St John Ambulance (England)
St John Ambulance is a charitable non-governmental organisation dedicated to the teaching and practice of first aid and the support of the national emergency response system in England.[4][5] Along with St John Ambulance Cymru, St John Ambulance Northern Ireland, and St John Scotland, it is one of four United Kingdom affiliates of the international St John Ambulance movement.[6]
The St John Ambulance Association was founded in 1877 to provide first aid training. In 1887, the St John Ambulance Brigade was founded to provide uniformed medics at public events. In 1968, the two were merged into the present foundation.[7] The organisation is a subsidiary of the England and the Islands priory (i.e. branch) of the Order of St John.[8] Until 2012, it also managed St John Ambulance services in the Isle of Man and Channel Islands.[9]
In 2022, St John Ambulance was commissioned by NHS England to provide England's ambulance auxiliary.[10]
History[edit]
The St John Ambulance Association was set up in 1877 by the Venerable Order of Saint John to teach industrial workers first aid so that they could provide on-the-spot treatment in emergencies.[11] Workers rarely had ready access to a doctor in 19th-century workplaces, and since accidents were frequent, death or disability from injuries was common. The organisation in Ipswich was founded in 1880.[12]
In 1887, trained volunteers were organised into a uniformed Brigade to provide a first aid and ambulance service at public events.[11] In many parts of England (and in parts of Scotland, until 1908), St John Ambulance was the first and only provider of an ambulance service right up to the middle of the 20th century, when the National Health Service was founded. When there were far fewer doctors and hospital beds than today, St John Ambulance nurses looked after the sick and injured in their own homes.
The St John Ambulance Brigade and St John Ambulance Association merged in 1968 to form St John Ambulance,[7] a single organisation providing both training and first aid cover.
In 1998, members of a paedophile ring which operated from within the St John Ambulance Brigade for several decades were arrested by police.[13] The ring was headed by Leslie Gaines, superintendent of the Farnborough Division of the Brigade in Hampshire.[13]
A significant restructure in 2012 consolidated 43 counties into eight large regions; these regions were then further merged during 2016 into four regions. During 2013, St John Ambulance trained approximately 278,000 adults through its workplace and community first aid programmes, and directly trained 91,000 schoolchildren. St John Ambulance personnel attended 45,000 public events, treating approximately 102,000 individuals. It also distributed 100,000 free first aid guides nationwide and its free smartphone app was downloaded by 148,000 people.[14]
Training[edit]
St John Ambulance runs courses in first aid and health and safety for members of the public, training 254,000 people in 2013.[14] Its First aid at work course is used by many companies to train designated individuals as first aiders, as required by employment laws; specialist training is also available, including courses for schools staff and people working with children, and professional drivers.[16]
Charitable community first aid courses also offer people of all ages the chance to learn basic first aid skills at little or no charge. In 2013, 24,000 people attended these courses.[14]
Community first responders[edit]
St John Ambulance community first responders (CFRs) were trained volunteers who provided emergency treatment to people in their region and were dispatched by NHS ambulance control to medical emergency (999) calls,[31] with the scheme operating as a community partnership between St John Ambulance and local ambulance service trusts. CFRs were dispatched to attend Category 1 "immediately life-threatening" calls such as cardiac arrest, diabetic emergency, unresponsive patient, breathing difficulties and seizures.[32] As of 2024, St John Ambulance CFR Schemes have all been transferred to local NHS Ambulance trusts and the St John CFR role has been retired.
