| St John Ambulance Priory of England and the Islands |
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Logo of St John Ambulance England and the Islands |
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| Formation | 1877 |
| Type | Charitable organisation Limited company |
| Headquarters | Registered Office: St John's Gate, Clerkenwell, London EC1M 4DA Headquarters: 27 St John's Lane, Clerkenwell, London EC1M 4BU |
| Location | England and the Islands |
| Membership | 40,000[1] |
| Chief Commander | Mr Mick Messenger (Acting) |
| Key people | Sue Killen (CEO) |
| Affiliations | St John Ambulance Johanniter International |
| Budget | £78.3m per annum[1] |
| Staff | 1532[1] |
| Website | http://www.sja.org.uk |
St John Ambulance is a volunteer-led, charitable non-governmental organisation dedicated to the teaching and practice of first aid [2] in England, Northern Ireland, the Isle of Man and the Channel Islands. It is one of two affiliates of the international St. John Ambulance movement in the United Kingdom. The organisation is a subsidiary charity of the Priory of England and the Islands of the Venerable Order of St John.
In the 1820s the Knights of Malta living in France offered knighthoods to specific people supporting the Order of Malta in Great Britain, irrespective of their Christian denomination. Their approach was not part of the official policy of the Order of Malta, but the English Knights devoted themselves to charitable activities, which were organised into what became known as Foundations. This British group carrying out very substantial charitable activities was recognised and incorporated in 1888 as the Grand Priory of the Order of the Hospital of Saint John of Jerusalem in England.
Britain was one of the first countries to become industrial and in the 19th century there were many dangerous workplaces. Accidents were frequent but workers rarely saw a doctor in time. Death or disability from untreated injuries was common. Members of the Order of St John wanted to find a way to help. They decided to train ordinary people in first aid so accident victims could be treated quickly and on the spot, and in 1877 they set up St John Ambulance to do this. Classes were set up across the country, particularly in workplaces and areas of heavy industry, but also in villages, seaside towns and middle class suburbs.
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 Britain, St John 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 nurses looked after the sick and injured in their own homes.
There were originally three charitable Foundations of the modern Order. One, which became The St John of Jerusalem Eye Hospital Foundation, was established in 1882. The St John Ambulance Association, which was concerned with training the public in first aid, was established in 1877. And, the third was The St John Ambulance Brigade, which provided first aid care to the public. It had its origins in 1873, and became a Foundation in 1887. The St John Ambulance Association and The St John Ambulance Brigade were amalgamated in 1974 to form the present St John Ambulance Foundation.
St John Ambulance was originally divided into two fields, teaching first aid to workplace employees via the St. John Ambulance Association, and providing uniformed medical volunteers to cover public and private events via the St. John Ambulance Brigade. However, these two entities merged in 1968 to form a single unified St. John Ambulance, providing both training and first-aid cover.
Within the Priory of England and the Islands, the organisation is broken down into Counties. The boundaries and areas of these Counties are determined by the organisation itself rather than strictly adhering to national borders. The Islands (Guernsey, Jersey and the Isle of Man[3]) are also considered counties for the purposes of administration. St John Ambulance in Northern Ireland is now no-longer administered by National Headquarters, however an advisory relationship still exists.
During 2006 St John Ambulance (England & the Islands) trained 551,000, cared for 137,000 people and worked with 20,000 young (age 5-17) volunteers. St John Ambulance volunteers gave 5,700,000 hours of service.[1]
St John Ambulance volunteers and employees attend thousands of events every year providing first aid to the sick and injured. This service is provided free at the point of delivery, although a charge may be made to the event organiser for attendance at events.
In addition to providing first aiders for events, where necessary St John Ambulance can provide mobile treatment centres, ambulances, Healthcare Professionals and other medical provision.
