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 and Northern Ireland. Emergency care including ambulance and emergency department treatment is free to everyone, regardless of immigration or visitor status; the NHS commissions most emergency medical services through the 14 NHS organisations with ambulance responsibility across the UK. As with other emergency services, the public access emergency medical services through one of the valid emergency telephone numbers. In addition to ambulance services provided by NHS organisations, there are some private and volunteer emergency medical services arrangements in place in the UK, the use of private or volunteer ambulances at public events or large private sites, as part of community provision of services such as community first responders. Air ambulance services in the UK are not part of the NHS and are funded through charitable donations.
Paramedics are seconded from a local NHS ambulance service, with the exception of Great North Air Ambulance Service who employ their own paramedics. Doctors are provided by their home hospital and spend no more than 40% of their time with an air ambulance service. Public ambulance services across the UK are required by law to respond to four types of requests for care, which are: Emergency calls Doctor's urgent admission requests High dependency and urgent inter-hospital transfers Major incidentsAmbulance trusts and services may 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 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 last St John Division, to be so contracted is reputed to have been at Whittlesey in Cambridgeshire, where the two-bay ambulance garage can still be seen at the branch headquarters. The Regional Ambulance Officers’ Committee reported in 1979 that “There was considerable local variation in the quality of the service provided in relation to vehicles 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.” The 142 existing ambulance services were transferred by the National Health Service Reorganisation Act 1973 from local authority to central government control in 1974, consolidated into 53 services under regional or area health authorities. This led to the formation of predominantly county based ambulance services, which merged up and changed responsibilities until 2006, when there were 31 NHS ambulance trusts in England.
The June 2005 report "Taking healthcare to the Patient", authored by Peter Bradley, Chief Executive of the London Ambulance Service, for the Department of Health led to the merging of the 31 trusts into 13 organisations in England, plus one organisation each in Wales and Northern Ireland. Following further changes as part of the NHS foundation trust pathway, this has further reduced to 10 ambulance service trusts in England, plus the Isle of Wight which has its own provision. Following the passage of the Health and Social Care Act 2012, commissioning of the ambulance services in each area passed from central government control into the hands of regional clinical commissioning groups; the commissioners in each region are responsible for contracting with a suitable organisation to provide ambulance services within their geographical territory. The primary provider for each area is held by a public NHS body, of which there are 11 in England, 1 each in the other three countries. In England there are now ten NHS ambulance trusts, as well as an ambulance service on the Isle of Wight, run directly by Isle of Wight NHS Trust, with boundaries following those of the former regional government offices.
The ten trusts are: East Midlands Ambulance Service NHS Trust East of England Ambulance Service NHS Trust London Ambulance Service NHS Trust North East Ambulance Service NHS Foundation Trust North West Ambulance Service NHS Trust South Central Ambulance Service NHS Foundation Trust South East Coast Ambulance Service NHS Foundation Trust South Western Ambulance Service NHS Foundation Trust West Midlands Ambulance Service University NHS Foundation Trust Yorkshire Ambulance Service NHS TrustThe English ambulance trusts are represented by the Association of Ambulance Chief Executives, with the Scottish and Northern Irish providers all associate members. On the 14 November 2018 West Midlands Ambulance Service became the UK's first university-ambulance trust; the service was operated before reorganisation in 1974 by the St Andrews’ Ambulance Association under contract to the Secretary of State for Scotland. The Scottish Ambulance Service is a Special Health Board that provides ambulance services throughout whole of Scotland, on behalf of the Health and Social Care Directorates of the Scottish Government.
Due to the remote nature of many areas of Scotland compared to the other Home Nations, the Scottish Ambulance Service has Britain's only publi
Scotland is a country, part of the United Kingdom. Sharing a border with England to the southeast, Scotland is otherwise surrounded by the Atlantic Ocean to the north and west, by the North Sea to the northeast and by the Irish Sea to the south. In addition to the mainland, situated on the northern third of the island of Great Britain, Scotland has over 790 islands, including the Northern Isles and the Hebrides; the Kingdom of Scotland emerged as an independent sovereign state in the Early Middle Ages and continued to exist until 1707. By inheritance in 1603, James VI, King of Scots, became King of England and King of Ireland, thus forming a personal union of the three kingdoms. Scotland subsequently entered into a political union with the Kingdom of England on 1 May 1707 to create the new Kingdom of Great Britain; the union created a new Parliament of Great Britain, which succeeded both the Parliament of Scotland and the Parliament of England. In 1801, the Kingdom of Great Britain and Kingdom of Ireland enacted a political union to create a United Kingdom.
