The Gloucestershire Health Overview and Scrutiny Committee met on 14 October 2025 to discuss the South Western Ambulance Service's decision to phase out fire-fighters as first responders, the NHS Gloucestershire Winter Plan, and to receive an update on maternity services in the county. The committee requested more information on community first responder figures and agreed to add items to their work plan.

South Western Ambulance Service (SWAST)

The committee scrutinised the South Western Ambulance Service NHS Foundation Trust's (SWAST) decision to phase out the use of fire-fighters as first responders in some medical emergencies. This matter was brought to the committee's attention following concerns that the decision was financially motivated and could negatively impact rural fire stations.

The committee had requested that John Martin, Chief Executive Officer of SWAST, attend the meeting, but instead Dr Matt Thomas, SWAST Executive Medical Director, Jane Whichello, SWAST Head of Volunteering and Community, and Steph Bonser, Head of Operations – Gloucestershire, were present to answer questions. Mark Preece, Gloucestershire Chief Fire Officer, also attended the meeting at the request of SWAST.

The committee were concerned about reports suggesting the decision may be driven by financial considerations, with the trust citing use of volunteer Community First Responders (CFRs) as being more cost effective. The Fire and Rescue Services Association has expressed concerns about the decision, arguing payments for medical co-responder services contribute to the viability of some rural fire stations. Fire co-responders are firefighters trained to respond to medical emergencies alongside ambulance crews.

SWAST stated that using volunteer CFRs, who are only paid expenses, is more financially sustainable, estimating savings of around £60 per call by using CFRs instead of fire co-responders, with total annual savings from the decision estimated to be around £280,000.

The Fire and Rescue Services Association has raised concerns that some rural fire stations may be at risk of closure due to the loss of revenue from medical co-responder calls. The union opposes the decision and has highlighted that co-responder calls often outnumber standard fire calls at some stations, impacting recruitment and retention of on-call firefighters.

SWAST defended its decision, emphasising that the change is part of their commitment to improve response times, especially for life-threatening emergencies. CFRs are volunteers trained to provide initial care in their communities until an ambulance arrives, often equipped with defibrillators and dispatched to various medical emergencies.

The committee requested details of Gloucestershire's Community First Responder (CFR) response figures from SWAST.

Gloucestershire Urgent and Emergency Care Winter Assurance Plan 2025-26

Eve Olivant, Director of System Flow NHS Gloucestershire, presented the NHS Gloucestershire Winter Plan 2025-26, which included proposals to ensure resilient winter planning and preparedness for Gloucestershire.

Gloucestershire Maternity Services

Matt Holdaway, from NHS Gloucestershire Hospitals Foundation Trust, provided an update on the delivery of maternity services in Gloucestershire. This included a review and subsequent publication of NHS Gloucestershire Neonatal and Maternal Mortality Reports on 8 September 2025, and the temporary closure of the Cheltenham Aveta Birth Centre and Stroud Maternity Unit.

Gloucestershire Integrated Care System (GICS) Performance Report

The committee received an update on the performance of the Gloucestershire Integrated Care System (GICS) against NHS constitutional and other agreed standards.

NHS Gloucestershire Integrated Care Board (ICB) Report

The committee received a report from the NHS Gloucestershire Integrated Care Board (ICB), known collectively as NHS Gloucestershire. The report included updates from Integrated Care System (ICS) partners responsible for overseeing the day-to-day commissioning and provision of NHS services in Gloucestershire. The report included updates from the respective Integrated Care System (ICS) Partners responsible for overseeing the day-to-day commissioning and provision of NHS services in Gloucestershire. The report also included an update on the NHS Gloucestershire 10-year plan.

The report was split into the following sections: -

• General NHS Gloucestershire Integrated Care Board (ICB) commissioner update.
• NHS Gloucestershire Integrated Care Board (ICB) commissioner update focussing on NHS primary care (general medical services (GP), community pharmacy, optometry, dentistry.
• NHS Provider updates from: Gloucestershire Health and Care NHS Foundation Trust (GHC); and Gloucestershire Hospitals NHS Foundation Trust (GHT) and Southwest Ambulance Service NHS Foundation Trust (SWAST).

Work Plan

The committee noted the dates of future meetings and suggested items to include on the committee work plan.