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The growth of the demand on the Accident section of the service, whilst not so
dramatic as that on the General section, has shown a steady annual expansion during the
last decade and the number of emergency calls received in 1958 was over 50 per cent.
above the 1947 level and constituted a record figure. Street accident cases, which
numbered 9,329 in 1947 rose to 19,182 in 1958; other accidents (including home
accidents) from 11,430 to 19,779 and cases of urgent illness in streets, public places,
etc., from 10,205 to 20,769.
Major A procedure has been evolved to meet the special circumstances of major accidents,
accidents The essential aims of this procedure are:
(a) to obtain as soon as possible full information as to the extent of the accident and
the probable number of casualties,
(b) to deploy quickly an adequate number of ambulances and crews for the removal
of casualties in the initial stages and to build up reserves at the incident,
(c) to set up a control point as soon as practicable. For this purpose a radio-controlled
and specially equipped vehicle is maintained in a constant state of readiness at Headquarters,
(d) to provide an adequate supply of equipment,
(e) to bring into full play the available resources of both sections of the service,
having regard to the need to continue dealing with normal work, including emergencies
in other parts of the County,
(f) to warn local hospitals and, if necessary, to call out mobile medical teams,
(g) to effect liaison with the Police, Fire Brigade, hospital authorities and other
services concerned and
(h) to provide any necessary transport for mobile medical teams and for the conveyance
of blood, plasma, etc.
In 1958 there were 18 large incidents. Ten fires involved 22 casualties ; three major
road accidents, 13 casualties; two railway accidents, 45 casualties and three other
incidents, nine casualties.
The General section is concerned mainly with the removal of sick persons to and from
hospitals, clinics, railway stations, etc., and is organised through a Chief Superintendent
and six large general ambulance stations. Each station is staffed by a resident superintendent,
an assistant superintendent and an average of seven ambulance control clerks
and 70 men.
40-50 vehicles of various sizes and types suitable for the conveyance of recumbent or
sitting patients are attached to each station. Orders for the provision of General section
ambulances are normally received from hospital authorities, the Emergency Bed
Service or general practitioners. About 100 of the larger hospitals and clinics at present
pass their transport requests, other than those for journeys of more than 25 miles from
the ' pick up ' point, railway journeys or requests for the removal of infectious or
mentally ill patients, directly to the appropriate local general ambulance station, the
remaining orders being received and dealt with through the Headquarters control.
At some 60 of the larger hospitals in London, in order to simplify the procedure and to
reduce dead mileage and unproductive time, one or more ambulances are stationed for
varying periods on week days to convey patients to and from those hospitals under
the direction of transport officers appointed by the hospital authorities.
In 1947 (the year preceding the inauguration of the National Health Service) the
General section dealt with the removal of 182,206 patients. Since that time there have
been gradual but substantial increases in demand year by year (table (i)) and by 1958
this figure had risen to 966,877. The volume of work in 1958 was inflated to some
extent by the bus strike which inevitably led to increased demands for special transport
during the months of May and June but, even so, it is estimated that there was a
' normal' increase of about 7 per cent as compared with the previous year and a fivefold
increase over the 1947 level.
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