Scottish Ambulance Service
The Scottish Ambulance Service (Scottish Gaelic: Seirbheis Ambaileans na h-Alba) is part of NHS Scotland, which serves all of Scotland's population.[3] The Scottish Ambulance Service is governed by a special health board and is funded directly by the Health and Social Care Directorates of the Scottish Government.[4]
Scottish Ambulance Service
It is the sole public emergency medical service covering Scotland's mainland and islands; providing a paramedic-led accident and emergency service to respond to 999 calls,[5] a patient transport service which provides transport to lower-acuity patients,[6] and provides for a wide variety of supporting roles including air medical services,[7][8] specialist operations including response to HAZCHEM or CBRN incidents[9] and specialist transport and retrieval.[10]
History[edit]
In 1948, the newly formed Scottish National Health Service (NHS) contracted two voluntary organisations, the St Andrew's Ambulance Association and the British Red Cross, to jointly provide a national ambulance provision for Scotland, known then as the St Andrew's and Red Cross Scottish Ambulance Service.[11]
After British Red Cross withdrew from the service in 1967, the service was renamed the St Andrew's Scottish Ambulance Service.[12] In 1974, with the reorganisation of the Scottish health services, ambulance provision in Scotland was taken over by the Scottish NHS, with the organisational title being shortened to the current Scottish Ambulance Service.[11]
St. Andrew's First Aid, the trading name of St. Andrew's Ambulance Association, continues as a voluntary organisation and provides first aid training and provision in a private capacity.[13]
The organisation was established as a NHS trust on 1 April 1995 when it legally became known as the Scottish Ambulance Service National Health Service Trust.[14] The trust was dissolved on 1 April 1999 and at the same time constituted as a special health board known as the Scottish Ambulance Service Board.[15][16]
Structure[edit]
Emergency Medical Service Capabilities[edit]
The Scottish Ambulance Service now continues in its current form as one of the largest emergency medical providers in the UK, employing more than 5,000 staff in a variety of roles and responding to 740,631 emergency incidents in 2015–2016 alone.[17] The service, like the rest of NHS Scotland, is free at point of access and is widely used by both the public and healthcare professionals. Employing almost 1,300 paramedic staff, and a further 1,200 technicians, the accident and emergency service is accessed through the public 999 system. Ambulance responses are changing in Scotland and are now prioritised according to patient needs: a traditional, double-crewed ambulance, a single response car or a paramedic practitioner may attend different kinds of emergencies.
Ambulance Control Centres[edit]
The Scottish Ambulance Service also maintains three command and control centres in Scotland, which facilitate handling of 999 calls and dispatch of ambulances; a further 350–400 staff employed as call handlers and dispatchers fulfil this role[17] across three locations: Edinburgh, Glasgow and Inverness. These three centres (which, through use of software, operate as one integrated unit) have been in use since 2004 and handle over 800,000 calls per year. The Advanced Medical Priority Dispatch System (AMPDS) is used for call prioritisation, and provides post-dispatch instructions to callers, allowing medical advice to be given over the phone, before the ambulance arrives.[18] Clinical staff are present to provide clinical oversight and tertiary triage. Co-located with the Ambulance Control Centres (ACC) are patient transport booking and control services, which handle approximately 1 million patient journeys per year.[18]
Patient transport[edit]
The Patient Transport Service carries over 1.3 million patients every year.[49] This service is provided to patients who are physically or medically unfit to travel to hospital out-patient appointments by any other means so that they can still make their appointments. The service also handles non-emergency admissions, discharges, transport of palliative care patients and a variety of other specialised roles.[50]
Patient Transport Vehicles come in a variety of forms and are staffed by ambulance care assistants, who work either double- or single-crewed. They are trained to look after patients during the journey, and to provide basic emergency care.[51]
Special Operations Response Team (SORT)[edit]
The SORT service is similar to the Hazardous Area Response Team in other parts of the United Kingdom. SORT paramedics have the same scope of practice as a regular paramedic, however have an enhanced scope of practice in relation to Personal protective equipment and other rescue equipment.[19] They do not however carry nor administer ketamine.[19]
In 2010, the service established three teams of specialist accident & emergency ambulance personnel who were given specialist training.[62] This £4.3 million initiative was to provide additional preparedness to be able to respond to large-scale hazardous incidents, such as those that might involve chemical, biological, radiological or nuclear material.[63] The work was in concert with the UK government.[63] In 2019, the SORT services responded to 1,200 calls requiring specialist intervention, and supported a further 9,000 calls.[64]
As of October 2017 there are five SORT teams; three full-time based in Edinburgh, Glasgow, and Aberdeen, and two on-call teams in Inverness and Dumfries.[65] These teams provide a specialist response to major incidents, and provide paramedic care in hostile environments. The team provides capability in arenas such as water rescue, safe working at height, search and rescue including the use of breathing apparatus, and confined space working. The SORT teams also provide a full-time emergency decontamination and inner-cordon capability.
ScotSTAR[edit]
With the remote towns and villages in Scotland often being hours away from advanced medical treatment, Scottish Specialist Transport and Retrieval (ScotSTAR) was setup incorporating paediatric and neonatal retrieval and transfer teams and the two adult Emergency Medical Retrieval Service teams (EMRS).[23] The ScotSTAR service was set up on 1 April 2014 and transported 2,654 patients 2014–2015. The service uses multiple vehicles, either owned by the ambulance service or other organisations: specialist ambulances and cars, five air ambulances and HM Coastguard helicopters. The service is based in Glasgow.
EMRS (The Emergency Medical Retrieval Service) was created in 2004 by ten emergency medical consultants from Glasgow and Paisley.[66] Initially, the service provided aeromedical cover to six isolated hospitals within Argyll and Bute.[66] The ten consultants only had £40,000 worth of funding for medical equipment. In its first year the service transported 40 patients. In years to follow, the clinical crew began to gather evidence for the life-saving impact and cost effectiveness of the service.[66] Following a successful 18-month trial period in the West of Scotland funded by the Scottish Government, in 2010 the service was opened up to the whole of the country, after securing permanent funding.[66] The service is currently staffed by 47 part-time retrieval consultants,[67] 14 retrieval practitioners,[68] and 4 registrars,[69] carrying out around 1000 missions every year.[66]
Training academy[edit]
The service has its own dedicated training academy within the campus of Glasgow Caledonian University, which opened in June 2011.[70] The facility has purpose built classrooms, lecture theatres, syndicate rooms and a clinical simulation area that recreates a 16-bed hospital ward and Accident & Emergency department allowing realistic interaction with other trainee healthcare professionals.[71]
From 1996 until April 2011, the service used its own dedicated training college located at Barony Castle in Eddleston near Peebles. Set in 25 acres (100,000 m2) of formal gardens and woodlands, Barony was a residential training and conference centre with 78 bedrooms that allowed the service to carry out all its training in house. Between 1985 and 1996 it used the former Redlands women's and children's hospital in Glasgow's west end and prior to that the training school was based at Bangour Hospital before moving to Gartloch Hospital.
In year ended 31 March 2020, the service:[72]
Other Scottish emergency and non-emergency services:
