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?