Emergency medical services in the United Kingdom

Emergency medical services in the United Kingdom provide emergency care to people with acute illness or injury and are predominantly provided free at the point of use by the four National Health Services of England, Scotland, Wales, and Northern Ireland. Emergency care including ambulance and emergency department treatment is free to everyone, regardless of immigraton or visitor status.

The NHS commissions most emergency medical services through the 14 NHS organisations with ambulance responsibility across the UK (11 in England, 1 each in the other three countries).

As with other emergency services, the public normally access emergency medical services through one of the valid emergency telephone numbers (either 999 or 112).

In addition to ambulance services provided by NHS organisations, there are also some private and volunteer emergency medical services arrangements in place in the UK, including all air ambulances (except those operated by the Scottish Ambulance Service), the use of private or volunteer ambulances at public events or large private sites, and as part of community provision of services such as community first responders.

Public ambulance services across the UK are required by law to respond to four types of requests for care, which are:

Ambulance trusts and services may also undertake non-urgent patient transport services on a commercial arrangement with their local hospital trusts or health boards, or in some cases on directly funded government contracts, although these contracts are increasingly fulfilled by private and voluntary providers.

The National Health Service Act 1946 gave county and borough councils a statutory responsibility to provide an emergency ambulance service, although they could contract a voluntary ambulance service to provide this, with many contracting the British Red Cross, St John Ambulance or another local provider. The Regional Ambulance Officers’ Committee reported in 1979 that “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 Service, whilst others relied upon agency methods for the provision of part or all of their services.”

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