England is a country, part of the United Kingdom. It shares land borders with Wales to Scotland to the north-northwest; the Irish Sea lies west of England and the Celtic Sea lies to the southwest. England is separated from continental Europe by the North Sea to the east and the English Channel to the south; the country covers five-eighths of the island of Great Britain, which lies in the North Atlantic, includes over 100 smaller islands, such as the Isles of Scilly and the Isle of Wight. The area now called England was first inhabited by modern humans during the Upper Palaeolithic period, but takes its name from the Angles, a Germanic tribe deriving its name from the Anglia peninsula, who settled during the 5th and 6th centuries. England became a unified state in the 10th century, since the Age of Discovery, which began during the 15th century, has had a significant cultural and legal impact on the wider world; the English language, the Anglican Church, English law – the basis for the common law legal systems of many other countries around the world – developed in England, the country's parliamentary system of government has been adopted by other nations.
The Industrial Revolution began in 18th-century England, transforming its society into the world's first industrialised nation. England's terrain is chiefly low hills and plains in central and southern England. However, there is upland and mountainous terrain in the west; the capital is London, which has the largest metropolitan area in both the United Kingdom and the European Union. England's population of over 55 million comprises 84% of the population of the United Kingdom concentrated around London, the South East, conurbations in the Midlands, the North West, the North East, Yorkshire, which each developed as major industrial regions during the 19th century; the Kingdom of England – which after 1535 included Wales – ceased being a separate sovereign state on 1 May 1707, when the Acts of Union put into effect the terms agreed in the Treaty of Union the previous year, resulting in a political union with the Kingdom of Scotland to create the Kingdom of Great Britain. In 1801, Great Britain was united with the Kingdom of Ireland to become the United Kingdom of Great Britain and Ireland.
In 1922 the Irish Free State seceded from the United Kingdom, leading to the latter being renamed the United Kingdom of Great Britain and Northern Ireland. The name "England" is derived from the Old English name Englaland, which means "land of the Angles"; the Angles were one of the Germanic tribes that settled in Great Britain during the Early Middle Ages. The Angles came from the Anglia peninsula in the Bay of Kiel area of the Baltic Sea; the earliest recorded use of the term, as "Engla londe", is in the late-ninth-century translation into Old English of Bede's Ecclesiastical History of the English People. The term was used in a different sense to the modern one, meaning "the land inhabited by the English", it included English people in what is now south-east Scotland but was part of the English kingdom of Northumbria; the Anglo-Saxon Chronicle recorded that the Domesday Book of 1086 covered the whole of England, meaning the English kingdom, but a few years the Chronicle stated that King Malcolm III went "out of Scotlande into Lothian in Englaland", thus using it in the more ancient sense.
According to the Oxford English Dictionary, its modern spelling was first used in 1538. The earliest attested reference to the Angles occurs in the 1st-century work by Tacitus, Germania, in which the Latin word Anglii is used; the etymology of the tribal name itself is disputed by scholars. How and why a term derived from the name of a tribe, less significant than others, such as the Saxons, came to be used for the entire country and its people is not known, but it seems this is related to the custom of calling the Germanic people in Britain Angli Saxones or English Saxons to distinguish them from continental Saxons of Old Saxony between the Weser and Eider rivers in Northern Germany. In Scottish Gaelic, another language which developed on the island of Great Britain, the Saxon tribe gave their name to the word for England. An alternative name for England is Albion; the name Albion referred to the entire island of Great Britain. The nominally earliest record of the name appears in the Aristotelian Corpus the 4th-century BC De Mundo: "Beyond the Pillars of Hercules is the ocean that flows round the earth.
