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
William Bridges (preacher)
William Bridges was a Methodist local preacher, hat block maker and founder of the Plumstead Peculiar People. William Bridges was born in Woodbridge, Suffolk to John Bridges, Mary Block, he was baptised at St Mary, Woodbridge on the 8 May 1802, his father is listed as a Wheelwright on the 1841 census, aged 80, still living in Suffolk. Little else is known about Bridges early years. By 1824 at the time of his marriage to Ann Siggers he was living in South London, at 8 Gravel Lane Southwark, working as a hat block turner. Bridges remained a hat block maker for over 50 years; the area of Southwark St Saviour near the Thames close to Blackfriars Bridge had been the traditional home of hat making since the days of Queen Elizabeth, so he was well placed to make a living. At some point during the early 1830's Bridges became a Methodist local preacher. In 1837 Bridges witnessed the fiery ex-Anglican Robert Aitken preaching at White's Row Chapel in Shoreditch which proved to be a crucial turning point in his life.
Bridges was inspired to begin his own mission and installed a tiny chapel in an upper room at Gravel Lane. In 1838 Bridges visited his sister at Rochford and it was here he met James Banyard. Subsequently Banyard visited Bridges in Southwark and was deeply moved by Aitken's evangelism. Banyard was "returned to Essex a changed man, he went on to found the Peculiar People of Essex. Bridges was involved in the sect's early years in Rochford, helped Banyard found his first chapel there in 1842. In the late 1840's Bridges inspired John Sirgood who went on to found his own rural sect the Society of Dependants aka'The Cokelers' in Sussex. Banyard and Bridges believed in Faith Healing and forbade the use of doctors. Banyard was estranged from his own movement in 1855, due to a change of heart over the calling in of a Doctor for his own sick child. In 1868 the first Peculiars were convicted of neglect during the "Wagstaffe Case". At the inquest a local church elder was called to give evidence. Although the London coroner concluded that "the age for miracles was past".
In his book Forgotten Thameside, Glyn H. Morgan asserts that the "alternative and now heard name Plumstead Peculiars" was due to its "place of origin". Though Bridges always lived and worked in Southwark and Walworth, the Plumstead Peculiars had meeting houses in both Woolwich and Plumstead. Maria was the daughter of Bridges sister Mary Ann and Maria seems to have been a prominent member of the sect; the chapter in Unorthodox London devoted to the Plumstead Peculiars was written at the time of the "Hurry Case" in 1872. Davies gives an interesting insight into the simplistic beliefs espoused by the sect and its predominately working class adherents. WIth local antipathy towards their movement growing, the Plumstead Peculiars invited the charismatic and controversial Mary Girling to preach for them, it was, however, a move. Like Bridges, Girling came from Suffolk, she had tried preaching to local Methodist's, but met resistance, she founded her own sect the Girlingites. She worked with the Plumstead Peculiars but fell out with the sect owing to her claims of divivnity.
She managed to take a great many of the Plumstead congregation with her when she began preaching in a railway arch off the Walworth Road where the Walworth Jumpers made headlines and drew huge crowds. Bridges seems to have been drawn to charismatic figures like Girling and Sirgood. Girling decamped with her disciples to the New Forest where the New Forest Shakers endeavoured to live on faith alone. Unlike the more practical Cokelers, Girling's Children of God refused to work and endured great poverty and hardship. Bridges died aged 72 on the 27 February 1874 at 12 Wansey Rd in Newington and was still working as a hat block maker, he was buried at Norwood Cemetery on 5 March 1874. At the time of his death the Peculiar People had 43 chapels, most of them in Essex
East of England Ambulance Service
The East of England Ambulance Service NHS Trust is the authority responsible for providing National Health Service ambulance services in the counties of Bedfordshire, Essex, Hertfordshire and Suffolk, in the East of England region. These consist of 7,500 square miles, it is one of 10 Ambulance Trusts providing England with emergency medical services, is part of the NHS, receiving direct government funding for its role. 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; as well as providing an emergency ambulance service, the Trust provides non emergency patient transport services, commercial services and special operations such as emergency planning, hazardous materials incident response. The service support a number of emergency charities, such as air ambulances, who provide doctors for serious incidents; the Trust controls the mobilisation of critical care charities throughout its area.
