Knowledge

NHS ambulance services

Source πŸ“

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four minutes to assess the urgency of the call before the clock starts. The target for the most seriously ill patients is now seven minutes. The 'clock' stops when the most appropriate response, not necessarily the first, arrives. There are condition-specific measures which will track time from 999 call to hospital treatment for heart attacks and strokes. 90% of eligible heart attack patients should receive definitive treatment (balloon inflation during angioplasty at a specialist heart attack centre) within 150 minutes by 2022. 90% of stroke patients should also receive appropriate management (thrombolysis for those who require it, and first
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minutes 15s. Average response time for category two calls, still classified as emergencies and including heart attacks and strokes, was 41 minutes 4s against a target of 18 minutes. In October 2021 there were around 28,900 ambulance handovers lasting longer than an hour. This was almost four times the 7,772 hour-long handovers recorded in October 2020. In April one patient waited 24 hours in an ambulance - thought to be the longest ever recorded. 11,000 patients waited more than three hours for handover, with 7,000 of them taking more than four hours and 4,000 over five hours.
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transport is required a suitable vehicle should arrive on the scene within 19 minutes. The number of these rose from 2.5 million in 2011/12 to just under 3.4 million in 2015/16, but response times fell steadily and the 75% target was not met after 2013. Green 1 required a vehicle within 20 minutes, Green 2 within 30 minutes. Green 3 required telephone assessment within 20 minutes and Green 4 telephone assessment within 60 minutes. These targets are only recommended.
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found that the rate of sickness of ambulance staff was the highest in the NHS - 20 days per person. Use of information technology was advancing very slowly. 25% of ambulances, of which there were 32 different types, were more than seven years old. There were large differences in costs and performance
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tendered a contract worth up to Β£30m for β€œauxiliary ambulance services”. This is worth Β£7.5m annually and is initially an eight-month contract. It covers both emergency and non-emergency ambulance crews β€œwith the capacity to respond to callouts across categories one to four”. Currently, England's
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put huge pressure on ambulance services. In July 2021 there were 81,685 category one incidents, up 32% in July 2019, and up 16% on the previous high in December 2019. Response time performance for these calls slumped to 8 minutes 33s, against a target of 7 minutes, with a tenth taking more than 15
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Category A (Red 1 and Red 2) were classed as life-threatening and the national standard sets out that a vehicle should reach the scene within eight minutes for 75% of these calls . Red 1 calls are for patients who have suffered cardiac arrest or stopped breathing and require two vehicles. If onward
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for all other stroke patients) within 180 minutes of making a 999 call. For other emergencies the target is for 90% to be seen in 40 minutes. Urgent or non-urgent calls should expect an average response time of 120 and 180 minutes respectively. Extensive trials have shown that fewer patients are
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In July 2017 a new set of performance targets for the ambulance service were announced after a trial across four different ambulance trusts, looking at more than 1 million patients overseen by Sheffield University. These are to apply to all 999 calls for the first time. Call handlers will be given
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11 July 2022 was said to be the worst night on record for ambulance services in England, with more than half of some trusts ambulance crews queued outside hospitals in very hot weather. There were more than 85,000 category one ambulance callouts in July - the highest ever recorded. Category one
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There was considerable local variation in the quality of the service provided, particularly in relation to vehicles, staff and equipment. Most Services were administered by Local Authorities through their Medical Officer of Health and his Ambulance Officer, a few were under the aegis of the Fire
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reported that ambulance services were relying on private providers because of lack of capacity. Some firms had failed to obtain references or carry out criminal record checks and a lack of staff training was leading to serious patient harm. More than Β£92 million was spent in 2018/9 on private
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launched the National Record Locator Service which gives ambulance staff access to patient records of mental health trusts, initially for the North West, North East, Yorkshire and London Ambulance Services. It is planned to roll it out across England and to include other records.
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sets targets for response times to 999 calls, which were first established in the 1970s. Call handlers were, until 2017, given just 60 seconds to decide on the urgency of the call. The clock stopped once a vehicle reached the patient - even if it was not the appropriate vehicle.
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Trusts asked for more resources to meet these targets, in particular the standards for the top 90% of responses. Taking patients to the "right" hospital rather than the nearest, leads to longer journeys. They were supported by a benchmarking exercise undertaken by the
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Between 2011-12 and 2015-16 ambulance activity in England rose by 30%. Funding only increased by 16%. In May 2018 several trusts told commissioners that they needed to spend many millions on extra staff and ambulances if they were to meet the response time targets.
