Emergency medical services in the United Kingdom
Emergency medical services in the United Kingdom provide emergency care to people with acute illness or injury and are predominantly provided free at the point of use by the four National Health Services (NHS) of England, Scotland, Wales, and Northern Ireland.
The Regional Ambulance Officers' Committee reported in 1979 that "There was considerable local variation in the quality of the service provided, particularly in relation to vehicles, staff and equipment.
The commissioners in each region are responsible for contracting with a suitable organisation to provide ambulance services within their geographical territory.
[8] The service was operated before reorganisation in 1974 by the St Andrews Ambulance Association under contract to the Secretary of State for Scotland.
[9] Due to the remote nature of many areas of Scotland compared to the other Home Nations, the Scottish Ambulance Service has Britain's only publicly funded air ambulance service, with two Airbus Helicopters H145 helicopters and two Beechcraft B200C King Air fixed-wing aircraft.
[24] A set of pre-triage questions identifies those patients in need of the fastest response and then further triaging occurs to decide the severity of the injury or illness.
Calls are categorised as such:[25] There are a range of clinical staff grades that work in emergency medical services in the UK.
The skills of a clinician working at technician or AAP level fall under grade F under the PHEM competency framework designed by the Royal College of Surgeons Edinburgh (Faculty of Pre-Hospital Care).
Paramedics have autonomous practice and a range of skills including intravenous cannulation and advanced airway placement.
Typically operating from an office-based environment, they develop new and innovative ways to help and care for patients and, like advanced paramedics, they provide clinical leadership and guidance to other clinicians.
CFRs are members of the public who have received training to answer ambulance 999 calls, and respond immediately within their local area, during their own time.
In more rural areas where ambulance responses can take longer, fire personnel have been trained in basic first aid and pain management.
They are trained in cardiopulmonary resuscitation (CPR), use of an automated external defibrillator (AED), oxygen and nitrous oxide.
There is a large market for private and voluntary ambulance services, with the sector being worth £800 million to the UK economy in 2012.
In 2017 the Commission warned all independent ambulance providers that during its inspections it had found "problems with the safety" of the care offered.
These firms are not regulated, and are not subject to the same checks as the registered providers, although they may operate similar vehicles, and offer near identical services.
In the past, voluntary organisations have also provided cover for the public when unionised NHS ambulance trust staff have taken industrial action.
[44] There are a number of smaller voluntary ambulance organisations, fulfilling specific purposes, such as Hatzalah who provide emergency medical services to the orthodox Jewish community in some cities.
The Welsh Assembly Government fully funds the clinical and road components of Emergency Medical Retrieval and Transfer Service (EMRTS Cymru), with helicopter transfer provided in partnership with the Wales Air Ambulance and Children's Wales Air Ambulance charities.
Private air ambulances also carry out patient transfer or medical repatriation back to the United Kingdom.
All emergency medical services in the UK are subject to a range of legal and regulatory requirements, and in many cases are also monitored for performance.
This framework is largely statutory in nature, being mandated by government through a range of primary and secondary legislation.
The CQC replaced the previous regulator of England's NHS ambulance services, the Healthcare Commission, with its remit expanded to include all private and voluntary providers.
Commonly called 'ORCON',[52] after the consultancy used to formulate them, the New Ambulance Performance Standards (NAPS) were developed in the 1990s, and merged into the Clinical Quality Indicators used subsequently.
In March 2022 average waits for an ambulance for stroke and heart attack patients (category 2) reached as long as two hours in some regions.
"[54] Ambulance vehicles responding to emergencies (blue lights and sirens) are exempt from speed limits under Section 87 of the Road Traffic Regulation Act 1984.
Trust staff are employed to check against the 999 incident logging information for the date and time of the ticket whether the vehicle was on an emergency call.