The majority of Ireland subsequently seceded from the UK in 1922. Within Scotland, the monarchy of the United Kingdom has continued to use a variety of styles and other royal symbols of statehood specific to the pre-union Kingdom of Scotland; the legal system within Scotland has remained separate from those of England and Wales and Northern Ireland. The continued existence of legal, educational and other institutions distinct from those in the remainder of the UK have all contributed to the continuation of Scottish culture and national identity since the 1707 union with England; the Scottish Parliament, a unicameral legislature comprising 129 members, was established in 1999 and has authority over those areas of domestic policy which have been devolved by the United Kingdom Parliament. The head of the Scottish Government, the executive of the devolved legislature, is the First Minister of Scotland. Scotland is represented in the UK House of Commons by 59 MPs and in the European Parliament by 6 MEPs.
Scotland is a member of the British–Irish Council, sends five members of the Scottish Parliament to the British–Irish Parliamentary Assembly. Scotland is divided into councils. Glasgow City is the largest subdivision in Scotland in terms of population, with Highland being the largest in terms of area. "Scotland" comes from the Latin name for the Gaels. From the ninth century, the meaning of Scotia shifted to designate Gaelic Scotland and by the eleventh century the name was being used to refer to the core territory of the Kingdom of Alba in what is now east-central Scotland; the use of the words Scots and Scotland to encompass most of what is now Scotland became common in the Late Middle Ages, as the Kingdom of Alba expanded and came to encompass various peoples of diverse origins. Repeated glaciations, which covered the entire land mass of modern Scotland, destroyed any traces of human habitation that may have existed before the Mesolithic period, it is believed the first post-glacial groups of hunter-gatherers arrived in Scotland around 12,800 years ago, as the ice sheet retreated after the last glaciation.
At the time, Scotland was covered in forests, had more bog-land, the main form of transport was by water. These settlers began building the first known permanent houses on Scottish soil around 9,500 years ago, the first villages around 6,000 years ago; the well-preserved village of Skara Brae on the mainland of Orkney dates from this period. Neolithic habitation and ritual sites are common and well preserved in the Northern Isles and Western Isles, where a lack of trees led to most structures being built of local stone. Evidence of sophisticated pre-Christian belief systems is demonstrated by sites such as the Callanish Stones on Lewis and the Maes Howe on Orkney, which were built in the third millennium BCE; the first written reference to Scotland was in 320 BC by Greek sailor Pytheas, who called the northern tip of Britain "Orcas", the source of the name of the Orkney islands. During the first millennium BCE, the society changed to a chiefdom model, as consolidation of settlement led to the concentration of wealth and underground stores of surplus food.
The first Roman incursion into Scotland occurred in 79 AD. After the Roman victory, Roman forts were set along the Gask Ridge close to the Highland line, but by three years after the battle, the Roman armies had withdrawn to the Southern Uplands; the Romans erected Hadrian's Wall in northern England and the Limes Britannicus became the northern border of the Roman Empire. The Roman influence on the southern part of the country was considerable, they introduced Christianity to Scotland. Beginning in the sixth century, the area, now Scotland was divided into three areas: Pictland, a patchwork of small lordships in central Scotland; these societies were based on the family unit and had sharp divisions in wealth, although the vast majority were poor and worked full-time in subsistence agriculture. The Picts kept slaves through the ninth century. Gaelic influence over Pictland and Northumbria was facilitated by the large number of Gaelic-speaking clerics working as missionaries. Operating in the sixth ce
Scottish Fire and Rescue Service
The Scottish Fire and Rescue Service is the national fire and rescue service of Scotland. It was formed by the merger of eight regional fire services in the country on 1 April 2013, it thus became the largest fire brigade in the United Kingdom, surpassing the London Fire Brigade After a consultation, the Scottish Government confirmed on 8 September 2011 that a single fire and rescue service would be created in Scotland to replace the eight existing services. Following further consultation on the detailed operation of the service, the Police and Fire Reform Bill was published on 17 January 2012. After scrutiny and debate by the Scottish Parliament, the legislation was approved on 27 June 2012; the Bill duly received royal assent as the Police and Fire Reform Act 2012. This Act created Police Scotland in place of the previous eight regional police forces; the mergers were effective from 1 April 2013. Eight months after the consolidation, an internal report said the reorganisation had not negatively affected operational response.
