How do Community First Responders contribute to rapid emergency response and recovery?

Conference:

SAPC ASM 2022 - UCLan

Talk Code:

5E.3

Presenter:

Viet-Hai Phung

Twitter:

@gupteshh

Co-authors:

Phung VH, Pattison J, Botan V, Smith M, Ørner R, Trueman I, Asghar Z, Ridyard C, Rowan E, Brewster A, Mountain P, Evans J, Spaight R, Siriwardena AN.

Author institutions:

Community and Health Research Unit - School of Health and Social Care - University of Lincoln, National Ambulance Commissioners Network, East Midlands Ambulance Service NHS Trust

Problem

Community First Responder (CFR) schemes are a longstanding means of engaging communities in the NHS. CFRs are community members who volunteer to respond to people with life-threatening conditions on completion of essential training. Previous studies highlighted the motivations for becoming CFRs, their training, community (un)awareness and implications of their work on themselves and others. The role of CFRs in prehospital care remains relatively underexplored. We aimed to explore real-world practices of CFRs and their contribution to emergency care in the community.

Approach

In a qualitative study, we conducted interviews with patients and relatives, CFRs and CFR leads, ambulance clinicians, and commissioners in England. Thematic analysis, supported by NVivo and guided by Actor-Behavioural change-Causal pathway (ABC) theory, enabled the identification of themes and subthemes.

Findings

We interviewed 47 participants, including patients and relatives (5), CFRs (21), CFR leads (15), ambulance staff (4), and commissioners (2) from six ambulance services and regions. The findings revealed that the CFRs’ work consisted of a series of sequential and interconnected activities. These included: identifying patients’ signs, symptoms and problems; information sharing with the control room and ambulance on the patient’s condition; rapid emergency response including assessment and care; and engaging with ambulance clinicians on arrival. The patient care sequence began with understanding pre-existing medical conditions, signs and symptoms, followed by CFRs sharing information with control room, ambulance crew en-route, or both on the risks and challenges in the patient’s condition. CFRs also supported the ambulance in navigating locations in rural regions to reduce ambulance response time. CFRs were primarily involved in stabilising patients’ conditions and taking observations prior to assisting with handover to ambulance crew. These practices supported the ambulance service to reduce patient transfer times.

Consequences

CFRs individual actions interconnected with others to enhance rapid prehospital care for patients requiring emergency assistance. The availability of emergency health services in the community is influenced by the patient’s living conditions, such as rurality, and by innovations in CFR practices. These behaviours, represented in several strata, help shape emergency patient care. The ambulance service received information about patients’ conditions, which could help ambulance clinicians adjust their treatment approaches. We conceptualised the ways that CFRs operated and found that they provided a valuable resource to improve emergency care.

Submitted by:

Gupteswar Patel

Funding acknowledgement:

This report presents independent research commissioned by the National Institute for Health Research (NIHR) Research for Patient Benefit Programme. The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NIHR.