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 Elbe is one of the major rivers of Central Europe. It rises in the Krkonoše Mountains of the northern Czech Republic before traversing much of Bohemia Germany and flowing into the North Sea at Cuxhaven, 110 km northwest of Hamburg, its total length is 1,094 kilometres. The Elbe's major tributaries include the rivers Vltava, Havel, Schwarze Elster, Ohře; the Elbe river basin, comprising the Elbe and its tributaries, has a catchment area of 148,268 square kilometres, the fourth largest in Europe. The basin spans four countries, with its largest parts in the Czech Republic. Much smaller parts lie in Poland; the basin is inhabited by 24.4 million people. The Elbe rises at an elevation of about 1,400 metres in the Krkonoše on the northwest borders of the Czech Republic near Labská bouda. Of the numerous small streams whose waters compose the infant river, the most important is the Bílé Labe, or White Elbe. After plunging down the 60 metres of the Labský vodopád, or Elbe Falls, the latter stream unites with the steeply torrential Malé Labe, thereafter the united stream of the Elbe pursues a southerly course, emerging from the mountain glens at Jaroměř, where it receives Úpa and Metuje.
Here the Elbe enters the vast vale named Polabí, continues on southwards through Hradec Králové and to Pardubice, where it turns to the west. At Kolín some 43 kilometres further on, it bends towards the north-west. At the village of Káraný, a little above Brandýs nad Labem, it picks up the Jizera. At Mělník its stream is more than doubled in volume by the Vltava, or Moldau, a major river which winds northwards through Bohemia. Upstream from the confluence the Vltava is in fact much longer, has a greater discharge and a larger drainage basin. Nonetheless, for historical reasons the river retains the name Elbe because at the confluence point it is the Elbe that flows through the main, wider valley while the Vltava flows into the valley to meet the Elbe at a right angle, thus appears to be the tributary river; some distance lower down, at Litoměřice, the waters of the Elbe are tinted by the reddish Ohře. Thus augmented, swollen into a stream 140 metres wide, the Elbe carves a path through the basaltic mass of the České Středohoří, churning its way through a picturesque, deep and curved rocky gorge.
Shortly after crossing the Czech-German frontier, passing through the sandstone defiles of the Elbe Sandstone Mountains, the stream assumes a north-westerly direction, which on the whole it preserves right to the North Sea. The river rolls through Dresden and beyond Meißen, enters on its long journey across the North German Plain passing along the former western border of East Germany, touching Torgau, Dessau, Magdeburg and Hamburg on the way, taking on the waters of the Mulde and Saale from the west, those of the Schwarze Elster and Elde from the east. In its northern section both banks of the Elbe are characterised by flat fertile marshlands, former flood plains of the Elbe now diked. At Magdeburg there is a viaduct, the Magdeburg Water Bridge, that carries a canal and its shipping traffic over the Elbe and its banks, allowing shipping traffic to pass under it unhindered. From the sluice of Geesthacht on downstream the Elbe is subject to the tides, the tidal Elbe section is called the Low Elbe.
Soon the Elbe reaches Hamburg. Within the city-state the Unterelbe has a number of branch streams, such as Dove Elbe, Gose Elbe, Köhlbrand, Northern Elbe, Southern Elbe; some of which have been disconnected for vessels from the main stream by dikes. In 1390 the Gose Elbe was separated from the main stream by a dike connecting the two then-islands of Kirchwerder and Neuengamme; the Dove Elbe was diked off in 1437/38 at Gammer Ort. These hydraulic engineering works were carried out to protect marshlands from inundation, to improve the water supply of the Port of Hamburg. After the heavy inundation by the North Sea flood of 1962 the western section of the Southern Elbe was separated, becoming the Old Southern Elbe, while the waters of the eastern Southern Elbe now merge into the Köhlbrand, bridged by the Köhlbrandbrücke, the last bridge over the Elbe before the North Sea; the Northern Elbe passes the Elbe Philharmonic Hall and is crossed under by the old Elbe Tunnel, both in Hamburg's city centre.
