East Neuk First Responders is an independent Community Resuscitation charity, working to improve the survival and outcome of people who suffer life threatening emergencies in the East Neuk. The charitable objects of East Neuk First Responders are to enable volunteer first responders to attend pre-emergency ambulance care intervention in accordance with their training for the benefit of the whole community.
In 2025 Elie & Earlsferry Community Council made a Participation Request to the Scottish Ambulance Service which sought to increase the number of trained Community First Responders in the East Neuk of Fife through the provision of local training.
Also, through extension of Community First Responder call categories, the Participation Request sought to enable the Community First Responders to attend Immediately Life-Threatening calls (ILTs) for which they are trained and willing to attend. This would support a move announced by the Scottish Ambulance Service in June 2022, towards a more flexible model with a tiered level of Responders. The Participation Request was submitted on 8 August 2024.
Background
Discussions over Community First Responder training requirements in the East Neuk of Fife had been ongoing for a number of years.
When Community First Responder training became centralised at Newbridge, a 3 hour round trip, the vast majority of the local volunteers found this unfeasible. Prior to the Covid pandemic there were never less than 12 active Community First Responders. Currently there are only 3 active covering the whole of the East Neuk of Fife. Over a 5-day period in 2022 ambulance response times for 2 Immediate Life-Threatening calls were 45 and 65 minutes. These were not isolated incidents, and little seems to have changed since then.
In April 2024 in an attempt to improve the situation, one of the local Community First Responders who is a qualified, experienced, nationally accredited instructor offered to deliver any training required. This offer was not taken up by the Scottish Ambulance Service.
It was felt that over a number of years there has been a lack of effective collaboration and even basic communication between the Scottish Ambulance Service management and the East Neuk Community First Responders and a perceived unwillingness by the Scottish Ambulance Service to involve the Community First Responders in any decision-making process involving identifying the issues and generating solutions.
Local ambulance crews have been found to be very supportive, and appreciative and respect what the East Neuk First Responders do. They also attend the local training sessions and provide support to the East Neuk First Responders.
Outcome Improvement Process
The Scottish Ambulance Service acknowledged receipt of the Participation Request on 13 August 2024 and arranged a Teams meeting with the chair of Elie & Earlsferry Community Council and Chief Executive of the Scottish Ambulance Service, which was to be followed by a meeting in Anstruther on 24th October 2024 between the Scottish Ambulance Service managers, the local Community First Responder team and chair of Elie & Earlsferry Community Council.
It was felt the Participation Request and Outcome Improvement Process would ensure the voices of the East Neuk First Responder team and the community group would be heard and acted upon.
The Participation Request would also ensure effective collaboration takes place between the Scottish Ambulance Service, the East Neuk First Responder team and the community group, with all key stakeholders being involved in the decision-making process.
However, the Scottish Ambulance Service announced at the Anstruther meeting they were unwilling to proceed with the Participation Request. They apparently did not wish to be involved in what they described as being a legal process. They were however willing to offer local training. They were not willing to consider extending the local Community First Responder role as there was currently work ongoing in relation to this.
Outcome
The 4-day training which took place in Anstruther in March 2025 was attended by 7 local recruits. The existing Community First Responders offered to assist with the training, but this offer was declined by the Scottish Ambulance Service. We believe it was due to lack of recognition and acknowledgement by the Scottish Ambulance Service of the prior learning acquired by the local Community First Responders.
The Chair of the Community Council asked to attend to review the training, but this request was also declined.
It is now several weeks since the new recruits obtained the necessary paperwork but as yet they have not received their Scottish Ambulance Service IDs or been activated on the system.
The Scottish Ambulance Service also stated that this was a One Off and local provision of training wouldn’t happen again. This is very concerning for the future and goes against the findings of the Independent Review of Volunteer Delivered Service.
The recent independent Review of Volunteer Delivered Service (31 January 2025) described how the Volunteers have a critical role in the delivery of compassionate safe and effective care to patients across Scotland. Yet the review found that this is not happening. In island and rural communities, where the lack of courses was a major obstacle to recruitment and retention of Volunteer Responders.
The island and rural communities expressed a very strong desire to expand their scope of practice and be empowered to deliver the 4-day training course.
The review also recommended that the Scottish Ambulance Service should consider establishing a Train the Trainer scheme and also consider adopting an externally validated approach for Volunteer training which could enable prior learning to be recognised.
In addition, feedback reflected frustration that the Volunteer voice is not being heard (within the Scottish Ambulance Service) and they were not being sent to appropriate calls.
The Way Forward – Quick Wins
The independent Review of Volunteers recommended the need to identify quick wins.
1. In Island and rural areas such as the East Neuk of Fife, training of Volunteers to the appropriate level and recognition and accreditation of prior learning would enable training to be delivered by local Community First Responders.
2. Collaborative working would ensure that Community First Responders are fully integrated into the Scottish Ambulance Service and their voice is heard.
3. Endorsing the Volunteers as the Eyes and Ears for the Scottish Ambulance Service would ensure they are dispatched to the appropriate calls.
4. Expanding skills training for the Volunteers would enable them to expand their Scope of Practice.
5. Also noted in the Independent Review was the need to evolve from managing Volunteers to delivering a Volunteer Responder Service which is supported by training, logistics and project management.
6. In moving forward, Volunteers should be fully involved in the future development of the service.
7. We believe it is also vital in rural and island areas, that training is delivered locally. This would help address the concerns cited in the Independent Review of Volunteer Delivered Services, where the lack of courses was a major obstacle to recruitment and retention of Volunteer Responders.
This could be achieved through the delegation of training to local Community First Responders who have been trained to the appropriate level.
8. It would also seem from the apparent lack of communication between the Scottish Ambulance Service and the Community First Responders that attention has shifted away from the importance of effective collaboration between the different services delivering care and the benefits which can be achieved by a more integrated partnership approach to working.
9. Local Community First Responders have a strong appetite for tackling and addressing health issues in their area.
They should therefore play a key role and be part of the solution for delivering effective safe and compassionate care as the Scottish Ambulance Service moves towards a more flexible model with a tiered level of Responders.
10. This flexible model should include Community First Responders being allowed to attend Immediately Life-Threatening calls (ILTs) for which they are trained and willing to attend.
