Emergency Services Integration and Austerity : Reform to ‘Transform’

Article by: Paresh Wankhade, August 10, 2017

The swift and professional response of the emergency services during the recent tragic events of the Grenfell Tower fire and the terrorist attacks in Manchester and London drew universal praise but also highlighted serious concerns about resources, funding levels and sustainability of the increased visibility and presence. Calls for greater interoperability between emergency services are also necessitated by the changing nature of demands, new threats to national security coupled with reduced budgets. But problems in these blue light organisations go much beyond the issues of staff numbers and resources, some of which I have summarised below.

Firstly, the UK provides a very fragmented governance model for the three main blue light emergency services, which worked historically under three different government departments. The ministerial responsibility of the fire services has now passed to the Home Office in 2016. There are about 52 police forces; 58 Fire and Rescue Services and 14 NHS ambulance trusts in the UK. This complexity was highlighted by the Pitts Review (2008) which examined the response of the various agencies to the summer flood in 2007 in the North of England and documented an interplay of more than 200 agencies. The Policing and Crime Act, 2017 now places a duty on police, fire and ambulance services to work together but which remains currently undefined. It also enables the Police and Crime Commissioners (PCCs) to make a business case to take responsibility of the fire and police services but the evidence base is patchy. There is a danger that unless these issues are addressed, the proposed approach could promote merely ritualistic compliance and the past experience of imposed performance indicators suggests it would.

Second, current models of service delivery and management do not reflect considerable changes to the working and nature of demand of these organisations. Recent evidence suggest that ambulance demand is showing is an average annual increase of 5-6 % but only ten percent of the callers dialling 999 having a life threatening emergency. The Fire services have witnessed a downward trend in the incidences of fire with the overall attendance at incidents down by 40 per cent and attendance at fires is down by almost 50 per cent. Their key focus is now is on fire prevention and protection work. Recorded crimes are falling and crime complexity has changed and the police forces are now dealing with increasing number of incidents involving mental health issues, crimes related to child and sexual abuse inquiries, cybercrime, security and terrorism cases. However these services have a dominant performance systems with an accompanying target chasing culture.

Thirdly, supporting workforce and dealing with staff issues has been a neglected management priority given the operational focus of these services with limited evidence of staff engagement in the design of organisational systems. Staff sickness is highest amongst ambulance services within the NHS and retention and recruitment is proving difficult with cases of shortage of paramedic staff reported nationally. Cases of Post-Traumatic Stress Disorder PTSD) and other stress-related illness in the emergency workers are widespread. Harassment and bullying instances are reported in media and now also incorporated in official reports. These may allude to sustained ressures to meet the performance demand but we need to look at the underlying causes and promote factors which will encourage employee engagement and reduce the cost of ill health and potential litigation claims.

Having a clear road map for equipping staff with the necessary skills is crucial for the success of emergency services. This has proved difficult in the emergency services due to the complexity of the work undertaken, organisational issues and disconnected ministerial oversight coupled with shifting political landscape and changing priorities. Building an evidence-based approach to decision making and harnessing the research capacity of staff should be a key policy and management priority. Developing meaningful partnerships between the practitioners and academia to influence the policy context to meet these new challenges should be supported and welcomed.

Finally, a strong but responsive and collaborative leadership culture is required to deal with the changing priorities for the emergency services and for dealing with new and emerging threats and challenges. Current thinking and models, based around individual services without much joined-up approach in developing future leaders is proving difficult. Moving away from the traditional and historical models of ‘heroic’ and ‘top-down’ leadership to a more collaborative and pluralist approach is the very much needed. Such an approach will also facilitate leadership development at different levels in the organisations and will be helpful to motivate staff to perform well.

This is a changeable moment for the emergency services. The police and the fire services merger is a work-in-progress and the position of ambulance services within the blue-light architecture is still being decided. We need a strong but innovative leadership to navigate the ship during this turbulent weather. Demands for more resources and increased budgetary support will have to be dealt with to meet new threats and challenges but it presents opportunities to change by trying new innovative organisational forms and management structures to bring about real reforms and ‘transformational’ changes.

Public Sector Focus, issue 11, July/August 2017, pp. 60-61.
Emergency Services Integration and Austerity: Reform to ‘Transform’

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Paresh Wankhade


I have a PhD in healthcare management from University of Liverpool, UK. My research and publications focus on analyses of organisational culture, organisational change and interoperability of the emergency services, especially the ambulance services, including strategic leadership in the public services. I have been chairing tracks on emergency services management at prestigious international management conferences including the annual European Academy of Management (EURAM) Conference; British Academy of Management (BAM) Conference and the Public Administration Committee (PAC) Conference. My published work is contributing to inform debates around interoperability of emergency ‘blue-light’ services and challenges faced by individual services. I am keen to hear from individuals who are interested in reading for a PhD in leadership and management of public services or related themes. Contact Paresh