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
Stonor Park is a historic country house and private deer park situated in a valley in the Chiltern Hills at Stonor, about four miles north of Henley-on-Thames in Oxfordshire, close to the county boundary with Buckinghamshire. The house has a 12th-century private chapel; the remains of a prehistoric stone circle are in the grounds. It is the ancestral seat of the Stonor family, Baron Camoys; the current Lord Camoys is 7th Baron Camoys. The house nestles in the Chiltern Hills. Behind the main house, there is a walled garden in an Italianate style on a rising slope, providing good views. Around the house is a park with a herd of fallow deer. Around the park are Almshill Wood, Balham's Wood and Kildridge Wood; the house and garden are open to the public. Stonor House has been the home of the Stonor family for more than eight centuries. In the house are displays of family portraits, tapestries and ceramics; the house has a 12th-century private chapel built with an early brick tower. The house was begun after 1280 when Sir Richard Stoner married his second wife, Margaret Harnhull.
During and after the English Reformation the Stonor family and many other local gentry were recusants. In 1581 the Jesuit priests Edmund Campion and Robert Parsons lived and worked at Stonor Park, Campion's Decem Rationes was printed here on a secret press. On 4 August 1581 a raid on the house found the press. Campion and Parsons had left a few days earlier, but the elderly Lady Cecily Stonor, her son John, the Jesuit priest William Hartley, the printers and four servants were taken prisoner, in 1585 Hartley was exiled. Despite further prosecutions and fines the Stonors remained Roman Catholic throughout the 17th and 18th centuries, enabled many local villagers to remain Roman Catholic by allowing them to attend Mass at their private chapel. Between 1716 and 1756 John Talbot Stonor, Vicar Apostolic of the Midland District used Stonor Park as his headquarters; the Stonor family's steadfast adherence to Roman Catholicism throughout the reformation led to their marginalization and relative impoverishment in subsequent centuries.
This has inadvertently resulted in the preservation of the house in a relative unspoiled and unimproved state. The house was built on the site of a prehistoric stone circle or henge and this has given it its name; the remains of the circle are still visible with one stone incorporated into the south-east corner of the chapel. The stones are a mixture of sarsens and puddingstone; the current stone positions are the result of re-positioning during 17th-century landscaping and 20th-century reconstruction. The site is listed as a folly in the Sites and Monuments Record ). Stonor has been used as a location for a number of film and television productions, including The Pumaman and the James Bond film The Living Daylights. In 1989, it was used as the home of millionaire Victor Hazell in the film version of the Roald Dahl book Danny, the Champion of the World, it is used for antique fairs, art exhibitions, craft shows, outdoor concerts. Stonor Cricket Club has a beautiful location, overlooking the Stonor Park estate.
Lobel, Mary D.. A History of the County of Oxford: Volume 8: Lewknor and Pyrton Hundreds. Pp. 98–115. Pevsner, Nikolaus; the Buildings of England: Oxfordshire. Harmondsworth: Penguin. Pp. 791–794. ISBN 0-14-071045-0. Stonor official website AboutBritain.com information Great British Gardens information Tour UK information The Living Daylights information Stonor Cricket Club official website
Pishill with Stonor
Pishill with Stonor is a civil parish in the high Chilterns, South Oxfordshire. It includes the villages of Pishill and Stonor, the hamlets of Maidensgrove and Russell's Water. Pishill with Stonor was formed by the merger of the separate civil parishes of Pishill and Stonor in 1922. In 2011 it had a human population of 304 across its 10.54km². Lobel, Mary D.. Victoria County History: A History of the County of Oxford: Volume 8: Lewknor and Pyrton Hundreds. Pp. 131–138
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
John Piper (artist)
John Egerton Christmas Piper CH was an English painter and designer of stained-glass windows and both opera and theatre sets. His work focused on the British landscape churches and monuments, included tapestry designs, book jackets, screen-prints, photography and ceramics, he was educated at Epsom College and trained at the Richmond School of Art followed by the Royal College of Art in London. He turned from abstraction early in his career, concentrating on a more naturalistic but distinctive approach, but worked in several different styles throughout his career, he was an official war artist in World War II and his war-time depictions of bomb damaged churches and landmarks, most notably those of Coventry Cathedral, made Piper a household name and led to his work being acquired by several public collections. Piper collaborated with many others, including the poets John Betjeman and Geoffrey Grigson on the Shell Guides, with the potter Geoffrey Eastop and the artist Ben Nicholson. In his years he produced many limited-edition prints.