In it are two large islands called Britannia. But modern scholarly consensus ascribes De Mundo not to Aristotle but to Pseudo-Aristotle, i.e. it was written in the Graeco-Roman period or afterwards. The word Albion or insula Albionum has two possible origins, it either derives from a cognate of the Latin albus meaning white, a reference to the white cliffs of Dover or from the phrase the "island of the Albiones" in the now lost Massaliote Periplus, attested through Avienus' Ora Maritima to which the former served as a source. Albion is now applied to England in a more poetic capacity. Another romantic name for England is Loegria, related to the Welsh word for England and made popular by its use in Arthurian legend; the earliest known evidence of human presence in the area now known as England was that of Homo antecessor, dating to approximate
Cumbria is a ceremonial and non-metropolitan county in North West England. The county and Cumbria County Council, its local government, came into existence in 1974 after the passage of the Local Government Act 1972. Cumbria's county town is Carlisle, in the north of the county, the only other major urban area is Barrow-in-Furness on the southwestern tip of the county; the county of Cumbria consists of six districts and in 2008 had a population of just under half a million. Cumbria is one of the most sparsely populated counties in the United Kingdom, with 73.4 people per km2. Cumbria is the third largest county in England by area, is bounded to the north by the Scottish council areas of Dumfries and Galloway and Scottish Borders, to the west by the Irish Sea, to the south by Lancashire, to the southeast by North Yorkshire, to the east by County Durham and Northumberland. Cumbria is predominantly rural and contains the Lake District National Park, a UNESCO World Heritage Site considered one of England's finest areas of natural beauty, serving as inspiration for artists and musicians.
A large area of the southeast of the county is within the Yorkshire Dales National Park while the east of the county fringes the North Pennines AONB. Much of Cumbria is mountainous, it contains every peak in England over 3,000 feet above sea level, with Scafell Pike at 3,209 feet being the highest point of England. An upland and rural area, Cumbria's history is characterised by invasions and settlement, as well as battles and skirmishes between the English and the Scots. Notable historic sites in Cumbria include Carlisle Castle, Furness Abbey, Hardknott Roman Fort, Brough Castle and Hadrian's Wall; the county of Cumbria was created in April 1974 through an amalgamation of the administrative counties of Cumberland and Westmorland, to which parts of Lancashire and the West Riding of Yorkshire were added. During the Neolithic period the area contained an important centre of stone axe production, products of which have been found across Great Britain. During this period stone circles and henges began to be built across the county and today'Cumbria has one of the largest number of preserved field monuments in England'.
While not part of the region conquered in the Romans' initial conquest of Britain in 43 AD, most of modern-day Cumbria was conquered in response to a revolt deposing the Roman-aligned ruler of the Brigantes in 69 AD. The Romans built a number of fortifications in the area during their occupation, the most famous being UNESCO World Heritage Site Hadrian's Wall which passes through northern Cumbria. At the end of the period of British history known as Roman Britain the inhabitants of Cumbria were Cumbric-speaking native Romano-Britons who were descendants of the Brigantes and Carvetii that the Roman Empire had conquered in about AD 85. Based on inscriptional evidence from the area, the Roman civitas of the Carvetii seems to have covered portions of Cumbria; the names Cumbria, Cymru and Cumberland are derived from the name these people gave themselves, *kombroges in Common Brittonic, which meant "compatriots". Although Cumbria was believed to have formed the core of the Early Middle Ages Brittonic kingdom of Rheged, more recent discoveries near Galloway appear to contradict this.
For the rest of the first millennium, Cumbria was contested by several entities who warred over the area, including the Brythonic Celtic Kingdom of Strathclyde and the Anglian kingdom of Northumbria. Most of modern-day Cumbria was a principality in the Kingdom of Scotland at the time of the Norman conquest of England in 1066 and thus was excluded from the Domesday Book survey of 1086. In 1092 the region was incorporated into England; the region was dominated by the many Anglo-Scottish Wars of the latter Middle Ages and early modern period and the associated Border Reivers who exploited the dynamic political situation of the region. There were at least three sieges of Carlisle fought between England and Scotland, two further sieges during the Jacobite risings. After the Jacobite Risings of the eighteenth century, Cumbria became a more stable place and, as in the rest of Northern England, the Industrial Revolution caused a large growth in urban populations. In particular, the west-coast towns of Workington and Barrow-in-Furness saw large iron and steel mills develop, with Barrow developing a significant shipbuilding industry.