Healthcare professionals[edit]
Qualified healthcare professionals may also volunteer with St John Ambulance, including nurses, paramedics, physiotherapists and doctors. Professionals can carry out any skill appropriate to their type and level of training and competence. HCPs are managed by specialists within their area and are supported with relevant CPD and annual professional appraisals. St John bases operational deployments of HCPs on the individuals' skills and expertise, and assigns professionals to a "pillar of practice" to define their scope of practice in the PHEM environment. These pillars are "Health Care", "Urgent Care", "Emergency Care" and "Critical Care"; this is viewed as a sliding scale, with the highest complexity and highest risk skills being restricted to the emergency care and critical care roles. By default, paramedics are placed in the emergency care pillar and only PHEM specialists (e.g. HEMS doctors and paramedics) may be placed in the critical care pillar. An individual's pillar of practice may change as their career and experience develops. The charity has also developed a suite of Patient Group Directives (PGDs) to enable administration of relevant medications by nurses and paramedics. Healthcare professionals wear coloured rank slides to distinguish them from internally trained first aiders and ambulance personnel.
Raising of awareness and campaigning[edit]
St John Ambulance campaigns to raise awareness of the importance of first aid, and equip more people with life-saving skills. Its 2013 Save the Boy campaign, demonstrating how to put a casualty in the recovery position, reached 15 million people through television and online media.[14]
In January 2015, it launched a new campaign, The Chokeables, designed to teach parents how to treat a choking infant. The animated film featured the voices of actors John Hurt, David Walliams, Johnny Vegas and David Mitchell.[52]
During the annual Save a Life September campaign, St John Ambulance trainers hold free first aid demonstrations in public spaces around the country, handing out first aid guides to attendees.[53] A free first aid app for smartphones is also available to download.[54]
Between 9–16 October 2018, St John Ambulance was involved in the promotion of Restart A Heart Day 2018, overseen by the Resuscitation Council UK, on behalf of the European Resuscitation Council and the International Liaison Committee on Resuscitation. St John Ambulance and partner organisations trained over 200,000 people in emergency resuscitation during the two weeks.
In 2022 St John Ambulance partnered up with BBC Radio Manchester following the inqury into the Manchester Arena bombing. St John volunteers provided free emergency first aid awareness to the public throughout Manchester, and between May and December over 16,000 members of the public were trained in a life saving skill.
First aid and medical equipment supplies[edit]
St John Ambulance Supplies (often abbreviated to SJS) is a trading sub-division of St John Ambulance providing first aid and medical equipment and consumables, training equipment, publications, health and safety equipment and clothing. Where a profit is made, surplus from sales are diverted into supporting the charitable work of the Order of St John and the St John Ophthalmic Hospital in Jerusalem.
SJS opened its doors at St John's Gate in Clerkenwell on 12 February 1879, and was originally known as The Stores Depot. It is now a major commercial operation supplying to the public, private and voluntary sector. The store is now only available online.
British Armed Forces[edit]
A section of St John Ambulance, St John Ambulance British Forces Overseas (SJABFO), has British units running where there are a large number of British servicemen and women with their families overseas. These are namely in Cyprus, with units in Germany beginning to close in preparation for the British withdrawal from Germany in 2019.[62] The divisions are directly linked to the UK and national headquarters so that members can transfer to another unit or region/district/area as they would be able to do at home. Cyprus and Germany are a part of St John Ambulance as two districts, unattached to any region, within the organisational structure. The uniform reflects the current service delivery uniform in England.
Volunteers can receive training in the full range of St John Ambulance qualifications.
The overseas forces units (then "divisions") were founded in 1980. They remained very strong for several years, however, as the forces in Germany were reduced many divisions closed. Since the final withdrawal of forces in Germany is expected in the next few years, the role for St John Ambulance will end. However, the two units in Cyprus founded in 1991 will continue to provide a service to the community there.
As well as providing medical cover at events, St John Ambulance British Forces provide first-aid training for people of all ages.
St John Ambulance British Forces Overseas works closely with the German Ambulance Services, particularly the sister organisation, Die Johanniter, in providing first aid and ambulance cover German public events where many British or English Speakers are expected to attend. Members can occasionally be seen on their non-emergency and emergency vehicles responding to public calls. St John Ambulance can also be seen working with Malteser, the German Red Cross and local fire brigades which provide ambulance services. The German Emergency Services also assist St John Ambulance at British events on military areas where many German civilians are expected to attend. With the planned withdrawal of British forces from Germany in 2019, this partnership, in this aspect at least, will be discontinued.
