St John Ambulance in England

The St John Ambulance Association was set up in 1877 by the Venerable Order of Saint John to teach industrial workers first aid, so that they could provide on-the-spot treatment in emergencies. Workers rarely had ready access to a doctor in 19th century workplaces, and since accidents were frequent, death or disability from injuries were common. The St John Ambulance Association set up training sessions across the country, particularly in workplaces in areas of heavy industry, but also in villages, seaside towns and suburban areas.

In 1887, trained volunteers were organised into a uniformed Brigade to provide a first aid and ambulance service at public events. In many parts of England (and in parts of Scotland, until 1908), St John Ambulance was the first and only provider of an ambulance service right up to the middle of the 20th century, when the National Health Service was founded. When there were far fewer doctors and hospital beds than today, St John Ambulance nurses looked after the sick and injured in their own homes.

The St John Ambulance Brigade and St John Ambulance Association merged in 1968[5] to form St John Ambulance, a single organisation providing both training and first aid cover. A significant restructure in 2012 further consolidated 43 counties into eight large regions based on the eight regions of the United Kingdom; these regions were then further merged during 2016 into four regions.

During 2013, St John Ambulance trained approximately 278,000 adults through its workplace and community first aid programmes, and directly trained 91,000 schoolchildren. St John Ambulance personnel attended 45,000 public events, treating approximately 102,000 individuals. It also distributed 100,000 free first aid guides nationwide and its free smartphone app was downloaded by 148,000 people.[3]

• 1540: The original Order of St John, the Knights Hospitallers is disbanded in England by Henry VIII
• 1826: An idea to re-establish the Order within England is put forward by some remaining French Knights of the original worldwide Order
• 1841: The "St John's Day Declaration" is prepared to seek official recognition of the new Order by the original Order, now known as the Sovereign Military Order of Malta
• 10 July 1877: St John Ambulance Association forms to teach first-aid in large railway centres and mining districts
• June 1887: St John Ambulance Brigade is formed
• 14 May 1888: English Order of St John is granted royal charter by Queen Victoria
• 1908: By reciprocal agreement St John Ambulance Brigade ceases to operate in Scotland and St Andrew's Ambulance Association ceases to operate in England
• March 1922: St John Ambulance Cadets is formed
• 1968: The Association and Brigade merge to form a unified St John Ambulance
• January 1987: Badger Setts are introduced to celebrate 100 years since the formation of the Brigade
• 1999: The Priory of England and the Islands is formed
• 2012: St John Ambulance changes its county structure to a regionalised model across England
• 2017-2018: Celebration of the Organisation's 140th anniversary[8]

Cycle Response Units (CRUs) providing cover at an event in London in 2014.

St John Ambulance provides first aid cover at thousands of events every year.[9] This service is provided free at the point of delivery, although a charge is often made to the event organiser for provision of the service at their event, in order to subsidise the Charity's free cover of community and charity events, as well as the organisation's wider charitable output.

In addition to providing volunteer first aiders for events, where necessary St John Ambulance can provide paramedics, doctors, nurses and cycle responders, as well as mobile treatment centres, ambulances and other medical provision.[3] Alongside support functions including command & control vehicles and incident catering units.

The organisation covers many major events across England including the London Marathon and Hyde Park concerts, as well as smaller and charitable events such as fetes and local fairs.[3]

St John Ambulance runs courses in first aid and health & safety for members of the public, training 254,000 people in 2013.[3] Its First aid at work course is used by many companies to train designated individuals as first-aiders, as required by employment laws; specialist training is also available, including courses for schools staff and people working with children, and professional drivers.[10]

Charitable Community first aid courses also offer people of all ages the chance to learn basic first aid skills at little or no charge. In 2013, 24,000 people attended these courses.[3]

St John Ambulance teaches first aid to thousands of young people, through programmes including Badgers (for seven- to ten-year-olds), Cadets (10 to 17-year-olds), Student Volunteering Units (based in colleges and universities)[11] and RISE, a specialist project aimed at those not in education, employment or training.[12]

Cadets volunteer alongside their adult counterparts on events, making St John Ambulance the only youth organisation to have their young people utilizing their skills in the "real world" with real patients.