Kendal and Carlisle all became mill town, with textiles and biscuits among the products manufactured in the region. The early nineteenth century saw the county gain fame as the Lake Poets and other artists of the Romantic movement, such as William Wordsworth and Samuel Taylor Coleridge, lived among, were inspired by, the lakes and mountains of the region; the children's writer Beatrix Potter wrote in the region and became a major landowner, granting much of her property to the National Trust on her death. In turn, the large amount of land owned by the National Trust assisted in the formation of the Lake District National Park in 1951, which remains the largest National Park in England and has come to dominate the identity and economy of the county; the county of Cumbria was created in 1974 from the traditional counties of Cumberland and Westmorland, the Cumberland County Borough of Carlisle, along with the North Lonsdale or Furness part of Lancashire referred to as "Lancashire North of
Thomas Harrison (soldier)
Major-General Thomas Harrison sided with Parliament in the English Civil War. During the Interregnum he was a leader of the Fifth Monarchists. In 1649 he signed the death warrant of Charles I and in 1660, shortly after the Restoration, he was found guilty of regicide and hanged and quartered; the son of Richard Harrison the mayor of Newcastle-under-Lyme, he moved to London where he was admitted to the Inns of Court as an attorney at Clifford's Inn. Whilst a lawyer he met Edmund Ludlow, he enlisted in Earl of Essex's lifeguard in 1642 and experienced his baptism of fire at the Battle of Powick Bridge During the Civil War he declared for Parliament and served in the Earl of Manchester's army. He fought in many of the major battles of the war and joined the New Model Army in 1645. By the end of the conflict he had risen to the rank of major-general and was a noted friend and supporter of Oliver Cromwell, he was elected to the Long Parliament for Wendover in 1646. His regiment maintained strong leveller sympathies, mutinying in 1647.
When conflict resumed he was wounded at Appleby in July 1648. He had to return to London but was well enough to command the escort that brought the King to London in January 1649. Harrison sat as a commissioner at the trial and was the seventeenth of fifty-nine commissioners to sign the death warrant of King Charles I. In 1650, Harrison was appointed to a military command in Wales where he was extremely severe, he was promoted to the rank of Major-General in 1651 and commanded the army in England during Cromwell's Scottish expedition. He fought at the battle of Knutsford in August and at Worcester in September 1651. By the early 1650s Harrison was associated with the radical Fifth Monarchists and became one of their key speakers, he still supported Cromwell and aided in the dissolution of the Rump Parliament in April 1653. Harrison was a radical member of the Nominated Assembly; when the Assembly was dissolved and others refused to leave and had to be forced out by soldiers. Harrison was dismissed from the Army in December.
Like many, he was outraged by the formation of the Protectorate and the elevation of Cromwell to Lord Protector. Under the Protectorate Harrison was imprisoned four times. After Cromwell's death Harrison remained in his home, supporting none of the contenders for power. Following the Restoration, Harrison declined to flee and was arrested in May 1660, he was tried on 11 October 1660. Edmond Ludlow described the trial in his memoirs, "... not only pleaded not guilty, but justified the sentence passed upon the King, the authority of those who had commissioned him to act as one of his judges. He plainly told them, when witnesses were produced against him, that he came not thither with an intention to deny anything he had done, but rather to bring it to light, owning his name subscribed to the warrant for executing the King, to be written by himself, he insisted that having done nothing, in relation to the matter in question, otherwise than by the authority of the Long Parliament, he was not justly accountable to this or any other inferior Court.
So that a hasty verdict was brought in against him, the question being asked, if he had anything to say, why judgement should not pass, he only said, that since the Court had refused to hear what was fit for him to speak in his defense, he had no more to say. And that the inhumanity of these men may the better appear, I must not omit, that the executioner in an ugly dress, with a halter in his hand, was placed near the Major-General, continued there during the whole time of his trial, which action I doubt whether it was equaled by the most barbarous nations, but having learned to condemn such baseness, after the sentence had been pronounced against him, he said aloud as he was withdrawn from the Court, that he had no reason to be ashamed of the cause in which he had been engaged." Major-General Harrison was the first of the Regicides to be executed by being hanged and quartered on 13 October 1660. Harrison, after being hanged for several minutes and cut open, was reported to have leaned across and hit his executioner—resulting in the swift removal of his head.