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between the different trusts, some of which were attributable to local geography and the performance of other parts of the NHS. Responses to the most urgent calls averaged 11 minutes in rural areas in 2018 but 7 minutes in urban areas. The worst waits were around
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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
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gave county (and county borough) councils in England and Wales a statutory responsibility to provide an emergency ambulance service, although they could contract a voluntary ambulance service to provide this.
1712: 2151: 1586: 88:). Additionally, some ambulance services are considering trialing a 999 video calling service, in order to be able to visually assess patients whilst crews are en route. 1979: 1825: 1510:
performance averaged 9 minutes 35 seconds, the same as in March 2022 and the joint lowest on record. Category two calls took an average of 59 minutes 7 seconds.
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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
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England was covered by 31 ambulance trusts, which were structured as below. In July 2006 the number of ambulance service trusts was reduced to thirteen.
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There are currently 14 NHS organisations (ambulance services trusts in England) which provide ambulance services across the UK, which are listed below:
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In 1977/78 ambulance services in the UK cost about Β£138m. At that time about 90% of the work was transporting patients to and from hospitals.
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NHS ambulance services are classed as an essential service, the public normally access emergency medical services through one of the valid
1803: 54: 2111: 1957: 1685: 1572: 17: 1483: 162: 135: 95:, but in England this is now often covered by separate contractual arrangements, and often delivered by private providers. 2314: 2279: 2216: 1133: 963: 489: 178: 70: 2186: 797: 257: 42: 1623: 1269: 104: 85: 81: 2335: 2226: 2221: 2211: 2181: 1478:
classed as life-threatening and fewer vehicles are dispatched, but responses for the most urgent calls improved.
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In July 2018 eight of the ten services in England missed the seven-minute target. A review conducted by
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Service, whilst others relied upon agency methods for the provision of part or all of their services.
57:. The current system comprises 14 NHS organisations: 11 ambulance services trusts cover the separate 1615: 127:
from local authority to central government control in 1974, and consolidated into 53 services under
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to any person requiring treatment, regardless of immigration or visitor status, within the
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before 1974, and was then transferred to the four health and social services boards.
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The 142 existing ambulance services in England and Wales were transferred by the
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Since 2013, the 11 ambulance trusts in England and Wales have been:
1083: 1040: 1016: 988: 914: 553: 537: 420: 185:. There have been two ambulance services trust mergers since 2006. 114:
The Regional Ambulance Officers' Committee reported in 1979 that:
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In Northern Ireland the service was the responsibility of the
