devo manc what does it mean for fire and rescue? steve mcguirk cbe, dl
TRANSCRIPT
Devo Manc
What Does it Mean for Fire and Rescue?
STEVE McGUIRK CBE, DL
The Plan
The Reality
WHY GREATER MANCHESTER MATTERS…
The GM Strategy: Stronger Together 2013
• GM has two priorities. Sustainable economic growth. And connecting people to that growth, so all benefit from sustained prosperity
• GM’s economy currently generates £17bn in taxes BUT requires £21 billion in public spending• Total spend has not changed in real terms, despite the cuts. Reductions in local public spending in
investment and growth But increasing spend on national welfare and health budgets
16,000
17,000
18,000
19,000
20,000
21,000
22,000
2012-13 2013-14 2014-15 2015-16 2016-17 2017-18 2018-19 2019-20 2020-21
£m (
2010
pri
ces)
Tax income Public spend
£21.5bn
£21.2bn
7.8 8.3
7.2 5.9
4.8 5.1
3.2 3.2
0.0
5.0
10.0
15.0
20.0
25.0
08/09 12/13
GM
exp
endi
ture
(£bn
)
Benefits and tax credits Local authorities Health Other
• A vision to move GM from being a cost centre to a net contributor to national public finances• Generating growth and jobs will not be sufficient to meet our ambition and to become a net contributor
to the national economy
The squeeze on all service expenditure
2010
/11
2011
/12
2012
/13
2013
/14
2014
/15
2015
/16
2016
/17
2017
/18
2018
/19
2019
/200
10
20
30
40
50
60
Money available for all other services Adult Social Care Waste Management Children's Social Care
£ b
illi
on
6
What is the problem we are trying to solve…?
….devolution can be the trigger for greater and necessary positive reform
A growing ageing population
Poorer health & growth in chronic conditions
Instability & fragmentation in the health & care system
Consequences: • Unplanned, Haphazard
change• Poorer care and
treatment• Difficulty in meeting
future health needs• Failing the health & care
workforce
Increasing pressure on health & social care
HEALTH AND SOCIAL CARE
BUDGET REDUCTION FOR FIRE….OVER 30% AND MORE TO COME….MUCH MORE?
2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/170
200
400
600
800
1000
1200
1057
996 989
914
847
Fire Total £'m
-0.7%-5.8% -7.4%-7.5% -10%
Status quo no longer an option…
How could we have responded…
• Wither on the vine: moved from action to reaction, finances and capacity are not sufficient to the task, retreating into statutory services run at the minimum.
• Run to stand still: led and managed well but not having the capacity or resources to deal with major shocks to the system.
• Nostril above the waterline: only able to act with a short-term view, existing hand to mouth and even a small external change might seriously challenge viability.
• Just local administration: lost the capacity to deliver services, either because organisations have 'handed back the keys' or because responsibility for significant services has been taken away…OR…BECOME
• Adaptive innovators “Local partners creatively redefining their role and able to affect their operating environment, often working in close partnership with other organisations”
THE GM DEVOLUTION AGREEMENTNew powers received by the Combined Authority:• Devolved responsibility for business support budgets, making it easier to join up services
to make sure that businesses are able to access the right support at the right time to help them grow and innovate
• The ability to work with Government to reshape and re-structure Further Education (FE) provision within Greater Manchester to ensure that the supply of skills in GM meets the needs of our businesses
• The power and resources to scale up our work on complex dependency pilot to help 50,000 people who have struggled to find work get into jobs
• GM to jointly commission (with the Department for Work and Pensions) the next phase of the Work Programme, giving us the influence to tailor services to best meet the needs of our residents
• Work with GM Clinical Commissioning Groups to develop a business plan for the integration of health and social care across Greater Manchester, allowing us to use existing health and social care budgets to invest in the community based care needed to support change
THE GM DEVOLUTION AGREEMENTNew powers received by a directly elected Mayor:• Devolved responsibility for a joined up and multi-year transport budget, to be agreed at the
next Spending Review• Responsibility for franchised bus services, including powers over fares, routes, frequency and
ticketing• The power to introduce integrated smart ticketing across all local modes of transport• the ability to shape local rail station policy and development across the Greater Manchester
area• Powers over strategic planning, including the power to create a statutory spatial framework for
Greater Manchester. This will need to be approved by a unanimous vote of the Mayor’s Cabinet• Control of a new £300 million recyclable Housing Investment Fund• Control of a reformed “earn back” deal, worth £900 million over 30 years• The role currently covered by the Police and Crime Commissioner….( subsequently expanded to
encompass Fire and Rescue)
A call to arms….the view of the political leadership
• Amidst the challenge of austerity there is a golden opportunity for radical change in the way public services are delivered to citizens
• We can mitigate the worst impact of the cuts by moving…. • from expensive palliative, reactive services…• to cheaper and more effective preventative interventions.. • that are better focussed on what our citizens require….• and co-ordinated, with sequenced interventions… thus (in theory at least)…• avoiding the artificial and arbitrary professional and organisational boundaries that have
hampered us in the pastWhich means we can be....• Iconoclasts, innovators and creative collaborators• More empowered and effective in what we do…• Deliverers of new more effective ways of working….• That have a more positive long-term impact on the people we serve
THAT’S THE BIG PICTURE…THE BIGGEST CHANGE IN A
GENERATION…BUT WHAT ABOUT FIRE AND
RESCUE?
