A Breathe of Fresh Air! – Celebrating a year of innovation across UK NHS ambulance services

By Justin Wand, Deputy Director of Fleet and Logistics, London Ambulance Service

As we look back on 2017, we’re reminded of what an innovative year it’s been for fleet services across the UK. Our Ambulance services are facing year-on-year increases in demand as well as being under constant pressure to be more efficient and deliver more with ever-decreasing budgets.

Below Justin Wand, Deputy Director of Fleet and Logistics at London Ambulance Service takes a quick look back at some key fleet initiatives and successes stories from across the UK. Whether it’s implementing leaner ways of working, minimising waste or introducing futuristic new vehicle designs and technologies, we’ve seen a wide range of strategies for optimising fleet services and, most importantly, delivering a better, more environmentally-friendly experience to our patients.

Justin Wand


London Ambulance Service: Going the extra mile to reduce emissions.
Like most, London Ambulance service is keen to define the next steps to implementing an operationally viable approach to a sustainable and environmentally efficient future.

With news that C10,000 premature deaths occur annually in the Capital as a result of vehicle emissions, the ambulance service has a moral obligation given the contradiction exhibited when operating large fuel hungry vehicles, the subsequent emissions they produce and the potential for contributing directly to the ill health of the communities we serve.

Key areas of the fleet strategy include; Fleet Composition and Mix: Right-sizing the fleet to match the skill of our staff and the needs of our patient demographic
Driver Behaviour: supporting and informing driver development and training to improve the patient experience.

Vehicle design – Explore opportunities for staged introduction of hybrid and EV technology, trial and evaluate response vehicles in service during 2018, light-weighting the vehicle build, improving safety and reducing the impact the trust has on the environment.

Vehicles such as the BMW i3 present a clear opportunity to Trusts in both operational and support roles with the technology creating familiarity and reassurance for our staff and wider competition in the market, improving the technology and driving innovation forward.


NWAS safeguards sustainability
Last year Ambulance Today reported  on North West Ambulance Service’s consolidation of 5 small, ageing ambulance workshops into their new, state-of-the-art Fleet and Logistics Centre situated in Haydock. Not only was the new centre breaking new ground in efficiency with everything needed for the servicing of NWAS vehicles under one roof, but it has also been assessed at BREEAM (Building Research Establishment’s Environmental Assessment Method) excellence in sustainability for its continued commitment towards energy-saving, the correct handling of clinical waste, general waste and recycling. This year NWAS have increased their drive towards environmental sustainability with the introduction of electric rapid responder vehicles.

Since then NWAS have introduced four electric vehicles to their fleet of 174 rapid responder cars. The BMW i3 RExAC, winner of Car of the Year and Green Car of the Year awards, was already being used in police and fire services across the UK. If the trial is successful it is estimated that NWAS will save up to £2.5 million in fuel costs over the next 4-years.

Neil Maher, Assistant Director Service Delivery Support said: “The trust relies heavily on rapid response vehicles to be able to attend patients as quickly as possible.

“The introduction of these electrically powered cars will not only provide huge cost savings for the Trust, it will also have a huge impact on our carbon footprint, reducing the carbon contribution from our RRVs by 90%”

Elsewhere, the i3 REx model has also been implemented by the Scottish Ambulance Service as part of their initiative Taking Care to the Patient.


SAS takes care to the patient
Last year Scottish Ambulance Service introduced a 12-month pilot of a new response model following the most extensive, clinically-evidenced review ever undertaken in the UK, with more than 500,000 patient calls examined. The 2020 strategy Taking Care to the Patient hopes to more accurately identify patients with immediately life-threatening conditions like cardiac arrest to ensure that all patients receive the response they need based on their clinical condition. As part of the strategy, SAS is also committed to seeing and treating more patients in their own homes and communities wherever possible, rather than unnecessarily taking them away from family support and into a hospital environment.

Delivering the transformational change will require ongoing investment into new vehicles and equipment. The service’s approved £77.8 million vehicle replacement project is currently in its second of five years and has provided the opportunity to develop a fleet that will meet both immediate and long-term needs, taking emerging technology and innovation into account. Having considered hydrogen fuel vehicles and the short-term challenges around the supply infrastructure, SAS became the first UK service to bring electric powered paramedic rapid response vehicles on to its operational fleet with the introduction of converted BMW i3 REx response vehicles in Edinburgh, Aberdeen and Glasgow.
Trevor Spowart, General Manager of Fleet Services, said: “The acceleration and maneuverability even when fully-loaded was beyond our expectations and although the excellent range on the battery exceeds our normal paramedic response shift needs, with the range extender specification our staff have the reassurance that they will never be in a situation where they cannot respond due to range.”
The i3 REx models use the latest technologies to reduce weight and manage power and have been designed for integration with the Telehealth communications hub providing the WiFi network for the removable tablets used by the service’s frontline staff.


Midlands Air Ambulance unveil new rapid response vehicles
The Midlands Air Ambulance charity is a regional helicopter emergency medical service which covers the largest operating area in England. It’s vitally important however, that when weather conditions become too bad to fly the expert aircrew still have some means of reaching their patients to administer prehospital care.

Early this year the charity was proud to unveil three new rapid response cars to complement their air operations.

The three authority specification BMW X5 vehicles will be located at the organisation’s three airbases in Shropshire, Staffordshire and Worcestershire. Five percent of the calls attended by Midlands Air Ambulance are via the rapid response vehicles.

Becky Steele, Air Operations Manager for Midlands Air Ambulance Charity, explains the decision-making that brought them to the BMW X5 series model: “The X5 is a tried-and-tested rapid response vehicle for the emergency services. Its large interior is perfect for a bespoke medical equipment fit out, while the model’s advanced capability means it is a reliable asset, ensuring our clinicians tend to incidents swiftly and safely.”

Closing statement by Justin Wand
It is clear we’re at the beginning of a revolution in ambulance fleet management and design which will see us examine the threads upon which we have built our operational history and knowledge.
The advantages offered by vehicles such as the BMW i3 Rex provide the basis for a step change in our approach to more environmentally efficient operations.
The challenge for Trusts and manufacturers alike is taking that next major step forward, in partnership with our staff, so we can ensure that patient care remains at the centre of all we do.


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