These include Magpas, Essex & Herts Air Ambulance, East Anglian Air Ambulance, BASICS Essex Accident Rescue Service, SARS, NARS and BASICS Hertfordshire. The service can if required, mobilise London's Air Ambulance and the Kent and Sussex Air Ambulance if there is a major incident requiring more than one critical care team, where other teams in the region are operating at maximum capacity; the trauma teams are dispatched by a Critical Care Paramedic at the Critical Care Desk, in their Control Room in Chelmsford, who filters through every call the ambulance service receives and makes a clinical decision on whether to dispatch a critical care resource. The trust was formed on 1 July 2006 following the three-way merger of the Bedfordshire and Hertfordshire Ambulance Service NHS Trust, the East Anglian Ambulance NHS Trust and the Essex Ambulance Service NHS Trust; the result was a service covering an area of over 7,500 square miles with a population of 5.8 million people, one which answers more than one million emergency calls per year.
The East Anglian Ambulance NHS Trust had been formed in 1994 from the three-way merger of Cambridgeshire and Suffolk Ambulance Services. In 2009, the Trust was censured by the Care Quality Commission after inspection of an ambulance depot and seven of its 100 ambulance stations found patient-carrying vehicles were "dirty" and that staff were "unsure of basic measures for infection prevention and control"; the service launched an "urgent and comprehensive review" of its ambulance cleaning programme and reiterated its stance on patient safety, adding that "ensuring consistent high standards of cleanliness is a challenge" with so many stations, covering six counties and an area of 7,500 square-miles. In 2015/16, the trust received 1,037,119 emergency calls and handled 500,620 non-emergency patient transport journeys; the trust arrived at 73.6% of emergency Red 1 calls within eight minutes, 69.4% of emergency Red 2 calls within eight minutes. EEAST has around 1,500 volunteers; as of July 2016, the Trust has the following resources in operation: 357 front-line emergency ambulances 201 marked rapid-response vehicles 164 non-emergency ambulances 52 major incident support vehicles Over 130 ambulance stations and response posts 3 emergency operations centers in Bedford and NorwichThe Trust has its own emergency driving school, which trains drivers in 999 emergency driving under blue lights and sirens.
The Trust used the Mercedes Sprinter as front-line Double Staffed Ambulances, with the exception of a single Vauxhall Movano 4 wheel drive vehicle for use at Newmarket Racecourse. In 2009, the service started the transition to a brand-new Sprinter only fleet from a wide range of other brands - including Fords and older Mercedes vehicles; the scheme was finished in 2016, when the last brand-new Sprinter was delivered, although many of the older ones are now ending their cycle life. In March 2018, four new vehicles will be trialled across the East of England, with one concept vehicle being designed for and by the Trust. In May 2018 the trust bought 32 five-year-old vehicles decommissioned by the West Midlands Ambulance Service - described as "clapped out vehicles which colleagues in other trusts would have sent to the scrapyard" and contrasted with the luxury cars with which senior managers were provided in 2017. Ford Mondeos and Skoda Octavia Scouts are the most common amongst the fleet. In addition Land Rover Freelander and Land Rover Discovery Sport operate out of a limited number of bases.
Some Land Rover are used as Officer Cars. Renault Masters and Vauxhall Movanos are used for the Patient Transport Service. A number of these vehicles are fitted with blue sirens for High Dependency transfers; the Hazardous Area Response Team team uses Volkswagen Transporters and Mercedes Sprinters, all of which have 4x4 capability. The new fleet arrived in 2017, standardising these vehicles across the 10 ambulances services in England and Wales, it replaced Iveco Dailys. The trust provides Critical Care Paramedics to 3 local charity air ambulances in the region: Magpas, Essex & Herts Air Ambulance and the East Anglian Air Ambulance; these paramedics work alongside doctors to administer advanced treatment at the scene of the accident. Although the service uses the air ambulances, it does not fund the charit
East of England
The East of England is one of nine official regions of England at the first level of NUTS for statistical purposes. It was created in 1994 and was adopted for statistics from 1999, it includes the ceremonial counties of Bedfordshire, Essex, Hertfordshire and Suffolk. Essex has the highest population in the region, its population at the 2011 census was 5,847,000. Bedford, Basildon, Southend-on-Sea, Ipswich, Colchester and Cambridge are the region's most populous towns; the southern part of the region lies in the London commuter belt. The region has the lowest elevation range in the UK. North Cambridgeshire and the Essex Coast have most of the around 5% of the region, below 10 metres above sea level; the Fens are in North Cambridgeshire, notable for the lowest point in the country in the land of the village of Holme 2.75 metres below mean sea level, once Whittlesey Mere. The highest point is at Clipper Down at 817 ft, in the far south-western corner of the region in the Ivinghoe Hills. Basildon and Harlow, with Stevenage and Hemel Hempstead, were main New Towns in the 1950s and 1960s, with much industry located there.