Relations with the Order of St John and other organisations[edit]
Although the Order of St John is largely seen as a Christian organisation for historical reasons, St John Ambulance does not restrict membership to, or promote, any particular religion or denomination. Technically, it falls under the sovereignty of the King, and thus is linked to the Church of England; however, this relationship is more tradition than authority, and adult members are not required to pledge allegiance to or support either the monarchy or the Christian faith. Historically, Cadet members pledged to join to the monarch and God, though this is no longer a requirement.
St John Ambulance personnel serve alongside the British Red Cross, whose members also undergo advanced training in first aid and event cover. However, the British Red Cross no longer has an event first-aid (EFA) department due to lack of profit and funding. (The Red Cross EFA department officially closed in March 2020.[63]) Both organisations' work supports the statutory services in times of civil emergency or crisis. In peacetime, St John Ambulance is senior to the Red Cross. However, in wartime, the Red Cross would become senior due to an agreement with the International Red Cross and Red Crescent Movement.
St John Ambulance, St. Andrew's First Aid of Scotland and the British Red Cross co-author and authorise the official First Aid Manual,[64] the de facto UK guide for emergency first aid.
Response to the COVID-19 pandemic[edit]
During the COVID-19 pandemic in England, St John Ambulance equipped their personnel with protective equipment to prevent the spread.[65][66]
In March 2020, the charity had around 8,500 volunteers available to support alongside the NHS in hospitals. This was trialed the same month, which saw volunteers in NHS hospitals across England including the NHS Nightingale Hospital London.[67]
St John Ambulance announced in January 2021 that their staff would be volunteering to help in the national vaccination program for the Oxford-AstraZeneca vaccine, alongside NHS staff.[68][69][65][70] Training centres were established across the country to train a targeted 30,000 vaccination volunteers. These volunteers would be made up of pre-existing volunteers and newly recruited people, and would be trained to one of the three operational roles.
30,000 vaccination volunteers were recruited and trained between November 2020 and March 2021.[71] Vaccination volunteers were assigned a Vaccination Volunteering Lead (VVL) who served as the volunteer's line manager. The majority of VVLs were volunteers themselves, and were recruited from pre-existing volunteers within the organisation.
The programme was hit by a number of technical problems throughout its operation including using the rostering system GRS, which hadn't been used by the charity before. This ultimately led to many delays to volunteers being able to deploy to vaccination centres, and many didn't continue with the programme after completing their training.[72]
In December 2021, the organisation put out a press release with the aim of encouraging people who had been trained as a vaccination volunteer to return to the organisation, as there had been a significant number of volunteers who had been trained but never completed a shift.[71]
Between July and September 2022, St John Ambulance sought an additional 5,000 Vaccination Volunteers to support the programme. Morale was low amongst the volunteers, who had already been recruited, due to lack of engagement and St John Ambulance volunteers not being utilised in parts of the country.[73]
Due to the decrease in public events throughout 2020, when Event Operations began to restart in 2021, the charity provided additional training for vaccination volunteers to be able to support Event Operations as First Aiders. Following successes at the Great North Run 2021 and Brighton Marathon 2021, the programme was rolled out more extensively, primarily in London, and was informally called the SJA Reserves Programme. Although it never left the pilot phase, the programme trained a significant number of vaccination volunteers to be able to support some of the charity's largest Event Operations including the London Marathon, the Platinum Jubilee of Queen Elizabeth II, and the funeral of Elizabeth II.[74]
By July 2021, volunteers had volunteered over 1 million hours towards the COVID-19 response programme since the beginning of the pandemic, including work in hospitals, responding to NHS 999 ambulance calls and on the vaccination programme.[75] The organisation's involvement with the vaccination programmes ended on 31 March 2023, having delivered 1.7 million hours to the overall Covid response.[76]