The service is headquartered in Cambuslang, South Lanarkshire, which houses a national training centre opened in January 2013. There are a further three service delivery centres in the east and north of the country. On 16 August 2012 the Scottish Government confirmed the first chief fire officer of the new service would be Alasdair Hay acting chief fire officer of Tayside Fire and Rescue Service, following an open recruitment exercise. Pat Watters, former president of the Convention of Scottish Local Authorities, was announced as chair of the service, an appointment to run for three years from September 2012. Members of the SFRS Board appointed in October 2012 were Watters, Bob Benson, James Campbell, Kirsty Darwent, Marieke Dwarshuis, Michael Foxley, Robin Iffla, Bill McQueen, Sid Patten, Neil Pirie, Martin Togneri and Grant Thoms; the Scottish Fire and Rescue Service attended 25,002 fires in 2014/15. The service delivers a preventative programme, with 65,343 free home fire safety visits conducted in 2015/16.
As well as fighting fires, the service attends tens of thousands of specialist services such as road traffic collisions, water rescues and flooding incidents. In 2014/15 it attended 10,740 non-fire incidents; the service works alongside other emergency services during flooding events to ensure the safety of communities and rescue people in difficulty, with specialist swift water rescue teams positioned on major waterways and areas of activity. Firefighters are called out to water and boat rescues. For example, during Storm Frank in December 2015 the SFRS received 350 flood related calls in the space of six days. In 2015 the SFRS were called out to 78 wildfire incidents in total, with over half of those taking place in the north of Scotland. In 2015 a national trial was launched, in partnership with the Scottish Ambulance Service, which has seen firefighters at certain stations receive enhanced CPR training aimed at increasing survival rates for people who suffer out-of-hospital cardiac arrests.
As of March 2016, the SFRS operates 356 stations throughout Scotland. Stations are split into three categories: Wholetime: A station with full-time firefighters. Retained: Part-time, on a call-out basis and predominantly based in some of the more rural areas of Scotland. Volunteer: On a call-out basis and predominantly based in some of the more remote villages and islands; the most northerly station is Baltasound on the Shetland Islands. The most southerly is a volunteer station in the village of Drummore in Galloway; the Scottish Fire and Rescue Service National Training Centre opened in January 2013. The facility in Cambuslang features a mock town with realistic motorways, railway tracks and buildings, including a multi-storey tenement structure; the following services were merged to create the Scottish Fire and Rescue Service: Central Scotland Fire and Rescue Service and Galloway Fire and Rescue Service, Fife Fire and Rescue Service, Grampian Fire and Rescue Service and Islands Fire and Rescue Service and Borders Fire and Rescue Service, Strathclyde Fire and Rescue, Tayside Fire and Rescue Service.
The number of control rooms handling 999 calls was reduced from eight to three. The consolidation of regional call centres has resulted in a number of dispatching errors. For example, in December 2016 a crew from Raasay was mobilised to an incident on Skye – a journey that would have required taking their fire engine on a ferry – despite an alternative crew being able to reach Skye directly via a road bridge. On another occasion, a crew from Beauly was sent to a blaze 10 miles away in Dingwall as the dispatcher was unaware Dingwall had its own fire station, her Majesty's Fire Service Inspectorate for Scotland Mountain Rescue Committee of Scotland List of British firefighters killed in the line of duty Official website BBC news report, 29 March 2013: Why Grampian is losing its unusual white fire engines, other questions... Consultation document: Keeping Scotland Safe and Strong: A Consultation on Reforming Police and Fire and Rescue Services in Scotland Police and Fire Reform Bill
Scottish Ambulance Service
The Scottish Ambulance Service is the NHS Ambulance Services Trust, part of NHS Scotland, which serves all of Scotland's population. Uniquely, the Scottish Ambulance Service is considered a special health board and is funded directly by the Health and Social Care Directorates of the Scottish Government, it is the sole public emergency medical service covering Scotland's mainland and islands. In 1948, the newly formed National Health Service 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 as the St Andrew's and Red Cross Scottish Ambulance Service; the British Red Cross withdrew from the service in 1967. In 1974, with the reorganisation of the National Health Service, ambulance provision in Scotland was taken over by the NHS, with the organisational title being shortened to the now-current Scottish Ambulance Service. 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.
