Comment

A need for new thinking on emergency services

Paresh Wankhade argues that transformational reforms are needed to improve emergency services in a time of austerity

Paresh Wankhade argues that transformational reforms are needed to improve emergency services in a time of austerity

Recent events in London and Manchester have highlighted the difficult and challenging role played by the emergency services. Their swift and professional response has drawn universal praise, but also raised concerns around reduced funding levels and job cuts against a heightened security threat. Transformational reforms are needed to improve our emergency services in a time of austerity.

Services under pressure

There are several barriers to better coordination between emergency services. For example, there is a fundamental shift in the nature of the work and staff deployment. Ambulance demand is growing at an annual rate of about 10%; the police service is witnessing a reduction in recorded crime and dealing increasingly with cases relating to cybercrime, child and sexual exploitation, and mental illness; and

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Paresh Wankhade argues that transformational reforms are needed to improve emergency services in a time of austerity

Recent events in London and Manchester have highlighted the difficult and challenging role played by the emergency services. Their swift and professional response has drawn universal praise, but also raised concerns around reduced funding levels and job cuts against a heightened security threat. Transformational reforms are needed to improve our emergency services in a time of austerity.


Picture: iStock

Services under pressure

There are several barriers to better coordination between emergency services. For example, there is a fundamental shift in the nature of the work and staff deployment. Ambulance demand is growing at an annual rate of about 10%; the police service is witnessing a reduction in recorded crime and dealing increasingly with cases relating to cybercrime, child and sexual exploitation, and mental illness; and fire services have seen a massive reduction in the incidence of fire. But these organisations continue to be performance-managed and target-driven, and current models of service delivery do not reflect these changes.

Government policy towards blue-light integration is also vague and unclear. The Policing and Crime Act 2017 places a duty on police, fire and ambulance services to work together, but how has not been specified. Police and crime commissioners can make a business case to run the police and fire and rescue services jointly, but ambulance services remain outside the scope of these provisions.

Neglected support

Workforce support remains a neglected management priority given the operational focus of these services. Staff input and knowledge does not necessarily get reflected in the design of organisational systems and often leads to frustration, lack of motivation and non-engagement.

In my research (Wankhade 2016), I have highlighted that staff sickness is highest among ambulance services in the NHS, and retention and recruitment is proving difficult, with shortages of paramedic staff reported nationally. A recent report from the King’s Fund (West et al 2015) pointed out that levels of discrimination reported by ambulance staff were the highest among NHS staff.

There is also a lack of clarity on the important issue of workforce professionalism. The three services are moving at different speeds and with different agendas. A national curriculum for police is available, but will have implications for fire services staff in the proposed merger plans. Entry level qualifications for paramedics are in operation but differences in roles and responsibilities across different organisations can create problems. The traditional and historical models of ‘heroic’ and ‘top-down’ leadership will also need to give way to a more collaborative and pluralist approach that allows development of leadership across all levels in the organisations.

References
  • Wankhade P (2016) Staff perceptions and changing role of pre-hospital profession in the UK ambulance services: an exploratory study. International Journal of Emergency Services. 5, 2, 126-144.
  • West M, Dawson J, Kaur M (2015) Making the Difference. Diversity and Inclusion in the NHS. King’s Fund, London.

About the author

Paresh Wankhade is professor of leadership and management at Edge Hill University Business School, Ormskirk, and programme leader for the new professional doctorate in emergency services management, as well as editor-in-chief of the International Journal of Emergency Services

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