Automated External Defibrillators: Public Access

(Limited Text - Ministerial Extracts only)

Thursday 18th November 2021 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. I thank the hon. Member for Strangford (Jim Shannon) for securing this debate, and also for his passion and dedication in championing this cause. He will know of my interest in the subject before I became a Minister. If anyone can get these changes through, it will be him. I thank him for that. I also thank my hon. Friend the Member for Sedgefield (Paul Howell), who is the No. 2 in these proceedings.

This is such an important issue. Twelve young people a week in this country die from sudden cardiac arrest. As we have heard, there are 30,000 cardiac arrests a year. This is not an insignificant issue. Behind every single one of those people is a family and a community. As we heard from my hon. Friend the Member for Newcastle-under-Lyme (Aaron Bell) when he spoke of the tragic news of Sam Benson, the impact will last forever.

I reassure hon. Members that the treatment and prevention of cardiovascular disease and access to defibrillators is a priority for the Government. There has been some significant progress in the last two years. We know that about 90% of sudden cardiac arrests are fatal, but if a defibrillator is used in the first three to five minutes, survival can be around 50% to 70%. Again, it makes a significant difference if someone has a sudden cardiac arrest out of hospital.

The Government are supporting a number of measures and working with key stakeholders. I want to highlight some of the work being done to ensure the best possible access to defibrillators and that people feel confident to use them. Hon. Members may be aware that “The NHS Long Term Plan”, published in January 2019, includes a section on cardiovascular disease and defibrillators. The NHS has committed to developing a national network of first responders and access to automated external defibrillators, which will save roughly 4,000 lives a year by 2028. It is high on our agenda, but it is important that we deliver on it now. I think that is the key message from the hon. Member for Strangford, because the chance of survival from a cardiac arrest occurring out of hospital doubles if someone received CPR or defibrillation, so it makes a difference.

I will highlight some of the work that has been done, notably with the British Heart Foundation, which a number of Members have mentioned today. We have worked with the British Heart Foundation to put in place The Circuit, a national network providing evidence of where defibs are in all our communities. If someone calls 999 or contacts the emergency services, ambulance services can identify for them where their nearest defibrillator is.

The Circuit is now live and covers 10 ambulance services, including Scotland, Wales and Northern Ireland. It is working with the two remaining ambulance services, London and South East Coast ambulance services, to get them on to the system. We expect that to happen in the first half of next year. That means all our ambulance services will be able to direct people to the nearest defibrillator ahead of the ambulance attending to the person in need. Currently, 33,237 defibrillators are registered with the eight live ambulance services in England, so we now have a network that we can direct people to.

Although defibrillators do not yet need to be legally registered with the British Heart Foundation, we are working with manufacturers, stakeholders and partners to promote the registration of all defibrillators. My ask of colleagues here this afternoon and anyone who is watching is please to register a defibrillator with the British Heart Foundation. Please do check it is on the register, because it is crucial that the ambulance service can give directions to the nearest defibrillator if someone has a cardiac arrest. We can also ensure that existing defibrillators are managed and looked after and that the register is a live register. We all know that things happen in our communities—defibrillators can be vandalised, or a building can be taken out of use and the defibrillator goes with it. It is important that this is a live piece of work.

The NHS is also working with St John Ambulance. Again, a number of Members have mentioned its excellent work to increase the importance of CPR. It is true that although people do not need training in order to use a defibrillator—my hon. Friend the Member for Sedgefield put it well—it is about educating them so that they are confident in using them. I want to reinforce the message that no harm can be done with a defibrillator; simply stick the stickers to someone’s chest, turn the machine on, and it will tell us exactly what to do. In some cases, it will not be appropriate, in which case it will say exactly what will happen. It is a valuable piece of kit; almost idiot-proof, in that you cannot get it wrong. We want to give the public the absolute confidence that if they come across a defibrillator, they should feel free to use it, but that overall CPR training is also vital.

[Paul Howell]

Just to clarify the point about a defibrillator telling someone if it will not work, it actually will not work as a machine if it is used in the wrong way.

[Maria Caulfield]

My hon. Friend is absolutely right. That gives people added reassurance that they can do no harm, because the machine is totally in control.

We are also using technology, and there are some exciting apps—the hon. Member for Delyn (Rob Roberts) talked about having apps. Some mobile technology works with the NHS to help people play a role in becoming first responders. If people know how to do CPR—the hon. Member for Gordon (Richard Thomson) seems to be trained up in that—I encourage them to use the GoodSAM app, which allows members of the public who can do CPR and feel confident about using a defibrillator to receive alerts. If someone collapses in the local area, they will get an alert on their phone, which will tell them where the nearest defibrillator and the person who needs help are. It integrates with ambulance dispatch systems and has a crowd-sourced map of defibrillators, including those in vehicles. The platform now has more than 19,000 volunteers and partnerships with 80 organisations, including the NHS and ambulance trusts.

