Critical Perspectives on the Management and Organization of Emergency Services

Paresh Wankhade, Leo McCann, Peter Murphy

• Publisher: Routledge
• Year: 2019
• ISBN:
  9781351598118
• Edition: 1
• Topic: Commerce
• Subtopic: Gouvernement et monde des affaires

Critical Perspectives on the Management and Organization of Emergency Services makes an important contribution to the subject of emergency services management and to public administration and organization studies more generally. It critically assesses developments in emergency services management by examining the multi-dimensional nature of the provision of emergency services and their connectedness in advanced western democracies. The effective management of emergency services has never been more important than in today's high-pressured and cost-conscious public sector. The authors of this volume forensically analyse the challenges of delivering emergency services within this context. This book provides an in-depth, scholarly and comprehensive analysis of the changing landscape of emergency service provision and clearly addresses a gap in the market for a critical volume on the emergency services.

For anyone seeking to understand why and how the management of emergency services matters, this collection is essential reading.

1 Introduction to Critical Perspectives on the Management and Organisation of Emergency Services

Paresh Wankhade,^* Leo McCann and Peter Murphy

* Correspondence E-mail ID: [email protected]

Background

Emergency services (in this book we focus primarily on police, fire and ambulance services) represent complex and diverse occupational fields. While each service has its own distinct history and way of operating, they are all widely known to be challenging environments for management, organisation and work. Workloads and responsibilities can be extremely demanding for employees and professionals given the common objective of reducing and managing risks of harm to the public. Public services have been undergoing substantial change in many societies since at least the 1980s and the onset of various, often controversial, reforms. Uniformed emergency services in many countries have a strong historical connection to notions of public service and duty: the very idea of an emergency service has connotations of being indispensable or ‘essential’; blue light services can be the only public service available to rapidly respond to those in the direst need. Its absence or shortage can have potentially catastrophic effects on public order, as in the policing metaphor of ‘the thin blue line’. In a time of reforms, cutbacks and ten years of austerity measures, an exploration of this particularly fundamental form of public service can be highly instructive; if major changes are being made to ‘essential’ emergency services then what does that say about government’s views about what is ‘essential’ for it to provide?

Despite emergency services being a worldwide phenomenon with an increasing number of scholars and practitioners actively researching and investigating these services, a critical understanding of these services is only recently beginning to emerge. Systematic understanding is also hampered by a ‘theory-practice’ divide and the dominance of occupational literature at the cost of balanced inquiry (Wankhade and Murphy, 2012). The need for an engaged and critical analysis of management in this sector is apparent. Much of the current literature on management in emergency services tends towards practical, mainstream and even common-sense treatments of notions such as ‘leadership’, ‘risk management’ and ‘professionalism’; concepts that in a critical perspective are considered loaded terms with a multiplicity of interpretations. Vast critical literatures about these concepts exist (Alvesson et al., 2009; Grey and Mitev, 1995) in parallel to the more practical publications emanating from emergency services education and training. There is a pressing need to complement and better integrate the more practical educational approach of the emergency services world with the more reflexive, critical, academic disciplines of business and management, organisation studies, criminology, public administration or sociology.

This need is even more important when one considers the prevalence of failure, controversy and struggle in the daily management of police, fire and ambulance services. Low morale, perceptions of remote and/or bullying management, industrial relations conflict, a lack of a research culture, failures to ‘learn lessons’ from untoward incidents, limited diversity in the workforce and blame cultures are all arguably severe problems in emergency services workplaces (Andrews and Wankhade, 2016; Charman, 2013; Granter et al., 2015; Murphy et al., 2017; McCann et al., 2013, 2015; Spencer et al., 2018; Wankhade et al., 2018). There is an urgent need to openly acknowledge and address some deep controversies around management failures in uniformed services. For this to have any chance of happening, there needs to be an acceptance of a need for reflexivity and critical understandings of workplace structures, behaviours, power relations and identities (Buchanan et al., 2013; Gascoigne et al., 2015; Granter et al., 2019; McCann et al., 2008).

Contested Policy and Organisational Terrain

Emergency services provision is increasingly global in nature but there are huge variations in the way they are commissioned and organised. A combination of delivery models including public, private and mixed is in vogue, making it difficult to make any meaningful international comparisons and identify best practices. In England alone, there are ten ambulance trusts working within the National Health Service (NHS); more than 40 fire and rescue services and authorities and over 40 police forces. They operate under different departments and ministers with different governance, management and organisational structures. The lack of a nodal agency further creates a fragmented policy and service delivery framework, which is discussed by Carl Daniels and Peter Murphy et al. in their chapters in this book.

