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About 200 volunteer drivers are enrolled in the service and the Council pays these
drivers at an agreed rate per mile and reimburses the Hospital Car Service for the whole of
its administrative and overhead expenditure. Figures relating to the work of this service
since 1948 are also given in table (i) and it will be noted that in 1958, 112,558 patients
were conveyed over a distance of 1,224,817 miles.
Agency arrangements also exist with the West Ham County Borough Council
whereby the ambulance service of that authority undertakes the removal of patients
in the two parts of the Metropolitan Borough of Woolwich which lie north of the
Thames and are separated from the rest of the administrative county by the river
or by that borough. 409 patients were dealt with under this arrangement in 1958
(table (i)).
Special services
Analgesia apparatus—Analgesia apparatus is located at accident ambulance stations and,
upon receipt of a call from a domiciliary midwife, a set can be delivered within a few
minutes to any address in the County.
Emergency obstetric units—A number of hospitals maintain emergency obstetric units
in a constant state of readiness to deal with complications arising during childbirth at
home and in London an arrangement exists by which any general medical practitioner
or midwife, who finds it necessary to call for the help of one of these units, simply has
to put through an emergency call to the ambulance service headquarters control and
an ambulance is despatched at once to pick up the nearest available unit, convey it to
the patient's address and, if necessary, stand by to remove the patient to hospital.
Premature baby units.—When the removal of a premature baby to hospital becomes
urgently necessary the service undertakes, if required, to collect a premature baby unit
from the hospital, take it to the patient's address and carry out the removal.
Transport of blood, drugs, ' iron lungs ' etc.—In emergency the service undertakes the
transport, on behalf of hospitals etc., of blood, drugs,' iron lungs' or other such items.
Smallpox and typhus.—Special arrangements have been made 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. Staff who have been successfully vaccinated and trained in the use of special
clothing and other precautions are employed and provision made for the disinfection of
vehicles and equipment. These services have been made available to neighbouring local
health authorities.
System of communications
With the exception of calls made directly to general ambulance stations by hospitals
under the decentralised arrangements already described, all calls for ambulances are
received in the control room at Headquarters. The Control Room staff receive requests
for general removals either by telephone or in writing and all telephoned emergency
calls upon the Accident section, decide which ambulance station shall carry out a
particular removal and transmit thereto the necessary instructions.
A specially designed telephone switchboard with 40 direct and 31 Exchange lines
gives direct communication with all the Council's ambulance stations. The exchange
fines are routed through six different telephone exchanges as a safeguard against failure
of the communications system. The calls come in either directly from hospitals, doctors,
midwives, police etc. or are relayed to the control room by telephone exchanges which
have received them as ' 999 ' calls. This central control enables the resources of the
entire service to be used to the best advantage by the diversion of work from one
station to another according to the fluctuating pressure. The control room is manned
throughout the day and night by a total staff of 32 working on a shift rota.
The maximum number of staff on duty at any one time is 16 to cope with the
peak period between 9.30 a.m. and 4 p.m. From 8 p.m. to 8 a.m. three ambulance
control clerks are on duty and on Sunday the staff is reduced to two shifts of three
control clerks, each between the hours of 8 a.m. and 8 p.m.
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