His entrails were thrown onto a nearby fire. Samuel Pepys wrote an eyewitness account of the execution at Charing Cross, in which Major General Harrison was drily reported to be "looking as cheerful as any man could do in that condition"; this account is quoted on a plaque on the wall of the Hung and Quartered public house near Pepys Street, where the diarist lived and worked in the Navy Office. In his final moments, as he was being led up the scaffold, the hangman asked for his forgiveness. Upon hearing his request Thomas Harrison replied, "I do forgive thee with all my heart... Alas poor man, thou doith it ignorantly, the Lord grant that this sin may be not laid to thy c
Historic counties of England
The historic counties of England are areas that were established for administration by the Normans, in many cases based on earlier kingdoms and shires created by the Anglo-Saxons and others. They are alternatively known as ancient counties, traditional counties, former counties or as counties. In the centuries that followed their establishment, as well as their administrative function, the counties helped define local culture and identity; this role continued after the counties ceased to be used for administration after the creation of administrative counties in 1889, which were themselves amended by further local government reforms in the years following. Unlike the self-governing boroughs that covered urban areas, the counties of medieval England existed as a means of enforcing central government power, enabling monarchs to exercise control over local areas through their chosen representatives – sheriffs and the Lord-Lieutenants – and their subordinate justices of the peace. Counties were used for the administration of justice, collection of taxes and organisation of the military, for local government and electing parliamentary representation.
They continue to form the basis of modern local government in many parts of the country away from the main urban areas, although sometimes with altered boundaries. The name of a county gives a clue to how it was formed, either as a division that took its name from a centre of administration, an ancient kingdom, or an area occupied by an ethnic group; the majority of English counties are in the first category, with the name formed by combining the central town with the suffix "-shire", for example Yorkshire. Former kingdoms, which became earldoms in the united England did not feature this formulation. Counties ending in the suffix "-sex", the former Saxon kingdoms, are in this category. Many of these names are formed from compass directions; the third category includes counties such as Cornwall and Devon where the name corresponds to the tribes who inhabited the area. County Durham is anomalous in terms of naming and origin, not falling into any of the three categories. Instead, it was a diocese, turned into the County Palatine of Durham, ruled by the Bishop of Durham.
The expected form would otherwise be "Durhamshire", but it was used. There are customary abbreviations for many of the counties. In most cases, these consist of simple truncation with an "s" at the end signifying "shire", such as "Berks" for Berkshire or "Bucks" for Buckinghamshire; some abbreviations are not obvious, such as "Salop" for Shropshire, from the Norman-derived word for its county town Shrewsbury. Counties were prefixed with "County of" in official contexts, such as "County of Kent"; those counties named after central towns lost the -"shire" suffix, for example Yorkshire would be known as "County of York". This usage was sometimes followed where there was no town by that name, such as the "County of Berks"; the "-shire" suffix was appended for some counties, such as "Devonshire", "Dorsetshire" and "Somersetshire", despite their origin. There is still a Duke of Devonshire. Great Britain was first divided into administrative areas by the Romans, most following major geographical features such as rivers.
Before their arrival there were distinct tribal areas, but they were in a constant state of flux as territory was gained and lost. After the demise of Roman Britain around 410 these first divisions of land were abandoned, although traditional divisions taking the form of petty kingdoms such as Powys and Elmet, remained in those areas which remained British, such as south west England; the areas that would form the English counties started to take shape soon afterwards, with the Kingdom of Kent founded by settlers around 445. In southern England more shires emerged from earlier sub-kingdoms as part of the administrative structure of Wessex, which imposed its system of shires and ealdormen on Mercia after it came under West Saxon control during the 9th century. Once the Kingdom of England was united as a whole in 927 it became necessary to subdivide it for administrative convenience and to this end, earldoms were created out of the earlier kingdoms; the whole kingdom was divided into shires by the time of the Norman conquest.
