Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event. Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development. This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being. More information is available online: www.expo.nhs.uk

1. Transforming care for older people with
the Fire and Rescue Service
Geoff Harris – Greater Manchester Fire and Rescue Service
Martin McShane – NHS England

2. The new ‘epidemic’?
Numberof Conditions1 % self reporting
1 30%
2 13%
3+ 10%
The 15 million people in England with long term conditions
have the greatesthealthcare needs of the population (50% of
all GP appointmentsand 70% of all bed days) and their
treatmentand care absorbs70% of NHS and social care
budgets in England
1.The percentageof peopleaged 18 and overself-reportingexperiencinglong-termconditionsintheGP PatientSurvey

3. 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+
Patients(%)
Age band (Years)
Morbidity (number of ETGs) by age band
0
1
2
3
4
5
6
7+
Number of
conditions
3

4. Emergency Bed Days
The number of bed days increases very strongly by age.
This ranges from less than 1 million for all age bands
under 40, to over 7 million for the age band 85+.

6. “Decided to stop chasing demand
and move to purposefully
preventing it.”
Learning from the Fire Service

7. Why the Fire and Rescue Service?
• 1995 – ‘In The Line Of Fire’
• 1997 – ‘Safe as Houses’
• 1998 – ‘Out Of The Line Of Fire’
• 2002 – ‘IRFS, The Future of the Fire Service: reducing
risk, saving lives’ (Bain Review)
• 2002/03 – ‘Industrial dispute’
• 2004 – ‘Fire and Rescue Services Act’
– Duty to promote Fire Safety
• 2013 – The Knight Review
• 2014 – Five Year Forward View (Simon Stevens,
ChiefExecutive, NHS)?

8. Why the Fire and Rescue Service?
• 670,000 Fire Safety Interventions in people’s homes
• 35% Reduction in the number of fires in the home
• 42% Reduction in the number of injuries from fire
• 39% Reduction in the number of fire deaths
• Access homes that others can’t
• Have conversations that others cant’
• There’s more than one way to rescue someone

9. Why the Fire and Rescue Service?

10. Why the Fire and Rescue Service?
Contributory Factors 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14
7 Year
Total
Alcohol 6 2 6 6 5 8 5 38
Recreational Drugs 0 0 2 0 0 3 1 6
Living Alone/Alone 4 4 7 6 8 11 5 45
Smoking Materials 10 4 4 4 3 7 5 37
Physical Disability 3 3 2 5 5 10 5 33
Social Service 4 1 6 3 5 6 6 31
Prescribed Medication 3 1 6 4 6 12 7 39
Mental Health 3 3 4 0 1 1 4 16
Accidental Fire Death Contributory Factors
Common Risk Factors
Age Range 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14
7 Year
Total
0 - 10 3 1 0 0 0 0 0 4
11 - 20 0 0 0 0 0 0 0 0
21 - 30 1 0 1 1 0 2 0 5
31 - 40 1 0 1 1 0 1 0 4
41 - 50 1 1 2 1 3 2 1 11
51 - 60 3 0 1 1 2 2 2 11
61 - 70 3 2 2 1 2 1 0 11
71 - 80 2 2 2 2 2 2 2 14
81 - 90 3 4 2 3 0 4 4 20
91 - 100 0 1 0 0 1 2 0 4
100 + 1 0 0 0 0 0 0 1
Total 18 11 11 10 10 16 9 85
Accidental Fire Deaths by Age

11. Why the Fire and Rescue Service?
Latent Capacity?

12. “A thousand lives a year could be saved if firefighters
responded to cardiac arrests with defibrillators”
Professor Andy Newton
Director of Clinical Operations, South East Coast Ambulance Service
“250,000 people a year cross the threshold of Accident and
Emergency units as a result of falls”
Simon Stevens, CEO NHS England
Only 5% of those that suffer a cardiac arrest in Greater
Manchester, attended only by NWAS, will survive
NWAS Paramedic

13. Fire and Mental Health
• 75% of calls to Greater Manchester Police are not crime
related
• % related to mental health
• % related to concernfor welfare
• Firefighters provided with Mental Health awareness
training and will be responding to concernfor welfare

14. Community Risk Intervention

15. Community Risk Intervention
• Multi-agency/Multi-disciplinary Prevention and Response
Teams
• Targeted work based on agreed risk profiles
• Objectives set by GMFRS/NWAS/GMP/LAs
• Falls Prevention & Rescue, Cardiac Rescue, Crime
Prevention, Fire & CO Prevention, Health & Well-being
advice

