NHS prevention agenda gets a fireman’s lift
Prevention holds the key to a sustainable health service. NHS England must lead the way in highlighting the important role that local fire services can play in delivering that sustainability.
If we stop smoking, moderate our drinking, exercise and eat healthily, we can reduce our years of ill-health and stop costing the taxpayer so much money with our problems, treatments, and dependency.
Prevention is the key. NHS England's Five Year Forward View, published last month, was full of it and this month’s Personalised Health and Care 2020 from the NHS National Information Board continues in the same vein:
If the nation fails to get serious about prevention then recent progress in healthy life expectancies will stall, health inequalities will widen, and our ability to fund beneficial new treatments will be crowded out by the need to spend billions of pounds on wholly avoidable illness.
Of course, as Ben Gowland points out in this week’s Inside Health column, prevention is a very hard sell. The story about the amazing surgeons who saved a life is always going to be more compelling than the one about the public health worker whose campaign contributed to someone giving up smoking. And people are more inclined to rely on the NHS being there when something goes wrong than modifying behaviours that cause them to.
All this was at the forefront of my mind when The Information Daily was invited to report on an event hosted by the West Midlands Fire Service.
The subject of the event was health inequalities, and the main speaker Sir Michael Marmot, author of Fairer Society, Healthy Lives, the hugely respected review published in February 2010, demonstrated that social inequalities cause health inequalities.
If you are wondering what health inequalities and the fire service have got to do with one another, you are in good company. Sir Michael was also surprised when, in the course of his research, he first came across work by fire services in the community that address the effects of social inequalities.
Marmot quickly realized that the agendas of preventing ill-health and preventing fires were closely linked: 'fires and ill-health occur in the more deprived areas, to people at the bottom of the socio-economic gradient, to those in poor quality housing, and to those whose circumstances have led them to take up unhealthy lifestyles.’
In the West Midlands, the Fire Service’s prevention work involves them visiting 25,000 homes a year to talk to residents about risks in and around the home and to supply kit like smoke alarms. These visits arise from incidents and referrals from neighbours, voluntary sector workers or other public authorities.
The Fire Service enjoys a degree of respect and general goodwill around its wider work that is proving a fantastic platform on which to engage and build trust with communities in areas where fire risks are high. These are typically areas that are also high on the indices of multiple deprivation and where ‘troubled’ families and ‘at risk’ individuals are also likely to live. Fires officers are often let into homes in these areas that may be extremely wary of social workers, let alone other uniformed public authorities like the Police.
Similarly, respect for what firefighters do is certainly a factor in gaining the trust of young people who have fallen foul of the authorities. Fire Service programmes are turning around young offenders’ lives for a fraction of the cost, and much greater chance of long term success, that that of a custodial sentence.
With previous prevention work having been so successful that only 10% of the Fire Service workforce’s time is spent fighting fires, there is capacity available after training and related activities to build further on this base to support wider public policies around health and wellbeing, particularly those concerned with prevention, healthy lives, and heath inequalities.
The Service is working with the voluntary sector – already acknowledged as a key player in the NHS sustainability strategy - with Age UK staff located in fire stations in Coventry and Solihull. Age UK staff are able to pick up wider health and social care issues that emerge from home visits, many of which involve older people, where small interventions can make a huge difference to the quality of individual lives.
A key current aspiration for West Midlands Fire Service is to achieve representation on the local authority Health and Wellbeing Boards that now drive and monitor local health and social care policies. WMFS currently sits on three of a possible seven run by local authorities within the area served by WMFS.
The chief executive of at least one of the authorities where they are not currently represented attended yesterdays West Midlands Fire Service event and tweeted, while he was there, that he would be asking at his own council why the Fire Service had not yet been invited to join both its Safeguarding and Health & Wellbeing Boards.
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