Features Editor Lorna King reports on how Surrey Fire and Rescue Service has gone to great lengths to support one of its firefighters with a bone anchored hearing aid and looks at what this means for recruitment going forward
Following the most recent HMICFRS State of Fire reports in December 2021, it is a pleasure to report on current projects that are actively working to build on the areas that require improvement. Surrey Fire and Rescue Service (SFRS) was reported as requiring improvement in how well it looks after its people; more specifically that steps need to be taken to remove inequality and improve fairness, diversity and inclusion at all levels within the service. At the time the inspections were taking place, a new employee within the Health and Safety department was implementing her skills and knowledge which would lead to a ground-breaking project that has just taken place among SFRSs newest batch of trainee on-call firefighters.
Health and Safety Star
Lucie Atwood started working for Surrey County Council as lead Health and Safety Advisor to Surrey’s fire service in April 2021, and she has spent the past year implementing her knowledge and experience to promote a health and safety culture and develop processes, procedures and strategic plans to improve conditions and keep everyone safe. Previously, Lucie worked as a Health and Safety Officer at Heathrow Airport. She says: “It’s been a challenge coming to support a county-based service because it’s so different from the private sector. It’s taken me a while to get my head around that; there aren’t endless budgets, and there are a lot more risks.”
Lucie describes herself as being passionate about health and safety. Her career developed from initially spending hours behind a desk reporting on statistics, to wanting to find out what was going on behind the numbers and dropping back down the career ladder to start her hands-on career as a health and safety officer at Heathrow, where she completed all the required training to progress to the lead role she finds herself in today at SFRS. She says: “I’m the kind of person that bounces out of bed every morning because there’s a new challenge every day. One day we might be doing risk assessments for an event we’re putting on to promote the service; another day we might be working with vulnerable children who have needs, which is amazing because people only think of firefighters putting out fires and rescuing people from cars, but there is some phenomenal work that goes on in the communities, which I wasn’t aware of before I joined SFRS. I am so proud to be a part of that.”
Earlier this year, Lucie was on a routine visit to a training centre where a group of trainee on-call firefighters were already well into their training. One of the instructors mentioned to her that one of the recruits wears a bone anchored hearing aid system (BAHA), and they had some concerns about his fire behavioural training which was due to take place within a few weeks. For those of you, like me, who are not familiar with a BAHA, it is a hearing system that works best for people with single-sided deafness. One part of the system – a titanium implant – is surgically inserted into the mastoid bone behind the ear and has a small abutment – like a popper – that sticks out through the skin as an attachment for the external sound conducting part of the device. When Lucie learned this information from the instructor, she immediately set up a meeting with the recruit.
Dave Newman is an engineer for the railway service who saw an advert for on-call firefighters asking: Why not you? Dave described himself to me as “no spring chicken anymore,” and is probably twice the age of some of the other new recruits, but he is fit and healthy and keen on supporting his local community, so he thought: “Why not me?” Dave has been deaf in his left ear since he was very young and has worn a BAHA for more than ten years now, which allows him to hear effectively out of both ears when he is wearing the sound conducting attachment.
Dave says he does not feel disabled, especially considering the ultra-marathons, cycling and kayaking that he is so fond of taking part in, but he still ticked the box on the application form that asks the question. He says: “I looked at the Discrimination Act and it says single-sided deafness is a disability so I put it down, being open and honest; I didn’t know if there were any half-deaf firefighters. I then went through all the various modules to be accepted as a trainee, and at the last minute I failed the standard hearing test, so I was a little bit disappointed.”
Because Dave will not be allowed to wear the conducting half of the BAHA when operational, he had to take the test without being able to hear through his left ear. The standard test consists of various sounds and tones that are meant to be heard in each individual ear, which is why he did not pass. Fortunately, SFRS sent Dave down to Lewes in East Sussex to take part in a functional hearing test, which involves wearing headphones and having words spoken to you whilst also listening to the distraction of intense background noise, such as might be experienced on a fire ground. Dave was asked to repeat the words that were being spoken and, because he has perfect hearing in his right ear, he passed this test easily and was cleared for training.
Hearing aside, the nature of the BAHA being a metal object that is attached to the skull and partly protruding through the skin asks many more questions about operational risks – most obviously around heat conduction and contamination, and it was the impending fire behavioural training exercise that prompted the instructors to seek Lucie’s advice. She says: “I was a bit anxious at first because people think that health and safety are there to put a stop to everything and put barriers in place. For me, it was so important that I built a relationship immediately with Dave; I needed him to trust me.”
Lucie wanted Dave to trust that she would assess the risks effectively and find a way of enabling Dave to do his job safely, but she had much to do. She says: “The disadvantage that we had was that his training had already started by the time I met him, so we’ve learnt from that.” Surrey FRS are now updating their application and recruitment process by enabling health and safety to become pro-active in putting risk assessments in place before candidates start training. But in Dave’s case, Lucie only had a matter of weeks to ensure he could safely enter the firehouse for the training module.
The next logical step for Lucie was to research firefighters who wear BAHAs, but she could not find a single case study anywhere in the world, let alone the UK. It soon transpired that Dave is the first firefighter who wears BAHA, which made the task of mitigating any potential hazards a much lengthier process than expected. Lucie contacted a number of hearing organisations for advice, including Cochlea, who said they would pass a written information request on to their clinical team, so Lucie asked: “I have a firefighter who’s going to be exposed to extreme heat of up to 300 degrees; what are the consequences if his abutment heats up?” The obvious answer is that it is going to cause pain, but Lucie did not know specifically what would happen with the titanium and Dave’s skin and skull. Cochlea’s clinical experts responded that Dave would be in extreme discomfort, but they had no case studies. They had never tested the BAHA in extreme temperatures, so they could not offer any concrete advice, only that he should protect the abutment as much as possible.