16. Community Risk Intervention
• Vehicle design includes capacity for specialist equipment
stowage e.g. lifting equipment for bariatric patients.
• Vehicles have facility to convey patients to GP Surgeries &
Urgent Care Facilities
• Vehicles available for community resilience e.g. Doctor or
care worker conveyance in adverse weather

17. Fire as a Health Asset?
Does it really matter who the First Responder is?

18. Fire as a Health Asset?
• Lincolnshire
• Hampshire
• Devon and Somerset
• Humberside
• Lancashire
• Cheshire
• Greater Manchester

19. Fire as a Health Asset?
43%
8%
16%
4%
1%
9%
5%
14%
Accidental deaths in the home
Falls
Fire / Burns
Poisoning by drugs
Other poisoning
Natural factors
Drowning / Suffocation
Other accidents
Undetermined

20. Fire as a Health Asset?
• Fire Brigades Union considering a future role in Public
Health
• GM Firefighters asking to be First Responders to assist
NWAS colleagues
• Firefighters to crewsome CRIT vehicles
• Firefighters to complete Safe and Well Visits
• Crews to deliver basic CPR training in schools?
• Responding to some CardiacArrests

21. CFOA Fire and Health Project

22. Safe and Well Principles
• FRS extending its approach to safety in the home to include risk factors that impact
on health and wellbeing
• The content of a ‘safe and well’ visit should be co-designed and based on
information regarding local risks and demand.
• Shouldn’t be confined to merely signposting to other agencies, but how these risks
can be mitigated or reduced during the initial visit
• Wherever possible the approach adopted should be:
– A light touch health check of all individuals in the home;
– Identification of risk factors while in the home;
– Provision of brief interventions and advice;
– Provision of appropriate risk reduction equipment e.g. smoke alarms, grab
rail;
– Referral to specialist advice and support where appropriate. e.g. health, local
authority or voluntary organisations.

23. Safe and Well Principles
• Referrals to specialist advice and support should be limited to those in need of such
support
• Health, local authority and third sector colleagues should support training and raising
awareness of their staff, where necessary.
• Consistent referral pathways into specialist services should be developed across
each FRS area. The CFOA, LGA, PHE, Age UK and NHSE will agree principles and
guidance to assist in achieving this.
• The quality of each visit is key to ensuring that they improve quality of life outcomes
and lead to reduced demand for services that can be evidenced.
• The number and scope of ‘safe and well’ visits completed will be determined by the
capacity within each organisation, which may differ significantly from area to area.

24. Safe and Well Visit
• Fire
– Cooking
– Candles
– Electrical Equipment
– Portable heaters and open fires
– Escape plans
• Health
– Winter Warmth
– Extreme weather events
– Weight
– Mobility
– Falls
– Frailty
– Provision of clinical and other
equipment in the home that could
increase fire risk
• Mental Health
– Memory
– Learning disability
– Sensory impairment
• Loneliness/Social Isolation
• Smoking
• E-Cigarettes
• Alcohol
• Drugs
• Prescription medicines
• Hoarding
• Safety of under 5s
• Employment
• Home security
• Consent to share information

25. Winter Pressures
• 30,000 excess winter deaths nationally
• Challenge from Simon Stevens
• Led by PHE
• At least 3 Pilot FRS’
• Focus
– Falls/Frailty
– Cold Homes
– Social Isolation
• Exeter Data
• Winter Pressures Lists
• Academic Evaluation, costbenefit analysis and examination of
social return on investment

26. Other Potential
• Flu Inoculations
• Indicators of Type 2 Diabetes
• Signposting
– Eye Screening (diabetes)
– Cancer
• Breast Cancer
• Bow el Cancer
– Aortic Aneurism
• Dementia Friends
• Youth Health Champions
• Fire Fit
– Older People
– Childhood Obesity
• Considering Secondmentfrom
PHE to Develop Further
Opportunities

27. How Can You Access This?
• Chief Fire Officer’sAssociation
– http://www.cfoa.org.uk/
• Individual Fire and Rescue Service
Websites
– http://www.manchesterfire.gov.uk/
• Chief Officers
• Directors of Prevention and/or
Protection
• Heads of Prevention

28. ‘To protect and improve the quality of
life of the people in Greater Manchester’