John Piper was born in Epsom, the youngest of three sons to the solicitor Charles Alfred Piper and his wife Mary Ellen Matthews. During Piper's childhood, Epsom was still countryside, he went exploring on his bike, drew and painted pictures of old churches and monuments on the way. He started making guide books complete with pictures and information at a young age. Piper's brothers both served in the First World War and one of them was killed at Ypres in 1915. John Piper attended Epsom College from 1919, he found refuge in art. When he left Epsom College in 1922, Piper published a book of poetry and wanted to study to become an artist. However, his father disagreed and insisted he join the family law firm, Smith & Piper in Westminster. Piper worked beside his father in London for three years, took articles but refused the offer of a partnership in the firm; this refusal left him free to attend Richmond School of Art. At Richmond, the artist Raymond Coxon prepared him for the entrance exams for the Royal College of Art, which Piper entered in 1928.
While studying at Richmond, Piper met Eileen Holding, a fellow student whom he married in August 1929. Piper disliked the regime at the Royal College of Art and left in December 1929. Piper and Holding lived in Hammersmith and held a joint exhibition of their artworks at Heal's in London in 1931. Piper wrote art and music reviews for several papers and magazines. One such review, of the artist Edward Wadsworth's work, led to an invitation from Ben Nicholson for Piper to join the Seven and Five Society of modern artists. In the following years Piper was involved in a wide variety of projects in several different media; as well as abstract paintings, he produced collages with the English landscape or seaside as the subject. He drew a series on Welsh nonconformist chapels, produced articles on English typography and made arts programmes for the BBC, he experimented with placing constructions of dowelling rods over the surface of his canvases and with using mixtures of sand and paint. With Myfanwy Evans, Piper founded the contemporary art journal Axis in 1935.
As the art critic for The Listener, through working on Axis and by his membership of the London Group and the Seven and Five Society, Piper was at the forefront of the modernist movement in Britain throughout the 1930s. In 1935 Piper and Evans began documenting Early English sculptures in British churches. Piper believed that Anglo-Saxon and Romanesque sculptures, as a popular art form, had parallels to contemporary art. Through Evans, Piper met John Betjeman in 1937 and Betjeman asked Piper to work on the Shell Guides he was editing. Piper illustrated the guide to Oxfordshire, focusing on rural churches. In March 1938 Stephen Spender asked Piper to design the sets for his production of Trial of a Judge. Piper's first one-man show in May 1938 included abstract paintings, collage landscapes and more conventional landscapes, his second in March 1940 at the Leicester Galleries, featuring several pictures of derelict ruins, was a sell-out. Piper had first met Myfanwy Evans in 1934 and early the next year, when Eileen Holding left Piper for another artist, the two moved into an abandoned farmhouse at Fawley Bottom in the Chilterns near Henley-on-Thames.
The farmhouse had no mains water and no telephone connection. Piper and Evans converted the farm's out-buildings to studios for their artworks but it was not until the 1960s that they could afford to modernise the property. At the start of World War Two, Piper volunteered to work interpreting aerial reconnaissance photographs for the RAF but was persuaded by Sir Kenneth Clark to work as an official war artist for the War Artists' Advisory Committee, which he did from 1940 to 1944 on short-term contracts. Piper was one of only two artists, the other being Meredith Frampton, commissioned to paint inside of Air Raid Precaution control rooms. Early in 1940 Piper was secretly taken to the ARP underground centre in Bristol where he painted two pictures. In November 1940 Piper persuaded the WAAC committee that he should be allowed to concentrate upon painting bombed churches; this may have reflected both his pre-war conversion to the Anglican faith as much as his previous interest in depicting derelict architectural ruins.