The Scottish Ambulance Service now continues in its current form as one of the largest emergency medical providers in the UK, employing more than 4,000 staff in a variety of roles and responding to 740,631 emergency incidents in 2015/2016 alone. The service, like the rest of the National Health Service is free at point of access and is utilised by the public and healthcare professionals alike. Employing 1,300 paramedic staff, a further 1,200 technicians, the accident and emergency service is accessed through the public 999 system. Ambulance responses are now prioritised on patient requirement; the Scottish Ambulance Service maintains three command and control centres in Scotland, which facilitate handling of 999 calls and dispatch of ambulances. These three centres have handle over 800,000 calls per year; the AMPDS system is used for call prioritisation, provides post-dispatch instructions to callers allowing for medical advice to be given over the phone, prior to ambulance arrival. Clinical staff are present to provide tertiary triage.
Co-located with the Ambulance Control Centres are patient transport booking and control services, which handle 1 million patient journeys per year. The Scottish Ambulance Service maintains a varied fleet of around 1,500 vehicles; this includes Accident and Emergency ambulances single-response vehicles such as cars and small vans for paramedics, patient-transport ambulances which come in the form of adapted minibuses and support vehicles for major incidents and events, specialist vehicles such as 4x4s and tracked vehicles for difficult access. The unique geography of Scotland, which includes urban centres such as Edinburgh and Glasgow, areas of low-population such as Grampian and the Highlands, the Island communities mean that fleet provision has to be flexible and include different approaches to vehicle construction. In the past, 4x4-build ambulances on van chassis have been used in more rural areas, traditional van-conversions in more urban. With a large fleet upgrade project being commissioned in 2016, the business case was made to move to a box-body on chassis build, to provide some flexibility and more resilient parts procurement.
Most of these replacement ambulances have been based on either Mercedes or Volkswagen chassis, with a mixture of automatic or manual transmissions. The equipment used on board Scottish Ambulance Service vehicles broadly falls in line with NHS Scotland and allows for intraoperability in most cases. Equipment is replaced at regular service intervals; the uniform falls in line with the NHS Scotland National Uniform standard, in keeping with the uniform standard described by the National Ambulance Uniform Procurement group in 2016. Amongst cost and comfort considerations, all Scottish Ambulance Service Staff now wear the national uniform which comprises a dark green trouser / shirt combination. Personal Protective Equipment are issued to all staff and denote rank / clinical rank by way of epaulette and helmet markings; the national headquarters are in west side of Edinburgh and there are five divisions within the Service, namely: The Patient Transport Service carries over 1.3 million patients every year.
This service is provided to patients who are physically or medically unfit to travel to hospital out-patient appointments by any other means can still make their appointments. The service handles non-emergency admissions, transport of palliative care patients and a variety of other specialised roles. Patient Transport Vehicles come in a variety of forms and are staffed by Ambulance Care Assistants, whom work
Strathcarron is a hamlet, situated at the head of the sea loch, Loch Carron, between the rivers, River Carron and River Taodail, in Wester Ross, Scottish Highlands and is in the Highland council area. It has a hotel called the Strathcarron railway station. Strathcarron is home to indie-folk musicians The Ramisco Maki Maki Rocking Horse and Oak Hero
The Scottish Parliament is the devolved unicameral legislature of Scotland. Located in the Holyrood area of the capital city, Edinburgh, it is referred to by the metonym Holyrood; the Parliament is a democratically elected body comprising 129 members known as Members of the Scottish Parliament, elected for four-year terms under the additional member system: 73 MSPs represent individual geographical constituencies elected by the plurality system, while a further 56 are returned from eight additional member regions, each electing seven MSPs. The most recent general election to the Parliament was held on 5 May 2016, with the Scottish National Party winning a plurality; the original Parliament of Scotland was the national legislature of the independent Kingdom of Scotland, existed from the early 13th century until the Kingdom of Scotland merged with the Kingdom of England under the Acts of Union 1707 to form the Kingdom of Great Britain. As a consequence, both the Parliament of Scotland and the Parliament of England ceased to exist, the Parliament of Great Britain, which sat at Westminster in London was formed.
