From Wikipedia, the free encyclopedia
Emergency medical services in the United Kingdom are almost all provided by one of the four National Health Services through local ambulance services, known in England and Wales as trusts. Each service in England is specific to a one or more local authority areas, and so the country is divided across a number of ambulance services, in a similar way to the British Police. In England there are twelve ambulance 'Trusts', with boundaries generally following those of the regional government offices. In Scotland, the Scottish Ambulance Service (a Special Health Board) serves the whole of Scotland, in Wales the Welsh Ambulance Service covers throughout the country and similarly in Northern Ireland the Northern Ireland Ambulance Service provides cover.
Remit of the Ambulance Services NHS ambulance services are required by law to respond to four types of requests for care, which are:
Ambulance Trusts and Services
EnglandFollowing 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 follow government office regional boundaries, exceptions to this are the Isle of Wight (where provision will remain with the Island's Primary Care Trust), and South East and South West England which are both split into two Trusts. This has led to a number of old trusts ceasing to exist. Staffordshire ambulance trust had a temporary reprieve, but became part of the West Midlands ambulance trust on 1st October 2007. The new Trust structure is as follows:
ScotlandThe Scottish Ambulance Service is a Special Health Board 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 Beechcraft B200C King Air fixed-wing aircraft (based at Glasgow & Aberdeen).
Northern IrelandThe Northern Ireland Ambulance Service (NIAS) is the ambulance service that serves the whole of Northern Ireland, and was established in 1995 by parliamentary order. 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 1044 staff based across 32 stations & sub-stations, 4 Control Centres and a Regional Training Centre.
WalesThe Welsh Ambulance Service NHS Trust (also called 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 :
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 - as decided by the computerised AMPDS (except the Berkshire Division of South Central Ambulance were CBD (Criterion Based Dispatch) is used), within 8 minutes. A number of initiatives have been introduced to assist meeting these targets, including Rapid Response Vehicles and Community First Responders.
Private Ambulance Services Private ambulance services are becoming more common in the UK, performing a number of roles, including providing medical cover at large events, either alongside, or instead of the voluntary sector providers. Some organisers use a private firm instead of a voluntary ambulance service because of wider availability during the week (sometimes difficult for a voluntary service to cover) or for a wider range of skills, such as provision of qualified Paramedics. The most common type of private ambulance provider is in the Patient Transport role, with many trusts and hospitals choosing to outsource this function to a private company, rather than use the NHS service, although the policy differs from trust to trust. It is uncommon to find an emergency (999 call) being attended by a private ambulance, although it has become more common with some of the PTS contracted ambulance companies providing 'second-tier' vehicles, capable of stretcher transport or attending non-life threatening emergencies. Recently, some companies have been contracted to provide additional emergency crews and vehicles to supplement the core NHS staff at busy times (such as New Year). The relevant UK legislation applies to all ambulances with no discrimination as to who owns or operates them. Another type of private ambulance are those operated by undertakers, who generally favour black vans, with the words private ambulance written discreetly on the vehicle.
Voluntary Ambulance Services The main voluntary ambulance providers are the British Red Cross and St. John Ambulance, who have both been providing emergency medical cover in the UK for many years, including active service in both World Wars (pre-dating the existence of any government organised service). The primary activity of both organisations in relation to ambulances, is the provision of ambulance cover at events, as an extension of their First aid contract. Depending on their agreement, or agreements, with their local ambulance service trust (known as a Memorandum of Understanding or MOU), they may treat and transport certain categories of patient to hospital, although for more serious incidents, such as cardiac arrest it is likely that they would be expected to summon the assistance of the statutory ambulance service.Both organisations also provide 'reserve' or 'support' cover to some, though not all, of the ambulance trusts (dependent on the local MOU), where ambulance crews from one of the organisations (who are usually volunteers, but in some instances may be paid staff) will attend 999, GP Urgent or PTS calls on behalf of the ambulance trust, with the organisation receiving recompense from the trust. This service is most often called on during major incidents, when there is a high level of staff absence or when there is an unusually high call volume, although in some areas, voluntary crews are regularly used to supplement full time trust cover.Both organisations have also provided cover for the public when unionised NHS ambulance trust staff have held strikes or walk outs.
Big White Taxi Service Big White Taxi Service is an informal term sometimes used by NHS ambulance staff in the United Kingdom to refer to the ambulances that they drive, or the service that they work for. This is mainly due to the fact that in recent years the ambulance services are persistently abused my members of the public who dial 999 for minor ailments and injuries that could be dealt with by the local General Practitioner.
This article is based on an article from Wikipedia, the free encyclopedia and is available under the terms of GNU Free Documentation License.
In the Wikipedia there is a list with all authors of this article available.