St John Ambulance (England and the Islands)
||This article's lead section may not adequately summarize key points of its contents. (August 2013)|
Logo of St John Ambulance England and the Islands
|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|
|Mr Mick Messenger|
|Sue Killen (CEO)|
|Affiliations||St John Ambulance
|Budget||£78.3m per annum|
St John Ambulance is a volunteer-led, charitable non-governmental organisation dedicated to the teaching and practice of first aid  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.
- 1 History
- 2 Key dates within the history of St John Ambulance in England
- 3 First aid services
- 4 Training services
- 5 Transport services
- 6 Youth services
- 7 First aid and medical equipment services
- 8 Vehicles
- 9 Volunteers
- 10 Structure
- 11 Uniform and ranks
- 12 St John Ambulance in the British Armed forces
- 13 Relations with the Order of St John and other organisations
- 14 See also
- 15 References
- 16 External links
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 England (Scotland was provided by St Andrew’s First Aid), 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. 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) 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.
Key dates within the history of St John Ambulance in England
- 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 SMOM
- 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: Cadet units are started
- 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.
First aid services
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 provision of the service at their event.
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 it can utilise the volunteer workforce across the country, providing all the infrastructure needed for event medical cover requirements.
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.
In addition, St John Ambulance teaches first aid to children in schools in various parts of England, through a mixture of employed staff and volunteer trainers. In London specifically, this is delivered through the Saving Londoners' Lives project.
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 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.
Super Badger Award
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.
Grand Prior Award scheme
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.
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 as 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 are new to St John Ambulance at the 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 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.
First aid and medical equipment services
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.
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, 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. 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.
By 2004, the national St John Ambulance emergency vehicle fleet was in a standard corporate livery, with standard vehicle types:
- 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, a Car or a 4x4 vehicle, Support Unit's 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 Van's are normally used only for logistical purposes. Mini-buses are also available, and can be used for Logistics or Member Transport. Occasionally these are also used to transport low priority patients.
St John Ambulance also maintains specialist response options in particular locations, such as the Motorcycle Units, Cycle Response Units, as well as larger vehicles or trailers used as static First Aid posts.
The majority of St John Ambulance's Event First Aid Services and Youth Services are provided by its volunteers. Approximately 40,000 people aged from 5 upwards are volunteers across the organisation.
Training and skills
Volunteers receive training according to the role they fulfill. 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. In addition to medical training offered, members have the opportunity to carry out other operational roles. These include event planning, event management, radio communications/control, plus other support roles such as providing member refreshements at events etc.
Qualifications in First Aid and Allied Subjects
Qualification levels for first aid volunteers (in order that they have to be achieved):
- Trainee First Aider (TFA)
- First aider (FA)
- Advanced first aider (AFA)
- Patient transport attendant (PTA)
- Emergency transport attendant (ETA)
Volunteers start as Trainee First Aiders and then, after a period of supervised practice and passing assessments, become first aiders, then, usually after a probationary period of six months or more and provided they can demonstrate significant experience as a first aider, they can move on to become Advanced First Aiders; then, if suitable, patient transport attendants (PTA) and finally, emergency transport attendants (ETA).
Beyond the initial qualification of First Aider, volunteers can train in additional medical skills as they progress up the qualifications ladder. Where previously members were able to study some of these advanced skills (such as administration of the medical gases oxygen and Entonox) as optional 'bolt-on' modules once they had reacted the level of First Aider, the use of medical gases is now a core Advanced skill and can only be performed by an Advanced First Aider. Similarly the use of an automated external defibrillator (AED) was previously held as an advanced skill which could be studied as an optional bolt-on, but is now incorporated as a core skill for all First Aiders. 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 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.
Trainee First Aider
Designed to be an introduction to what St John Ambulance is about, the course replaces the old 'induction' and brings in a variety of key skills and concepts vital for any future operational first aider. The two day course covers:
- Communication & casualty care
- Incident management
- Primary Survey (casualty assessment)
- Unconscious casualty & recovery poisiton
- Compression only resuscitation (Vinnie Jones style)
- Bleeding & bruising (minor)
- Burns & scalds
- Bites & stings
- Shock (recognition & treatment)
IPC (Infection Prevention & Control)
- Personal hygiene
- Care of uniforms
- Effective hand hygiene
- Effective use of PPE
Moving & Handling Principles
- Relevant Health & safety information
- Spinal Anatomy, relevant structure & function
- Causes of back pain
- Risk assessment & planning
- Basic rules & positions
Once members are familiar with basic first aid and life-saving skills, the First Aider course provides them with a very comprehensive look at a wide variety of first aid principles and skills. All further training builds on what is taught on this course. If members complete the course successfully, they are permitted to treat on duties as a First Aider. The course typically lasts two days and consists of practical and theoretical training and a final assessment of competence.
The syllabus consists of:
- Role of the FA
- Governance & documentation
- PPE, Management of waste etc.
