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Urgent and emergency care services in England

NHS ambulance services

Ambulance services help many people with serious or life-threatening conditions. They also provide a range of other urgent and planned healthcare and transport services.

Ambulance services should ensure that patients are given the appropriate level of care.

Who will treat you?

Depending on the situation the ambulance service can dispatch the following units:

  • an ambulance
  • a rapid response vehicle (car, motorbike or bicycle)
  • a doctor
  • an air ambulance
  • a patient transport service (PTS)
  • a community first responder (CFR) and volunteers
  • a combination of the above

Ambulance crews
Ambulance crews can include a range of medical staff, such as emergency care assistants and paramedics. Crews are highly trained in all aspects of emergency care, from trauma injuries to cardiac arrests. An ambulance is equipped with a variety of emergency care equipment, such as heart defibrillators, oxygen, intravenous drips, spinal and traction splints, and a range of drugs.

Patients will always be taken to hospital when there is a medical need for this. However, paramedics now carry out more diagnostic tests and do basic procedures at the scene. Many crews also refer patients to social care services, and directly admit patients to specialist units such as major trauma centres or stroke units. Paramedics also administer a wide range of drugs to deal with conditions such as diabetes, asthma, allergic reactions, overdoses, and heart failure.

A rapid response vehicle (car, motorbike or bicycle)
These units are often sent ahead of an ambulance as they are quicker at getting through traffic or large pedestrian areas. This is important in situations where every second counts.

Air ambulance
Air ambulances deliver emergency care, especially in rural areas and where road access is a problem. They can be an effective way of getting better and faster access to hospitals and are valuable in transferring patients between hospitals and are dispatched by NHS ambulance services where there is a need. All air ambulances operate as independent charities. However, the cost of some clinical staff on air ambulances has been met by the NHS.

Community First Responders (CFRs) and volunteers
Many local ambulance services run volunteer responder schemes. Volunteers receive medical training and are expected to provide emergency care alongside ambulances or until an ambulance can be on site. They are often trained to use defibrillators, provide CPR and are able to give oxygen treatment. The volunteers have to provide their own cars and usually don't have blue lights. 

Non-emergency patient transport services (PTS)
If you have a hospital appointment you usually need to make your own transport arrangements. However, under certain circumstances a Non-emergency patient transport service (PTS) can be arranged. Transport can and should encompass a wide range of vehicle types and levels of care consistent with the patients' medical needs.

PTS services are commissioned by Clinical Commissioning Groups (CCGs) and it remains up to local CCGs to decide how these services are managed. To find out if you are eligible for PTS speak with your GP, your hospital team or contact your local CCG.

Handling 999 calls

Any 999 call to an ambulance service is prioritised into two categories to ensure life-threatening cases receive the quickest response:

1. Immediately life threatening

A. Red 1: 75% of Category A Red 1 calls (the most time critical, where patients are not breathing or do not have a pulse) to be responded to within 8 minutes

B. Red 2: 75% of Category A Red 2 calls (still serious, but less immediately time critical, like strokes or fits) to be responded to within 8 minutes. The clock starts ticking up to 60 seconds after the clock for Red 1.

C. A19: 95% of Category A calls to be responded to within 19 minutes.

2. All other calls – For conditions that are not life threatening, response targets are set locally

Figures from the Health and Social Care Information Centre (HSCIC) show that in 2013/14 ambulance trusts dealt with an average of 16.1 emergency calls per minute. You can find the full report about ambulance services in England on HSCIC's website.

Page last reviewed: 14/09/2015

Next review due: 14/09/2017

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