Ambulance Service

What is the Ambulance Service?

The ambulance service is the emergency response wing of the National Health Service (NHS).

The ambulance service has two main functions: an accident and emergency paramedical function, and the Patient Transport Service function which transfers immobile patients to and from their hospital appointments.

There are 35 ambulance service NHS Trusts across England, Wales, Scotland and Northern Ireland.


Background

The ambulance service in the UK dates back to the late 19th century, with locally-funded services such as the Metropolitan Asylums Board operating in the London area in 1897. The earliest British Ambulance Flight was recorded in war torn Turkey in 1917. It was not until the formation of the National Health Service (NHS) in 1948 that it became a public duty to provide ambulances for all those who needed them.

Between then and today, ambulance services have undergone numerous reorganisations and redefinitions.

In 2001, the Government set out a programme for reforming emergency care services over the following four years. 'Reforming Emergency Care' has seen improvements in emergency response times, the deployment of new technology (including satellite navigation systems and better equipment to deal with heart patients) and has funded increases in frontline ambulance staff and vehicles.

The NHS Modernisation Agency has also formed an Ambulance Group, 'The Improvement Partnership for Ambulance Services', to support ambulance staff to modernise their own services, help individual ambulance trusts improve performance and spread good practice.


Controversies

Like all NHS bodies, the ambulance service has to meet national performance targets - and it has not been immune to accusations of distorting priorities as a result. A report in Health Which? magazine in 2002 claimed that ambulance service paramedics had admitted to manipulating response times to meet ambitious new government targets.

The article quoted from one paramedic who stated that if the crews were in danger of missing the targets: "That's where the magic pen comes in. Crews do a rough calculation. If it is not within eight minutes, they change it." The magazine even alleged that some ambulance Trusts had begun a practice of re-classifying certain conditions as non-life threatening so that they could avoid the eight-minute target.
Suspicions were raised of potential malpractice when figures published by the ambulance service showed a dramatic improvement in performance, with 28 out of 32 ambulance trusts in England meeting the target, compared to just three the previous year.


Statistics

The number of life threatening calls responded to within eight minutes rose by 16 per cent - from 722,000 to 834,000 - between 2001/2002 and 2002/2003

The number of emergency calls rose by seven per cent from 4.7 million to 5.0 million in the same period

The number of incidents attended rose by five per cent from 3.8 million to 4.0 million in that time

It costs £150 every time an ambulance is called out. A fully equipped ambulance costs £75,000

Statistics 1, 2 and 3: (Source: Statistical Bulletin Ambulance services, England 2002-03); Statistics 4 and 5: (Source: London Ambulance Service, 2004)