Extension of defibrillator grant scheme The government will extend the defibrillator grant scheme with a further 1 million. George Osborne, Chancellor of the Exchequer, March 2016
Out of hospital cardiac arrest (OHCA) survival rates in England are low. Less than one in 10 people who suffer an OHCA survive to leave hospital. Countries which are international leaders in this field boast up to 25 per cent survival rates in some areas 1. If England could reach the same standard we could save nearly 5,000 lives each year 2. The Cardiovascular Disease Outcomes Strategy 2013 also highlighted that the wider availability of defibrillators could save additional lives. The internationally recognised method to improve OHCA survival rates is called the chain of survival. This project aims to improve links two and three in the chain of survival. That is: someone performing effective CPR quickly; and early defibrillation. Public access defibrillators (PADs) can be found in public spaces such as shopping centres, gyms, train stations, parks or village halls. PADs are simple and safe and can be used by anyone on a person who is in cardiac arrest no training is needed as the machine itself gives clear, spoken instructions. Many also have pictures, flashing lights and instructions on screen for people who have hearing impairments. Once in position, the defibrillator detects the heart's rhythm. It won't deliver a shock unless one is needed. In his budget of March 2015 the Chancellor of the Exchequer set aside 1m to increase the accessibility and availability of PADs in England. This funding was passed to the Department of Health and subsequently awarded to the British Heart Foundation (BHF) to allocate on the Department s behalf. Through this project 700 award packages were made to 525 organisations across England. In March 2016 an additional 1m was allocated to continue the project. The BHF successfully applied to the Department of Health to administer the delivery of this second phase of funding. 1 Lindner TW, Soreide E, Nilsen OB, Torunn MW, Lossius HM. Good outcome in every fourth resuscitation attempt is achievable-an Utstein template report from the Stavanger region. Resuscitation 2011; 82:1508-13. 2 BHF calculation comparing current OHCA survival rates in UK with survival rates in parts of Norway.
The project board was reconvened which comprised members from NHS England, the Resuscitation Council (UK), Association of Ambulance Chief Executives, Department of Health, Arrhythmia Alliance and BHF. The board was responsible for governing the management of the project and met every two months to monitor progress. On 11 th November the funding stream opened through an online application form. Community groups, organisations and businesses were encouraged to apply for one of three award packages: 1. A free public access defibrillator, CPR training kit and a cabinet 2. A free public access defibrillator, CPR training kit 3. A free cabinet to improve accessibility to a current defibrillator The project board decided that success criteria for the funding were to remain the same as in the previous round. Successful applicants were required to demonstrate: That the defibrillator will be accessible to the public, preferably 24/7 A commitment to train the local community in CPR A clear need for the device such as high footfall or a rural location The funding was available in England only. Each application was approved by the regional NHS ambulance service. They provided expert advice to ensure the funding was allocated in the most effective way. It also created an awareness of the defibrillator placement so that devices could be registered on their computer aided dispatch systems. Since the previous round in 2015 the BHF has seen a sustained demand for defibrillator funding. Good national and regional media coverage promoted the funding and saw a high number of applications received within the first weeks. Given the high demand for funding previously, we predicted that the allocated amount would be spent quickly. Indeed, most of the funding was awarded within four months of the project launch date. Funding was allocated to applicants from across England. A map of the geographical spread of applications can be found in appendix A. Successful applicants included parish councils, sports clubs, community centres, local businesses and community first responder groups. The majority of applicants requested the full package; a defibrillator, CPR kit and cabinet (92%). A roughly equal number of applicants requested a defibrillator and CPR kit (4%) and a cabinet only (3.5%). Of the 708 applications submitted for review 21% were rejected against criteria set and agreed by the project board. The most common reason for rejection was that the application stated that the defibrillator wouldn t be frequently or easily available to the public allowing 24/7 access or there was no commitment to CPR training in the community.
Expenditure 1,200,000 1,000,000 800,000 600,000 400,000 Target Spend 200,000 0 November December January February March Figure 1. Rate of expenditure against target The project made 504 awards, providing 682 award packages to successful applicants. Type of award package Cost Awards Units Defibrillator, CPR kit and cabinet 925,991.20 464 636 Defibrillator and CPR kit 24,269.60 22 23 Cabinet only 11,160.00 18 23 Total 961,420.80 504 682 Over 95 per cent of the 1m funding was spend on award packages. Cost type Cost Percentage Costs (staff and grant tracker) 43,159.00 4% CPR kits 144,875.00 14% Defibrillators and cabinets 813,190.80 81% Total 1,001,224.80 100%
The funding provided around 700 award packages in both phases of the project. In 2017 there was a small increase in the cost of equipment which meant slightly fewer awards could be made than in the previous year. Year Awards Units 2016 525 700 2017 504 682 The application process was improved in 2017 as lessons had been learnt from the previous year. Closer monitoring of the project meant the programme was closed to applicants in good time and fewer people were disappointed to not receive funding. Demand for funding for public access defibrillators and CPR training kits was high and the 1 million was easily allocated. Continued interest in the funding programme, even after it has closed, proves that there is an appetite within communities to provide life saving training and equipment. A survey will be carried out later in September 2017 to gather data on the instances of defibrillator use and regularity of CPR training in these communities. This will be published in an additional report. We thank the Treasury for this additional funding which has provided life saving equipment to 682 new locations across England.
Map of the geographical spread of awards made through the second phase of the Department of Health funding programme.