BBC Homepage
  • Skip to content
  • Accessibility Help
  • Your account
  • Notifications
  • Home
  • News
  • Sport
  • Weather
  • iPlayer
  • Sounds
  • Bitesize
  • CBBC
  • CBeebies
  • Food
  • More menu
More menu
Search BBC
  • Home
  • News
  • Sport
  • Weather
  • iPlayer
  • Sounds
  • Bitesize
  • CBBC
  • CBeebies
  • Food
Close menu
BBC News
Menu
  • Home
  • InDepth
  • Israel-Gaza war
  • War in Ukraine
  • Climate
  • UK
  • World
  • Business
  • Politics
  • Culture
More
  • Tech
  • Science
  • Health
  • Family & Education
  • In Pictures
  • Newsbeat
  • BBC Verify
  • Disability
  • Health

How to reduce rural ambulance waits

  • Published
    7 March 2019
Share page
About sharing
Ambulance on roadImage source, Getty Images
Nick Triggle
Health correspondent
@nicktriggle

The NHS is promising to reduce the gap between how long it takes to get a 999 response to critically injured patients in rural and urban areas.

A BBC News investigation into the highest-category callouts has found rural areas waited over 50% longer.

That equates to four minutes - something that can make the difference between life and death for those in cardiac arrest, stab victims and patients struggling to breathe. So what can and is being done?

For the full interactive experience, please update your browser or enable JavaScript.

Urgent ambulance response times

Average response time by postcode district

Average response time by postcode district

Check urgent ambulance response times in your area

Enter a postcode or click on the map to explore

    Loading interactive map...

    No data Few callouts 8 12 16+ Minutes
    8 12 16+ No data Few callouts Minutes

    Source: Ambulance trusts. Data is shown for postcode districts with more than nine highest category callouts in January-October 2018. Districts with 10-49 callouts are labelled "low numbers". Northern Ireland does not use comparable categorisation.

    Click here if you cannot see the interactive map, external

    Is more money the solution?

    Every part of the health service would readily accept more money.

    About £2bn a year is spent on answering more than 10 million urgent calls - although only about 5% of these are classed as "immediately life-threatening".

    That sum equates to just over 1.5% of the health budget.

    More money could certainly help deploy extra paramedics and vehicles, to ensure better coverage in rural areas.

    But even those working in the service acknowledge there is a limit - crews sitting around for long periods with nothing to do is clearly not the best use of NHS resources.

    Volunteer lifesavers

    One of the most important steps in rural areas is training up members of the community to help answer these high-priority calls.

    These are known as "community first responders" and volunteer to be on call to help critically injured patients if paramedics are not going to be on the scene quickly.

    Some police and fire crews have also been trained to lend a hand.

    While thousands of these volunteers have been trained, the ambulance service says it can always do with more.

    Paul ElliottImage source, Other
    Image caption,

    Community first responder Paul Elliott says the system is facing significant pressures

    Paul Elliott, a St John Ambulance community responder who covers the Bodmin area in Cornwall, even carries a defibrillator in his car, to treat cardiac-arrest patients.

    "We're supposed to travel within a three-mile radius of our home locations but because we're in such a rural area, with some tricky geography, we can go up to 20 miles to help people sometimes," he said.

    The service was under "significant pressure" and needed more full-time staff and first responders like him, Mr Elliott said.

    But the problem is that in some areas it can be a challenge keeping these volunteers because of the demands placed on them.

    BBC News has heard from one former community responder who served Wells-next-the-Sea, in north Norfolk, the place with longest response times, who said he had given up after being left for too long tending to badly injured patients.

    Getting bystanders to help

    DefibrillatorImage source, PA
    Image caption,

    Call-centre staff can instruct members of the public to use defibrillators

    No matter where a patient is when a life-threatening situation develops, the simple fact remains in all probability a member of the public will be on the scene more quickly than a trained response.

    And they can play a critical role. Take cardiac arrests, for example. A bystander can provide cardiopulmonary resuscitation (CPR) to patients. Even those who have not been trained can be talked through the process by control-room staff and told where to access community defibrillators to deliver electric shocks to restart the heart.

    Action like this can double the chances of survival before 999 help arrives. Every minute without treatment reduces the chances of surviving a cardiac arrest by 10%.

    The problem is that the UK has one of the lowest rates of bystander involvement - less than half of out-of-hospital cardiac arrests see members of the public get involved.

    It is one of the reasons why the announcement last year to introduce first-aid training into schools has been so widely welcomed and work continues to ensure there are enough defibrillators situated in community locations.

    Adjusting the targets

    The way ambulance crews answer calls in England, Scotland and Wales has changed in recent years.

    All have introduced a system that prioritises a smaller number of calls for the quickest response.

    Today, just one in 20 calls is treated as the highest-priority, whereas traditionally about a third of calls were.

    Out went things such as strokes, as the research suggested what mattered most to those was whether they ended up at the right hospital not how quickly help arrived at the scene.

    This is allowing crews to make faster responses to the most-in need patients, according to Adam Brimelow, of NHS Providers.

