From our beginnings in the late 19th century we have grown to become the busiest emergency ambulance service in the world. This is our story.
The very beginning: horse-drawn ambulances
It may be hard to imagine today, but if you were injured in the 1890s, it was left to the police, firefighters and even taxi drivers to staff a fleet of wheeled stretchers, named ‘litters’, to take patients to the nearest hospital or doctor’s surgery.
A full-time ambulance service wasn’t established until shortly before the turn of the 20th century. The Metropolitan Asylums Board ran just six ambulance stations, each adjoining the Board’s hospitals at Deptford, Fulham, Hampstead, Homerton, Stockwell, and Woolwich. Almost the whole of London fell within a three-mile radius of one of the stations.
Early on, the ambulance fleet was horse-drawn. The first petrol driven ambulance appeared in 1904 and could carry a single stretcher at up to 15mph.
Major change came in 1930 when the Government announced proposals for the reorganisation of local government in England and Wales, including the transfer of responsibilities for the ambulance service to the county councils. So, on 1 April 1930, the Board’s duties and responsibilities passed to the London County Council, which also took over responsibility for all the hospitals.
As the Second World War approached, an auxillary ambulance service was set up as part of the Government’s civil defence service. Ennis Smith became a well-known figure for she was the youngest ambulance driver at the age of just 16. After the war, she joined London Ambulance Service.
Introducing the National Health Service
Post-war reorganisation led to the National Health Service Act of 1948. As part of this, for the first time, there was a requirement for ambulances to be available for all those who needed them.
By now, a more recognisable service was beginning to take shape. In the 1950s the London County Council’s ambulance service moved to Headquarters at Waterloo Road, but it was already clear this wouldn’t be large enough. By the early 1960s it was agreed a new headquarters would be built further up Waterloo Road. ‘Londam’, the Service’s newsletter, described it as ‘the promised land’.
A London-wide service was created in 1965 when one ambulance service was formed in London from parts of nine existing services. It comprised nearly 1,000 vehicles and 2,500 staff.
In 1974, when the National Health Service was reorganised, the London Ambulance Service was transferred from the control of local government to the South West Thames Regional Health Authority.
In 1989 staff took part in a nationwide strike for better pay and working conditions. Every station was involved with many giving out the phone number of the stations so that the public could call the crews directly in case of emergency. After six months of not being paid and living on donations from the public, a pay deal was reached and the crews went back to work.
In 1992 the failure of a new computer system led to worldwide public and media interest. The crash of the computer-aided dispatch system led to long delays in dispatching ambulances.
Service managers continued to report to South West Thames until 1 April 1996, when the organisation became an NHS trust. London Ambulance Service as we know it today officially came into being.
A 21st century service
Just like the capital itself, we are continuing to grow and develop. The London Ambulance Service of today, and the skills and capabilities of our staff, bear little resemblance to the Service of even 20 years ago. There are now more than 5,000 staff based at over 70 ambulance stations and support offices across London.
We continue to see a rise in demand for our service and each year received a record number of 999 calls. Last year, we handled almost 2 million emergency calls from across London, that’s just under 5,500 calls a day, a 25% increase from 2012!
Historically, we designed our service around a small number of our patients—those with life-threatening conditions. We are now turning our attention to our largest group of patients whose conditions, whilst not life-threatening, still need medical care. Many of these patients need different treatment to that offered by an A&E department. This could be treatment at home, referrals to a GP or social services, or treatment elsewhere at minor injuries units or walk-in centres.
The way we respond to calls is changing too. Our staff now attend to patients in cars, and on motorbikes and bicycles, as well as in ambulances. This enables us to reach patients quicker in busy built-up areas. We are increasing public access to defibrillators—machines used to restart a patient’s heart when it has stopped beating—and are providing training in how to use this equipment, so that people in the community can provide life-saving treatment while ambulance staff make their way to a call.
We play a vital role in the London trauma system, taking patients with life-threatening injuries such as amputations and stab wounds to specialist centres for treatment.
