefighting’ and some that aren’t: there should only be tasks as directed and those that aren’t happy with this can either opt from those jobs (for volunteers)  or opt out of THE job (for fulltime: You don’t get to choose which jobs you attend or not)

Cheers for reading this far. You’re welcome to post this to the blog as a comment – not sure why I can’t – and I hope there is a big debate on this issue: dealing with medical situations is an unavoidable part of the job and we have t get it right for the community and our firefighters…


Simon O’Neill
QFF
National Park Volunteer Fire Brigade

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