- Resuscitation - Basic life support (all ages)
- Resuscitation - Use of face shield / pocket mask
- Secondary survey
- Bleeding (severe)
- Allergic reaction
- Low blood sugar
- Bone, muscle & joint injuries
- Casualty management outdoors
- Childhood conditions
- Eye injuries
- Head injury
- Administration of medication
- Chest pains
- Mental Capacity Act (consent)
- Abdominal pain
- Heat + cold extremes
- Spinal injuries
- Foreign objects (ear, nose, eye)
- AED (Automated Defibrilator)
- Incident management
- Research into CPR & defibrillation
- Basic anatomy and physiology of the heart
- Practical Introduction to AED and use of AED protocol
Advanced First Aider
Once members have gained significant experience on duty and are confident with their first aid skills, they can progress to be an Advanced First Aider. This builds on their qualification as a First Aider by going into more depth about the medical conditions that AFA's may come across and by giving them the use of more advanced treatment and observation equipment. This added knowledge and improved skillset provides the AFA with more confidence when treating casualties, helping them to provide a higher standard of medical care.
The Syllabus includes:
- Role of the AFA (inc. Governance & Documentation)
- Blood oxygen measurement
- Mental Capacity Act (consent)
- Spinal immobilisation using collars
- Fracture immobilisation using splints
- Removing a crash helmet
- Patient care positioning
- Use of equipment carred on MTU
- Body temperature measurement (tympanic / electronic)
- Blood pressure measurement
- Use of spinal boards
Medical gases are an advanced first aid skill and are extremely valuable in the right circumstances. Oxygen is used to treat critical conditions (such as cardiac arrests and asthma attacks) and Entonox is used in relief of severe pain (usually fractures). Members must have a good amount of experience before venturing into these skills; the Advanced First Aider must know when to use gases and what safety precautions must be taken.
- Medical gas cylinders (safety, storage & preparation)
- Oxygen - casualty assessment
- Oxygen therapy (inc. suction & oropharyngeal airways)
- Oxygen as an adjunct to resuscitation
- Entonox as an analgesic gas (pain relief)
Moving & Handling for Advanced First Aiders
- Use of carry chairs
- Use of carry sheets
- Use of folding (Furley) stretcher
- Use of wheelchairs
- Use of ambulance trolley beds
Patient Transport Attendant
This course is aimed at the scenario of transporting by ambulance a patient whose condition is stable (typically chronic) and not expected to deteriorate. For example, an inter-hospital transfer may fall into such a category. On its own, the qualification usually will not allow you to crew an ambulance on a duty and bears a strong resemblance to the Advanced First Aid qualification, although the skills gained can be useful on duty. There is a strong emphasis on good patient handling.
- PTA: Role & responsibility
- Infection prevention & control (clinical)
- Vehicle inspection & use
- Ambulance familiarisation
- Radio communication protocol
- Patients with chronic conditions
- Medical gases
- Mental health
Moving and handling of patients/casualties (6 hrs)
- Safe manual handling techniques
- Ambulance carry chair
- Pole and canvas stretchers
- Carry sheet
- Furley stretcher
- Orthopaedic scoop stretcher
- Ambulance trolleys (Pioneer and Falcon)
Emergency Transport Attendant
This covers the competencies needed to provide accident and emergency care inside and outside of an ambulance. It is a high level First Aid course with a rigorous examination at the end, and in addition to the time commitment for formal instruction, candidates should expect to put in extra practice time. Significant experience of hands-on First Aid is essential.
- Extended primary survey
- Taking of observations (blood pressure, oximetry, chest auscultation and palpation)
- Patient assessment scenarios
- Fracture management
- Use of ambulance trolleys
- Spinal immobilisation: cervical collars, rescue board, scoop, KED
- Head and chest trauma
- Trauma and medical scenarios
- Assisting the paramedic
Qualified healthcare professionals may also volunteer their time in St John Ambulance. These include:
- Operating Department Practitioners
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 parts of the training may be omitted if the candidate can attain accreditation of prior learning. This is dependent 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 may never have done).
The structure of the organisation is currently in the process of changing from county based to regional based. Previously the general structure was National Headquarters (NHQ) > County Headquarters (CHQ) > Divisions > members. There were various ranks & roles within that structure. In autumn 2011 it was announced that the organisation would adopt a regional role, with counties merging to form regions. The regions would have a new command structure (completely abolishing all roles above division level) with a Regional Director in overall charge (answering to NHQ), and various new roles to manage the activities of the organisation in the region. The first regions came into being in March 2012, and the reorganisation process is still on-going in some parts of the country.
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 in England. 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, as well as supplying the organisation's medical equipment and consumables needs internally, sell s a range of medical and health and safety products to external customers.
The organisation is divided into eight Regions for purposes of both administration and management. The Regions, and the geographical areas they contain, are as shown below.