In the late 1960s, the Roskill Commission considered Thurleigh in Bedfordshire, Nuthampstead in Hertfordshire and Foulness in Essex as a possible third airport for London. The East of England succeeded the standard statistical region East Anglia; the East of England civil defence region was identical to today's region. England between the Wash and just south of the town of Colchester has since post-Roman times been and continues to be known as East Anglia, including the county traversing the west of this line, Cambridgeshire; the inclusion of Essex as part of East Anglia is open to debate, notably because it was a Saxon kingdom, separate from the kingdom of the East Angles. Essex, despite meaning East-Saxons formed part of the South East England, as did Bedfordshire and Hertfordshire, a mixture of definite and debatable Home Counties; the earliest use of the term is from 1695. Charles Davenant, in An essay upon ways and means of supplying the war, wrote, "The Eleven Home Counties, which are thought in Land Taxes to pay more than their proportion..." cited a list including these four.
The term does not appear to have been used in taxation since the 18th century. East Anglia is one of the driest parts of the United Kingdom with average rainfall ranging from 450 mm to 750 mm; this is because low pressure systems and weather fronts from the Atlantic have lost a lot of their moisture over land by the time they reach Eastern England. However the Fens in Cambridgeshire are prone to flooding. Winter is cool but non-prevailing cold easterly winds can affect the area from the continent, these can bring heavy snowfall if the winds interact with a low pressure system over the Atlantic or France. Northerly winds can be cold but are not as cold as easterly winds. Westerly winds bring milder and wetter weather. Southerly winds bring mild air but chill if coming from further east than Spain. Spring is a transitional season that can be chilly to start with but is warm by late-April/May; the weather at this time is changeable and showery. Summer is warm and continental air from mainland Europe or the Azores High leads to at least a few weeks of hot, balmy weather with prolonged warm to hot weather.
The number of summer storms from the Atlantic, such as the remnants of a tropical storm coincides with the location of the jet stream. The East tends to receive much less of their rain than the other regions. Autumn is mild with some days being unsettled and rainy and others warm. At least part of September and early October in the East have warm and settled weather but only in rare years is there an Indian summer where fine weather marks the entire traditional harvest season; the most deprived districts, according to the Indices of deprivation 2007 in the region are, in descending order, Great Yarmouth, Luton and Ipswich. At county level, after Luton and Peterborough, which have a similar level of deprivation, in descending order there is Southend-on-Sea Thurrock; the least deprived districts, in descending order, are South Cambridgeshire, Mid Bedfordshire, East Hertfordshire, St Albans, Rochford, Huntingdonshire, Mid Suffolk, North Hertfordshire, Three Rivers, South Norfolk, East Cambridgeshire and Suffolk Coastal.
