ATTACHMENT B: BCEHS letter Re: Local Government Interest in First Responder Services

ATTACHMENT B

January 3, 2014

File: 200-20/RAP Cliff: 990287

To Your Worship,

Re: Local Government Interest in First Responder Services

One of the challenges all emergency services face is ensuring the safety of the travelling public while responding to incidents using the lights and siren. Anytime a first responder agency, be it police, fire or ambulance, responds on an emergency basis, the risk of a motor vehicle incident increases, whether or not the emergency vehicle is involved directly. As you can understand, the safety of the public and the staff that provide the services to the public is important to the BCEHS board.

Additionally, all emergency service providers must ensure that there are enough resources available to provide a timely, safe and quality response to the public while also enabling resiliency in the system to respond to major incidents or other spikes in demand on any given day.

Under the Emergency Health Services Act, the Board of BC Emergency Health Services (BCEHS) is responsible for governing all emergency medical services provided in British Columbia, including those provided by both BC Ambulance Service (BCAS), first responder agencies, BC Patient Transfer Network and Trauma Services BC. We take our responsibility to patients and taxpayers seriously; we are committed to ensuring patient needs come first and using all resources as effectively and efficiently as possible.

On November 12, 2013, BCEHS President Michael MacDougall sent a letter outlining the rationale and process used to update the Resource Allocation Plan (RAP) for ambulance and first responders. The RAP assigns the appropriate resource(s) and response mode (lights and siren or routine) for over 800 different types of pre-hospital medical calls. The evidence-based review was undertaken to ensure that the right resource, responds to the right patient, at the right time and the public isn't exposed to unnecessary risk from emergency vehicles responding using lights and siren when not clinically required.

The results of the review reduced the number of call types requiring a lights and siren response and/or Advanced Life Support ambulances to attend. The review also found that first responders were not required to attend 35 per cent of the medical calls that they are now notified of by BCAS because the patients do not require their medical services. Additionally, if a first responder is assigned a lower priority medical call, there is an increased risk that they are not available to respond to calls of a critical nature where they can have the greatest impact on a patient's outcome. The RAP does not affect the other services fire departments provide such as scene safety or vehicle extraction. A report summarizing the RAP review is available online at http://www.bcas.ca/about-us/reports-statistics/. If you wish to respond to all the incidents, irrespective of the response rating, this is an issue that we would be pleased to discuss with you.

To date, the RAP changes that affect ambulance responses have been implemented, but those affecting first responders have not. Following the review process, BCEHS heard from many municipal fire departments providing first responder services that they were interested in assuming a greater role in pre-hospital care. However, at the Union of BC Municipalities Convention (UBCM), many local governments felt that it was important to use public resources as efficiently and effectively as possible and only wanted to attend medical calls where first responders could have a significant positive impact on the patient's outcome. Most often these instances are during calls involving trauma or cardiac arrests.

It is important to note that historically first responders have driven to all medical calls using lights and siren even if the ambulance was responding routine. Since the RAP changes for ambulances were implemented earlier this fall, most fire departments in B.C. have decided to match BCAS's response mode and only drive lights and siren if the patient's condition warrants an emergency driving response. This change is a significant improvement in public safety for communities throughout B.C. and an example of the positive benefit of collaboration between the groups involved.

BCEHS and BCAS aim to provide pre-hospital patient care that is safe, timely and of high quality. The BCEHS Board of Directors believes it is important that our partners in pre-hospital care, municipalities and first responders, have an opportunity to provide input into how services are delivered, particularly when changes are being contemplated. BCEHS has been speaking with delegates at the UBCM Convention, the Fire Chiefs' Association of BC, the Greater Vancouver Fire Chiefs Association, an expanded BCEHS First Responder Committee that included several fire chiefs from throughout B.C., individual local governments and other stakeholders about the RAP changes.

BCEHS is in the process of setting up briefings for those municipalities which requested an opportunity discuss the further implementation of RAP following Mr. MacDougall's letter of November 12, 2013. If you want to provide input or require more information, please contact Shelly Drew at Shelly.Drew@bcehs.ca or call 250 474-7582.

The BCEHS Board of Directors believes that with your perspectives being considered, we will be able to provide the direction needed to ensure that the BCEHS First Responder Program can be refined in a way that meets the needs of individual communities.

Thank you in advance for your attention to this matter.

Sincerely,

G.W. (Wynne) Powell CPA, FCGA, D. Tech (Hon.) Board Chair