Recent statutory changes to the services in England resulting from the Policing and Crime Act 2017 have placed increasing scrutiny on the emergency services and call for a critical analysis of their role, responsibilities and contribution to the wider public and society. Current evidence points to several fundamental shifts in the nature of the work undertaken by the three services, with all three facing significant operational problems. Ambulance demand is now rising at an annual rate of about 10% every year, creating massive organisational challenges (National Audit Office, 2017). Police services are working in a climate of overall reductions in recorded crime, but are grappling with very different types of crime, or crimes and social problems that have recently become much more significant priorities, such as modern slavery, cybercrime, childhood sexual exploitation, domestic violence, and mental health and vulnerability (College of Policing, 2015). The fire and rescue services have been very successful in preventing fires in recent years (although numbers of fire incidents are once again rising), but as a result have faced the challenges of new duties and funding cutbacks. Current models of service delivery and management are being challenged by the changes in the nature of demand and new workforce dynamics emerging in these services.

The overall picture of the performance of emergency services and their legitimacy with the public is mixed. Emergency services and the professionals who staff them have an increasingly prominent profile in news media and public discourse given the scale of such incidents as the Grenfell Tower fire in London as well as the recent terror attacks in London and Manchester. The services’ response to multi-casualty incidents has attracted praise but has also highlighted serious concerns about resources, funding levels, operational doctrine, effectiveness of leadership and the sustainability of these organisations. The Keslake Report (2018), an independent review commissioned to look at the response of the emergency services to the Manchester Arena suicide bomb incident in 2017, praised the overall response of the services but also expressed concerns about coordination and communication between various agencies involved.

Another very prominent issue has been the potential impact of the organisational, financial and cultural challenges of emergency work on the health and well-being of its staff. Cases of stress, poor mental health and post-traumatic stress disorder (PTSD) are on the increase in the emergency services (Bentley & Levine, 2016; Granter et al., 2019; MIND, 2016; Sterud et al., 2011). Cases of harassment and bullying are also well known and feature significantly in many inspection reports (Care Quality Commission CQC, 2016; NHS Improvement, 2018). Recruitment of black and minority ethnic staff remains a challenge, and staff retention is also proving difficult (NAO, 2017). The risks of sickness absence, burnout, conflict and low morale are among the biggest challenges facing the emergency services worldwide (Bigham et al., 2014; Brady, 2015; Maguire et al., 2018; Wankhade, 2016).

In approaching this volume, we took a broad approach to providing a critical understanding of emergency services given the significant organisational and cultural differences between them. The field is further complicated if we include more specialised services such as the coastguard, air-sea and mountain rescue. The editors chose to focus on the three main ‘blue light’ services, namely the ambulance, police, and fire and rescue services, acknowledging that further research into other uniformed services is an area for future development. The chapters in the book take a descriptive, normative and reflexive approach in order to generate critical understandings of the emergency services landscape. We also include case studies to help the reader understand key issues across different policy and organisational settings.

This book is a part of Routledge’s ‘Critical Studies in Public Management’ book series. It is probably useful at this stage to explain what we mean by ‘critical’ in this context. Critical Management Studies (CMS) is a broad field of writing and teaching contributed to by scholars who, for various reasons, are dissatisfied with the kinds of ‘mainstream’ business and management knowledge and practice that tends to dominate large organisations, is taught in business schools and is circulated by corporate consultants. All too often the ‘solutions’, ‘toolkits’ or ‘gold standards’ provided by those who claim to best understand and practice management and leadership are simplistic and inadequate (Alvesson et al., 2009). CMS literature often highlights the importance of the context and structures in which ‘management’ takes place, drawing attention to the conflicts and contradictions between groups and perspectives in organisations that are often very pronounced. Our approach is to try to be as honest as possible about organisational problems and conflicts rather than to deny or erase them from the discussion. Emergency services organisations have largely been somewhat isolated from university teaching and research—until rather recently—and there are dangers associated with applying expert knowledge (which can include business consulting as well as research emanating from universities) to new and unfamiliar fields. Texts in this Routledge series aim to present, critique, explore and evaluate the emergent, existing and developing nature of public administration, management and governance in a wide range of settings. The principle aim of this volume is to establish a comprehensive understanding of the organisation and management of the emergency services while critically explaining the distinct organisational issues they face. Areas of debate that repeatedly resurface include the changing meanings of ‘professionalism’ in the workforce, the difficulties of leadership style and means of decision-making, problems around establishing safety and quality cultures, the changing identity of emergency services workers, and the critical importance of professional mental health and well-being.