At county level, the least deprived areas in the region, in descending order, are Cambridgeshire and Bedfordshire, with all three having a similar level of deprivation Essex. The region has the lowest proportion of jobless households in the UK – 0.5%. In March 2011 the region's unemployment claimant count was 3.0%. Inside the region, the highest rate is Great Yarmouth with 6.2%, followed by Peterborough and Southend-on-Sea on 4.7%. In the 2015 general election, there was an overall swing of 0.25% from the Conservatives to Labour, the Liberal Democrats lost 16% of its vote. All of Hertfordshire and Suffolk is now Conservative; the region's electorate voted 49% Conservative, 22% Labour, 16% UKIP, 8% Liberal Democrat and 4% Green. Like other regions, the division of seats favours th
King James Version
The King James Version known as the King James Bible or the Authorized Version, is an English translation of the Christian Bible for the Church of England, begun in 1604 and completed as well as published in 1611 under the sponsorship of James VI and I. The books of the King James Version include the 39 books of the Old Testament, an intertestamental section containing 14 books of the Apocrypha, the 27 books of the New Testament; the translation is noted for its "majesty of style", has been described as one of the most important books in English culture and a driving force in the shaping of the English-speaking world. It was first printed by Robert Barker, the King's Printer, was the third translation into English approved by the English Church authorities: The first had been the Great Bible, commissioned in the reign of King Henry VIII, the second had been the Bishops' Bible, commissioned in the reign of Queen Elizabeth I. On the European continent, the first generation of Calvinists had produced the Geneva Bible of 1560 from the original Hebrew and Greek Scriptures, influential in the writing of the Authorized King James Version.
In January 1604, King James convened the Hampton Court Conference, where a new English version was conceived in response to the problems of the earlier translations perceived by the Puritans, a faction of the Church of England. James gave the translators instructions intended to ensure that the new version would conform to the ecclesiology of, reflect the episcopal structure of, the Church of England and its belief in an ordained clergy; the translation was done by 47 scholars. In common with most other translations of the period, the New Testament was translated from Greek, the Old Testament from Hebrew and Aramaic, the Apocrypha from Greek and Latin. In the Book of Common Prayer, the text of the Authorized Version replaced the text of the Great Bible for Epistle and Gospel readings, as such was authorised by Act of Parliament. By the first half of the 18th century, the Authorized Version had become unchallenged as the English translation used in Anglican and English Protestant churches, except for the Psalms and some short passages in the Book of Common Prayer of the Church of England.
Over the course of the 18th century, the Authorized Version supplanted the Latin Vulgate as the standard version of scripture for English-speaking scholars. With the development of stereotype printing at the beginning of the 19th century, this version of the Bible became the most printed book in history all such printings presenting the standard text of 1769 extensively re-edited by Benjamin Blayney at Oxford, nearly always omitting the books of the Apocrypha. Today the unqualified title "King James Version" indicates this Oxford standard text; the title of the first edition of the translation, in Early Modern English, was "THE HOLY BIBLE, Conteyning the Old Teſtament, AND THE NEW: Newly Tranſlated out of the Originall tongues: & with the former Tranſlations diligently compared and reuiſed, by his Maiesties ſpeciall Comandement". The title page carries the words "Appointed to be read in Churches", F. F. Bruce suggests it was "probably authorised by order in council" but no record of the authorisation survives "because the Privy Council registers from 1600 to 1613 were destroyed by fire in January 1618/19".
For many years it was common not to give the translation any specific name. In his Leviathan of 1651, Thomas Hobbes referred to it as the English Translation made in the beginning of the Reign of King James. A 1761 "Brief Account of the various Translations of the Bible into English" refers to the 1611 version as a new and more accurate Translation, despite referring to the Great Bible by its name, despite using the name "Rhemish Testament" for the Douay-Rheims Bible version. A "History of England", whose fifth edition was published in 1775, writes that new translation of the Bible, viz. that now in Use, was begun in 1607, published in 1611. King James's Bible is used as the name for the 1611 translation in Charles Butler's Horae Biblicae. Other works from the early 19th century confirm the widespread use of this name on both sides of the Atlantic: it is found both in a "Historical sketch of the English translations of the Bible" published in Massachusetts in 1815, in an English publication from 1818, which explicitly states that the 1611 version is "generally known by the name of King James's Bible".