A bit more downstream the Low Elbe's two main anabranches Northern Elbe and the Köhlbrand reunite south of Altona-Altstadt, a locality of Hamburg. Right after both anabranches reunited the Low Elbe is passed under by the New Elbe Tunnel, the last structural road link crossing the river before the North Sea. At the bay Mühlenberger Loch in Hamburg at kilometre 634, the Northern Elbe and the Southern Elbe used to reunite, why the bay is seen as the starting point of the Lower Elbe. Leaving the city-state the Lower Elbe passes between Holstein and the Elbe-Weser Triangle with Stade until it flows into the North Sea at Cuxhaven. Near its mouth it passes the entrance to the Kiel Canal at Brunsbüttel before it debouches into the North Sea; the Elbe has been navigable by commercial ve
Edwin of Northumbria
Edwin known as Eadwine or Æduinus, was the King of Deira and Bernicia – which became known as Northumbria – from about 616 until his death. He converted to Christianity and was baptised in 627. Edwin seems to have had two siblings, his sister Acha was married to king of neighbouring Bernicia. An otherwise unknown sibling fathered Hereric, who in turn fathered Abbess Hilda of Whitby and Hereswith, wife to Æthelric, the brother of king Anna of East Anglia; the Anglo-Saxon Chronicle reported. The exact identity of Æthelric is uncertain, he may have been a brother of Ælle, an elder brother of Edwin, an otherwise unknown Deiran noble, or the father of Æthelfrith. Æthelfrith himself appears to have been king of "Northumbria"—both Deira and Bernicia—by no than 604. During the reign of Æthelfrith, Edwin was an exile; the location of his early exile as a child is not known, but late traditions, reported by Reginald of Durham and Geoffrey of Monmouth, place Edwin in the kingdom of Gwynedd, fostered by king Cadfan ap Iago, so allowing biblical parallels to be drawn from the struggle between Edwin and his supposed foster-brother Cadwallon.
By the 610s he was in Mercia under the protection of king Cearl, whose daughter Cwenburg he married. By around 616, Edwin was in East Anglia under the protection of king Raedwald. Bede reports that Æthelfrith tried to have Raedwald murder his unwanted rival, that Raedwald intended to do so until his wife persuaded him otherwise with Divine prompting. Æthelfrith faced Raedwald in battle by the River Idle in 616, Æthelfrith was defeated. Raedwald's son Raegenhere may have been killed at this battle, but the exact date or manner of Raedwald's death are not known, he died between the years 616–627, the efficacy of Edwin’s kingship ostensibly depended on his fealty to Raedwald. Edwin was installed as king of Northumbria confirming Raedwald as bretwalda: Æthelfrith's sons went into exile in Irish Dál Riata and Pictland; that Edwin was able to take power not only in his native Deira but in Bernicia may have been due to his support from Raedwald, to whom he may have remained subject during the early part of his reign.
Edwin's reign marks an interruption of the otherwise consistent domination of Northumbria by the Bernicians and has been seen as "contrary to the prevailing tendency". With the death of Æthelfrith, of the powerful Æthelberht of Kent the same year and his client Edwin were well placed to dominate England, indeed Raedwald did so until his death a decade later. Edwin expelled Ceretic from the minor British kingdom of Elmet in either 616 or 626. Elmet had been subject to Mercia and to Edwin; the larger kingdom of Lindsey appears to have been taken over c. 625, after the death of king Raedwald. Edwin and Eadbald of Kent were allies at this time, Edwin arranged to marry Eadbald's sister Æthelburg. Bede notes that Eadbald would agree to marry his sister to Edwin only if he converted to Christianity; the marriage of Eadbald's Merovingian mother Bertha had resulted in the conversion of Kent and Æthelburg's would do the same in Northumbria. Edwin's expansion to the west may have begun early in his reign.
