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In order to cope with the continuing increase in the volume of work, constant
vigilance has had to be exercised and the best use of available resources carefully planned.
The results of these efforts are indicated in table (iii).
By far the greatest single category of users of the Service are out-patients attending
hospital departments and clinics and in 1958 they accounted for about 80 per cent of
the whole of the work of the Service. Taking into account the various schemes now in
hand or in contemplation for the re-building or extension of hospitals within the
London area, the increasing average age of the population and the policy of the Ministry
of Health in encouraging out-patient as distinct from in-patient treatment by the
provision of day hospitals and geriatric, rehabilitation and chiropody services, it is not
unreasonable to expect a continuing increase in the volume of out-patient treatment
in the future and a corresponding increase in the demand for ambulance transport.
The special functions of the Headquarters station are to supply relief staff and Headquarters
ambulances to other stations, to provide a battery and tyre service for the Accident station
section ambulances and, when necessary, to deal with vehicle breakdowns on the road.
A mobile servicing unit makes a regular circuit of accident ambulance stations to carry
out routine servicing and inspection and a fully equipped ambulance is provided by the
Headquarters station to accompany this unit and to stand in for each ambulance as it is
temporarily taken out of commission.
When a patient has to travel a long distance, arrangements have continued to be Removals
made, with the co-operation of the present hospital administrations and their medical by train
officers and of the railway authorities, for the major portion of the removal to be carried
out by train when the condition of the patient permits and rail transport would be
quicker and more comfortable than a long journey by road. Reserved accommodation is
arranged on the train and ambulance transport is provided as necessary at each end of
the rail journey. These arrangements help to achieve an appreciable shortening of the
time taken for the overall journey and not only is this a significant factor in minimising
the fatigue occasioned to the patient but the saving gained in vehicles and man-power
affords valuable relief to the ambulance service.
Patients coming into London by rail from out-county areas are also met at the
various railway stations and arrangements made to enable them to continue their
onward journeys.
It is estimated that about 24,000 patients are being taken by ambulance transport to
and from the eleven London railway termini in the course of a year. The Council pays
the rail fare of a patient who, in the opinion of the hospital or doctor concerned,
cannot be regarded as travelling as an ordinary passenger and the number of such
patients for whom railway fares were paid by the Council in 1958 was 1,622.
The Ambulance Department of the Joint Committee of the Order of St. John of Agency and
Jerusalem and British Red Cross Society and the County of London Hospital Car supple-
Service render valuable assistance in relieving the directly provided service of a large mentary
services
volume of work.
The Ambulance Department of the Joint Committee carries out removals at an
agreed rate of reimbursement and undertakes much of the conveyance of patients
who need to travel by ambulance to out-county areas. A summary of the work
carried out by this organisation since 1948 is given in table (i), from which it will be
noted that 17,151 patients were conveyed in 1958 over a distance of 394,145 miles.
The Hospital Car Service is a voluntary organisation administered jointly by the
Order of St. John of Jerusalem, the British Red Cross Society and the Women's
Voluntary Services. This service supplements the Council's own services by undertaking
the conveyance by motor car of certain patients who do not need an ambulance but who,
nevertheless, are unable to travel by ordinary means of public transport. In order that
the combined resources of the Hospital Car Service and the Council's own service may
be deployed with the maximum efficiency and economy, all demands for Hospital Car
Service transport are made through the Council's control organisation.
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