St John Ambulance cover many large events all across England and Wales. Being a national organisation (but run day to day locally) they have the ability to get many members from all over the country, providing all the infrastructure needed for event medical cover. This covers things such as the first aid staff providing the frontline treatment, the mobile treatment centre they are working in, their own command structure, and their own communcations. Many areas have good working relationships with the local NHS services, and so may also take NHS resources into St John command at events, making it much more efficient to manage.
St John Ambulance also runs courses for external individuals, in a variety of different skills and medical issues. The First Aid at Work course is used by many companies to train designated individuals as first-aiders, as required by employment laws.
The Community First Aid suite has recently been released offering the community a variety of low cost first aid courses at convenient times. They also provide useful training courses for people of all ages.
St John Ambulance owns a large number of ambulances and transport vehicles, which are used for commercial and charitable patient transport services and emergency use.
St John Ambulance employees and volunteers provide support to the NHS Ambulance Services in some areas, responding to Patient transport requests, 999 calls at busy times, and assisting the statutory emergency services during times of major incident.
St John Ambulance have specially adapted ambulances for the purposes of the transport of critically acute paediatric patients, although the St John Ambulance staff are not involved in the direct treatment of the patients they provide Emergency Drivers with the vehicles to transport the patients. This service was part of and seen in the BBC One documentary series Children's Emergency in 2010 which followed followed the Doctors and Nurses of the CATS (Children's Acute Transport Services) based in London.
St John Ambulance is also a major youth organisation, with over half its membership being made up of those aged 25 and under. Cadet units are run for those 10 to 17, and Badger Setts are provided for younger children aged 5 to 10. These groups are similar to the Scouts, although there is a greater emphasis on teaching first aid. Members aged 16 or 17 are encouraged to transfer to First Aid Services units if they wish to continue training in First Aid, to become Youth Leaders within their unit.
St John Badgers work towards the 'Super Badger Award'. This award consists of members completing 12 subjects, such as 'Creative', 'Global' and 'Wild' Badger. The award is split into 5 sections, where Badgers advance through completing more subjects.
The Grand Prior Award is the primary award designed for Cadets. The award is an essential part of Cadet life, and was updated in 2004 after around 50 years of retaining the previous programme. The award consists of completion of 24 subject areas over the period of Cadet membership, until the age of 21. There is no maximum time limit (other than age restrictions) upon completion of the award, however the award should not be completed in fewer than 3 years from the commencement date. The subject areas range from topics such as photography and clerical skills to childcare and crafts. The award is seen as the highest award a Cadet can achieve, and is one of the only badges, as well as the Amalfi Award, 1000 hours service badge, National Competition Winner's badge and Sovereign's Award, which may be retained on the adult uniform.
Every year a reception is held at Buckingham Palace and is attended by HRH The Princess Royal to celebrate chosen individuals who have gained their Grand Prior Award.
The Amalfi Award was launched in recognition of the need for a programme after the Grand Prior Award. The Amalfi Challenge is open to all cadet and adult members aged 16 to 25. The structure of the award focuses on personal task set by the individual. These tasks are categorised into service, relationships, society and challenge. Each participant has to undertake 12 tasks and at completion of 4, 8 and 12 subjects a badge is awarded.
Cadets in St John Ambulance are encouraged to attend Cadet Leadership courses. These courses are progressive and intended to give cadets the skills to take a more active role within their divisions. The courses teach skills which enable cadets to be promoted to NCOs within their divisions. They can then progress and attend further courses designed to improve said skills. Ideally all cadets promoted to the ranks of Cadet Corporal or Cadet Sergeant should have completed Cadet Leadership 1, and those promoted to Leading Cadet should have completed Cadet Leadership 2. Both Cadet Leadership courses also count a subject towards the Cadet's Grand Prior Award. Following the Cadet leadership 2 course, Cadet Leadership 3 allows Cadets to learn the skills required to take on an assistant youth leader role within their division, and includes the BTEC-accredited Essential skills in youth work course.