This book is a timely and critical inquiry into the functioning of emergency services in a dynamic policy environment dictated by very considerable cuts in public service budgets. The continuing climate of austerity has forced emergency services organisations to explore new forms of management and service delivery in order to do ‘more for less’ while protecting the public from increased risk.

The chapters are written by academics, experts and practitioners of acknowledged scholarship in a language accessible and suitable to a range of audiences. The themes covered in the book will resonate with various stakeholders engaged in emergency services planning, organisation, service delivery, education and professional development. We hope that the book will be of interest to a wide audience including professionals, practitioners, policymakers and university students. We are confident that this book provides an in-depth, scholarly and comprehensive analysis of the changing landscape of emergency service provision and clearly addresses a gap in the market for a critical volume on the organisation and management of emergency services.

Outline of the Chapters

The book is divided into four parts. Part 1 provides an overview of the issues along with contextual background to the blue light field in general.

Chapter 2, “Emergency Services Architecture: JESIP and Interoperability” by Carl Daniels, clarifies the emergency services architecture in the UK, including the Joint Emergency Services Interoperability Programme (JESIP), which provides a framework for collaboration or interoperability between the emergency services. Drawing from his personal experience of working in the Cabinet Office and having the responsibility for the delivery of the JESIP programme, the author provides an historical context for the legislative and organisational set-up of the three services. Citing recent evidence on the experience and evaluation of the JESIP framework, the author cautions against the persistent failure to learn from past incidents for want of a clear mechanism with which to audit or monitor any progress taken against these incidents.

Chapter 3, “History of the UK Paramedic Profession” by Bob Fellows and Graham Harris, provides a fascinating account of the development of the paramedic profession in the UK. Ambulance services predate the creation of the NHS 70 years ago, but the real growth in the development of the paramedic profession took place in the 1970s once the ambulance services became part of the NHS family. As the leading lights in the development of the paramedic curriculum and establishment of the professional body for the service, the College of Paramedics, our authors review the key historical aspects from the 60s to the present day while charting key milestones. Implications for future direction of travel and the trajectory for further reforms are discussed and analysed.

Chapters 4–6 provide reflections from three senior practitioners, each representing one of the three blue light services and looking at a particular issue.

Chapter 4, “Personal Reflections on Fire and Rescue Service Incident Command” by Roy Wilsher, explores the role of incident command as a mainstay of an operational fire officer’s role. Reflecting on personal experiences, the author narrates his own perspective in dealing with a building fire, a terrorist attack, a depot fire and a rail crash in his fascinating career. He highlights the importance of some key issues, namely understanding operational principles, who is in charge, the incident command structure and how one fits into the operational plan. Drawing support from the JESIP principles, he demonstrates how incident command is vital to a multi-agency approach to tackling major and complex incidents.

Chapter 5, “Quo Vadis: Eight Possible Scenarios for Changes in the Ambulance Services” by Andy Newton, provides a critique of the current structure and condition of the ambulance services. It highlights unreformed organisational and managerial practices accompanied by fundamental shortcomings and variation in the performance of the NHS ambulance service in England. Questioning the ‘fitness for purpose’ of the organisational and management structures within the ambulance service in its current form, eight possible scenarios are outlined, each with possible issues and implications for the ambulance services and the broader blue light landscape.

In Chapter 6, “Galvanising Partnership and Communities to Tackle Domestic Violence and Abuse: Why Wicked Problems Have No Easy Solutions”, Linda Reid tackles the ‘wicked’ problem of domestic abuse—the characteristics of which are complexity, ambiguity and uncertainty—that requires a collective response. Detailing the scale of the problem and the effects it has for victims and families, the author, a former Detective Chief Inspector, argues a case for a more strategic response to this problem. She makes a strong plea for a future reform agenda based on a greater understanding of family violence and how it differs from other forms of violence and which addresses the needs of survivors from diverse communities.

Part 2 of this book covers theoretical perspectives and examines two key issues for emergency services. The controversial issues of police discretion and professionalisation are tackled in Chapter 7: “Beyond the Scope of Managerialism: Explaining the Organisational Invisibility of Police Work”. Written by Cliff Bacon, formerly a British police officer at the rank of Inspector, the chapter explores the ways in which policing has undergone significant change in the last ten years. While much of the practitioner and academic literature on police professionalisation suggests that British policing has gone through a successful and much-needed change programme, the chapter suggests that organisational, cultural and behavioural change in policing has actually been profoundly difficult. Based on interviews and observations within a UK police force, Bacon describes a demoralised and confused organisation, in which the rhetorical, operational and professional shifts from ‘fighting crime’ to ‘handling vulnerability’ have not matched the optimistic appraisals of much of the practitioner lit...