Automated External Defibrillators: Public Access

Paul Howell Excerpts

Thursday 18th November 2021 Westminster Hall

[Paul Howell (Sedgefield) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. It has been an absolute pleasure to support the hon. Member for Strangford (Jim Shannon) in his endeavours. I thank him for his kind comments, and thank all other colleagues who are supporting the debate.

The importance of access to AEDs in a life-threatening medical emergency cannot be disputed. In addition to the high-profile and extremely upsetting events at Euro 2020 when Christian Erikson suffered his cardiac arrest, there was a similar event in Newcastle’s football ground on TV the other week, when an 80-year-old gentleman collapsed. Fortunately, there was an AED to help that situation too.

Is the Minister aware that in the UK, nearly 300 school children die of sudden cardiac arrest every year? The emotional statements of colleagues on the specifics mentioned only further endorse the need for something to happen on these proposals. An obvious start for this is our public buildings, such as schools, libraries, and local government buildings, to have access to AEDs.

Unfortunately, without on-site and urgent access to defibrillation, the vast majority of cardiac arrests will be fatal. At present, there are just not enough AEDs accessible to people. As has already been said, for each minute that passes following a cardiac arrest without CPR, the survival rate drops by 20%.

Given that the average response time for emergency services to a cardiac arrest is just under seven minutes, we cannot rely purely on our emergency services—however good they are—to fill the gap. If we want to save as many lives as possible, we need as many defibrillators in the community as possible. That is particularly true in rural areas, like most of my Sedgefield constituency, where call-out times are naturally longer, simply because of the distances the emergency services will have to travel. Prompt, community access to defibrillators can dramatically help improve the chances of survival. Indeed, it would help to level up between urban and rural communities.

The AED Bill would make an important legislative change, helping to build a better, safer environment for people in the community and increasing the cardiac arrest survival rate. As a nation, we have the opportunity to be world leaders in ensuring that we all have access to defibrillation. We should we pass this legislation into law and be the first country to mandate that new public buildings provide access to a defibrillator.

I am aware that the Department for Education offers reduced-cost defibrillators through NHS Supply Chain’s Defibs4Schools programme, which in itself shows that it values the provision. Could the Minister encourage it to go further, particularly with new school builds, and also push other Departments to follow suit? It is clear that it would be challenging to ensure that all current public buildings have AEDs, but it is something the Minister should look at trying to mandate. I strongly encourage her to push her Department—and indeed other ministerial colleagues—to look for cross-departmental engagement to introduce that compulsion for new public buildings, whether they are for local government, health, education, or other purposes.

As has been mentioned, mandated AEDs on public buildings will work best if they are comprehensively mapped so members of the public could be directed to their nearest location. On that, I do like the earlier proposal for an app-driven solution. The proposed Bill would take an important step towards ensuring that AEDs can be readily located wherever they are needed. In addition to ensuring that AEDs are mapped, we need to ensure that we have a system in which people are clear about whose responsibility it is to maintain them, particularly if they are in the public domain.

We all know—we have heard many representations today—that excellent work has done up and down the country by volunteers who understand the importance of AED access to their communities. As already mentioned, in Newton Aycliffe, for example, David Sutton-Lloyd has worked tirelessly to ensure that 32 AEDs are now available to residents. However, I believe that we, as the legislature and elected representatives, have a duty to ensure that all new buildings are fitted with AEDs, and that the work of volunteers is to complement that, rather than provide the initial provision.

Again, this was mentioned earlier, but I have been educated on the use of defibrillators. Mr Sutton-Lloyd is incredibly active in running training courses. I am not sure “training” is the right word. It is not training, it is education. Unless we know about these pieces of kit, we could get concerned that the electricity could cause problems. As has been mentioned, it cannot do that; the machines are good. The machine makes the decision and it is not possible to use a defibrillator on somebody if it is not the right thing to do. I encourage the Minister to promote campaigns to educate the public around this, so that when defibrillators are necessary people are confident and not worried about using them.

To summarise, the provision of AEDs, in and around our communities, is a real aid to saving lives at minimal cost. The opportunity to make them compulsory in public buildings, at least initially in new-build public buildings, is surely a no-brainer. How could the Minister consider otherwise?

[Mr Philip Hollobone (in the Chair)]

We now come to the Front-Bench speeches. Apologies to the Scottish National party spokesman for being so keen to get him in earlier, but his moment has now come.

--- Later in debate ---

[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.