Ambulance - Service Providers

Service Providers

Some countries closely regulate the industry (and may require anyone working on an ambulance to be qualified to a set level), whereas others allow quite wide differences between types of operator.

• Government Ambulance Service – Operating separately from (although alongside) the fire and police service of the area, these ambulances are funded by local or national government. In some countries, these only tend to be found in big cities, whereas in countries such as Great Britain almost all emergency ambulances are part of a nationwide system under the National Health Service. In Canada ambulance services are normally operated by local municipalities or provincial health agencies as a separate entity from fire or police services.
• Fire or Police Linked Service – In countries such as the United States, Japan, Hong Kong and France ambulances can be operated by the local fire or police service. This is particularly common in rural areas, where maintaining a separate service is not necessarily cost effective. In some cases this can lead to an illness or injury being attended by a vehicle other than an ambulance, such as a fire truck.
• Volunteer Ambulance Service – Charities or non-profit companies operate ambulances, both in an emergency and patient transport function. This may be along similar lines to volunteer fire companies, providing the main service for an area, and either community or privately owned. They may be linked to a voluntary fire department, with volunteers providing both services. There are charities who focus on providing ambulances for the community, or for cover at private events (sports etc.). The Red Cross provides this service across the world on a volunteer basis. (and in others as a Private Ambulance Service), as do other smaller organisations such as St John Ambulance and the Order of Malta Ambulance Corps. These volunteer ambulances may be seen providing support to the full-time ambulance crews during times of emergency. In some cases the volunteer charity may employ paid members of staff alongside volunteers to operate a full-time ambulance service, such in some parts of Australia and in Ireland.
• Private Ambulance Service – Normal commercial companies with paid employees, but often on contract to the local or national government. Private companies may provide only the patient transport elements of ambulance care (i.e. nonurgent or ambulatory transport), but in some places, they are contracted to provide emergency care, or to form a 'second tier' response. In many areas private services cover all emergency transport functions and government agencies do not provide this service. Companies such as Falck, Acadian Ambulance, and American Medical Response are some of the larger companies that provide such services. These organisations may also provide services known as 'Stand-by' cover at industrial sites or at special events . From April 2011 all private ambulance services in the UK must be Care Quality Commission (CQC) registered. Private services in Canada operate non-emergency patient transfers or for private functions only.
• Combined Emergency Service – these are full service emergency service agencies, which may be found in places such as airports or large colleges and universities. Their key feature is that all personnel are trained not only in ambulance (EMT) care, but as a firefighter and a peace officer (police function). They may be found in smaller towns and cities, where size or budget does not warrant separate services. This multi-functionality allows to make the most of limited resource or budget, but having a single team respond to any emergency.
• Hospital Based Service – Hospitals may provide their own ambulance service as a service to the community, or where ambulance care is unreliable or chargeable. Their use would be dependent on using the services of the providing hospital.
• Charity Ambulance – This special type of ambulance is provided by a charity for the purpose of taking sick children or adults on trips or vacations away from hospitals, hospices or care homes where they are in long term care. Examples include the UK's 'Jumbulance' project.
• Company Ambulance – Many large factories and other industrial centres, such as chemical plants, oil refineries, breweries and distilleries, have ambulance services provided by employers as a means of protecting their interests and the welfare of their staff. These are often used as first response vehicles in the event of a fire or explosion.