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Project 13: Joint Ambulance, Fire, Police and Rescue Services Control Rooms.The project1. This project, led by the Department of Health in partnership with the Home Office and the Department for Environment Transport and the Regions, aims to set up and evaluate the cost effectiveness of joint ambulance, fire, police and rescue services control rooms. The project is also testing the expansion of the model to including a range of shared support facilities such as fleet management, IT, occupational health, finance and accommodation services. This approach to co-ordinate control would involve the use of common facilities to provide cross service handling and despatching using call handlers who would work across disciplines.2. The concept is of a flexible system which would incorporate current service developments in addition to dealing with public information needs in the case of local or national emergencies, scares or crises. There would be a key role for new and advanced technologies including Call Line Identity, Automatic Vehicle Location and bringing together and ‘firewalling’ appropriate databases. The development of the joint call centres was also expected to take account, ‘where appropriate’ of the emerging technology associated with ‘a public safety radio communications system’ which has been funded by the Home Office.
4 The impetus behind the ISB submission stems from the Frank Dobson speech to the Ambulance Service 1998 supported by the Home Secretary and other senior ministers. It was stated that emergency services should explore the practicalities of cross sectoral working, the scope for improved value for public spending including the scale of cost avoidance from sharing expensive new technologies, and the potential for improving emergency access for the public. The concept of inter- Fire Brigade collaboration was mooted as far back as 1995 by the Audit Commission when it published the ‘In the Line of Fire’ report.
6 Contingency plans to address the risks outlined above were built into the process whereby bids were received and assessed from potential local projects. Proposal criteria included ongoing discussion with local union members, demonstration of support at the local level and that legal advice be engaged at the outset.
8 The DoH contribution is in the form of match funding provided by the local ambulance service sponsoring the individual pilot. Home Office and DETR contributions are similarly channelled via Local Authority spend on the emergency services involved in each pilot. In addition the invitation to tender for prospective pilots required each project to exploit PPP/PFI funding where appropriate particularly to supplement capital intense aspects of their proposals. 9 At 13million this ISB bid was one of the largest received by HM Treasury and it was decided to allocate 60% of the ISB funds that were initially bid for which came to 7.8m. The basis for this decision was the Department’s advice in the original bid document that the project would be viable with three pilots. Following these revisions to the project costs and the overall scale of the project this project was still the third largest of all those approved and this prompted the Treasury to request further clarification of a number of key points. The DoH were therefore required to supply further information on; the time taken to select pilots, local monitoring and evaluation arrangements, and milestones and phasing of the pilots. These issues were resolved in a relatively straightforward manner as detailed information could only be supplied when the pilots were selected, although DoH confirmed that local monitoring would be implemented at each initiative. The three eventual pilots were established in Gloucester, Wiltshire and Cleveland. 10 A review of the bid material and our discussions with the pilot project mangers identified several key advantages of the joint call centre approach and a number of disadvantages. The major advantages were improved cost effectiveness for the three services; improved working relationships; integrated emergency responses and better siting of ambulance services through use of other services’ stations. Other advantages mentioned by consultees at the pilots included the greater operational resilience brought about by having a larger labour pool, improved technology and increased joint training opportunities. 11 The key disadvantage of the project was the risk of trade union disputes in one service affecting all three of the emergency services. Other potential problems which need to be resolved include a perceived feeling among some ambulance service employees that patient care may diminish as a result of a weakening of the ambulance service’s integration with the NHS. There are also serious concerns among emergency services staff surrounding the issue of equalising pay/terms and conditions across the services. One of the primary functions of the pilots must therefore be to demonstrate how these issues can be overcome and/or managed. The main benefits set out in the bid are as follows:
13 Each of the pilots have appointed a dedicated full-time project manager. This, in part, reflects the size and complexity of the programme but is also a consequence of how seriously the lead department and each of the pilots are taking the project. All three projects are using the PRINCE 2 methodology which has, in this case, led to tightly managed local pilots and a consistent approach in which project information can be transferred between departments at both the strategic and delivery levels. 14 In each of the three pilots the project manager emphasised the importance of the PRINCE methodology to the project. The PRINCE system allows complex elements of the project to be co-ordinated and phased effectively. This was critical in relation to the capital programme where progress was often dependent on a multitude of decisions, some political, taken externally. Critical path analysis and the use of the ‘issues’ and ‘highlight’ reports were deemed fundamental to project progress by the consultees who had all received training on PRINCE.
16 The DoH has requested proposals from each of the pilots to specify performance indicators and monitoring information. The project managers were strongly of the view that the pilots would generate this information as they progressed and as they were in essence feasibility studies they were unable to produce any monitoring information at this early stage other than the progress reports supplied to DoH. It was clear that the pilot projects were intended to inform the development of an evaluation methodology for joint call centre projects and that this would become firmer over the life of the pilots.
18 At the individual pilot project level the project managers indicated that the pilots could have gone ahead without ISB but on a smaller scale. PPI/PFI was identified as an alternative source and it was suggested that emergency services were, at the regional level, in discussion about rationalising certain aspects of their services. The key point argued by the pilots was that in order to maximise the impact of joint call centres they have to be tested comprehensively. In other words as many aspects of joint working must be examined as possible- i.e. training, procurement, technology and fleet management. All project managers were in broad agreement that without the funding from the Invest to Save Budget this level of testing would have been impossible in any of the pilot areas. Both the departments and the pilot managers were of the view that it was too early to ascertain whether the projects offered good value for money. The ISB project was seen as a ‘platform from which future savings could be made not the means of savings in itself’. 19 Longer-term effects depend largely on whether the pilots are successful and rolled out on a national basis. At the individual project level managers were clear that the project has led to better working relationships between the emergency services and that these were likely to be sustained in the long-term. The key here seems to be the level of senior commitment and ‘buy-in’ to the project from across the services. It was also felt that structures (both financial and non-financial) had been put in place that would facilitate wider partnership working in the long-term.
22 The project has made considerable contribution towards the overarching objectives of the ISB. This has included improved interdepartmental working and effective joined-up approaches at the delivery end. The project contributes towards stated government objectives whilst supporting the objectives and mission statements of each local partner. 23 There is no doubt that in the absence of ISB these projects could not have tested this approach to the extent and on the scale they have done so far. It is probable however that individual partnerships may have progressed some level of joint working across the emergency services to improve delivery and bring about savings. 24 This project demonstrates the value of tight project management extremely well especially in large projects. The application of the PRINCE methodology enabled partners to deal with delays in elements of the programmes whilst maintaining progress on other areas. This is particularly important when the project contains within it a capital building programmes for which delays would have threatened the viability of the whole project. The pilots have exceeded the basic reporting requirements set out by HM Treasury and have established comprehensive information systems to disseminate and share experience/lessons. 25 The overall project manager at DoH commented that he would have benefited from a tighter project reporting regime from the Treasury. It was felt that the lead partners were unclear about which information was required by Treasury and how much detail they should provide. This caused unnecessary uncertainty and delays. |
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