News Release

19th October 2006

UNCERTAIN FUTURE FOR STAFFORDSHIRE FIRST RESPONDERS

Following the withdrawal of medicines from Staffordshire Ambulance First Responders, a number are now considering their future with the service. Michael Fabricant says: "I bitterly oppose this dumbing down of the Staffordshire Ambulance Service. This is in direct contradiction to promises made by Tony Blair to Staffordshire MPs and I have now tabled a formal Parliamentary Question to the Prime Minister regarding this and the removal of ResQPOD heart attack emergency equipment from our ambulances." And today, Michael has been contacted by First Responders and by the former Chief Executive of Staffordshire Ambulance Service.

Roger Thayne, former Chief Executive of the award winning Staffordshire Ambulance Service has today told Michael Fabricant: "There is absolutely no legal reason for banning any drugs from the list which Ambulance Techs, CFRs and Health Care Workers are trained and allowed to use. This is action taken against the advice of the Medicines and Healthcare Products Regulation Agency who confirmed to the Trust in July 2006 that they could be used. Parliament was told that Staffordshire Ambulance Service would remain a separate Trust. The Department of Health ignored Parliament and has directed them to replace their Directors with ones from West Midlands and work under West Midlands direction. The result will be West Midlands performance standards and therefore an increase in lives lost unnecessarily in Staffordshire." Michael Fabricant says: "I agree."

And in a further development today, Cllr Frank Bartlett Chairman of Whittington Staffordshire First Responders, has written the following letter to the Acting Chief Executive of the Ambulance Service throwing the future of the First Responders throughout Staffordshire into doubt:-

Thursday, October 19, 2006

Dear Mr. Catling

I write on behalf of Whittington Community First Responders to acknowledge receipt and provide a personal response to your letter withdrawing Atrovent, Diazepam Stesolid, GTN, Salbutamol, Pulmicort, Midazolam, (Buccal) and Entonox from the medical armoury currently available to CFR groups with immediate effect.

Their withdrawal leaves us unable to respond effectively to a neighbour experiencing chest pain resulting from angina or cardiac infarction; a child with croup; a person experiencing an epileptic episode or a life threatening asthma attack, together without an inability to provide effective pain relief in trauma situations. Such episodes provide a major proportion of our responses.

Given a proven track record of effective interventions in such situations by Staffordshire CFR groups over the years the withdrawal of these drugs could well lead to loss of life and will certainly put us in the totally unacceptable position of being tasked to life threatening incidents with the knowledge and skills to intervene effectively, but lacking the means to do so. This is not a position I could in conscience personally countenance.

I was not among those who opposed on principle the moves towards combination into a regional service, preferring to believe assurances that we would see a raising of the standard of service offered to the highest level rather than a reduction to the lowest common denominator. The changes that we have now seen and the context in which they occur clearly make nonsense of such assurances.

A meeting will shortly be held to establish a Whittington CFR group position and no doubt there will be a County level response, however I believe that few will wish to continue given the limited role and ability to respond that the new restrictions impose. We were enlisted, trained and equipped by Staffordshire Ambulance Service to be in position to respond in a meaningful and effective way to all medical emergencies occurring in our locality. This is clearly no longer the case. What a waste of the hundreds of hours of training, service and fund raising freely given by members of the group and the wider local community and what a tragedy for that community!

I go on to question: * The assertion that the decision was made by Staffordshire; * The basis of the legal advice on which the decision was made; and * The wider consequences to the service and elsewhere should the decision not be rescinded.

Where the decision was made

Robert Lake, Chairman, Staffordshire Ambulance Service NHS Trust in his e-mail of 18th October asserted that the withdrawal of the drugs followed inevitably from advice from the Regional Strategic Health Authority. "Geoff and I fully appreciate the consternation and, indeed, anger felt by many of the CFRs on the issue of drug withdrawal. However, on receiving the advice of the Regional SHA Pharmacists and the SHA Chief Executive that CFRs are not covered, in law, to administer the seven drugs in question, we had no option but to withdraw them."

The legal position

The above body however is not the regulatory authority on the authorization of drug use. This role is undertaken at national level by the Medicines and Healthcare Products Regulatory Agency.

In July of this year that body was supplied with a list of the drugs available to Staffordshire CFR schemes and requested advice on the legality of the situation.

Their reply asserts that Adrenaline and Glucagon are on the list of parenteral medicines which may be administered by anyone for the purpose of saving life in an emergency and goes on to say, "Medicines legislation does not address the administration of non-parenteral medicines so there is nothing to prevent CFRs administering the remaining products listed in your letter."

Wider implications of the Regional Strategic Health Authority Advice

The advice would appear to be based upon an inappropriate application of the Medicines Act of 1968. If that Act were to taken as the authority in the matter, then the effect would be catastrophic not just for CFR groups, but also the whole of the Ambulance Service and many other organisations involved in healthcare. The Act very restrictively describes those who may administer certain medicines and then goes on to define a limited number of groups of people to whom exceptions apply. Among these exceptions are paramedics but not technicians. It is thus inescapable that the interpretation of the law currently being applied to CFR groups, if correct, must also be applied to the technicians who staff our ambulances and still have the full range of drugs available.

The ruling would also have to be applied to the many other caring organisations such as schools with epileptic pupils who currently administer either Diazepam or Midazolam.

Conclusion

In view of the advice from a more appropriate organisation than that on whose advice the decision to withdraw the drugs was based, the wider apparently unforeseen implications of the changes and the potentially fatal reduction in the support we can offer to our community, I ask as a matter of urgency that CFR groups' ability to use the full range of drugs referred to is restored pending a more considered, informed and hopefully more consultative approach to the issue.

Yours sincerely