St John Ambulance units dedicated to meeting the needs of student and university communities can be found at many institutes of higher education across England, Wales and Northern Ireland. These units, known as LINKS units, were originally established at universities to form a 'link' between cadet and adult membership, allowing members to carry on their membership and maintain their skills whilst in higher education. However, LINKS units have become integral parts of the student community and the majority of members new to St John Ambulance at point of joining, as students new to university look for societies to join.
LINKS units differ from most other sections in that they do not use a rank structure, instead having a democratically elected committee. This is due to the fact that, as well as being a unit within St John Ambulance, a LINKS unit typically exists as a society in the university's Students' union, and as such must have a committee structure.
As well as providing first aid training to the student community and first aid cover at student events, LINKS members can be found frequenting other events attended by mainstream St John Ambulance units.
It is essential that as a large major youth organisation as well as a first aid organisation that its Youth Leaders are trained appropriately to be youth leaders within the organisation, Youth Leaders teach first aid; the Grand Prior Award Subjects; organise weekly meetings; social activities and games. Youth Leaders often attend the BTEC-accredited Essential Skills in Youth Work course to which St John Ambulance offers to all its members for the role of a Youth Leader, support is offered by Divisional Officers and County Staff Officers to members in this role where it is required for them to perform to their full potential.
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 markup 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. SJS is also the only approved supplier of St John Ambulance uniform, clothing and branded merchandise.
As individual (local) Divisions of St John Ambulance have historically been responsible for providing their own vehicles, these have taken many and varied forms, beginning with horse-drawn ambulances. Even into the late twentieth century, and 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.[4][5] 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.[6]
By the year 2004 the national St John Ambulance emergency vehicle fleet was in a standard corporate livery, and was based upon four different vehicle types, as follows:[7]
These were (and remain) complemented by the Companion, a non-emergency version of the Companion Plus, not fitted with sirens or blue lights, and used for patient transport, first-aid post base, and other general duties.
St John Ambulance also maintains specialist transport options in particular locations, such as the motorcycle paramedic responders based in London, cycle emergency responders deployed nationwide, and horse-mounted units maintained in some rural areas.
The majority of St John Ambulance's Event First Aid Services and Youth Services are provided by its volunteers. Approximately 40,000 volunteers aged from 5 upwards are members across the organisation.
Volunteers receive training according to the role they fulfil. Those volunteering to provide Event First Aid services are offered a number of first aid qualifications, ranging from a basic emergency life support course and the further first aid modules, which deal with common injuries and ailments, through to Emergency Transport Attendant training which covers many of the competencies of the National Health Service Ambulance Technicians. The training for those delivering Youth Services comprises emergency life support training, coupled with training from the organisation's own youth leader training suite including Essential skills in youth work and Leadership skills in youth work, depending on the volunteer's role.[8] In addition to medical training offered, members have the opportunity to carry out other operational roles. These include event planning, event management, radio communcations/control, plus other support roles such as providing member refreshements at events etc.
Qualification levels for first aid volunteers (in order that they have to be achieved):
Members start as a Trainee First Aider, and then after a period of supervised practice and passing assessments, become a first aider, then can move on to advanced first aider, then if suitable a patient transport attendant (PTA), then finally emergency transport attendant (ETA) which bears some resemblance to the NHS ambulance technician role.
Beyond the initial qualifications, members can train in additional medical skills, such as administration of medical gases, and use of an automated external defibrillator (AED). For those wishing to go further still, the organisation runs two internal qualification courses known as Patient Transport Attendant and Emergency Transport Attendant (formerly Ambulance Aid level 1 and 2 respectively). These build upon the first aid skills with additional skills required for ambulance crewing. Those attaining the first level are allowed to crew St John vehicles and provide Patient Transport services (PTS). Those attaining the second level are additionally called upon to crew emergency ambulances as necessary. Training of the Ambulance Aid courses (especially the second) are sometimes undertaken or supplemented by the NHS Ambulance Services.
