Emergency Response Systems in the United Kingdom
By Khalil Jetha
Emergency response protocol in the United Kingdom is unique, dependent on both the nature of the incident and the branch responding. The British police, whose existence spans hundreds of years, has streamlined emergency response using methods that incorporate the general public as well as a relatively new mode of operations which focuses on service orientation. In contrast, the specter of the privatization of healthcare services has driven British Emergency Medical Teams (EMTs) to adopt a five-tiered system in order to maintain the smooth running of operations at the scene of major incidents. British policies are unique, catering to the ever-changing demands of a dynamic population. Incident response relies on the crisis response policies implemented; “simply put, the purpose of” British crisis response policies “are to help ensure the provision of effective and efficient crisis” service (Brock 1998, p. 46).
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All British crisis response involves a set system of application. The initial “crisis response task is for” authorities “to assess the impact of a given situation and determine if [their resources will be able to deal with the crisis” (Brock 1998, p. 94). Once the facts surrounding the crises are determined, the appropriate branches are then sent to the scene. Though policies and protocols exist to effectively approach urgent or compromising situations, the smooth running of operations is largely reliant upon an official government policy statement. While it serves to alleviate public concerns, “an important reason for developing a crisis response policy statement is to protect” public servants “from charges of negligence” (Brock 1998, p. 46). In the rush of incident response, operations at the scene are streamlined and practiced tirelessly; the most important aspects of incident response are those that allow emergency response officials to carry out the functions of their jobs. Educational programs and training regimens are required of all incident response teams. “Education and training helps instill in individuals the appropriate actions to take in different circumstances and mentally and physically prepares them to carry out” actions to ensure the smooth running of operations at the scene of a major incident (Davis 2003, p. 59). The many overlapping aspects of incident response duties among various departments necessitates a separation of duties and responsibilities; by establishing firmly the different responsibilities of incident response teams, the government enabled each sector to operate while minimizing legal liabilities in the course of action. The separation of responsibilities involves “sources of information shared among service departments” such as “police departments, coroner’s offices, fire departments, [and hospitals]” (Brock 1998, p. 47). Like incident response teams in most democracies, British incident response teams are subject to scrutiny from many angles as they are part of a larger bureaucracy at work. The British government not only delineates the duties to which a certain response team is obligated, but also restricts other teams from carrying out the duties of another team. All effective crisis response policy statements include components such as “a definition of what types of crisis situations will require a crisis response, a statement of official responsibilities during crisis response, and a statement of the government’s stance on crisis preparedness” (Brock 1998, p. 47). The most important systems are those that prevent the halt of incident response services, such as the establishment of public relations figures as well as figures who cater to the public both during and immediately following major incidents. Crisis response systems, after all, exist to respond both to “sudden and unexpected events” that “have the potential to affect a large number” of people’s “social and emotional well being” (Davis 2003, p. 38). Establishment of liaisons in public are key in the establishment of crisis response, as most emergencies also require “facilitating communication between” the public and official bodies (Brock 1998, p. 272). Such communication has proven to empower the public to take part in the workings that exist to protect them. One such case is the British police, whose centuries-old operations were redrawn in the late 1970s and early 1980s in order to accommodate the changing needs of an increasingly diverse population.
“As the twentieth century moved to a close the police were looming large in the national culture of the United Kingdom,” initially as figures on which the public could rely (Howell et al 1999, p. 207). The South Asian immigrant boom of the twentieth century caused rifts between the population and the police force. The majority of incidents reported were those of civil unrest, not criminal activity. Officers would respond who could do little, as their mode of operations did not accommodate for rioting or street violence. As a result, the standard of police services has drastically evolved since 1975, when “the public considered the UK police poor performers,” with surveys [recording] falling levels of public satisfaction with the police” (Ebbe 2000, p. 157). Both native Britons and new immigrants were contemptuous of a police force they perceived to be inept and indifferent. The British police therefore were required to change the nature of incident operation from one of simple response to one of containment. The inabilities of the police in the 1970s not only disheartened many citizens, but also proliferated violence and criminal transgressions. A growing “number of incidents of public disorder during the late 1970s and early 1980s were interpreted as symptoms of a loss of confidence in the police” (Ebbe 2000, p. 157). Change, however, did not come easily. The bureaucracies that served to protect law enforcement and other departments also stalled the evolution of police responsibilities and duties. Public intervention in the bureaucratic system for the most part hastened the facilitation of policy shift. In effect, the police developed a symbiotic relationship with the public, who revolutionized the police force; “communities [asked] for a more caring police [force],” one that operated more like a customer-service organization than a law enforcement agency (Ebbe 2000, p. 157). Operations at emergency scenes therefore became one that necessitated public involvement, especially in matters of containment. The official British stance changed, as police officers became more empowered. Changing their duties and responsibilities (not to mention their mode of operations) was a compromising situation for politicians from all parts of the governmental spectrum. The growing frequency of civil unrest and public disorder changed reactionary protocol from one of practiced methodology to one of severe administration of personal infringement. Officers essentially “have different powers to restrict the liberty of citizens and different degrees of discretion with regard to how and when these powers can be exercised” (Tupman et al 1997, p. 17). With full knowledge of these new powers in mind, the political left and right-wing were further polarized as neither could decide what limitations, if any, were called for with the growing number of riots and hate crimes. It was the “inner-city riots of 1981” that prompted politicians to call “for new policing methods but, even as suggested reforms were being implemented, there were further scandals and increasingly political controversies” (Howell et al 1999, p. 208). Police duties and methodologies at the scenes of major events were called into question. The statute of containment superseded the statute of limitations previously set as “policing involves not only crime management (repression) but also order maintenance” (Tupman et al 1997, p. 27). Criminals were apprehended with no due process or formal charges levied against them, earning the police the widespread contempt of British citizenry; “at the very time when the public perceived that they were not being given effective protection against new classes of criminals, the police themselves seemed riddled with corruption and prone to conspire in ‘gross miscarriages of justice’” (Howell et al 1999, p. 208). As a result of media scrutiny and the police’s perennial existence in the public eye, the British government instituted a series of quality checks, rapidly and radically changing the face of emergency response.