This name was found as King James' Bible: for example in a book review from 1811. The phrase "King James's Bible" is used as far back as 1715, although in this case it is not clear whether this is a name or a description; the use of Authorized Version and used as a name, is found as early as 1814. For some time before this, descriptive phrases such as "our present, only publicly authorised version", "our Authorized version", "the authorized version" are found; the Oxford English Dictionary records a usage in 1824. In Britain, the 1611 translation is known as the "Authorized Version" today; as early as 1814, we find King James' Version, evidently a descriptive phrase, being used. "The King James Version" is found, unequivocally used as a name, in a letter from 1855. The next year King James Bible, with no possessive, appears as a name in a Scottish source. In the United States, the "1611 translation" is generally
Essex is a county in the south-east of England, north-east of London. One of the home counties, it borders Suffolk and Cambridgeshire to the north, Hertfordshire to the west, Kent across the estuary of the River Thames to the south, London to the south-west; the county town is the only city in the county. For government statistical purposes Essex is placed in the East of England region. Essex occupies the eastern part of the ancient Kingdom of Essex, which united with the other Anglian and Saxon kingdoms to make England a single nation state; as well as rural areas, the county includes London Stansted Airport, the new towns of Basildon and Harlow, Lakeside Shopping Centre, the port of Tilbury and the borough of Southend-on-Sea. The name Essex originates in the Anglo-Saxon period of the Early Middle Ages and has its root in the Anglo-Saxon name Ēastseaxe, the eastern kingdom of the Saxons who had come from the continent and settled in Britain during the Heptarchy. Recorded in AD 527, Essex occupied territory to the north of the River Thames, incorporating all of what became Middlesex and most of what became Hertfordshire.
Its territory was restricted to lands east of the River Lea. Colchester in the north-east of the county is Britain's oldest recorded town, dating from before the Roman conquest, when it was known as Camulodunum and was sufficiently well-developed to have its own mint. In AD 824, following the Battle of Ellandun, the kingdoms of the East Saxons, the South Saxons and the Jutes of Kent were absorbed into the kingdom of the West Saxons, uniting Saxland under King Alfred's grandfather Ecgberht. Before the Norman conquest the East Saxons were subsumed into the Kingdom of England. After the Norman conquest, Essex became a county. During the medieval period, much of the area was designated a Royal forest, including the entire county in a period to 1204, when the area "north of the Stanestreet" was disafforested; the areas subject to forest law diminished, but at various times they included the forests of Becontree, Epping, Hatfield and Waltham. Essex County Council was formed in 1889. However, County Boroughs of West Ham, Southend-on-Sea and East Ham formed part of the county but were unitary authorities.
12 boroughs and districts provide more localised services such as rubbish and recycling collections and planning, as shown in the map on the right. A few Essex parishes have been transferred to other counties. Before 1889, small areas were transferred to Hertfordshire near Bishops Stortford and Sawbridgeworth. At the time of the main changes around 1900, parts of Helions Bumpstead, Sturmer and Ballingdon-with-Brundon were transferred to Suffolk. Part of Hadstock, part of Ashton and part of Chrishall were transferred to Cambridgeshire and part of Great Horkesley went to Suffolk; the boundary with Greater London was established in 1965, when East Ham and West Ham county boroughs and the Barking, Dagenham, Ilford, Romford and Wanstead and Woodford districts were transferred to form the London boroughs of Barking and Dagenham, Newham and Waltham Forest. Essex became part of the East of England Government Office Region in 1994 and was statistically counted as part of that region from 1999, having been part of the South East England region.
In 1998, the boroughs of Southend-on-Sea and Thurrock were granted autonomy from the administrative county of Essex after successful requests to become unitary authorities. Essex Police covers the two unitary authorities; the county council chamber and main headquarters is at the County Hall in Chelmsford. Before 1938, the council met in London near Moorgate, which with significant parts of the county close to that point and the dominance of railway travel had been more convenient than any place in the county, it has 75 elected councillors. Before 1965, the number of councillors reached over 100; the County Hall, made a listed building in 2007, dates from the mid-1930s and is decorated with fine artworks of that period the gift of the family who owned the textile firm Courtaulds. The highest point of the county of Essex is Chrishall Common near the village of Langley, close to the Hertfordshire border, which reaches 482 feet; the ceremonial county of Essex is bounded to the south by its estuary.
The pattern of settlement in the county is diverse. The Metropolitan Green Belt has prevented the further sprawl of London into the county, although it contains the new towns of Basildon and Harlow developed to resettle Londoners after the destruction of London housing in the Second World War, since which they have been developed and expanded. Epping Forest prevents the further spread of the Greater London Urban Area; as it is not far from London with its economic magnetism, many of Essex's settlements those near or within short driving distance of railway stations, function as dormitory towns or villages where London workers raise their families. Part of the s