2002:"Exclusive: Patient waited 24 hours in ambulance for A&E" 1573:"Medics to assess 999 callers by video before ambulance sent" 1392: 1225: 1020: 814: 691: 541: 270: 41:. These services are provided by National Health Services of 2159: 2068:"'Model ambulance' to be created to achieve Carter savings" 1201: 976: 494: 91:
The work of ambulance services included responsibility for
1757:"St John Commissioned as the Nation's Ambulance Auxiliary" 2090:"Ambulance trusts demand millions to meet new targets" 1892:"Ambulance trusts demand millions to meet new targets" 1735:"NHSE tenders Β£30m deal for emergency 'surge' support" 1616:"Secondary legislation relating to ambulance services" 2046:"Summer crisis deepens as trolley waits hit new high" 1936:"Critically injured? The longest waits for 999 help" 1914:"Ambulances not an A&E taxi service, NHS warned" 143:
National Health Service and Community Care Act 1990
2024:"24 hour ambulance handover on 'worst night ever'" 1706: 1587:"Royal Commission on the National Health Service" 2327: 1958:"Big surge in the most serious ambulance calls" 125:National Health Service Reorganisation Act 1973 2145: 1610: 1608: 721: 173:(where provision remained with the island's 1848:"New ambulance service standards announced" 2152: 2138: 1605: 61:and; individual nationwide services cover 28:National Health Service ambulance services 1982:. Health Service Journal. 3 November 2021 1804:"Ambulance response categories explained" 1686:Association of Ambulance Chief Executives 1570: 1522: 2161:Ambulance services in the United Kingdom 2048:. Health Service Journal. 11 August 2022 1960:. Health Service Journal. 12 August 2021 1678:"Structure of the UK Ambulance Services" 1643: 1513: 392:, and the area of the former county of 14: 2328: 2070:. Health Service Journal. 20 June 2017 2026:. Health Service Journal. 12 July 2022 1828:. Health Service Journal. 13 July 2017 714:, provides ambulance services for the 169:(which had a temporary reprieve), the 2133: 2004:. Health Service Journal. 16 May 2022 1737:. Health Service Journal. 12 May 2022 163:government office regional boundaries 2092:. Health Service Journal. 4 May 2018 1894:. Health Service Journal. 4 May 2018 136:Northern Ireland Hospitals Authority 1670: 1449:ambulance auxiliary is provided by 129:regional or area health authorities 24: 2315:St John Ambulance Northern Ireland 2280:Northern Ireland Ambulance Service 2114:. Digital Health. 28 November 2018 490:South East Coast Ambulance Service 179:South East Coast Ambulance Service 25: 2347: 1715:from the original on 18 June 2022 1431: 258:East of England Ambulance Service 1624:Parliament of the United Kingdom 105:National Health Service Act 1946 2104: 2082: 2060: 2038: 2016: 1994: 1972: 1950: 1928: 1906: 1884: 1862: 1840: 1818: 1796: 1711:. Independent. 27 August 2019. 1644:Bradley, Peter (30 June 2005). 609:West Midlands Ambulance Service 601:West Midlands Ambulance Service 576:Staffordshire Ambulance Service 529:South Western Ambulance Service 455:South Central Ambulance Service 342:South Western Ambulance Service 301:Great Western Ambulance Service 215:East Midlands Ambulance Service 183:South Central Ambulance Service 167:Staffordshire Ambulance Service 1806:. North East Ambulance Service 1784:. Quality Watch. November 2016 1774: 1749: 1727: 1699: 1637: 1579: 1571:Whitehead, Dan (10 May 2018). 1564: 161:. Most of the trusts followed 13: 1: 1557: 1591:Socialist Health Association 1552:Hazardous area response team 1503:COVID-19 pandemic in England 1013:Bath and North East Somerset 416:North West Ambulance Service 377:North East Ambulance Service 306:Bath and North East Somerset 141:Under the provisions of the 7: 2310:St John Ambulance (England) 1850:. NHS England. 