Following a referendum in 1997, in which the Scottish electorate voted for devolution, the powers of the devolved legislature were specified by the Scotland Act 1998. The Act delineates the legislative competence of the Parliament – the areas in which it can make laws – by explicitly specifying powers that are "reserved" to the Parliament of the United Kingdom; the Scottish Parliament has the power to legislate in all areas that are not explicitly reserved to Westminster. The British Parliament retains the ability to amend the terms of reference of the Scottish Parliament, can extend or reduce the areas in which it can make laws; the first meeting of the new Parliament took place on 12 May 1999. The competence of the Scottish Parliament has been amended numerous times since most notably by the Scotland Act 2012 and Scotland Act 2016, with some of the most significant changes being the expansion of the Parliament's powers over taxation and welfare. Before the Treaty of Union 1707 united the Kingdom of Scotland and the Kingdom of England into a new state called "Great Britain", Scotland had an independent parliament known as the Parliament of Scotland.
Initial Scottish proposals in the negotiation over the Union suggested a devolved Parliament be retained in Scotland, but this was not accepted by the English negotiators. For the next three hundred years, Scotland was directly governed by the Parliament of Great Britain and the subsequent Parliament of the United Kingdom, both seated at Westminster, the lack of a Parliament of Scotland remained an important element in Scottish national identity. Suggestions for a'devolved' Parliament were made before 1914, but were shelved due to the outbreak of the First World War. A sharp rise in nationalism in Scotland during the late 1960s fuelled demands for some form of home rule or complete independence, in 1969 prompted the incumbent Labour government of Harold Wilson to set up the Kilbrandon Commission to consider the British constitution. One of the principal objectives of the commission was to examine ways of enabling more self-government for Scotland, within the unitary state of the United Kingdom.
Kilbrandon published his report in 1973 recommending the establishment of a directly elected Scottish Assembly to legislate for the majority of domestic Scottish affairs. During this time, the discovery of oil in the North Sea and the following "It's Scotland's oil" campaign of the Scottish National Party resulted in rising support for Scottish independence, as well as the SNP; the party argued that the revenues from the oil were not benefitting Scotland as much as they should. The combined effect of these events led to Prime Minister Wilson committing his government to some form of devolved legislature in 1974. However, it was not until 1978 that final legislative proposals for a Scottish Assembly were passed by the United Kingdom Parliament. Under the terms of the Scotland Act 1978, an elected assembly would be set up in Edinburgh provided that a referendum be held on 1 March 1979, with at least 40% of the total electorate voting in favour of the proposal; the 1979 Scottish devolution referendum failed: although the vote was 51.6% in favour of a Scottish Assembly, with a turnout of 63.6%, the majority represented only 32.9% of the eligible voting population.
Throughout the 1980s and 1990s, demand for a Scottish Parliament grew, in part because the government of the United Kingdom was controlled by the Conservative Party, while Scotland itself elected few Conservative MPs. In the aftermath of the 1979 referendum defeat, the Campaign for a Scottish Assembly was initiated as a pressure group, leading to the 1989 Scottish Constitutional Convention with various organisations such as Scottish churches, political parties and representatives of industry taking part. Publishing its blueprint for devolution in 1995, the Convention provided much of the basis for the structure of the Parliament. Devolution continued to be part of the platform of the Labour Party which, in May 1997, took power under Tony Blair. In September 1997, the Scottish devolution referendum was put to the Scottish electorate and secured a majority in favour of the establishment of a new devolved Scottish Parliament, with tax-varying powers, in Edinburgh. An election was held on 6 May 1999, on 1 July of that year power was transferred from Westminster to the new Parliament.