Robert of Gloucester accounts for thirty-five shires and William of Malmesbury thirty-two, Henry of Huntingdon, thirty-seven. In most cases the counties or shires in medieval times were administered by a sheriff on behalf of the monarch. After the Norman conquest the sheriff was replaced and the shires became counties, or "areas under the control of a count", in the French manner. Although all of England was divided into shires by the time of the Norman conquest, some counties were formed later, up to the 16th century; because of their differing origins the counties varied in size. The county boundaries were static between the 16th century Laws in Wales acts and the Local Government Act 1888; each shire was responsible for gathering taxes for the central government. In southern England the counties were subdivisions of the Kingdom of Wessex, in many areas represented annexed independent, kingdoms or other tribal territories. Kent derives from the Kingdom of Kent, Essex and Middlesex come from the East Saxons, South Saxons and Middle Saxons.
Norfolk and Suffolk were subdivis
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
The Lake District known as the Lakes or Lakeland, is a mountainous region in North West England. A popular holiday destination, it is famous for its lakes and mountains, its associations with William Wordsworth and other Lake Poets and with Beatrix Potter and John Ruskin; the National Park covers an area of 2,362 square kilometres. It was designated a UNESCO World Heritage Site in 2017; the Lake District is located within the county of Cumbria. All the land in England higher than 3,000 feet above sea level lies within the National Park, including Scafell Pike, the highest mountain in England, it contains the deepest and largest natural lakes in England, Wast Water and Windermere respectively. The Lake District National Park includes all of the central Lake District, though the town of Kendal, some coastal areas, the Lakeland Peninsulas are outside the park boundary; the area was designated a national park on 9 May 1951. It retained its original boundaries until 2016 when it was extended by 3% in the direction of the Yorkshire Dales National Park to incorporate areas such as land of high landscape value in the Lune Valley.
It is the most visited national park in the United Kingdom with 15.8 million annual visitors and more than 23 million annual day visits, the largest of the thirteen national parks in England and Wales, the second largest in the UK after the Cairngorms National Park. Its aim is to protect the landscape by restricting unwelcome change by commerce. Most of the land in the park is in private ownership, with about 55% registered as agricultural land. Landowners include: Individual farmers and other private landowners, with more than half of the agricultural land farmed by the owners; the National Trust owns about a quarter of the total area. The Forestry Commission and other investors in forests and woodland. United Utilities owns 8% Lake District National Park Authority The National Park Authority is based at offices in Kendal, it runs a visitor centre on Windermere at a former country house called Brockhole, Coniston Boating Centre, Information Centres. It is reducing its landholding. In common with all other national parks in England, there is no restriction on entry to, or movement within the park along public routes, but access to cultivated land is restricted to public footpaths and byways.
Much of the uncultivated land has statutory open access rights. The lakes and mountains combine to form impressive scenery. Farmland and mining have altered the natural scenery, the ecology has been modified by human influence for millennia and includes important wildlife habitats. Having failed in a previous attempt to gain World Heritage status as a natural World Heritage Site, because of human activities, it was successful in the category of cultural landscape and was awarded the status in 2017; the precise extent of the Lake District was not defined traditionally, but is larger than that of the National Park, the total area of, about 912 square miles. The park extends just over 32 miles from east to west and nearly 40 miles from north to south, with areas such as the Lake District Peninsulas to the south lying outside the National Park; the Lake District is one of the most populated national parks. There are, only a handful of major settlements within this mountainous area, the towns of Keswick, Windermere and Bowness-on-Windermere being the four largest.