In 2013, 91,000 schoolchildren were trained in first aid by St John Ambulance's schools team, while hundreds of thousands more had access to the organisation's training materials for schools, which are available to download for free from its Teach the difference website.[3]

In 2014, the organisation also launched The Big First Aid Lesson, a free first aid lesson, which was streamed live into classrooms across England. 32,384 students took part in the inaugural event.[13] Events took place the following 3 years. The Big First Aid Lesson was not held in 2018, to allow the team to focus on promoting first aid as part of the national curriculum.[14]

St John Ambulance campaigns to raise awareness of the importance of first aid, and equip more people with life-saving skills. Its 2013 Save the Boy campaign, which featured an interactive element, demonstrating how to put a casualty in the recovery position, reached 15 million people through television and online media.[3]

In January 2015, it launched a new campaign, The Chokeables, designed to teach parents how to treat a choking infant. The animated film featured the voices of actors John Hurt, David Walliams, Johnny Vegas and David Mitchell.[19]

During the annual Save a Life September campaign, St John Ambulance trainers hold free first aid demonstrations in public spaces around the country, handing out first aid guides to attendees.[20] A free first aid app for smartphones is also available to download.[21]

Between 9–16 October 2018, St John Ambulance was a nationwide-leader in the promotion of Restart A Heart Day 2018, overseen by the Resuscitation Council UK, on behalf of the European Resuscitation Council and the International Liaison Committee on Resuscitation. Alongside partner organisations, St John Ambulance trained over 200,000, over the two weeks, in emergency resuscitation.

(CATS 1) St John Ambulance

St John Ambulance is a leading supplier of ambulance services in England, providing patient transport services to over 100,000 people a year, and working in partnership with NHS trusts, private healthcare groups, local authorities and individuals.[22]

Services offered include A&E support, patient transport, bariatric transfer, paediatric and neonatal services, high-dependency transfers, planned journeys, repatriations, community first response and emergency response and major incident support.[23]

In 2010, St John Ambulance was awarded the Private Ambulance Service Team of the Year Award by the Ambulance Services Institute[24] for the work it carried out with the CATS (Great Ormond Street) and the South Thames Retrieval Service (Evelina Children's Hospital).[25]

St John Ambulance Supplies (often abbreviated to SJS) is a trading sub-division of St John Ambulance providing first aid and medical equipment and consumables, training equipment, publications, health and safety equipment and clothing. Where a profit is made, surplus from sales are diverted into supporting the charitable work of the Order of St John and the St John Ophthalmic Hospital in Jerusalem.

SJS opened its doors at St John’s Gate in Clerkenwell on 12 February 1879 and was originally known as The Stores Depot. It is now a major commercial operation supplying to the public, private and voluntary sector. The store is now only available online.

St John Ambulance Crusader ambulance in a London street.

Originally, individual divisions of St John Ambulance were responsible for providing their own vehicles. These have taken many and varied forms, beginning with horse-drawn ambulances. Even into the late twentieth century, with some centralisation of control and classification of vehicle types such as Motor Ambulance Units (the title arising historically as a distinction from horse-drawn units), First Aid Posts and Rapid Deployment Vehicles, there remained within the organisation an enormous range of deployed vehicles of different types and even assorted local vehicle liveries. Some ambulances were donated second-hand from industrial plants, some were purchased (from different suppliers) and some were local conversions of commercial vehicles. At the start of the twenty-first century, new legislation regarding emergency ambulances effectively rendered a significant proportion of the then current St John Ambulance fleet redundant. The solution was the development of a specialist St John Ambulance vehicle, which was designed jointly by the organisation and vehicle manufacturer Renault. The result was the Crusader 900 ambulance.

An early assessment suggested that 100 of the Crusader ambulances (costing, at that time, £40,000 each) would be required immediately, representing an investment of £4 million. In 2000, St John Ambulance committed itself to raising £2 million by public subscription, whilst English and Welsh Freemasons committed a further £2 million, supplying 50 Crusader ambulances which were handed over in local ceremonies across the country during 2000 and 2001.[26][27] This very large donation allowed the rapid transformation of the national St John Ambulance fleet of front-line ambulances within a much shorter time-scale than could otherwise have been possible. Subsequently, many local Provinces of Freemasons have maintained relations with their local St John Ambulance County units and supported the running costs of these vehicles or even donated further (additional) Crusader ambulances.[28]

By 2004, the national St John Ambulance emergency vehicle fleet was in a standard corporate livery, with standard vehicle types:[29]

Image showing the various vehicles St John Use (Left to Right: 2 Crusaders, a Challenger, a Companion Plus and 2 further Crusaders)

• Crusader – a front-line emergency ambulance, based on the Renault Master (or similar);
• 4x4 Ambulance – a 4-wheel drive emergency ambulance, based on the Nissan Patrol (or similar), but with additional headroom, for rural and off-road deployment;
• Support Vehicle – either based on a van, car or a 4x4 vehicle, Support Units can be used for a variety of purposes. For instance, a Support Car may be used to carry members to and from duties, in a logistical capacity, or even as a response vehicle on larger duties. Support Vans are normally used only for logistical purposes. Mini-buses are also available, and can be used for logistics or the transport of members.