There is firm evidence of a war waged in the early 620s between Edwin and Fiachnae mac Báetáin of the Dál nAraidi, king of the Ulaid in Ireland. A lost poem is known to have existed recounting Fiachnae's campaigns against the Saxons, the Irish annals report the siege, or the storming, of Bamburgh in Bernicia in 623–624; this should be placed in the context of Edwin's designs on the Isle of Man, a target of Ulaid ambitions. Fiachnae's death in 626, at the hands of his namesake, Fiachnae mac Demmáin of the Dál Fiatach, the second Fiachnae's death a year in battle against the Dál Riata eased the way for Edwin's conquests in the Irish sea province; the routine of kingship in Edwin's time involved regular annual, wars with neighbours to obtain tribute and slaves. By Edwin's death, it is that these annual wars, unreported in the main, had extended the Northumbrian kingdoms from the Humber and the Mersey north to the Southern Uplands and the Cheviots; the royal household moved from one royal vill to the next, consuming the food renders given in tribute and the produce of the royal estates, dispensing justice, ensuring that royal authority remained visible throughout the land.
The royal sites in Edwin's time included Yeavering in Bernicia, where traces of a timber amphitheatre have been found. This "Roman" feature makes Bede's claim that Edwin was preceded by a standard-bearer carrying a "tufa" appear to be more than antiquarian curiosity, although whether the model for this practice was Roman or Frankish is unknown. Other royal sites included Campodunum in Elmet, Sancton in Deira, Goodmanham, the site where the pagan high priest Coifi destroyed the idols according to Bede. Edwin's realm included the former Roman cities of York and Carlisle, both appear to have been of some importance in the 7th century, although it is not clear whether urban life continued in this period; the account of Edwin's conversion offered by Bede turns on two events. The first, during Edwin's exile, tells; the second, following his marriage to Æthelburg, was the attempted assassination at York, at Easter 626, by an agent of Cwichelm of Wessex. Edwin's decision to allow the baptism of his daughter Eanfled and his su
An Túr Gloine
An Túr Gloine was a cooperative studio for stained glass and opus sectile artists from 1903 until 1944, based in Dublin, Ireland. An Túr Gloine was conceived of in late 1901 and established January 1903 at 24 Pembroke Street, Ireland, on the site of two former tennis courts, it was active throughout the first half of the 20th century. Affiliated artists included Michael Healy, Evie Hone, Beatrice Elvery, Wilhelmina Geddes, Harry Clarke, Catherine O'Brien, Kathleen Quigly, founder Sarah Purser; the original impetus for the project, spurred by the Irish cultural activist Edward Martyn, was the building of the Roman Catholic cathedral in Loughrea, County Galway, to become St. Brendan's. Purser and Martyn hoped to provide an alternative to the commercial stained glass imported from England and Germany for Irish churches and other architectural projects. Purser's knowledge of French and English medieval glass, together with her social connections and organizational skills, were crucial to the success of the cooperative.
A writer for The Studio, a magazine of fine and applied art, called the formed An Túr Gloine "perhaps the most noteworthy example of the newly awakened desire to foster Irish genius," describing it as "at once a craft school, where instruction in every detail connected with the designing and production of stained glass is given to the workers, a factory from which some beautiful work has appeared." The writer extolled the economic benefits of an Irish glass industry to supply churches. The studio is regarded as part of the Arts and Crafts Movement, but was infused with the contemporary spirit of Irish revivalism and drew on the artistic tradition of Celtic manuscript illumination. Ireland became an internationally renowned center of stained-glass art at this time, to a large extent as a result of An Túr Gloine; the studio was run by Purser until 1940, she was succeeded by Catherine O'Brien who ran it until 1944. After which time O'Brien leased a large section of it to Patrick Pollen. A commission for An Túr Gloine occasioned an outburst of criticism in Samhain magazine from the Irish poet W.
