Northern Ireland Ambulance Service Health and Social Care Trust | |
---|---|
Established | 1 April 1995 |
Headquarters | Belfast [1] |
Region served | Northern Ireland |
Area size | 5,345 square miles (13,840 km2) |
Population | 1.9 million |
Establishments | 46 stations and deployment points |
Chair | Michele Larmour [2] |
Chief executive | Michael Bloomfield [3] |
Staff | 1,300 (2018/19) [4] |
Website | nias |
The Northern Ireland Ambulance Service (NIAS) is an ambulance service that serves the whole of Northern Ireland, approximately 1.9 million people. As with other ambulance services in the United Kingdom, it does not charge its patients directly for its services, but instead receives funding through general taxation. It responds to medical emergencies in Northern Ireland with the 300-plus ambulance vehicles at its disposal. Its fleet includes mini-buses, ambulance officers' cars, support vehicles, RRVs and accident and emergency ambulances.
NIAS was formed on 1 April 1995 through the amalgamation of its four predecessors. Its full title is the Northern Ireland Ambulance Service Health and Social Care Trust.
The service is split up into five operational areas:
The service employs approximately 1,300 staff of which approximately 420 are paramedics, 300 are emergency medical technicians (EMT) and 100 are control centre staff, which work shift patterns to ensure the service is operational 24/7. They are based across 46 stations and sub-stations, two control centres (emergency and non-emergency) and a regional ambulance training centre. It responds to approximately 201,000 emergency (999) calls per year (with the number of 999 calls is increasing per year) with a combination of traditional emergency ambulances with two crew members, and rapid response vehicles (RRV) crewed by a single paramedic. RRVs respond mostly to calls where there is a potential immediate life-threat (Category 1) because they can respond more quickly than a conventional ambulance, RRVs can also be used to respond to lower category of calls that may not require hospital care. [5] Double-crew ambulances respond to both emergency and non-emergency (healthcare professional-initiated urgent) calls as well as providing critical-care transfers between hospitals. The Trust aims to provide at least one paramedic to every emergency call by staffing each double-crew emergency ambulance with two paramedics, or a paramedic and an EMT, and utilising RRV. The trust has not adopted the controversial use of emergency care assistants (ECA) in the way some other UK ambulance services have.
In addition to the emergency medical services, NIAS has a fleet of Patient Care Service vehicles which are used for more routine patient transport to/from hospital. Within the Patient Care Service there are both single-crewed 'sitting case' (minibus) vehicles as well as double-crewed 'intermediate care vehicles' (ICV) which carry a stretcher.
In 2019, the service entered a partnership with the Ulster University to deliver a foundation degree in Paramedic Science, with the first cohort of trainees graduating in December 2019 and the final 'fourth' cohort graduating in January 2023. Future cohorts are now managed directly by Ulster University with the BSc honours degree commencing in September 2021.
In 2016, NIAS was commissioned to provide a helicopter emergency medical service (HEMS) for the first time in Northern Ireland, which was by then the only region of the UK not to have one. Following a public consultation, they partnered with the charity Air Ambulance Northern Ireland who provide the aircraft and airbase, with the doctors and paramedics provided by NIAS. The service undertook its first live mission in August 2017.
NIAS triages all emergency calls using an internationally recognised system of prioritisation. Currently it has a target time of eight minutes to reach the scene of the highest priority calls i.e. those deemed to represent an immediate risk to life, but during December 2017 only 47.5% of this target was met therefore the average response time in Northern Ireland was 16 minutes 10 seconds. [6] Currently the trust works with volunteer and private ambulance services to help cope and meet key response times, this is a result of the current increased demand due to an aging population and the squeeze on public spending across Northern Ireland over the last decade. [7] [8] Staff have expressed concern by the growing pressures they face and overall low morale across the service. [9] The ambulance service aims to restructure their service to cope with future increased demand.
In September 2018, the ambulance service requested an additional £30 million in funding from the Department of Health to restructure the service and to recruit an additional 300 staff members, most of whom would be Paramedics, EMTs and emergency call takers. This recruitment is meant to quicken response times and relieve pressure on staff. [10] As of May 2022 this funding has not been delivered. [11]
In July 2022, NIAS average regional response time to the second highest priority calls (e.g. chest pain) had risen to 39 minutes and 31 seconds. [12] Paramedics have voiced their concern following reports that these lengthy response times have been a 'possible contributing factor' towards the death of 14 people. [13] The current NIAS Chief Executive Michael Bloomfield has expressed his disappointment and partly blames the poor response times on the high number of staff shortages and lengthy waiting times to hand over patients at Emergency Departments. [14] [15]
Emergency medical services (EMS), also known as ambulance services ""pre-hospital care"" or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. They may also be known as a first aid squad, FAST squad, emergency squad, ambulance squad, ambulance corps, life squad or by other initialisms such as EMAS or EMARS.
An emergency medical technician is a medical professional that provides emergency medical services. EMTs are most commonly found serving on ambulances and in fire departments in the US and Canada, as full-time and some part-time departments require their firefighters to at least be EMT certified.