13 July 2017 1535: 652:Yorkshire Ambulance Service 78:emergency telephone numbers 10: 2352: 2248:Scottish Ambulance Service 1782:"Ambulance response times" 1456: 1426: 722:Current ambulance services 98: 2292: 2272: 2256: 2240: 2174: 2167: 1317: 1170: 1127: 899: 745: 150:English local authorities 1916:. BBC. 27 September 2018 1872:. BBC News. 13 July 2017 1107:East Riding of Yorkshire 657:East Riding of Yorkshire 350:London Ambulance Service 155:London Ambulance Service 32:free at the point of use 18:Ambulance services trust 2305:St John Ambulance Cymru 2264:Welsh Ambulance Service 1438:Care Quality Commission 712:Isle of Wight NHS Trust 687:Welsh Ambulance Service 2336:NHS ambulance services 1523:Information technology 1441:ambulances and taxis. 165:. Exceptions included 121: 35:emergency medical care 1484:National Audit Office 1198:Dumfries and Galloway 1045:South Gloucestershire 991:and eastern parts of 116: 1657:Department of Health 1514:Funding and activity 1491:Lord Carter of Coles 983:, and North Eastern 511:North East Hampshire 159:Department of Health 1938:. BBC. 6 March 2019 1547:Category:NHS trusts 1417:around 3.1 million 1250:West Dunbartonshire 1234:East Dunbartonshire 470:(excluding NE) and 344:on 1 February 2013 1620:legislation.gov.uk 1496:Wells-next-the-Sea 911:Greater Manchester 738:Population served 732:Ambulance service 603:on 1 October 2007 429:Greater Manchester 175:primary care trust 59:regions of England 2323: 2322: 2300:British Red Cross 2288: 2287: 1527:In November 2018 1451:St John Ambulance 1424: 1423: 1409:Vale of Glamorgan 1397:Rhondda Cynon Taf 1381:Neath Port Talbot 1302:Perth and Kinross 1270:City of Edinburgh 1266:South Lanarkshire 1262:North Lanarkshire 1238:East Renfrewshire 1128:Northern Ireland 710:In addition, the 708: 707: 93:patient transport 16:(Redirected from 2343: 2273:Northern Ireland 2217:South East Coast 2172: 2171: 2154: 2147: 2140: 2131: 2130: 2124: 2123: 2121: 2119: 2108: 2102: 2101: 2099: 2097: 2086: 2080: 2079: 2077: 2075: 2064: 2058: 2057: 2055: 2053: 2042: 2036: 2035: 2033: 2031: 2020: 2014: 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464:Buckinghamshire 398:North Yorkshire 314:Gloucestershire 220:Nottinghamshire 101: 23: 22: 15: 12: 11: 5: 2349: 2339: 2338: 2321: 2320: 2318: 2317: 2312: 2307: 2302: 2296: 2294: 2290: 2289: 2286: 2285: 2283: 2282: 2276: 2274: 2270: 2269: 2267: 2266: 2260: 2258: 2254: 2253: 2251: 2250: 2244: 2242: 2238: 2237: 2235: 2234: 2229: 2224: 2219: 2214: 2209: 2204: 2199: 2194: 2189: 2184: 2178: 2176: 2169: 2165: 2164: 2157: 2156: 2149: 2142: 2134: 2126: 2125: 2103: 2081: 2059: 2037: 2015: 1993: 1971: 1949: 1927: 1905: 1883: 1861: 1839: 1817: 1795: 1773: 1761:www.sja.org.uk 1748: 1726: 1698: 1669: 1636: 1604: 1578: 1562: 1561: 1559: 1556: 1555: 1554: 1549: 1544: 1537: 1534: 1524: 1521: 1515: 1512: 1458: 1455: 1433: 1432:Subcontracting 1430: 1428: 1425: 1422: 1421: 1418: 1415: 1373:Merthyr Tydfil 1326: 1320: 1319: 1315: 1314: 1311: 1308: 1306:Outer Hebrides 1286:Orkney Islands 1190:South Ayrshire 1186:North Ayrshire 1179: 1173: 1172: 1168: 1167: 1164: 1161: 1136: 1130: 1129: 1125: 1124: 1121: 1119:West Yorkshire 1104: 1098: 1097: 1094: 1072:Worcestershire 1061: 1055: 1054: 1051: 1033:North Somerset 1006: 1000: 999: 996: 966: 960: 959: 956: 939: 933: 932: 929: 908: 902: 901: 898: 895: 881:Northumberland 878: 872: 871: 868: 865: 863:City of London 859:Greater London 856: 850: 849: 846: 843: 838: 832: 831: 828: 825: 811:Cambridgeshire 800: 794: 793: 790: 787: 761:Leicestershire 754: 748: 747: 743: 742: 739: 736: 735:Region served 733: 723: 720: 706: 705: 703: 700: 697: 694: 689: 683: 682: 680: 677: 674: 671: 669:West Yorkshire 654: 648: 647: 645: 642: 639: 636: 634:Worcestershire 611: 605: 604: 597: 594: 591: 588: 587:before merger 585:Stoke-on-Trent 578: 572: 571: 569: 566: 563: 560: 531: 525: 524: 522: 519: 516: 513: 492: 486: 485: 483: 480: 477: 474: 457: 451: 450: 448: 445: 442: 439: 418: 412: 411: 409: 406: 403: 400: 386:Northumberland 379: 373: 372: 370: 367: 364: 361: 359:City of London 355:Greater London 352: 346: 345: 338: 335: 332: 329: 328:before merger 318:North Somerset 303: 297: 296: 294: 291: 288: 285: 267:Cambridgeshire 260: 254: 253: 251: 248: 245: 242: 228:Leicestershire 217: 211: 210: 207: 204: 201: 198: 195: 100: 97: 73:respectively. 