Quality checks have become a part of the British police force in order to ensure the smooth running of operations and the cooperation of the public in incident response. Public intervention caused an outcry among many law enforcement officials, who argued that the police existed outside the public in order to perform their duties unhindered by the public they were striving to protect. Many analysts countered, “arguing that the problem-oriented policing would answer many of the community concerns being raised by the changes in society, and would overcome the insular culture of the police” (Ebbe 2000, p. 158). Today, quality service checks and public involvement determines the course of police response methods and protocol. Quality checks prompt the police to change their mode of operations through “training, planning, and identifying” public needs (Ebbe 2000, p. 159).
The police force’s involvement with the public is an exemplary incident displaying the operations that exist in order to better conform to the issues warranting emergency response. Perhaps most important are the functional areas of incident response that, along with bureaucratic requisite institutions, aid in retaining the efficacy of emergency response. The action of response is divided into five functional areas: “incident command, operations, planning, logistics, and finance” (Worsing 1993, p. 19).
Delineated in Robert Worsing’s Rural Rescue and Emergency Care, the five areas are applicable in all aspects of emergency medical response. “All five functions” are implemented “in almost every rescue operation, though they may not be performed a s separate entities” (Worsing 1993, p. 19). Incident command serves as the operational head at the onset of every encounter, organizing and deploying response teams as deemed necessary. Operations serves to handle the physical protocol tailored to most every situation foreseeable, while planning handles workings with the city and different branches of government. Logistics and finance are incorporated at every turn, as both are immediately involved in the bureaucracies of incident response. Bureaucratic cooperation is essential in the sharing of information and the delegation of responsibility in all emergency response situations. Interdepartmental workings in both logistics and finance serve to better work in times of heightened stress. Often, “a system of mutual aid may be incorporated,” meaning “that different agencies or organizations may be preassigned [sic] to various functional areas” (Worsing 1993, p. 19). For example, a fire brigade may be sent to aid in emergencies when medical response resources may be depleted. The cross-assignment of duties relegated can prove to be a logistical nightmare, however. “One of the most common problems in emergency response occurs when more than one jurisdiction or agency is involved in an accident”; if more than one response team has the capability to treat an incident, logistics and operations cannot dictate and assign said duties as the departments have been separated for liability’s sake (Worsing 1993, p. 19).
Policy shifts have allowed for “mutual aid agreements” to define “roles and responsibilities to minimize the potential for disagreements and problems,” speeding “the operational response to an incident” (Worsing 1993, p. 19). Ongoing bureaucratic reform ensures the smooth running of operations in incident response. These reforms and proposed changes in the policies of emergency response pose the potential to ensure furthered efficiency in incident response. Emergency medicine has the unique opportunity to contribute to health care and incident reform “by instituting a comprehensive and collaborative public health approach to emergency medicine” and incident response (Bernstein 1996, p. 15). The British government ensures “that resources [are] available” to facilitate policy shifts in order to reform deficient aspects of medical incident response (Bernstein 1996, p. 15).
Incident response operations in the United Kingdom are heavily reliant on the bureaucracies that surround their workings. Most of the systems that enable them to carry out their daily functions are political in nature, as the five functional areas are reliant upon each other’s separation, regimentation, and cooperation in order to serve the public. Political action, not physical response, ensures the smooth execution of emergency care. Whether the police force, fire brigade, or EMT, incident response in the United Kingdom remains reliant upon the assurance of public and governmental intervention to preserve the nature and efficacy of incident response; what separates the United Kingdom from other countries is its citizen’s empowerment to become involved in the processes that develop emergency services.
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