Significant towns outside the boundary of the national park include Millom, Barrow-in-Furness, Ulverston, Dalton-in-Furness, Cockermouth and Grange-over-Sands. Villages such as Coniston, Glenridding, Pooley Bridge, Broughton-in-Furness, Newby Bridge, Lindale and Hawkshead are more local centres; the economies of all are intimately linked with tourism. Beyond these are a scattering of hamlets and many isolated farmsteads, some of which are still tied to agriculture; the Lake District National Park is contained within a box of trunk routes. It is flanked to the east by the A6 road; the A590 which connects the M6 to Barrow-in-Furness, the A5092 trunk roads cut across its southern fringes and the A66 trunk road between Penrith and Workington cuts across its northern edge. The A595 trunk road runs through the coastal plains to the west of the area, linking the A66 with the A5092. Besides these, a few A roads penetrate the area itself, notably the A591 which runs north-westwards from Kendal to Windermere and on to Keswick.
It continues up the east side of Bassenthwaite Lake. "The A591, Lake District" was short-listed in the 2011 Google Street View awards in the Most Romantic Street category. The A593 and A5084 link the Ambleside and Coniston areas with the A590 to the south whilst the A592 and A5074 link Windermere with the A590; the A592 continues northwards from Windermere to Ullswater and Penrith by way of the Kirkstone Pass. Some valleys which are not penetrated by A roads are served by B roads; the B5289 serves links via the Honister Pass with Borrowdale. The B5292 ascends the Whinlatter Pass from Lorton Vale before dropping down to Braithwaite near Keswick; the B5322 serves the valley of St John's in the Vale whilst Great Langdale is served by the B5343. Other valle
North West Ambulance Service
The North West Ambulance Service NHS Trust is the ambulance service for North West England. It is one of 10 Ambulance Trusts providing England with Emergency medical services, is part of the National Health Service, receiving direct government funding for its role. NWAS was formed on 1 July 2006, it was created by the merge of 4 previous services as part of Health Minister Lord Warner's plans to combine ambulance services. Based in Bolton, the new Trust provides services to 7 million people in Greater Manchester, Merseyside, Lancashire and the North Western fringes of the High Peak district of Derbyshire in an area of some 5,500 square miles. There is no charge to patients for use of the service, under the Patient's charter, every person in the United Kingdom has the right to the attendance of an ambulance in an emergency. NWAS provides emergency ambulance response via the 999 system, as well as operating the NHS 111 advice service for North West England, they operate non-emergency patient transport services, in 2013/2014 carried out 1.2 million such journeys.
Since 2016, the PTS in Cheshire and Wirral has instead been carried out by West Midlands Ambulance Service. NWAS utilise a mixed fleet of emergency ambulances based on the Mercedes-Benz Sprinter or Fiat Ducato, the former consisting of a demountable box body on a chassis, the latter a van conversion; the Trust uses Skoda Octavia estates as the main Rapid response car although since 2017 begun using BMW i3 electric cars and use Renault Masters for Intermediate, Urgent care and Patient Transport vehicles. In Central Manchester, some paramedics respond on specially converted bicycles; the Trust operates from 104 ambulance stations across the North West. The most northerly station is at Carlisle, the furthest south is at Crewe, it maintains three Emergency Operations Centres for the handling of 999 calls and dispatch of emergency ambulances. Parkway Anfield Preston In 2017, NWAS signed an agreement to purchase a new EOC and area office for £2.9m at Liverpool International Business Park next to Liverpool John Lennon Airport As of 2019, this building has been converted and services are being moved from the Anfield site.
Over recent years, the Trust has combined many of their older ambulance stations into purpose-built facilities shared with other emergency services, including Greater Manchester Fire and Rescue, Lancashire Fire and Rescue and Greater Manchester Police. NWAS was the first ambulance trust to be inspected by the Care Quality Commission, in August 2014; the Commission found the trust provided safe and effective services which were well-led and with a clear focus on quality but it was criticised for taking too many callers to hospital and for sending ambulances when other responses would have been more appropriate. The Trust was subsequently inspected in 2018 and was found to have improved with a rating of "Good" Emergency medical services in the United Kingdom Healthcare in Greater Manchester North West Air Ambulance List of NHS trusts NWAS Website