Will the 999 emergency services seek closer co-operation or will the potential pitfalls put them off? Alison Moore reports

The three 999 services have much in common - but could their current level of co-operation be taken a step further? The first joint emergency services conference, held last week, saw much potential for closer working but also many pitfalls.

The ambulance service probably feels more threatened than police and fire by the prospect of closer working. Unlike the other two blue light services, it reports to the Department of Health, and many staff see their key relationships as being within the NHS.

So there was some trepidation about what junior health minister Gisela Stuart might have to say.

Although she stressed the importance of co-operative working, the ministers' message was, on the whole, reassuring.

'We should make sure that no organisation or professional interest forms a barrier to more effective working, ' she said. 'There is a very important difference between ambulance services, and police and fire. The ambulance service is part of a much larger health service.

'A decreasing proportion of the emergency calls answered by the ambulance service is to accidents and other emergencies.'

Many calls are for medical problems which may need hospital admission, but could also involve walk-in centres or NHS Direct, she added. The skills of paramedics were particularly important - such as their new role in administering clot-busting drugs - and the DoH was now considering the development of practitioners in emergency care.

Her sentiments were echoed by many from the ambulance service: 'The vast majority of our work is medical emergencies and this is pushing us to work more closely with our NHS colleagues, ' said Paul Sutton, operational strategy director of the East Anglian Ambulance trust. 'We are working with primary care groups and primary care trusts. We need to communicate more information to the NHS than to the other emergency services.'

Home secretary Jack Straw took a more upbeat theme, while acknowledging the slightly different role of the ambulance service.

He urged the services to make use of 'the many opportunities for better and more joined-up working' and asked the presidents of the three professional associations to look at how collaboration could be pushed forward. 'It is through better co-operation that we will provide better services for the public, ' he said. 'Seeking out opportunities for co-operation cannot be an optional extra.'

But where could co-operation start? Procurement is one area in which there has been some action.

London Ambulance Service trust logistics manager Graham Bewsy pointed out there could be opportunities to work with local authorities and other NHS bodies as well as with the other emergency services.

Some personnel issues are also common across the services. They recruit from a shared pool of potential staff, elements of training and management development are similar, and they face similar problems in dealing effectively with the public.

LAS community relations specialist John Batchelor warned that services should take action to ensure they were not tarred with the brush of racism, which could affect morale and recruitment as well as public image. Action to promote diversity and racial equality within blue light services was needed, and staff needed consistent messages from different parts of the organisation.

The overwhelmingly white male audience he addressed suggested that diversity had some way to go.

'As emergency services we must come to terms with the fact that the different cultural and community groups we serve are not going to go away, ' he said.

'We need to think, perhaps, about having multilingual control staff or interpreters. All too often, inappropriate use of our resources is based on the person not being able to communicate effectively.'

South Wales chief constable Anthony Burden suggested community and race relations training could be done across all three services, and there could be scope for sharing advisers.