39:United Kingdom 9: 6: 4: 3: 2: 2348: 2337: 2334: 2333: 2331: 2316: 2313: 2311: 2308: 2306: 2303: 2301: 2298: 2297: 2295: 2291: 2281: 2278: 2277: 2275: 2271: 2265: 2262: 2261: 2259: 2255: 2249: 2246: 2245: 2243: 2239: 2233: 2230: 2228: 2227:West Midlands 2225: 2223: 2222:South Western 2220: 2218: 2215: 2213: 2212:South Central 2210: 2208: 2205: 2203: 2200: 2198: 2195: 2193: 2192:Isle of Wight 2190: 2188: 2185: 2183: 2182:East Midlands 2180: 2179: 2177: 2173: 2170: 2166: 2162: 2155: 2150: 2148: 2143: 2141: 2136: 2135: 2132: 2113: 2107: 2091: 2085: 2069: 2063: 2047: 2041: 2025: 2019: 2003: 1997: 1981: 1975: 1959: 1953: 1937: 1931: 1915: 1909: 1893: 1887: 1871: 1865: 1849: 1843: 1827: 1821: 1805: 1799: 1783: 1777: 1762: 1758: 1752: 1736: 1730: 1714: 1709: 1702: 1687: 1683: 1679: 1673: 1658: 1654: 1647: 1640: 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1076:Staffordshire 1073: 1069: 1068:Herefordshire 1065: 1062: 1060: 1059:West Midlands 1057: 1056: 1053:5.47 million 1052: 1050: 1046: 1042: 1038: 1034: 1030: 1026: 1022: 1018: 1014: 1010: 1007: 1005: 1004:South Western 1002: 1001: 998:4.75 million 997: 994: 990: 986: 982: 978: 974: 970: 967: 965: 962: 961: 957: 955: 951: 947: 943: 940: 938: 937:South Central 935: 934: 930: 928: 924: 920: 916: 912: 909: 907: 904: 903: 896: 894: 890: 889:County Durham 886: 885:Tyne and Wear 882: 879: 877: 874: 873: 869: 866: 864: 860: 857: 855: 852: 851: 847: 844: 842: 841:Isle of Wight 839: 837: 836:Isle of Wight 834: 833: 829: 826: 824: 820: 819:Hertfordshire 816: 812: 808: 804: 801: 799: 796: 795: 791: 788: 786: 782: 778: 774: 770: 766: 762: 758: 755: 753: 752:East Midlands 750: 749: 744: 740: 737: 734: 731: 730: 727: 719: 717: 716:Isle of Wight 713: 704: 701: 698: 695: 693: 690: 688: 685: 684: 681: 678: 675: 672: 670: 666: 662: 658: 655: 653: 650: 649: 646: 643: 640: 637: 635: 631: 630:West Midlands 627: 623: 622:Staffordshire 619: 615: 614:Herefordshire 612: 610: 607: 606: 602: 598: 595: 592: 589: 586: 582: 581:Staffordshire 579: 577: 574: 573: 570: 567: 564: 561: 559: 555: 551: 547: 543: 539: 535: 532: 530: 527: 526: 523: 520: 517: 514: 512: 508: 504: 500: 496: 493: 491: 488: 487: 484: 481: 478: 475: 473: 469: 465: 461: 458: 456: 453: 452: 449: 446: 443: 440: 438: 434: 430: 426: 422: 419: 417: 414: 413: 410: 407: 404: 401: 399: 395: 391: 390:Tyne and Wear 387: 383: 382:County Durham 380: 378: 375: 374: 371: 368: 365: 362: 360: 356: 353: 351: 348: 347: 343: 339: 336: 333: 330: 327: 323: 319: 315: 311: 307: 304: 302: 299: 298: 295: 292: 289: 286: 284: 280: 276: 275:Hertfordshire 272: 268: 264: 261: 259: 256: 255: 252: 249: 246: 243: 241: 237: 233: 229: 225: 221: 218: 216: 213: 212: 208: 205: 202: 199: 196: 193: 192: 189: 186: 184: 180: 176: 172: 171:Isle of Wight 168: 164: 160: 156: 151: 146: 144: 139: 137: 132: 130: 126: 120: 115: 112: 109: 106: 96: 94: 89: 87: 83: 79: 74: 72: 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Index

Ambulance services trust
free at the point of use
emergency medical care
United Kingdom
England
Scotland
Wales
Northern Ireland
regions of England
Scotland
Wales
Northern Ireland
emergency telephone numbers
999
112
patient transport
National Health Service Act 1946
National Health Service Reorganisation Act 1973
regional or area health authorities
Northern Ireland Hospitals Authority
National Health Service and Community Care Act 1990
English local authorities
London Ambulance Service
Department of Health
government office regional boundaries
Staffordshire Ambulance Service
Isle of Wight
primary care trust
South East Coast Ambulance Service
South Central Ambulance Service

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