Commission calls for national guidelines

CRF survey shows lack of consistency

The Healthcare Commission has called for national guidelines to be developed to enable ambulance trusts to manage and govern their community first responder (CFR) schemes consistently.

Community first responders were set up across England in 1999 after the Government encouraged ambulance services in rural areas to use them to help achieve Government targets (on Category A calls) requiring services to reach life threatening emergencies within eight minutes of a 999 call being made.

Over time the role and function of CFR schemes have expanded but there have been no national guidelines available to ambulance services for their development.

The Commission believes the development of this service requires the NHS to ensure the schemes are properly managed, supported and audited by ambulance services.

Community first responders are commonplace in ambulance services. The Commission's survey has found there are 1,331 CFR schemes and 10,158 CFRs working throughout ambulance trusts in England.
Ambulance services value the support of CFR schemes. When asked in a survey about the benefits of CFR schemes the response from ambulance trusts was generally very positive, with the main benefit being the contribution CFRs made to trusts achieving their government target of responding to category A (life or death) 999 calls within eight minutes.

Twelve out of the 13 NHS ambulance trusts in England took part in the survey (one trust did not take part in the survey because it is based in a highly urban area and therefore does not run a community first responder scheme). The survey sought to present a national picture of the role and the management of community first responder schemes, and focus on important areas such as training.

The Healthcare Commission carried out the survey after it began an investigation into Staffordshire Ambulance NHS Trust which included an assessment of the management of community first responders within that trust. The Commission found there was no national information on the role and management of community first responders to provide a context for this investigation, so carried out the survey to provide this information.

Healthcare Commission Head of Investigations Nigel Ellis said, "Community first responders are recognised as providing a valuable service to their local communities. Our survey shows that ambulance trusts value the contribution that CFRs make, especially in helping them to reach patients in rural areas as quickly as possible.

"What needs to happen now is for these schemes to receive a consistent level of support, no matter what part of the country they are operating in. We believe that national guidelines are necessary to achieve this. These guidelines need to cover the management and governance of these schemes, as well as the level of training provided to volunteers."