The UK ambulance service started after the Second World War in 1946 with an act of parliament called the National Health Services Act which came into power on 5th July 1948. This act of parliament ensured that the minister of health set up a health system for England and Wales, and that the secretary of state for Scotland and Northern Ireland did the same.
The whole Act of 1946 was replaced with the National Health Services Act 1977. Initially the ambulance service was staffed by volunteers but the Millar report of 1964 which was compiled after 3 working party groups made recommendations including that patients should be treated en route to hospital.
As a result of the Millar report, training schools were set up and ambulance staff trained, these trained staff were referred to as “Millar trained” and wore a badge of laurel leafs. Training was basic first aid with a few add extended skills in the use of Oxygen, Entonox etc. Ambulance staff were referred to as “Ambulance Men or Driver attendants”.
Early ambulances were kitted out to very basic stands to what is considered today, one of the working groups that the Millar report is based made the following recommendations,
Each ambulance should have two padded stretchers, 6 blankets, various canvas stretchers including poles, 1 carry chair, wooden splints, burns dressings (roehampton) a maternity pack and each ambulance person should carry a “first aid satchel” the report also recommends carrying light rescue equipment.
From 1974 each ambulance service was transferred to the NHS area that it served and as a result differences in training and equipment soon started to arise, a trend which still happens today.
In 1960 the Council for Professions Supplementary to Medicine (CPSM) was formed its job was to regulate a number of medical specialities which included paramedic, the only problem the title “Paramedic” wasn’t protected so anyone could and did call themselves a Paramedic, in 2001 the Health Professions council (HPC) was formed, from this point on it became illegal to call yourself a Paramedic unless you appeared on the HPC register. On the 1st August 2012 the HPC changed it name to HCPC.
Alongside a paramedic you will get either an emergency medical technician (EMT) or more commonly known as a Tech or in some services an Emergency Care Assistant (ECA) neither of these titles is protected which has resulted in some confusion. Traditionally the Ambulance service trained Technicians for a period of 6-8 weeks then did 1500 hours, now reduced to 750 hours on the road usually with a technician but some private training providers run a 5 day technician or EMT course.
Recently ambulance services started to canvas the general public on the idea of gaining foundation trust status. A number of ambulance services gained trust status which allows for greater freedom of the board of executors to run the service in a more dynamic way, some ambulance services have failed and have had to be taken over by other trusts.
Today ambulance services have to be dynamic and their remit is changing, the formation of Hazardous Area Response Teams, Rapid Response Vehicles, and Emergency Care Practitioners together with an ever demanding and growing public will ensure that the UK ambulance service has to be capable of change. The only thing that gets bigger is the patients and the only thing that is shrinking is the budget.