The realisation that some incidents involving fire and mental health service users could have been avoided led to holistic safety assessments, say David Marsden and Paula Breeze
It is widely acknowledged that there is a decreasing trend in fire casualties and incidents and that this is the result of successful fire safety and prevention activity. Although the number of injuries and deaths due to fire has reduced, the rate at which this figure is reducing has slowed.
The fire service is continually striving to reduce the number of fires and injury by considering the small group of people left whom they describe as People at Increased Risk of Fire.
Local partnership working is one of the secrets to success when it comes to helping those with mental and physical health problems avoid risk of fire, as Manchester Mental Health and Social Care Trust (MMHSCT) and Greater Manchester Fire and Rescue Service (GMFRS) have proven.
In 2007, MMHSCT and GMFRS initially identified that approximately a third of all those who died from fire-related incidents in Manchester had mental health issues. Our team cross-referenced fire-related deaths from 2001 to 2007 and found that of 217 fire fatalities which occurred in Greater Manchester, approximately 30 per cent were known to mental health services.
The root cause analysis of a number of serious untoward incidents involving fire and patients of the trust identified that some of these incidents could have been prevented with effective risk assessment and management plans.
A post of occupational therapist was created, equally funded by the two organisations. This would allow the fire service to think beyond the environmental cause of fire and with the assistance of the occupational therapist they could look at the interrelationships between the person, the things they do day-to-day (occupation) and their physical and social environment.
Partnership working between the organisations led to improved patient safety as a direct result of joint risk assessment – and fire safety being built into risk management or safety plans and care plans.
Once the posts had become established, a better trained workforce in assessing the risk of fire in vulnerable service users and improved awareness of mental illness issues within other agencies were all notable improvements.
In 2011, the University of Salford was commissioned to independently evaluate the project. It was noted by the author that the project was a ‘successful collaboration’ and that mental health awareness training for the fire service and fire safety awareness for health and social care staff were positive outcomes in helping to reduce injury and death from fires locally.
In consideration of the evaluation, MHHSCT and GMFRS identified that a sustainable approach was required to maintain these outcomes. Furthermore, the involvement of an occupational therapist and national fire statistics highlighted that any future approach should expand to acknowledge that, in general, physical and mental health issues contributed to fire risk, not mental health issues alone.
This positive feedback from an external source further encouraged the group that the project was working.
Safe and Well
The resulting approach was to move from one occupational therapist bridging the organisations to training occupational therapists in the trust to carry out specialist occupational assessments in collaboration with the fire service personnel and building this into routine practice.
A clear process was developed for collaborative work between the organisations and a detailed partnership agreement was signed. At this point GMFRS took the positive step of recruiting a health and social care coordinator to foster similar partnerships across Greater Manchester.
In 2015 the guidance on the model was published online, supported by the Advancing Quality Alliance. Key objectives for the guidance include:
- Help promote successful partnership working between health and social care services and fire and rescue services. The partnership model can be applied strategically but it will also be of value for practitioners if there is not a partnership already in place.
- Support health and social care staff from any organisation to strengthen their interventions with knowledge and skills to reduce the risk of fire to service users/patients.
- Help promote successful partnership working between practitioners and fire and rescue service staff and between organisations.
MMSHCT and GMFRS are working together continuously to reduce the risk of fire for their service users. The two organisations have committed to share best practice nationally and have started to locate all the learning on a web page and host further best practice sharing sessions using online platforms.
The fire services are currently promoting themselves as a “health asset” in a range of ways. For example, they are developing their Home Fire Risk Assessments or Home Safety Checks, into ‘Safe and Well’ checks which will be more holistic. Additionally the fire service staff will extend the reach of health and social care services by increasing health and wellbeing support by identifying health issues and signposting members of the public.
David Marsden is the head of occupational therapy at Manchester Mental Health and Social Care Trust. Paula Breeze is health and social care service coordinator at Greater Manchester Fire and Rescuse Service. Read the guidance here.