Since September 2004, the official home of the Scottish Parliament has been a new Scottish Parliament Building, in the Holyrood area of Edinburgh. The Scottish Parliament building was designed by Spanish architect Enric Miralles in partnership with local Ed
The United Kingdom the United Kingdom of Great Britain and Northern Ireland, sometimes referred to as Britain, is a sovereign country located off the north-western coast of the European mainland. The United Kingdom includes the island of Great Britain, the north-eastern part of the island of Ireland, many smaller islands. Northern Ireland is the only part of the United Kingdom that shares a land border with another sovereign state, the Republic of Ireland. Apart from this land border, the United Kingdom is surrounded by the Atlantic Ocean, with the North Sea to the east, the English Channel to the south and the Celtic Sea to the south-west, giving it the 12th-longest coastline in the world; the Irish Sea lies between Great Ireland. With an area of 242,500 square kilometres, the United Kingdom is the 78th-largest sovereign state in the world, it is the 22nd-most populous country, with an estimated 66.0 million inhabitants in 2017. The UK is constitutional monarchy; the current monarch is Queen Elizabeth II, who has reigned since 1952, making her the longest-serving current head of state.
The United Kingdom's capital and largest city is London, a global city and financial centre with an urban area population of 10.3 million. Other major urban areas in the UK include Greater Manchester, the West Midlands and West Yorkshire conurbations, Greater Glasgow and the Liverpool Built-up Area; the United Kingdom consists of four constituent countries: England, Scotland and Northern Ireland. Their capitals are London, Edinburgh and Belfast, respectively. Apart from England, the countries have their own devolved governments, each with varying powers, but such power is delegated by the Parliament of the United Kingdom, which may enact laws unilaterally altering or abolishing devolution; the nearby Isle of Man, Bailiwick of Guernsey and Bailiwick of Jersey are not part of the UK, being Crown dependencies with the British Government responsible for defence and international representation. The medieval conquest and subsequent annexation of Wales by the Kingdom of England, followed by the union between England and Scotland in 1707 to form the Kingdom of Great Britain, the union in 1801 of Great Britain with the Kingdom of Ireland created the United Kingdom of Great Britain and Ireland.
Five-sixths of Ireland seceded from the UK in 1922, leaving the present formulation of the United Kingdom of Great Britain and Northern Ireland. There are fourteen British Overseas Territories, the remnants of the British Empire which, at its height in the 1920s, encompassed a quarter of the world's land mass and was the largest empire in history. British influence can be observed in the language and political systems of many of its former colonies; the United Kingdom is a developed country and has the world's fifth-largest economy by nominal GDP and ninth-largest economy by purchasing power parity. It has a high-income economy and has a high Human Development Index rating, ranking 14th in the world, it was the world's first industrialised country and the world's foremost power during the 19th and early 20th centuries. The UK remains a great power, with considerable economic, military and political influence internationally, it is sixth in military expenditure in the world. It has been a permanent member of the United Nations Security Council since its first session in 1946.
It has been a leading member state of the European Union and its predecessor, the European Economic Community, since 1973. The United Kingdom is a member of the Commonwealth of Nations, the Council of Europe, the G7, the G20, NATO, the Organisation for Economic Co-operation and Development and the World Trade Organization; the 1707 Acts of Union declared that the kingdoms of England and Scotland were "United into One Kingdom by the Name of Great Britain". The term "United Kingdom" has been used as a description for the former kingdom of Great Britain, although its official name from 1707 to 1800 was "Great Britain"; the Acts of Union 1800 united the kingdom of Great Britain and the kingdom of Ireland in 1801, forming the United Kingdom of Great Britain and Ireland. Following the partition of Ireland and the independence of the Irish Free State in 1922, which left Northern Ireland as the only part of the island of Ireland within the United Kingdom, the name was changed to the "United Kingdom of Great Britain and Northern Ireland".
Although the United Kingdom is a sovereign country, Scotland and Northern Ireland are widely referred to as countries. The UK Prime Minister's website has used the phrase "countries within a country" to describe the United Kingdom; some statistical summaries, such as those for the twelve NUTS 1 regions of the United Kingdom refer to Scotland and Northern Ireland as "regions". Northern Ireland is referred to as a "province". With regard to Northern Ireland, the descriptive name used "can be controversial, with the choice revealing one's political preferences"; the term "Great Britain" conventionally refers to the island of Great Britain, or politically to England and Wales in combination. However, it is sometimes used as a loose synonym for the United Kingdom as a whole; the term "Britain" is used both as a synonym for Great Britain, as a synonym for the United Kingdom. Usage is mixed, with the BBC preferring to use Britain as shorthand only for Great Britain and the UK Government, while accepting that both terms refer to the United K