A vision for the NHS ambulance sector: co-designing urgent and emergency care provision

Exploring the potential for the ambulance service to take a greater role in leading and co-designing urgent and emergency care provision.

15 March 2024

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Key points

  • This report, developed by the Association of Ambulance Chief Executives in collaboration with NHS Providers and NHS Confederation, highlights the pivotal role ambulance trusts play in delivering urgent and emergency care and sets out a long-term vision for an enhanced role they could take in co-designing this care. It sets out the case for change and includes several case studies that demonstrate the benefits of ambulance services taking this broader approach. It is intended to be used as a conversation starter at national, regional and system level.

  • The core remit of any NHS ambulance service will always be to provide emergency response to those who have a life-threatening health need and to major incidents. However, this is a relatively small proportion of what ambulance services do (circa 10-11 per cent) and is delivered alongside a much greater proportion of responses to urgent care needs in the out-of-hospital environment. In many cases they support other parts of the NHS where there are unmet urgent care needs.

  • There are clear benefits of the ambulance sector taking on a greater, more consolidated role in UEC provision. These are outlined in this paper, and we have already witnessed where this ambition is turning into reality in various places. However, where it is happening it is mostly by default rather than as part of a system strategy; and where new ways of working and pathways have been introduced, these are often yet to be realised at scale. This might provide certain benefits at local levels but the real possibilities of meaningful change in UEC at regional and national levels are being missed.

  • This paper sets out a case for change and investment in the ambulance sector. By investing in the ambulance workforce, infrastructure, and digital innovation there is an there is an opportunity to address inefficiencies and make significant progress in meeting the ambitions set out in NHS England’s UEC recovery plan, as well as those detailed in the NHS Long Term Plan.

The Association of Ambulance Chief Executives, NHS Confederation and NHS Providers believe that the ambulance sector has much more to offer the rest of the NHS in improving urgent and emergency care (UEC) provision in the UK. 

We would like leaders across the national, regional and system UEC landscape to use this paper as a starting point to explore the possibilities of enhancing the ambulance role within UEC, promoting collaborative cross-sector planning, and implementing a long-term strategy to deliver meaningful change for patients and our people. Download the report.