SOME OF THE HISTORICAL DRIVERS FOR FIRE…• 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’• 2003 onwards - National Frameworks/ IRMPs• 2004 – ‘Fire and Rescue Services Act’
• Duty to promote Fire Safety
• 2013 – The Knight Review• 2014 – Five Year Forward View (Simon Stevens, Chief
Executive, NHS)?
INTEGRATED APPROACH TO REGULATION AND RISK MANAGEMENT…( we shouldn’t underestimate effectiveness)
KNIGHT REVIEW & GMFRS’ RESPONSE
KEY PRINCIPLES IN CONFRONTING THE FUTURE…
• We recognised that we must deal with the new financial reality…
• We want to keep Firefighters safe• We want to keep the Public safe…But…• We also want to continue to reduce fire damage and the
cost of fire…• So the only way we can do this is by embracing, adapting
or adopting new technology• …and by changing fundamentally our approach to safety
in the home and our wider community role
GMFRS Purpose:
To protect and improve the quality of life of the people in Greater Manchester
“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
On average 5% of those that suffer a cardiac arrest in Greater Manchester will survive, when relying on ambulance attendance alone
NWAS Paramedic Trainer
“250,000 people a year cross the threshold of Accident and Emergency units as a result of falls”
Simon Stevens, CEO NHS England
FRS ROLE IN A DEVOLVED GREATER MANCHESTER• Cost of Public Sector in Greater Manchester increasing (Currently £22bn. Almost £6bn
relates to Health & Social Care)
• £1.1bn gap ( and rising) within Health and Social Care budgets
• Fire budget equates to less than 0.5% of Public spend in GM
• Increasing demand on GMP, NWAS and Local Authority Adult Services. Demand on Fire
reducing, despite same demographics!
• Public Sector Reform; traditionally most focus on rationalising response models rather than
upstream prevention
• GMFRS track record in prevention (40+% reduction in demand over 10 years)…very, very
impressive to other partners
FIRE TRANSFORMATION
NOW PROVIDES A POWERFUL NARRATIVE
WHERE CAN WE ADD VALUE?
FRS OFFER TO A NEW DEVOLVED ADMINISTRATION IN GREATER MANCHESTER
StrategicCommitment
Access to 60,000 homes
Referral pathways
Innovation Fund
Community Risk
Intervention Teams
Dedicated personnel
Use of firestations
Information sharing
FIRE DEMAND
AMBULANCE DEMAND
SHIFTING ACTIVITY
STAFF NUMBERS
BROADLY SIMILAR -WHOLETIME
ALL HAZARDS RESPONSE?
WHY NOT FIREFIGHTERS?‘LATENT CAPACITY’?
COMMUNITY RISK INTERVENTION TEAMS (CRIT)
PARTNERS AND SUPPORT
• North West Ambulance
Service
• Greater Manchester Police
• Greater Manchester Police
and Crime Commissioner
• GM Police and Crime Leads
Group
• GM Directors of Public Health
• GM Public Sector Reform
Executive
• GM Health and Wellbeing
Board
• GM Directors of Adult Social
Services
• GM Strategic Safeguarding
Partnership Board
• GM Association of Clinical
Commissioning Groups
• University of Salford
PILOT
• Pilot in 3 Boroughs, Wigan, Salford and Manchester (Dec 14 – April 15)
• Integrate fully with new Health & Social Care arrangements within
Boroughs
• Engage staff from GMP, NWAS and GMFRS volunteers, those returning from
military service and EFCs that have engaged with GMFRS
• Fixed term 20 hr/wk contracts to cover period 0700 – 1900 hours
• Minimum 12 hr/wk out of hours cover provided through ‘on-call’
arrangements
ACTIVITY
• Prevention work 0700 to 1900 – focus on fire, falls, CO, crime
and general detrition in health
• Provide risk reduction equipment at point of contact and referral
to specialists where appropriate
• Response to Falls in the home on behalf of NWAS (manage risk
with a view to casualty remaining at home wherever possible)
• Response to Concern for Welfare relating to mental health on
behalf of GMP
• Response to Cardiac Arrests within a 3-mile radius of their
location
NEXT PHASE FOR CRIT?
• DCLG funding £3.73million awarded in April
• Multi Agency Steering Group maturing
• Expansion across Greater Manchester (one team per borough)
• Phased roll-out post April 2015
• Independent evaluation (in live time) through Salford University
• Cost Benefit Analysis through New Economy
• Estimated £9 Million saving so far from an £898K investment (3
Months)
FIRE AS A ‘HEALTH ASSET’• FBU now considering a future role in
Public Health• GM Firefighters asked to be First
Responders to assist NWAS colleagues…MOU signed
• Firefighters to crew some CRIT vehicles
• Firefighters & Community Risk Reduction Teams to complete Health, Falls, Crime and Fire risk assessments in the home – Safe & Well
• Crews to deliver basic CPR training in schools?
• Responding to some Cardiac Arrests
DOES IT REALLY MATTER WHO THE FIRST RESPONDER IS?
Its not easy taking everyone with you!
What do you mean it’s a bit muddy?
NOT EVERYONE
HAS READ THE SAME SCRIPT
What really happens
THE FUTURE? EVERYTHING UNDER ONE ROOF?