The Department of Health (DH) has published a renewed strategy for combating the 25 000 ‘avoidable’ deaths that occur each year as a result of cold weather in the UK (DH, 2012). Since 2010, when the country was gripped by a particularly disruptive cold stint, in which Heathrow airport was closed for three consecutive days and the UK economy lost an estimated £840 million (UK Parliament, 2011), the government has focused attention on combating the UK's susceptibility to, so-called ‘extreme’ weather.
The Cold Weather Plan for England 2012 is an elaboration on the government's 2011 document of the same name and aims to gather information and climactic data, increase multidisciplinary cooperation across the NHS and emulate the emergency response services of countries “such as Finland” (DH, 2012) to reduce the excess winter death toll.
Though the strategy seems to lack much guidance or advice other than vague, overarching generalisations encouraging cooperation within and beyond the NHS, it includes responsibilities for paramedics and ambulance personnel, begging the question: Where does the paramedic profession fit into DH's plan?
As well as listing obvious health conditions exacerbated by colder weather such as strokes, falls and trips, and more interestingly, depression, the main role of ‘ambulance crews’ as detailed in the document is as an information gathering force ‘to collect information on where accidents and falls are taking place to share with road, police and other organisations so that remedial action can be undertaken’, including responsibilities for ambulance chiefs and trust leaders who are to evaluate the increased demand for nebulisers and splints.
With many paramedics already under increased stress and strain during the winter due to longer shift patterns, more intoxicated and/or belligerent patients and dangerous callout journeys, this ambiguous new responsibility may seem rather irksome. Furthermore, there is likely be a spike in unwanted (and often unwarranted) media attention as newspapers and TV crews, rarely factoring on the multi-symptomatic approach as a component in a patient's outcome, seek-out fatalities, redirected callouts and missed deadlines for their pages and broadcasts. And, though it will be social care and their local government administrators who take the brunt of any increase in the ‘excess deaths’ statistic on a national scale (especially concerning elderly patients), the paramedic profession may find itself in the public's eye on occasions where the media hold them responsible for vulnerable patients who's recoveries are hindered or prevented mainly, or entirely, due to the weather.
In short, the document seems more like a governmental safeguard against any potential media storm that may erupt in 2013 more than a deliberate attempt to improve EMS response to dangerous weather, and the poignant lack of specifics in the plan highlights this. However, paramedics must remember that the duty of improving the infrastructure of the country and its preventative safeguards against inclement weather lies categorically in the jurisdiction of local government, Parliament and Whitehall, and the profession should not direct focus away from their primary concern, namely to provide the best treatment to patients on-scene, prioritising callouts in accordance within new weather conditions and trying to keep themselves sane during the galling winter period.