From then to now
The 19th century
- 1880s – First full-time ambulance service run by the Metropolitan Asylums Board. The ambulance fleet is horse-drawn.
The 20th century
- 1900s – Petrol driven ambulances are introduced
- 1912 – The last horse-drawn ambulance is used.
- 1917 – The ambulance service recruits the world’s first female ambulance crew.
- 1930 – London County Council takes responsibility for the ambulances in London.
- 1937 – The 999 call service starts in London
- 1948 – The National Health Service is established.
- 8 October 1952 – Triple train crash at Harrow and Wealdstone kills 112 and injures 170 people.
- 1965 – London Ambulance Service is established from nine existing services and becomes the largest service of its kind in the world with 2,500 staff responding to one million 999 calls a year.
- 1967 – Defibrillators are first used on ambulances.
- 1968 – Ronan Point building collapse in Newham.
- 1972 – The Queen makes a visit to us.
- 1973 – New headquarters open at Waterloo.
- 1974 – London Ambulance Service transfers to control of the South West Thames Regional Health Authority.
- 1974 – We recruit 32 16-17 year olds to London’s first ever paramedic cadet course which involves practical training in all departments.
- 1975 – The Queen visits our new HQ in Waterloo.
- 1984 – The Queen awards us the crown badge, which is still used today.
- 1989 – London Ambulance Service museum opens at Ilford.
- 1989 – £2m Fulham ambulance station opens. At the time it was the largest ambulance station in the UK.
- 7 July 1989 – Princess Diana visits.
- 1991 – First paramedic motorcycles used.
- 1991 – Permanent emergency planning unit established.
- 1992 – Major failure of software in control room causes delays in attending to calls.
- 1996 – Following the introduction of the level one paramedic qualification, our first staff qualify as paramedics.
- 1 April 1996 – London Ambulance Service becomes an NHS trust.
- 1998 – The defibrillator becomes portable with a life-long battery
- May 1998 – Queen Mother visits.
The 21st century
- 2000 – First bicycle ambulances used.
- 2001 – Introduction of fast response units – staff who work on their own in cars as a single responder.
- 2002 – We achieve the government target of reaching 75% of the most serious and life-threatening calls within eight minutes.
- 2002 – Satellite navigation and mobile data terminals (to track changes in patient condition en-route to a call) is introduced onto ambulances and fast response cars.
- 2003 – First yellow A&E Mercedes Sprinter ambulances are in use
- 2004 – Community defibrillation officer appointed to coordinate installation of defibrillators—machines used to restart a person’s heart—in public places and training of members of the public in how to use them.
- 2005 – Dedicated urgent operations centre opened to deal with less serious calls.
- 7 July 2005 – More than 250 staff involved in the emergency response to the London bombings.
- 2006 – Introduction of Fast Response Electronic Dispatch (FRED) and Fast Response Electronic Dispatch for Ambulances (FREDA). This award-winning computer software automatically dispatches emergency vehicles to incidents.
- 2006 – We launch the Hazardous Area Response Team (HART), a team if highly trained clinicians who provide life-saving medical care in hostile environments such as industrial accidents and natural disasters.
- 2007 – Ambulance community responder volunteers introduced to provide medical aid to patients while an ambulance is on its way.
- 2008 – London Ambulance Service rated best ambulance service in the country in the Healthcare Commission annual health check.
- 2012 – We launch the Joint Response Unit (JRU), a specialist team that works closely with the Metropolitan Police in high demand areas at peak times, in a selection of London boroughs.
- 2017 – We respond to an unprecedented number of major incidents during one of our busiest years on record, including the terror attacks at Westminster Bridge and London Bridge and the fire at Grenfell Tower.
- 2018 – We now have over 1,100 vehicles across London including ambulances, cars, motorcycles and bicycles.
- 2019 – We have more than 5,000 staff responding to almost 2million 999 calls every year.