    But does this help rural areas? The BBC News investigation looked at response times from January to October last year - after these changes were brought in.

    It was not possible to look at a historical trend over time.

    Academic research carried out during the piloting phased of the new system in England suggested it might reduce variation.

    But the NHS in England believes it will. A spokesman for the service said there was now a "strong incentive to tackle the longer waits historically seen for those who live in rural and remote areas".

    Indeed, even in Northern Ireland, which uses the old system, there is now a desire to follow the lead of England, Wales and Scotland.

    There may be some way to go, but many think the ambulance service is on the right track.

    More on this story

    • Who gets social care and who pays for it?

      • Published
        8 February 2017
      Walking with a frame
    • Integrating health and social care 'uphill battle' Audio, 00:01:30Integrating health and social care 'uphill battle'

      • Published
        8 February 2017
      1:30
      A nurse holding the hand of a patient
    • MPs urge 'swift' review on social care

      • Published
        6 January 2017
      Elderly man walking into hospital
    • Is social care getting more money?

      • Published
        12 December 2016
      Elderly person and carer
    • What's the cost of care in your area?

      • Published
        13 September 2016
      graphic

    Related internet links

    • Department of Health

    The BBC is not responsible for the content of external sites.

    Top stories

    • Live. 

      At least 15 dead after Lisbon funicular derails and hits building

      • 26419 viewing26k viewing
    • Rayner admits underpaying tax on Hove flat as PM backs her

      • Published
        2 hours ago
    • Rayner at risk of fine over stamp duty, tax experts say

      • Published
        2 hours ago

    More to explore

    • Rayner's political future under threat after stamp duty admission

      Sir Keir Starmer and Angela Rayner on a building site in Cambridgeshire in 2024. They are both wearing hard hats and high vis jackets, and are framed within scaffolding poles.
    • A let-off or tougher than it looks? What the Google monopoly ruling means

      The Google logo in white lettering is visible on a dark glass office building in the US city of Atlanta, Georgia
    • My rent's gone up by almost 20% - and my landlord wants to evict me

      Elle Glenny, who has bobbed blond hair, looking directly at the camera and wearing a turquoise fleece. There is a bed frame in the background.
    • A scheme helped prevent sex offenders committing more crimes - then it closed. Why?

      Illustration of a man walking from darkness towards a door, which light is coming through
    • Watch: Timelapse shows Northern Lights display over North Sea

      The Northern Lights seen over the North Sea
    • What do we know about Kim Jong Un's daughter - and potential successor?

      Kim Ju Ae, daughter of North Korean leader Kim Jong Un, attends a military parade to mark the 75th founding anniversary of North Korea's army, at Kim Il Sung Square in Pyongyang, North Korea February 8, 2023, in this photo released by North Korea's Korean Central News Agency (KCNA).
    • Don't pay a fake parking fine – four ways to protect yourself from scams

      Young woman holding smartphone, making mobile payment at the parking payment machine.
    • Chris Mason: How Polanski's Green leadership could impact UK politics

      New Green Party leader Zack Polanski at the United Voice of the World in London on 2 September 2025.
    • Captain Scott’s famous polar shipwreck as never seen before

      Black and white image of the Terra Nova ship sailing in Antarctica. The ship is wooden, it's sails are open. It is moving across ice-covered ocean.
    loading elsewhere stories

    Most read

    1. 1

      Hot mic catches Xi and Putin discussing organ transplants and immortality

    2. 2

      Rayner admits underpaying tax on Hove flat as PM backs her

    3. 3

      Rayner at risk of fine over stamp duty, tax experts say

    4. 4

      Putin says Russia will achieve all aims militarily if Ukraine does not agree deal

    5. 5

      Met chief calls for law change after Linehan arrest

    6. 6

      Search for painting looted by Nazis may have found more stolen art

    7. 7

      At least 15 dead after Lisbon's historic funicular derails

    8. 8

      'Ketamine Queen' pleads guilty in Matthew Perry overdose case

    9. 9

      Radiohead to tour for first time in seven years

    10. 10

      Epstein accusers say they are compiling list of his associates

    BBC News Services

    • On your mobile
    • On smart speakers
    • Get news alerts
    • Contact BBC News

    Best of the BBC

    • A unique new dating series hosted by Davina McCall

      • Attribution
        iPlayer
      Stranded on Honeymoon Island
    • Wayne Rooney on the latest Premier League drama

      • Attribution
        Sounds
    • Revisiting the world’s deadliest offshore disaster

      • Attribution
        iPlayer
      Disaster at Sea: The Piper Alpha Story
    • Hannibal: The fearsome enemy of ancient Rome

      • Attribution
        Sounds
    • Home
    • News
    • Sport
    • Weather
    • iPlayer
    • Sounds
    • Bitesize
    • CBBC
    • CBeebies
    • Food
    • Terms of Use
    • About the BBC
    • Privacy Policy
    • Cookies
    • Accessibility Help
    • Parental Guidance
    • Contact the BBC
    • Make an editorial complaint
    • BBC emails for you

    Copyright © 2025 BBC. The BBC is not responsible for the content of external sites. Read about our approach to external linking.