The use of Cycle Response Units has been introduced by the organisation. The cycles used by St John Ambulance are custom designed and built for the task, with strengthened frames to take the extra weight of the large quantity of medical equipment they carry, including oxygen cylinders and AEDs. Members acting as Cycle Response Units are additionally trained with commercial cycling courses and must demonstrate a reasonable level of fitness. They wear a dedicated cycle uniform, replacing the conventional operational uniform.
Qualified healthcare professionals may also volunteer their time in St John Ambulance. These include:
All healthcare professionals have their qualifications and professional status checked with the appropriate regulatory body before practicing in St John Ambulance. Professionals can carry out any skill appropriate to their type, level of training, competence and when relevant to the situation or patient. Healthcare professionals wear coloured rank slides to distinguish them from internally-trained first aiders and ambulance personnel. With the exception of Paramedics/IHCD Ambulance Technicians, any HCP wishing to work on an ambulance though must become a PTA/ETA, but many parts of the training can be skipped depending on the HCP's professional training already undertaken. This is to ensure that the HCP is prepared for working in an ambulance/emergency environment (which they maynever have done since their initial training).
Student Nurses and Medical Students may act in their role as a student on duty under the supervision of a registered practitioner of the same profession, however at present St John Ambulance does not have any provision Student Paramedics in the same way which they do Student Nurses or Medical Students. Coloured stripes are added to the rank slides to indicate they are acting in that role.
The National Headquarters of St John Ambulance in England is located in the Clerkenwell area of London. Clerkenwell has been associated with the order of St John throughout its history. St John Ambulance units in the Crown Dependency territories of Jersey, Guernsey, and the Isle of Man are also administered from this National Headquarters, and these island groups give the associated langue of the Order of St John its formal name of ‘’England and the Isles’’.
The National Headquarters of St John Ambulance includes the administrative hub of the organisation, the offices of various departments, the offices of the Chief Commander, and a supplies (equipment) department which trades as an independent company.
The organisation is divided into nine Regions for purposes of both administration and competition (regular competitive exercises are staged to test the competency of volunteers under pressure). The Regions, and the county areas they contain, are as shown below.
The County (or sometimes District) is the basic command unit of St John Ambulance, each with a County/District Headquarters, and a range of departments and support staff to facilitate the activities of volunteers in the subordinate units. There are 44 counties/districts at this level.
In Jersey and Guernsey, which are independent states rather than British counties, the alternative term “Bailiwick” is employed.
County administrations are often sub-divided into areas/sectors/zones, with area staff officers (or similar) reporting to the county administration. Historically they were each headed by their own area commissioner.
The local unit of St John Ambulance is the division (or unit). Divisions historically were ambulance divisions (for men), nursing divisions (for women) and ambulance cadet divisions and nursing cadet divisions for boys and girls respectively. In modern times, only a few single-sex divisions remain, and most are either termed 'combined division' (men and women together) or 'quadrilateral division' (men and women, boys and girls under one command structure). Other types of local units exist, such as Badger Setts (for 5-10-year-olds), and specialised groups such as cycle response units, LINKS units within universities, and sometimes informal social groups, each with a distinctive command, management or leadership structure.
The St John Ambulance uniform is well-known to the general public. All orders of dress (as described below) make provision for displaying the insignia of the wearer's rank within the organisation. Members are required to wear uniform when providing first aid or transport services, both for identification and to present a professional image. It is protected by law[10] and may only be worn by registered members. Unlike the uniform of other volunteer organisations, the St John uniform is relatively formal and is similar to a British Police uniform, for which members are sometimes mistaken.
The uniform has been updated several times since original creation and is due to be revised further by 2012.
There are nine orders of dress intended for different situations. No.1 and No.2 are formal ceremonial dress uniforms, the former with a tailored uniform jacket, the latter without; No.3 and No.4 are less formal, suitable for nursing duties in other medical establishments and during hot weather; No.5 is the basic operational uniform; No.6 is a casual uniform for training and informal events; No.7, No.8 and No.9 are operational uniforms for specific tasks, corresponding respectively to Patient Transport Services, Community First Responder, and Cycle Responder. The two most widely used are No.2 (dress uniform without tailored jacket) and No.5 (operational uniform). Where there is no access to full uniform, LINKS members may wear a uniform polo shirt in place of the formal shirt.