A certified first responder is a person who has completed a course and received certification in providing pre-hospital care for medical emergencies. Certified individuals should have received much more instruction than someone who is trained in basic first aid and cardiopulmonary resuscitation (CPR) but they are not necessarily a substitute for more advanced emergency medical care rendered by emergency medical technicians and paramedics. First responders typically provide advanced first aid level care, CPR, and automated external defibrillator (AED) usage. The term "certified first responder" is not to be confused with "first responder", which is a generic term referring to the first medically trained responder to arrive on scene and medically trained telecommunication operators who provide pre-arrival medical instructions as trained Emergency Medical Dispatchers (EMD). Many police officers and firefighters are required to receive training as certified first responders. Advanced medical care is typically provided by EMS, although some police officers and firefighters also train to become emergency medical technicians or paramedics.
The London Ambulance Service NHS Trust (LAS) is an NHS trust responsible for operating ambulances and answering and responding to urgent and emergency medical situations within the London region of England. The service responds to 999 phone calls across the region, and 111 phone calls from certain parts, providing triage and advice to enable an appropriate level of response.
A nontransporting EMS vehicle is a vehicle that responds to and provides emergency medical services (EMS) without the ability to transport patients. For patients whose condition requires transport, an ambulance is necessary. In some cases they may fulfill other duties when not participating in EMS operations, such as policing or fire suppression.
The Scottish Ambulance Service is part of NHS Scotland, which serves all of Scotland's population. 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.
The Welsh Ambulance Services University NHS Trust, or simply the Welsh Ambulance Service, is the national ambulance service for Wales. It was established on 1 April 1998 and as of December 2018 has 3,400 staff providing ambulance and related services to the 3 million residents of Wales. As of 1 April 2024, the trust was awarded "university" status by the Welsh government, making it the second ambulance trust to achieve university status in the United Kingdom.
The North West Ambulance Service NHS Trust (NWAS) is the ambulance service for North West England. It is one of ten ambulance trusts providing England with Emergency medical services, and is part of the National Health Service, receiving direct government funding for its role.
Yorkshire Ambulance Service NHS Trust (YAS) is the NHS ambulance service covering most of Yorkshire in England. It is one of ten NHS Ambulance Trusts providing England with emergency medical services as part of the National Health Service it receives direct government funding for its role.
The East of England Ambulance Service NHS Trust (EEAST) is an NHS trust responsible for providing National Health Service (NHS) ambulance services in the counties of Bedfordshire, Cambridgeshire, Essex, Hertfordshire, Norfolk and Suffolk, in the East of England region. These consist of approximately 6.2 million people across an area of 7,500 square miles (19,000 km2).
The West Midlands Ambulance Service University NHS Foundation Trust (WMAS UNHSFT) is responsible for providing NHS ambulance services within the West Midlands region of England. It is one of ten ambulance trusts providing England with emergency medical services, and is part of the National Health Service.
Louisville Metro Emergency Medical Services is the primary provider of pre-hospital life support and emergency care within Louisville-Jefferson County, Kentucky. LMEMS is a governmental department that averages 90,000 calls for service, both emergency and non-emergency, each year.
In the United States, emergency medical services (EMS) provide out-of-hospital acute medical care and/or transport to definitive care for those in need. They are regulated at the most basic level by the National Highway Traffic Safety Administration, which sets the minimum standards that all states' EMS providers must meet, and regulated more strictly by individual state governments, which often require higher standards from the services they oversee.
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 (NHS) of England, Scotland, Wales, and Northern Ireland. Emergency care including ambulance and emergency department treatment is only free to UK residents and a charge may be made to those not entitled to free NHS care.
Emergency medical personnel in the United Kingdom are people engaged in the provision of emergency medical services. This includes paramedics, emergency medical technicians and emergency care assistants. 'Paramedic' is a protected title, strictly regulated by the Health and Care Professions Council, although there is tendency for the public to use this term when referring to any member of ambulance staff.
Emergency Medical Responders (EMRs) are people who are specially trained to provide out-of-hospital care in medical emergencies, typically before the arrival of an ambulance. Specifically used, an emergency medical responder is an EMS certification level used to describe a level of EMS provider below that of an emergency medical technician and paramedic. However, the EMR is not intended to replace the roles of such providers and their wide range of specialties.
State Medical Rescue in Poland is a system of free public emergency healthcare established by Ustawa o Państwowym Ratownictwie Medycznym, including ambulance service and Emergency Departments (EDs). While in Polish public hospitals and clinics NFZ common public insurance is required, PRM medical services in ambulances and EDs are completely free for everyone. Since 2018 emergency ambulances that operates in PRM, that is Polish 112 and 999 emergency numbers, are operated by public entities only.
The National Ambulance Service is the statutory public ambulance service in Ireland. The service is operated by the National Hospitals Office of the Health Service Executive, the Irish national healthcare authority.
Essex & Herts Air Ambulance Trust (EHAAT) is a charity air ambulance service providing a free, life-saving Helicopter Emergency Medical Service (HEMS) for the critically ill and injured of Essex, Hertfordshire and surrounding areas.
The New York City Fire Department Bureau of Emergency Medical Services is a division of the New York City Fire Department (FDNY) in charge of emergency medical services for New York City. It was established on March 17, 1996, following the merger of the FDNY and New York City Health and Hospitals Corporation's emergency medical services division. FDNY EMS provides coverage of all five boroughs of New York City with ambulances and a variety of specialized response vehicles.