NHS ambulance services provide:
- accident and emergency services for patients who may require resuscitation and/or paramedical care at the scene of an accident or emergency.
- route to hospital emergency. Emergency ambulance journeys are made in response to 999 calls from the public, doctors and other emergency services.
- non-urgent patient transport services for NHS patients. Forty years ago the ambulance services carried only emergency patients but now 85% of patients carried are non-emergency cases. National Health Service patients who are medically unfit to travel by other means are entitled to NHS transport free of charge. Patient transport services carry some 25 million patients a year, mainly by ambulance and hospital car service.
- urgent patient transport may also be requested by doctors, dentists and midwives where there is a requirement for the provision of a fully equipped ambulance and trained crew for the transport of a patient to hospital within a specified time. Routine (non-emergency) journeys are usually planned by the ambulance service and involve the transport of patients between home and hospital, clinic or day centre.
There are 45 ambulance services in England, nine in Wales, and a Scottish Ambulance Service covering eight areas in Scotland. The National Health Service took over control of the ambulance services from local authorities in 1974. Ambulance authorities now have NHS Trust status. All ambulance services, whether trusts or not, are now required to secure contracts for the services they provide to health authorities.
An increasing number of ambulance staff are now trained in paramedical skills. Every emergency ambulance in the country must carry at least one paramedically trained crew member. All front line ambulances now carry defibrillators (a device which uses electric shock to restore normal heart rhythms in people who have had a cardiac arrest).
In July 1996, the Government announced plans to prioritise calls (for example, for those people suffering from heart attacks and other life threatening conditions) to enable patients to be seen within eight minutes where possible. The proposals involve providing specially trained control room operators who question the caller and identify potentially life threatening emergencies.