High visibility garments may be worn over the uniform, adopting the yellow/green two-tone generally accepted for emergency medical services. An alternative No.5 operational uniform is a green two-piece suit, similar to those of paramedics and technicians from many other ambulance organisations; this has most commonly been worn by members operating as an ambulance crew, but may also worn by first aiders.
Other priories and countries have various regional variations of uniform, but most are loosely based on the same design as the English uniform.
St John Ambulance has a wide and complicated rank structure, both nationally and locally, with different departments, teams and roles. The rank markings and local structure are similar in some respects to the army.
The highest ranking officer in the organisation is the Chief Commander based at the National Headquarters, London, currently this office is held by Mick Messenger, former commander of London Prince of Wales district, at this moment he is in the role in an acting capacity after the retirement of Roger Chatterton.
At a county level the County Commander is the most senior officer in the county and is responsible for an area, such as Cornwall or Humberside, each county has a single Commander who will run them.
At local or town (Divisional) level, a Superintendent is usually in charge, with a 2 or 1 pip officer as their deputy. There may be additional 1/2 pip officers for larger divisions responsible for certain sections (e.g. adult members, cadet members etc.) although these role may also be fulfilled by Sergeants and Corporals. Sergeant(s) and Corporal(s) provide support and general day to day unit management, as well as management and member support at events.
See St John Ambulance Ranks and Insignia for the St John Ambulance ranking structure.
St John Ambulance now has British divisions running where there are a large amount of British servicemen and women with their families overseas. These are namely in Germany and Cyprus. The divisions are directly linked to the UK and national headquarters so that members can transfer to another division or county as they would be able to do at home. The overseas divisions are classed as one whole extra county for the UK in the St John Ambulance structure. The shoulder flash on the uniform states "St John Ambulance Germany" as it would say, for example, "St John Ambulance London District" which shows that they are directly linked to the UK. St John Ambulance British Forces Overseas is run by a volunteer paramedic with links to the military.
Members are able to be trained in a the full-range of St John Ambulance Qualifications. The majority of the volunteers hold positions as First Aiders or Advanced First Aiders; however, recently some members have been trained up to Patient Transport Attendant (PTA) or Emergency Transport Attendant (ETA) qualifications.
The overseas forces divisions were originally founded in 1980. They remained very strong for several years, however, as the forces in Germany were reduced many divisions closed. Over the past few years, St John Ambulance is again making a strong return to British Forces Germany and in the past year a series of divisions were re-opened across Germany.
Until last year, they had a number of ambulance available for public use; but these were decommissioned and an ambulance from the UK borrowed for use in Germany. A car was also donated by a local dealership for use of the training services or transport of volunteers. Current attempts are being made to raise funds to purchase the new 'Crusader' Ambulances that St John Ambulance are using in the UK to further benefit the forces communities.
St John Ambulance British Forces does not just provide medical cover for events, but just as in the UK they provide commercial first aid training, quite often run in co-ordination with Military Education Centres. There is a strong team of first aid trainers across Germany who can teach the range of civilian first aid courses include the HSE-approved First Aid at Work. They are the lone supplier of these courses to soldiers and civilians in the British Forces.
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 equally assist St John Ambulance at British events on military areas where a high number of German civilians are expected to attend.
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. Cadet members do still make a pledge upon joining to the monarch and "God"; however, this is again largely seen as tradition, and there is no pledge to the Church of England.
St John Ambulance often serve alongside the British Red Cross, whose members also undergo advanced training in first aid and event cover, the British Red Cross also provides general humanitarian aid, both organisations work together in times of civil emergency or crisis. St. Andrew's Ambulance Association is the equivalent organisation in Scotland. Together these three Voluntary Aid Societies publish the official First Aid Manual, the de facto guide for emergency first aid.
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