:entral Organization Increases Ambulance Efficiency
Page 57
Page 58
If you've noticed an error in this article please click here to report it so we can fix it.
MBULANCE operations north of the Border, unlike those in 6-England, are organized on a 'nal basis: Throughout Scotland,. port is provided by the St. -ew's and Red Cross Scottish ulance Service in which, since var, the vehicular resources of two organizations have been .d.
e underlying object of this gement, which was inaugurated me 1, 1946, was the provision tter means for transport for the Ind injured, and it arose out ;gotiations which took place en the St. Andrew's Ambulance iation and the British Red Society (Scottish Branch). ing the war, the two bodies d in close co-operation on the ort of wounded and injured is, so that the new peace-time was a logical outcome of activities. Operations are hutted by a joint central cornon which both organizations ually represented, there being administrative arrangements 1, of the local centres. activities of the two associa-. re entirely separate; it is only the joint committees conwith the operation of nees that they are linked so together.
joint service worked as I during the period 1946-48, Len the National Health Act came into force, the facilities were offered to the Secretary of State for Scotland, operations continuing on what was by then a well-established system.
The Scottish Ambulance Service is financed by the Department of Health for Scotland on a net cost basis. For the rest, the work is voluntary and, in areas, is under the supervision of local transport committees who operate at some 130 points and are responsible for the day-to-day efficiency of the duties performed in their respective territories.
86,430 Patients Carried
At the present time, mileage run by the .ambulances is averaging approximately 10m. annually; the total for the service during December 1953, was 825,000. During the same month, 48,409 journeys were made and 86,430 patients carried. The total number of vehicles operated on a day-by-day basis is about 570, although the number rises to 650 when pool vehicles are taken into account.
Responsibility for the provision of adequate facilities for the whole of Scotland rests with the service, and the ambulance work is administered through 257 local centres incorporated within five regional boundaries, the latter corresponding to the areas of the Regional Hospital Boards. The 'Inverness and Northern Region
includes the counties of Caithness, Ross and Cromarty, Sutherland and Nairn, together with the islands of Lewis and Skye and the Hebrides. In this scattered area, 42 vehicles are distributed at 27 centres.
In the Eastern Region, which incorporates the counties. of Angus, Perth and Kinross, there are 44 vehicles and 21 centres, and in Aberdeen and the North-east (including Kincardineshire, Morayshire, Banffshire, Shetland and Orkney) there are 29 centres with 47 vehicles.
The South-eastern Region has 60 centres (139 ambulances) and covers the counties of Fife, Midlothian, West Lothian, East Lothian, Peebles, Selkirk, Roxburgh and Berwick. Biggest of the regions is that of the West of Scotland which takes in the Bute area and the counties of Argyll, Ayr, Clackmannan, Dumbarton, Dumfries, Kirkcudbright, Stirling, Lanark, Renfrew and Wigtown. This absorbs 293 vehicles which are spread over 120 centres.
Units of the fleet are allocated on the basis of need, the actual locations being largely dependent upon recommendations made by the Regional Hospital Boards. Records show that the average use of ambulances varies from five turn-outs a month in the isolated spots to up to 15 turn-outs a day in busy industrial centres.
Where vehicles are located at hospitals, a full-time service is
provided with drivers available 24 hours a day, seven days a week. At local centres, arrangements may exist for full-time drivers, but, where demand is infrequent, vehicles may be operated on a contract arrangement with the motor trade, the drivers being supplied as necessary by the con tractor.
The then existing joint fleet of the two associations was supplemented by 281 ambulances with the coming of the National Health Act. These were previously under the control of the Scottish Police authorities and hospitals, or were based at mines.
Subsequently, the demands of the service developed rapidly and, in the days of 'supply difficulties, a variety of makes was represented in the fleet. Present policy, however, is aimed at homogeneity, with a view
to simplifying storage of spares. Although a number of veterans is still operated the emphasis since
1948 has been principally on MorrisCommercial, Humber and Austin Sheerline ambulances. The chassis are purchased through the Ministry of Supply, the bodybuilding being put out to tender. In view of the increasing demands for sitting case transport that have arisen with the widening scope of the health services, endeavours are now being made to reduce costs by introducing the smaller type of utility capable of carrying 9 or 10 passengers.
Supervision of service efficiency is carried out by the local transport committees, except in the 57 direct contract centres where vehicles and staff are provided by arrangement
with local motor traders. These centres are visited at regular periods by headquarters' repiesentatives, who refer back to head office the points on which action is needed to meet the special requirements of a locality.
One uniform is used for staff throughout the service, supplies emanating from a central stores to which the local secretary, usually an honorary official, sends in the stock measurement forms.
A central repair organization at the headquarters in Glasgow deals with all major repairs and complete overhauls, spare machines being sent out from the main pool so that local centre work can be carried on while
units are under repair. Day-to-day adjustments and maintenance are performed at district garages, at some places by full-time mechanics, at others by driver-mechanics and, in a number of cases, by the motor
trade. The mechanical history of each vehicle is maintained in log books.
500-mile Check
At big centres such as Glasgow, Edinburgh, Aberdeen and Dundee, there is a set mileage system of maintenance, but elsewhere work is carried out as necessary, the guiding factor being driver's reports. When received at headquarters, all new vehicles are checked over and run in for a distance of 500 miles. They are then inspected and adjusted before being issued to the local centres to which they have been allocated.
The Scottish Ambulance Service has four main workshops located in Glasgow, Dundee, Aberdeen and Irvine, where a substantial amount of the main overhaul work is performed. It is, however, necessary to contract-out a fairly high proportion of major work, many different garages throughout Scotland being employed.
In order to obtain the most favourable terms, tyres, brake facings, replacement engines and other components are bought centrally in bulk and supplied to districts as required. As befits ambulances, a smart appearance is invariably maintained, and it is interesting to note that a brown livery is used in contrast to the cream largely favoured in England. Telecommunication equipment employed in the principal cities has proved a potent factor in minimizing waste mileage.
Apart from the normal duties of the service, the organization is also responsible for Civil Defence ambulance drivers.