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journeys has been reduced by more than half and that delays of ambulances at hospitals
of over half an hour's duration have been reduced from 2,996 in 1953 to 283 in 1958.
An immediate effect of the National Health Service was a large increase in orders
for transport. Some measure of decentralisation was necessary and in consequence
arrangements were introduced for certain hospitals to place their orders directly with the
appropriate general ambulance station instead of centrally. This system was extended
year by year and called for a high degree of co-operation between the hospital
authorities and the ambulance service. At the end of 1949, some 30 hospitals had been
brought within the ambit of these arrangements and steps had also been taken at 14
of these hospitals to station ambulances there during day-time for the purpose of
conveying out-patients to and fro under the direction of hospital transport officers. By
the end of 1958 the number of hospitals and clinics decentralised to local general
ambulance stations had risen to 100 and at about 60 of the larger hospitals some 80-90
vehicles and crews were stationed daily to work directly under the instructions of the
hospital transport officers.
(b) General medical practitioners—Many emergency calls are received at headquarters in
circumstances where it is clear that what is required is not an ambulance but medical
attention for a person ill at home. In such a case the caller is advised to call in the
patient's own doctor or is given particulars of other general practitioners in the locality.
(c) Other ambulance authorities—The Council has fostered co-operation with other
ambulance authorities and a number of reciprocal arrangements, both operational and
financial, have been made in the interests of mutual economy and efficiency.
Agreements on standard charges were reached with sixteen neighbouring
authorities for work done by one authority on behalf of another in the conveyance of
patients between the various county areas and, to avoid unnecessary clerical and
accounting work, the settlement of financial claims and counter claims between London
and Middlesex, Surrey and Kent, is effected on a basis of compounded payments.
To reduce as much as possible the period before the arrival of an ambulance, arrangements
were made in 1948 with all neighbouring local ambulance authorities for
emergency calls near the common boundary to be answered by the nearest available
ambulance and crew, irrespective of whether or not the parent ambulance station is
controlled by the authority in whose area the incident has occurred. During 1958 no
fewer than 1,014 emergency calls were dealt with under these arrangements.
The special facilities provided by the Council for the removal of patients suffering
from smallpox or typhus and for the conveyance of consultants in emergency to
examine patients suffering or suspected to be suffering from these diseases have now been
made available to seven county councils and four county borough councils.
When long road journeys are made, the practice has been developed of notifying
the distant authorities as a routine so that use can be made of vehicles which would
otherwise be returning empty.
(d) Agency services—Valuable supplementary work has been done on behalf of the
Council since the inception of the National Health Service by the Hospital Car Service
and by the Ambulance Department of the Joint Committee of the Order of St. John
of Jerusalem and British Red Cross Society; the former undertakes the conveyance,
by motor cars manned by volunteer drivers, of patients who do not need an ambulance
but who are unable to travel by ordinary means of public transport and the latter
deal primarily with the removal of patients by ambulance from places within the
county to places outside the county. Details of the work done by these agencies are
shown in table (i), page 83. In 1949 these two organisations transported 117,224
patients ; the corresponding figure in 1958 was 129,709.
Close co-operation between the Hospital Car Service and the directly provided
service was achieved soon after the inauguration of the National Health Service by