B. Yeats on how the "bourgeois mind is never sincere in the arts": The following table provides examples of work commissioned from the studio or created by individual artists associated with An Túr Gloine
Newcastle City Centre
Newcastle City Centre, is the city centre of Newcastle upon Tyne, England. Newcastle city centre is the historical heart of the city and the main cultural and commercial centre of North East England. Along with nearby Gateshead town centre, which lies on the opposite side of the River Tyne, the city centre forms the central core of the Tyneside conurbation; the area may be divided into the areas of Haymarket, Central station, Grainger Town, Monument and Chinatown. Haymarket is the northern edge of the city centre bordered by Spital Tongues and Jesmond to the north west and north east respectively, it is the location of Newcastle Civic Centre, Newcastle University, Northumbria University, Haymarket bus station and the City Pool, is a business area. The Church of St Thomas the Martyr is a prominent landmark in the area opposite the Metro station at the northern end of Northumberland Street, the city's main shopping street; the Quayside is a more modern part of Newcastle city centre known for its restaurants.
Four bridges cross the River Tyne at the Quayside: The High Level Bridge, the Swing Bridge, the Tyne Bridge and the Gateshead Millennium Bridge. The QuayLink bus route links the area with Monument and Haymarket and Central station, Gateshead metro stations; the path along the river forms part of the cycle network eastwards towards North Shields and Tynemouth and westwards to Hexham. Newcastle railway station, or locally known as Central station, is surrounded by an assortment of bars and clubs. Towards the western end is the city's popular Gay District known locally as the Pink Triangle; the Centre for Life on Times Square, Metro Radio Arena, Newcastle Cathedral, Discovery Museum and the Mill Volvo Tyne Theatre are all located in the vicinity, as is the city's coach station. Grainger Town is the streets between, encompassing, Pilgrim Street, Clayton Street and Blackett Street, it was built in the mid-19th century and, today, is an area centred on shopping and most notable neo-classical architecture.
The Theatre Royal is situated on Grey Street. The Grainger Market is a covered market built to house the traders displaced during the re-modelling of the city. Gallowgate is a small area surrounding St James' Park, the stadium of Newcastle United F. C, St James Metro station, named after the main road running through the area. There are a small number of pubs in the area but it is not a major area of residence, except for some student accommodation. Businesses include and various law firms in Citygate and the built Time Central, a Sainsbury local store and sandwich shops. Behind it is Leazes Park; the area is to host a 400 square metre memorial garden to Sir Bobby Robson. Work began on it in November 2010, with it due to be opened in Spring 2011. Chinatown is on the western edge of the city centre centred on Stowell Street with a number of Chinese restaurants and the rear entrance to The Gate; the Tyne and Wear Metro has four stations in Newcastle city centre. Running north to south, Haymarket and Central Station are on both the Green and Yellow lines which run northbound to the Airport or towards the coast via Whitley Bay and southbound to South Hylton or South Shields.
St James is the western terminus of the Yellow precedes Monument. Trains run towards the coast via North Shields. Newcastle has two bus stations for regional terminating bus services. Services heading north and east use Haymarket bus station, whilst those to the south and west use Eldon Square bus station. Both bus stations are operated by Nexus. Many roads in the city centre are have bus lanes. Stagecoach is the predominant operator for bus services within the city, which tend to call at several stops in the city centre rather than at a bus station; the QuayLink service, with its bright yellow electric buses, has two routes - Q1 from Haymarket to Quayside and Q2 from Central Station to Gateshead. For long-distance coach services, National Express uses Newcastle Coach Station on St James Boulevard, Megabus stop outside Central Station. Newcastle, known locally as Central, is the city's mainline railway station and a principal stop on the East Coast Main Line From there, local and national destinations served directly.