We are also reassured that the British Heart Foundation is developing an app. It will link to The Circuit and show people where their nearest defibrillator is. Technology is being used to help communities to help themselves.

[Rob Roberts]

On a different but related subject, in this place and in the main Chamber, the Pensions Minister, our hon. Friend the Member for Hexham (Guy Opperman), has talked about how he is working with the BBC and other broadcasters to do some kind of nationwide campaign to raise awareness of pension credit. Is that something the Department of Health and Social Care could work on for this subject?

[Maria Caulfield]

The hon. Gentleman makes an excellent point. Some of the developments have been over the past two years and, during covid, they have not necessarily had the publicity they deserve. We all have a role in promoting initiatives. There is work to be done so that people are aware of the apps and initiatives.

In our communities, defibrillators are available at airports, shopping centres, train stations and community centres. School-age children are at low risk, but it can still happen, as I said earlier. As a result, and thanks to the work of the Oliver King Foundation, huge pressure was placed on the Department for Education, so defibs are now available for schools and other education providers across the UK to purchase through the NHS supply chain. They can get those important pieces of equipment at reduced cost. As of January this year, more than 5,000 defibs had been purchased through the defibrillators for schools programme, so we are getting defibs out into our schools.

Since May 2019, the Government have required all new and refurbished schools in Department for Education school building programmes to have at least one defib in their buildings. We are pushing that out for new and refurbished schools, but that does not cover all schools in the network.

[Graham Stuart (Beverley and Holderness) (Con)]

To get defibrillators into the community, I established the Community Access Defibrillators for East Yorkshire campaign. I formed a committee and worked with the highly estimable Warren Bostock of the Yorkshire ambulance service, challenging him with the question: “What would a complete network look like?” His initial response was, “How long is a piece of string?”, but he came up with rules and a map showing all the communities that did and did not have defibrillators—60-plus did not—and over the past two or three years we have been working on that. We now have that figure down to fewer than 20 and hope that in the next 12 months we will have it down to zero. Colleagues might be interested to hear the history of that, to get a template that can be applied elsewhere. If we have clarity about where we ought to have defibrillators, we can ensure that we have them there. In parallel, if we work on awareness and confidence, as discussed, we could save even more than the 4,000 lives that the Minister so rightly highlighted earlier.

[Maria Caulfield]

I thank my hon. Friend for his hard work in his community. There are some excellent examples of where defibrillators have been rolled out. Many communities now have them, but if we have them mandated in public buildings, we can address the gaps outside them with excellent work such as my hon. Friend’s. That is the point that the hon. Member for Strangford is making with his forthcoming private Member’s Bill.

We are also providing training, and CPR training is so important. From September of last year, all state-funded schools have been required to teach first aid as part of the new subject of health education, which was introduced alongside relationship education. Primary school children are taught basic first aid now, and pupils in secondary schools are taught further aid, such as administering CPR and the purpose of defibrillators, so hopefully the next generation will be far more confident than perhaps we are in performing CPR and using defibrillators.

Separately, Sport England has announced that it is working with the Football Foundation in support of the Premier League initiative to put £3 million into providing defibs for grassroots football clubs. A number of people mentioned Christian Eriksen. We also had the case of Fabrice Muamba in 2012. Very often in sports facilities, these are crucial pieces of kit that can save lives. We heard about the supporter at Newcastle who also benefited.

This is an incredibly important issue. I want to reassure the hon. Member for Strangford and all hon. Members here today that we absolutely take it seriously. It is an absolute priority to improve the lives and healthcare outcomes of people who suffer cardiac arrest outside a hospital. I hope that the work in the last two years, although perhaps it is not as well known, as the hon. Member for Delyn points out, shows that we are making key progress in some of the really important areas. But there are gaps in provision. We have heard that what matters is not just where defibs go but that they are outside, with 24-hour access. There are tricky issues such as whether to have a code on a defib. All these things need to be nailed down. I am happy to work with colleagues. This work does not involve just the Department of Health and Social Care; some of it needs the Department for Levelling Up, Housing and Communities, the Department for Education, or the Department for Digital, Culture, Media and Sport. It is a cross-Government approach, and I am happy to work with Members to bridge any gaps that still exist.