The terms of this commission meant Piper would be visiting bombed cities, other sites, as soon as possible following an air raid "the following morning, before the clearing up". Hence he arrived in Coventry the morning after the Coventry Blitz air raid of 14 November 1940 that resulted in 1000 casualties and the destruction of the medieval Coventry Cathedral. Piper made d
South Central Ambulance Service
South Central Ambulance Service NHS Foundation Trust is the ambulance service for the counties of Buckinghamshire, Oxfordshire and Hampshire. It is a foundation trust of the National Health Service, one of 10 NHS ambulance trusts in England; as an ambulance service, SCAS responds to emergency 999 calls, in addition to calls from the NHS non-emergency number. These services are provided in an area that covers the counties of Buckinghamshire, Oxfordshire and Hampshire; the exceptions are North East Hampshire, served by South East Coast Ambulance Service and the Shrivenham area of Oxfordshire, served by South Western Ambulance Service. The service provides an emergency transport service for patients in life-threatening condition and a Non-Emergency Patient Transport Service; the NEPTS transports patients unable to use public transport due to their medical conditions, patients using outpatient clinics and patients being admitted or discharged from hospital. The Trust has a commercial division, which provides first aid training to members of the public, a community equipment service and logistic services.
Since 2017, SCAS has run the NEPTS in Sussex and Surrey, within the South East Coast ambulance area. It has a resilience and specialist operations department which plans for major or hazardous incidents; this includes a Hazardous Area Response Team, which responds to emergencies involving chemical, radiological or nuclear materials, as well as major incidents. The Trust trains and supports volunteer community first responders, it is the only NHS ambulance organisation in the UK to be supported by its own League of Friends, a registered charity. The South Central Ambulance League of Friends raises funds that are used to enhance the standard of care for patients, provide additional benefits for service personnel, encourage the acquisition of essential life-support skills among the public, support the deployment of volunteer community first responders; this group had been founded in 1982 to raise funds for the former Oxfordshire Ambulance NHS Trust. South Central Ambulance Service NHS Trust was formed on 1 July 2006, following the merger of the Royal Berkshire Ambulance Service NHS Trust, the Hampshire Ambulance Service NHS Trust, the Oxfordshire Ambulance NHS Trust, part of the Two Shires Ambulance NHS Trust.
The Trust achieved Foundation status on 1 March 2012, becoming known as South Central Ambulance Service NHS Foundation Trust. In June 2011 it was named England's top performing ambulance service, managing to respond to 77.5% of Cat A calls within the 8 minute target time, compared to the national average of 74.9%. In October 2011 the BBC discovered that SCAS spent more on private ambulance services to cover 999 calls than any other service in the country. On 1 March 2012, the Trust became an NHS Foundation Trust. In October 2013 the Trust accidentally published on its website a document listing the age and religion of all its 2,826 staff members. SCAS took over patient transport services in Hampshire in October 2014. In 2014 the trust held a recruitment drive in Poland to help fill vacancies. On 1 November 2016, it was announced that the trust would take over the running of NEPTS in the south-east of England from April 2017; the service had been run by South East Coast Ambulance Service until 1 April 2016, when it had been taken over by Coperforma, a private-sector provider, unable to provide a satisfactory level of service.
In 2015 the trust established a subsidiary company, South Central Fleet Services Ltd, to which 41 estates and facilities staff were transferred. The intention was to achieve VAT benefits, as well as pay bill savings, by recruiting new staff on less expensive non-NHS contracts. VAT benefits arise because NHS trusts can only claim VAT back on a small subset of goods and services they buy; the Value Added Tax Act 1994 provides a mechanism through which NHS trusts can qualify for refunds on contracted out services. Performance of SCAS is provided by national NHS England Ambulance Quality Indicators. In February 2016: The Trust managed to respond to 70% of Red 1 calls within 8 minutes 68% of Red 2 calls were responded to within 8 minutes 93% of Red 19 calls were responded to within 19 minutes Cardiac arrest survival rates were 16% 53% of stroke patients arrived at a thrombolysis centre within 60 minutes of their calls The average time to answer 999 calls was 43 seconds There were 21,024 incidents requiring patients being taken to an A&E department 42% of 999 patients were treated by paramedic crews only.