Manors is the only other station in the city, but it has a limited service
Aidan of Lindisfarne
Aidan of Lindisfarne Irish: Naomh Aodhán was an Irish monk and missionary credited with restoring Christianity to Northumbria. He founded a monastic cathedral on the island of Lindisfarne, known as Lindisfarne Priory, served as its first bishop, travelled ceaselessly throughout the countryside, spreading the gospel to both the Anglo-Saxon nobility and to the disenfranchised, he is known as the Apostle of Northumbria and is recognised as a saint by the Eastern Orthodox, the Catholic Church, the Anglican Communion and others. Bede's meticulous and detailed account of Aidan's life provides the basis for most biographical sketches. One notable lacuna, which reinforces the notion of Bede's reliability, is that nothing is known of the monk's early life, save that he was a monk at the ancient monastery on the island of Iona from a young age and that he was of Irish descent. Aidan was known for his strict asceticism. Saint Aidan of Lindisfarne, the Apostle of Northumbria, was the founder and first bishop of the Lindisfarne island monastery in England.
He is credited with restoring Christianity to Northumbria. Aidan is the Anglicised form of the original Old Irish Aodhán. Born in Connacht, Aidan was a monk at the monastery on the Island of Iona, founded by St Columba. In the years prior to Aidan's mission, propagated throughout Britain but not Ireland by the Roman Empire, was being displaced by Anglo-Saxon paganism. In the monastery of Iona, the religion soon found one of its principal exponents in Oswald of Northumbria, a noble youth, raised there as a king in exile since 616. Baptized as a Christian, the young king vowed to bring Christianity back to his people—an opportunity that presented itself in 634, when he gained the crown of Northumbria. Owing to his historical connection to Iona's monastic community, King Oswald requested that missionaries be sent from that monastery instead of the Roman-sponsored monasteries of Southern England. At first, they sent him a bishop named Cormán, but he alienated many people by his harshness, returned in failure to Iona reporting that the Northumbrians were too stubborn to be converted.
Aidan was soon sent as his replacement. He became bishop in 635. Allying himself with the pious king, Aidan chose the island of Lindisfarne, close to the royal castle at Bamburgh, as the seat of his diocese. An inspired missionary, Aidan would walk from one village to another, politely conversing with the people he saw and interesting them in Christianity: in this, he followed the early apostolic model of conversion, by offering "them first the milk of gentle doctrine, to bring them by degrees, while nourishing them with the Divine Word, to the true understanding and practice of the more advanced precepts." By patiently talking to the people on their own level and his monks restored Christianity to the Northumbrian countryside. King Oswald, who after his years of exile had a perfect command of Irish had to translate for Aidan and his monks, who did not speak English at first. In his years of evangelism, Aidan was responsible for the construction of churches and schools throughout Northumbria.
At the same time, he earned a tremendous reputation for his pious charity and dedication to the less fortunate—such as his tendency to provide room and education to orphans, his use of contributions to pay for the freedom of slaves: He was one to traverse both town and country on foot, never on horseback, unless compelled by some urgent necessity. … This was the daily employment of himself and all that were with him, wheresoever they went. At that time, many religious men and women, stirred up by his example, adopted the custom of fasting on Wednesdays and Fridays, till the ninth hour, throughout the year, except during the fifty days after Easter, he never gave money to the powerful men of the world, but only meat, if he happened to entertain them. Moreover, he afterwards made many of those he had ransomed his disciples, after having taught and instructed them, advanced them to the order of priesthood; the monastery he founded grew and helped found churches and other religious institutions throughout the area.
It served as centre of learning and a storehouse of scholarly knowledge, training many of Aidan's young charges for a career in the priesthood. Though Aidan was a member of the Irish branch of Christianity, his character and energy in missionary work won him the respect of Pope Honorius I and Felix of Dunwich; when Oswald died in 642, Aidan received continued support from King Oswine of Deira and the two became close friends. As such, the monk's ministry continued unchanged until the rise of pagan hostilities in 651. At that time, a pagan army attacked B