- East Midlands - Derbyshire, Leicestershire & Rutland, Lincolnshire, Northamptonshire, Nottinghamshire.
- East of England - Bedfordshire, Cambridgeshire, Essex, Suffolk, Norfolk, Hertfordshire.
- London - London.
- North East - Durham, Humberside, Northumbria, North Yorkshire & Teesside, South & West Yorkshire.
- North West - Cheshire, Merseyside, Lancashire, Greater Manchester, Cumbria.
- South East - Buckinghamshire, Oxfordshire, Berkshire, Hampshire, Kent, Surrey, Sussex, Isle of Wight.
- South West - Avon, Cornwall, Devon, Dorset, Gloucestershire, Somerset, Wiltshire.
- West Midlands - Herefordshire, Shropshire, Staffordshire, Warwickshire, West Midlands, Worcestershire.
- Northern Ireland - Northern, Eastern, Western, Southern and Belfast.
The regional director is the head of their region, within the boundaries of policies set by NHQ. They have a team of regional managers to head up various functions such as events, facilities, logistics, HR, training, youth and more. Each departmental manager has at least one person assigned to coordinate the same support service to each district. The regional director also has a number of district managers to run parts of each region and provide line management to the next level down.
The region is divided into a number of districts, usually between three and five, depending on the number of units in the region. A district may contain one or more former "counties" from the previous structure. Each district is managed by a district manager, and area managers report to them. District managers are in overall charge of all activities in their district, assisted by the area managers. They have a support team of district specialists in place coordinating functions such as event cover and youth provision, but they have no line management responsibility and report to their respective regional departmental manager. Each district usually contains 3–6 areas.
Districts are further divided into geographic areas, led by an area manager. Unit managers report to the area manager, and the area manager is in overall charge of the activities of the units in their area, within the boundaries of policies etc. set by Regional Headquarters (RHQ) and NHQ. They are assisted/advised by district specialists to provide the day-to-day functions of the organisation, such as member training and event cover. Each area contains about 8–15 units.
A unit (formerly a "division") is the smallest administrative division of St John Ambulance. Most volunteers are managed within a unit and by a unit manager. Units traditionally 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- to 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 unit manager may have one or more assistant unit managers to assist them. The unit usually has a weekly meeting where members train, practice their skills, and occasionally have visits from guest speakers. Youth units (badgers and cadets) follow the St John Ambulance youth program. Units plan and execute the cover of most of the events requested of the organisation, supported by their area and district managers, district specialists and regional events team. Units are where most people start their time in the organisation.
Uniform and ranks
A transition from the old formal style of St John uniform and a more practical style started in May 2011, with a new uniform introduced, superseding dress orders 2 to 8.
The new service delivery uniform consists of a green shirt, black combat trousers, either a green and black Parka Jacket or a reversible fleece and appropriate black footwear. The ceremonial uniform still exists and consists of a peaked cap, tailored jacket, white St John shirt, black trousers, black shoes and clip-on tie. All rank insignia are worn on the outer layer of the jacket; on the service delivery uniform, a role badge is worn to denote the member's first-aid qualification. 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.
St John Ambulance has a wide and complex 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.
At a regional level, the organisation is run by the regional director, who is ultimately accountable for all St John Ambulance activity in their region.
St John Ambulance in the British Armed forces
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.
In the past they had a number of ambulances 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. Fund-raising for new ambulances was started.
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 sole 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 also assist St John Ambulance at British events on military areas where many German civilians are expected to attend.
Relations with the Order of St John and other organisations
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 First Aid is the equivalent organisation in Scotland. Together these three voluntary aid societies publish the official First Aid Manual, the de facto UK guide for emergency first aid.
- St. John Ambulance
- St John Ambulance Ranks and Insignia
- St. John Ambulance Brigade of Ireland
- Venerable Order of St. John
- Service Medal of the Order of St John
- Insignia of the Venerable Order of St John
- Annual reports
- Killen, Sue. "CEO - SJA UK". Retrieved 7 May 2013.
- Charity Commission
- Microsoft Word - Priory Rules 2006 FINAL.doc
- St John Ambulance first aid training for pupils
- See references on the Mark Master Masons website of Gloucestershire & Herefordshire, here.
- Referenced by the Mark Master Masons of County Durham on their charity webpages, here.
- Hertfordshire Freemasons presented their ambulance to Hertfordshire St John Ambulance in 2001. In 2005, they donated a second vehicle, as referenced on their news website, here.
- Fleet details outlined in the St John Ambulance Supplies Department publication "The New Driving Force", first published June 2004, by SJS, London, EC1V 7NE.
- St John Ambulance Youth leader training suite
- HQC 014/07 Appendix C
- "St John Ambulance - Becoming the Difference - Regions". Retrieved 30 July 2012.
- "St John Ambulance - rank review group". St John Ambulance. Retrieved 30 July 2012.
- 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.
- St John England, Registered Charity no. 1077265 at the Charity Commission