Emergency medical services in the United Kingdom NHS ambulance services prior to 2006 Hampshire & Isle of Wight Air Ambulance South Central Ambulance Service NHS Foundation Trust South Central Ambulance Service NHS Foundation Trust South Central Ambulance League of Friends
Manorialism was an essential element of feudal society. It was the organizing principle of rural economy that originated in the Roman villa system of the Late Roman Empire, was practiced in medieval western and parts of central Europe as well as China, it was replaced by the advent of a money-based market economy and new forms of agrarian contract. Manorialism was characterised by the vesting of legal and economic power in a Lord of the Manor, supported economically from his own direct landholding in a manor, from the obligatory contributions of a subject part of the peasant population under the jurisdiction of himself and his manorial court; these obligations could be payable in several ways, in labor, in kind, or, on rare occasions, in coin. In examining the origins of the monastic cloister, Walter Horn found that "as a manorial entity the Carolingian monastery... differed little from the fabric of a feudal estate, save that the corporate community of men for whose sustenance this organization was maintained consisted of monks who served God in chant and spent much of their time in reading and writing."Manorialism died and piecemeal, along with its most vivid feature in the landscape, the open field system.
It outlasted serfdom as it outlasted feudalism: "primarily an economic organization, it could maintain a warrior, but it could well maintain a capitalist landlord. It could be self-sufficient, yield produce for the market, or it could yield a money rent." The last feudal dues in France were abolished at the French Revolution. In parts of eastern Germany, the Rittergut manors of Junkers remained until World War II. In Quebec, the last feudal rents were paid in 1970 under the modified provisions of the Seigniorial Dues Abolition Act of 1935; the term is most used with reference to medieval Western Europe. Antecedents of the system can be traced to the rural economy of the Roman Empire. With a declining birthrate and population, labor was the key factor of production. Successive administrations tried to stabilise the imperial economy by freezing the social structure into place: sons were to succeed their fathers in their trade, councilors were forbidden to resign, coloni, the cultivators of land, were not to move from the land they were attached to.
The workers of the land were on their way to becoming serfs. Several factors conspired to merge the status of former slaves and former free farmers into a dependent class of such coloni: it was possible to be described as servus et colonus, "both slave and colonus". Laws of Constantine I around 325 both reinforced the semi-servile status of the coloni and limited their rights to sue in the courts; the legal status of adscripti, "bound to the soil", contrasted with barbarian foederati, who were permitted to settle within the imperial boundaries, remaining subject to their own traditional law. As the Germanic kingdoms succeeded Roman authority in the West in the fifth century, Roman landlords were simply replaced by Germanic ones, with little change to the underlying situation or displacement of populations; the process of rural self-sufficiency was given an abrupt boost in the eighth century, when normal trade in the Mediterranean Sea was disrupted. The thesis put forward by Henri Pirenne supposes that the Arab conquests forced the medieval economy into greater ruralization and gave rise to the classic feudal pattern of varying degrees of servile peasantry underpinning a hierarchy of localised power centers.
The word derives from traditional inherited divisions of the countryside, reassigned as local jurisdictions known as manors or seigneuries. The lord held a manorial court, governed by local custom. Not all territorial seigneurs were secular. By extension, the word manor is sometimes used in England to mean any home area or territory in which authority is held in a police or criminal context. In the generic plan of a medieval manor from Shepherd's Historical Atlas, the strips of individually worked land in the open field system are apparent. In this plan, the manor house is set apart from the village, but often the village grew up around the forecourt of the manor walled, while the manor lands stretched away outside, as still may be seen at Petworth House; as concerns for privacy increased in the 18th century, manor houses were located a farther distance from the village. For example, when a grand new house was required by the new owner of Harlaxton Manor, Lincolnshire, in the 1830s, the site of the existing manor house at the edge of its village was abandoned for a new one, isolated in its park, with the village out of view.
In an agrarian society, the conditions of land tenure underlie all economic factors. There were two legal systems of pre-manorial landholding. One, the most common, was the system of holding land "allodially" in full outright ownership; the other was a use of precaria or benefices. To these two systems, the Carolingian monarchs added a third, the aprisio, which linked manorialism with feudalism; the aprisio made its first appearance in Charlemagne's province of Septimania in the south of France, when Charlemagne had to settle the Visigothic refugees who had fled with his retreating forces after the failure of his Zaragoza expedition of 778. He solved this problem by allotting "desert" tracts of uncultivat