The majority of St John Ambulance's volunteers deliver first aid at events and as Community First Responders or work with young people as youth leaders. Other specialist roles are available for healthcare professionals, volunteer managers and in safeguarding, human resources, quality and assurance and health and safety.[30]

In 2012, St John Ambulance was reorganised into a regional structure, with the goal of increasing accountability and maximising charitable outputs.[32] Up until that point the organisation had been divided into 42 semi-autonomous county organisations.

As part of the reorganisation, a more streamlined structure was introduced, with fewer layers of management between the front-line and the St John Ambulance Board.

Personnel in the current uniform (centre and right) and the ceremonial uniform (left).

St John Ambulance first aid personnel wear a service delivery uniform consisting of a green shirt; black combat trousers; and either a green and black Parka Jacket, a reversible fleece, or green and black softshell jacket with appropriate black footwear. Epaulettes on the shirts vary in colour dependent on the profession of the volunteer: Black for first aid personnel, green for registered paramedics, grey for registered nurses, and red for registered doctors. Healthcare professionals' (HCPs) epaulettes don't show specialism such as midwives. Student HCPs wear black epaulettes until they're qualified in their respective profession.

On the service delivery uniform, a role bar is worn to denote the wearer's role on that event. High-visibility two-tone yellow-and-green tabards (accepted to denote medical personnel) are only worn when the risk assessment of the event calls for it.

Badgers wear a branded black polo-shirt and a branded black jumper, where they can wear the badges they earn through the Super Badger programme.

Cadets wear the same uniform as their adult counterparts, though are permitted to wear a brassard on their left arm where they're able to show their current/highest Grand Prior Award badge at the top-centre; up to three badges, including duty hours, Duke of Edinburgh Award, Sovereign's Award, national competitions winners badge, Amalfi Challenge (discontinued) or Diana Award (if won for services to St John Ambulance); and the Super Badger award (if achieved) at the bottom of the brassard.

A ceremonial uniform still exists for adult volunteers, consisting of a peaked cap, tailored jacket, white shirt, black trousers, black shoes and clip-on tie. All rank insignia are worn on the outer layer of the jacket.[33]

A section of St John Ambulance, St John Ambulance British Forces Overseas (SJABFO), has British units running where there are a large amount of British servicemen and women with their families overseas. These are namely in Cyprus, with units in Germany beginning to close in preparation for the British withdrawal from Germany in 2019.[34] The divisions are directly linked to the UK and national headquarters so that members can transfer to another unit or region/district/area as they would be able to do at home. Cyprus and Germany are a part of St John Ambulance as two districts, unattached to any region, within the organisational structure. The uniform reflects the current service delivery uniform in England.

Volunteers can receive training in the full range of St John Ambulance qualifications.

The overseas forces units (then "divisions") were founded in 1980. They remained very strong for several years, however, as the forces in Germany were reduced many divisions closed. Since the final withdrawal of forces in Germany is expected in the next few years, the role for St John Ambulance will end. However the two units in Cyprus founded in 1991 will continue to provide a service to the community there.

As well as providing medical cover at events, St John Ambulance British Forces provides first-aid training for people of all ages.

St John Ambulance British Forces Overseas works closely with the German Ambulance Services, particularly the sister organisation, Die Johanniter, in providing first aid and ambulance cover German public events where many British or English Speakers are expected to attend. Members can occasionally be seen on their non-emergency and emergency vehicles responding to public calls. St John Ambulance can also be seen working with Malteser, the German Red Cross and local fire brigades which provide ambulance services. The German Emergency Services also assist St John Ambulance at British events on military areas where many German civilians are expected to attend. With the planned withdrawal of British forces from Germany in 2019, this partnership, in this aspect at least, will be discontinued.

Although the Order of St John is largely seen as a Christian organisation for historical reasons, St John Ambulance does not restrict membership to nor promote any particular religion or denomination. Technically, it falls under the sovereignty of The Queen, and thus is linked to the Church of England; however, this relationship is more tradition than authority, and adult members are not required to pledge allegiance to or support either the monarchy or the Christian faith. Historically, Cadet members made a pledge upon joining to the monarch and to God, though was reviewed and no longer a requirement.

St John Ambulance personnel serve alongside the British Red Cross, whose members also undergo advanced training in first aid and event cover. Both organisations' work supports the statutory services in times of civil emergency or crisis. In peacetime, St John Ambulance is senior to the Red Cross however during wartime, the Red Cross would become senior due to an agreement with the International Red Cross and Red Crescent Movement.

St John Ambulance, St. Andrew's First Aid of Scotland and the British Red Cross co-author and authorize the official First Aid Manual,[35] the de facto UK guide for emergency first aid.

• St John Ambulance Cadets in the UK
• St John Ambulance Ireland
• Service Medal of the Order of St John
• Insignia of the Venerable Order of St John

• St John Ambulance – The Priory of England and the Islands
• Caring on the Home Front A website dedicated to the memories of St John Ambulance and British Red Cross volunteers during World War II.