Lucie returned to the training centre and asked the instructors exactly what Dave would have to do in his training, and they all agreed that the biggest risks to Dave would be heat conduction and contamination. Lucie says: “So at this point we only had three to four weeks to put control measures in place, carry out the fire behavioural training safely, get through it and pass!”
Lucie went straight to the research and development team who look after all the specialist PPE. She says: “They met with Dave and made sure that his helmet didn’t obstruct the abutment or sit uncomfortably against it in any way, and that was all fine. Then we looked at grades of fire hoods because that is what’s really going to protect him from the heat, and they did a lot of research with our PPE provider to make sure that we had the best level of heat and contamination protection possible.”
Lucie was satisfied that Dave had the best protection possible from the fire hood and helmet, because they protect our firefighters from the same hazards every day, the only difference being that no other firefighter has metal protruding from their head. Firefighters are not allowed to wear any jewellery when operational because it will conduct heat and it will burn, so Lucie still had to mitigate this additional risk for Dave.
Meanwhile, Dave himself was not at all concerned about going into the firehouse with his abutment. He even asked Lucie to use him as a guinea pig and just put him in there; he would let her know if it hurt! But obviously that was not an option, as Lucie said to him: “We have a legal duty to protect and look after you. We need to be confident that you are as safe as you can be during your training and also in the future when you are operational.” Lucie is quite sure that Dave must have been a little frustrated with her diligence and attention to every little detail.
Lucie became increasingly anxious at this point, and spent sleepless nights researching how best to protect the abutment. She had the full support of her managers but could not find any clinical or professional help or advice on the matter. But inspiration finally came from a conversation with Area Commander Mick Thompson when he suggested that silicon oven gloves protect our hands from the heat, so why not design a silicon plug to protect the abutment?
Following a UK-wide search for a rubber company that would be willing to work on such a project, Lucie found Butser Rubber right on her own doorstep. The lady she spoke to, by coincidence, also wore a BAHA and was very keen to be involved with the project. So, at the time of writing, Dave is having a bespoke silicon plug designed to cover his abutment that will protect him from heat and contamination. But the process would take three weeks just to make the tools needed for the work, which meant Lucie needed to find an interim solution for the fire behavioural training. With silicon in mind, Lucie and her team used a silicon patch and silicon tape to cover Dave’s abutment. She says: “I’m not going to lie, it felt a little Heath Robinson! I wasn’t very proud of it at the time, but it worked!”
Lucie attended the fire behavioural training to observe the outcome of all her hard work. She says: “I was so nervous! We could either be celebrating a UK first and inspiring people with BAHAs and other conditions around the UK to join the FRS, or we could be in IOSH magazine being found liable for harming somebody at work.”
The instructors talked Lucie through everything that was going to happen. There were additional control measures in place such as cooling mechanisms and constant monitoring of the temperature to make sure it did not go above 300 degree. When Dave went into the firehouse, Lucie said she felt like she was waving her child into school for the first time: “I was petrified! I kept checking the time and talking to the instructors asking, what’s happening now? What’s the temperature?”
Dave was inside for 90 seconds the first time. He came out, handed back the hose and turned to face Lucie with both thumbs up. Lucie says: “I was just so happy for him, and I was so relieved. It was an amazing moment for Dave and a massive relief for us.”
When I spoke to Dave about the experience he reported that he had not been at all worried about the outcome. He was fully confident that his PPE would be protection enough and with the additional make-shift silicon cover for his abutment, he had no concerns about the risks. He says of any pain or discomfort: “No, not through the abutment, but whenever you go through the hot-house and you’re blinded by smoke and fire, it’s an interesting experience! But as far as the abutment was concerned, absolutely no problems at all. SFRS were brilliant. The training officers were ensuring I was monitored and looked after, and it was very refreshing to have somebody like Lucie on board, she’s been fantastic.”
Dave entered the firehouse three more times that day with the same results and he passed the fire behavioural training. Lucie was elated and said that even if the make-shift silicon patch had not worked, she would have returned to her research and found another solution until the professionally made plug was ready.
Dave explained to me that this work goes further than just him and his hearing aid. He has spoken with other recruits on his team who have dyslexia, and they have been offered all the learning support they need to learn and train effectively. He says: “Having worked for other companies, this is one element that Surrey Fire and Rescue Service are doing exceptionally well.”
Going forward, the National Fire Chiefs Council are going to create a case study of this project for their recruitment drive to inspire many more people to apply. Lucie says: “A few years ago, Dave would not have met the criteria. He would not have been able to fulfil his ambition to become a firefighter. There are so many people out there who have disabilities and have been told, no you can’t; you don’t fit this; you’re not able to. If there is a message to come out of this it’s this: don’t let people tell you that you can’t. Give it a go! With an open mind-set you can achieve anything, you just need to think outside the box sometimes.”
As previously mentioned, SFRS are reviewing their application process in response to this project. One of the questions on the original form asked if you are disabled with only ‘yes’ or ‘no’ options for an answer, but the form is now being designed to allow applicants to give more detailed information about their individual circumstances. Health and safety can then assess the applications much earlier in the process and ensure a more inclusive approach to risk assessment is followed.
Lucie has this final message for other FRSs: “This is all about a collaborative approach for FRSs. I was desperate for someone to offer some advice about whether it would be safe to put Dave in this situation, so if I can offer information, support or advice on how we have managed to do this then please get in touch.”
Lucie can be contacted directly at: Lucie.Attwood@surreycc.gov.uk