Emergency medical services in the United Kingdom

Crest of NHS ambulance services in England

In the UK, the majority of ambulance services are provided under the National Health Service through local ambulance 'trusts'. Each trust is specific to a county or area, and so the country is divided across a number of ambulance trusts, in a similar way to the British Police are.

In England there are thirteen ambulance 'trusts' with boundaries generally following those of the regional government offices. In Scotland, the Scottish Ambulance Service NHS trust serves the whole of Scotland.

The Ambulance Trusts

England

Following consultation, on 1 July 2006 the number of ambulance trusts fell from 29 to 13. The reduction can be seen as part of a trend dating back to 1974, when local authorities ceased to be providers of ambulance services. This round of reductions in the number of trusts originated in the June 2005 report "Taking healthcare to the Patient", authored by Peter Bradley, Chief Executive of the London Ambulance Service, for the Department of Health. Most of the new Trusts will follow government office regional boundaries. Exceptions include Staffordshire Ambulance Service (which has a temporary reprieve), the Isle of Wight (where provision will remain with the island's Primary Care Trust), South East Coast Ambulance Service, and South Central Ambulance Service. This has lead to a number of old trusts ceasing to exist.

East Midlands Ambulance Service NHS Trust - Based in Nottingham, covering Derby, Derbyshire, Nottingham, Nottinghamshire, Lincolnshire, North Lincolnshire, North East Lincolnshire, Leicestershire, Rutland and Northamptonshire
East of England Ambulance Service NHS Trust- Based in Norwich, covering Luton, Bedfordshire, Cambridgeshire, Hertfordshire, Norfolk, Suffolk, Peterborough, Southend-on-sea, Thurrock and Essex
Great Western Ambulance Service NHS Trust - Based in Chippenham, covering Bath and North East Somerset, Bristol, Gloucestershire, South Gloucestershire, North Somerset, Swindon and Wiltshire
Isle of Wight Primary Care Trust - Responsible for all primary care, including community and mental health services on the Isle of Wight
London Ambulance Service NHS Trust - Covering the entire Greater London area
North East Ambulance Service NHS Trust - Based in Newcastle-upon-Tyne, covering Darlington, Durham, Hartlepool, Middlesborough, Northumberland, Redcar & Cleveland, Stockton-on-Tees and Tyne & Wear
North West Ambulance Service NHS Trust - Based in Bolton, and covering Blackburn with Darwen, Blackpool, Cheshire, Cumbria, Greater Manchester, Lancashire and Merseyside
South Central Ambulance Service NHS Trust - Based in Wokingham, and covering Berkshire, Buckinghamshire, Hampshire, Milton Keynes, Oxfordshire, Portsmouth & Southampton
South East Coast Ambulance Service NHS Trust - Based in Lewes, and covering Brighton & Hove, Kent, Medway, Surrey, East Sussex and West Sussex
South Western Ambulance Service NHS Trust - Based in Exeter, covering Bournemouth, Cornwall, Devon, Dorset, Plymouth, Poole, Somerset and Torbay
Staffordshire Ambulance Service NHS Trust - Based in Stafford, covering Staffordshire and Stoke-on-Trent
West Midlands Ambulance Service NHS Trust - Based in Brierley Hill, covering Herefordshire, Shropshire, Telford & Wrekin, Warwickshire, West Midlands and Worcestershire
Yorkshire Ambulance Service NHS Trust - Based in Wakefield and covering East Riding of Yorkshire, Kingston-upon-Hull, North Yorkshire, South Yorkshire, West Yorkshire and York

Scotland

Two Mercedes Sprinter vehicles of the Scottish Ambulance Service

In Scotland, the Scottish Ambulance Service is a special trust funded directly by the Health Department of the Scottish Executive. In 2006 the service responded to over 520,000 emergency calls. Scotland also has Britain's only publicly funded Air Ambulance service, comprising of two Eurocopter EC 135 Helicopters (based in Glasgow & Inverness) and two Beech King Air 200c fixed-wing aircraft (based at Glasgow & Aberdeen). In the rest of the UK, air ambulances are funded by public and corporate donation.

Northern Ireland

The Northern Ireland Ambulance Service (NIAS) is the ambulance service that serves the whole of Northern Ireland. As with other ambulance services in the United Kingdom, it does not charge its patients directly for its services, but instead receives funding through general taxation. It responds to medical emergencies in Northern Ireland with the 270 plus ambulances at its disposal. The Service employs approximately 850 staff based across 32 stations & sub-stations, 4 Control Centres and a Regional Training Centre.

Wales

The Welsh Ambulance Service (also called the Welsh Ambulance Services NHS Trust or Ymddiriedolaeth GIG Gwasanaethau Ambiwlans Cymru) was established on April 1, 1998 and has 2,500 staff providing ambulance and related services to the 2.9 million residents of Wales.

Its headquarters is located at H.M.Stanley Hospital, St Asaph, Denbighshire and it is divided into three regions:

Central and West Region based at Ty Maes Y Gruffudd, Cefn Coed Hospital, Cockett, Swansea
North Region based at H.M.Stanley Hospital, St Asaph, Denbighshire
South-East Region based at Caerleon House, Mamhilad Park Estate, Pontypool

Measuring Performance

The performance of every Ambulance Trust is measured by the government, as part of a system called 'ORCON'. The Governments targets are to reach 75% of Category A (life threatening) calls within 8 minutes. A number of initiatives have been introduced to assist meeting these targets, including Rapid Responders and Community Responders.

Private Ambulance Services

St. John Ambulance emergency/multi-purpose ambulance.

Private ambulance services are becoming more common in the UK, along with the traditional voluntary sectors, such as the Red Cross and St. John Ambulance. However both the voluntary and private services tend to be concerned with PTS and medical cover at large events; it is uncommon to find an emergency being attended by a non-NHS ambulance, though this differs from trust to trust. More recently, private ambulance companies have been contracted to provide additional emergency crews and vehicles to supplement the core NHS staff. The relevant UK legislation applies to all ambulances with no discrimination as to who owns or operates them. The majority of UK Private Ambulance Services are members of the British Ambulance Association.

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