North West Ambulance Service

About NWAS

North West Ambulance Service NHS Trust (NWAS) has a workforce of over 6000 staff, operating its emergency services from ambulance stations distributed across Cheshire, Cumbria, Greater Manchester, Lancashire and Merseyside, three Emergency Operations Centres, one support centre, and two Hazardous Area Rescue Team centres.  In addition, the Trust provides the NHS 111 Service for the North West region and the Patient Transport Services for most of the area.

Our operational area covers a population of approximately 7.5 million people over five counties. We respond to patients across a geographical footprint of approximately 5,400 square miles. NWAS is the largest ambulance service in the UK receiving over 1.4 million emergency calls per year, with telephone based clinicians and emergency crews attending to more than 1.2 million incidents each year (2017/18).

Our NHS 111 service is the largest in the UK taking over 1.5 million calls each year. Patient Transport undertakes over 1.2 million non-emergency patient transport journeys each year. NWAS also forms part of the NHS response to Major Incidents, ensuring that plans are in place to provide a comprehensive response to major incidents, risks, or hazards.

These services are enabled by teams covering workforce, finance, digital, estates, fleet, project management, patient safety, patient experience, legal and many more ensuring that we provide the right care, at the right time, in the right place; every time.

Research & Development at NWAS

North West Ambulance Service NHS Trust is proud to be a research-active organisation. We develop and host research studies with a focus on pre-hospital healthcare, injuries and emergencies as well as supporting projects in other clinical specialities. We also explore non-clinical research opportunities involving the organisation and our workforce.

Our Research Strategy priorities are:

  1. Ensure that research is visible and supported throughout the whole organisation
  2. Expand our research networks and facilitate research collaborations
  3. Increase our research capacity and capability

We work in collaboration with a range of partners including the National Institute for Health and Care Research (NIHR), the National Ambulance Research Steering Group (NARSG), NHS organisations and academic institutions to engage in research that will improve health outcomes for the population.

NWAS has a core Research & Development (R&D) Team that is led by Consultant Paramedic, Steve Bell, and consists of Research Manager, Sandra Igbodo, Research Support Officer, Jesse Oliver, and NIHR Research Paramedics, Adam Wright and Michelle Waddington.

For more information, please visit NWAS website.

Current and previous studies

The following are a selection of NIHR Clinical Research Network Portfolio studies that NWAS has been involved in:

• AHP perceptions of NHS research capability and culture: A national research capacity in context survey

• ASPIRE-COVID-19 CENTRE: Achieving Safe and Personalised maternity care in response to epidemics – Case studies of eight NHS Trusts in England

• CARA Study: A cross-sectional survey evaluating the effects of the COVID-19 pandemic on the wellbeing of ambulance personnel in the United Kingdom

• CESSATION: A mixed-methods study of female ambulance staff experiences of the menopause transition

• COLLABORATE Project: Developing patient-centred, feasible alternative care for emergency department users with epilepsy. A model for service design

• Communities in Charge of Alcohol (CICA) Programme: Evaluation of a community alcohol champions programme in Greater Manchester

• Community First Responders’ role in the current and future rural health and care workforce

• The COMPARE Study: The impact of COVID-19 on paramedic led out of hospital cardiac arrest resuscitation: A Qualitative study

• Exploring the Impact of Alcohol Licensing in England and Scotland (ExILEnS)

• Head Injury Transportation Straight to Neurosurgery (HITS-NS) trial – a feasibility study

• Impact of Restart A Heart Day 2019 in the UK

• OPTIMIST: Optimising Implementation of Ischaemic Stroke Thrombectomy: Exploring NHS professional views about the emergency stroke pathway

• Out of Hospital Cardiac Arrest Outcomes Project

• PARAMEDIC-3: Pre-hospitAl RAndomised trial of MEDICation route in out-of-hospital cardiac arrest

• Paramedic Acute Stroke Treatment Assessment (PASTA) Trial

• Psychological impact of COVID- 19 pandemic and experience: An international survey

• PRE-FEED REAL: Pre-hospital feedback in the United Kingdom: A realist evaluation of current practice using a multiple-case study design

• The Pre-hospital Evaluation of Sensitive Troponin (PRESTO) Study

• PRINCIPLE Trial: Platform Randomised trial of INterventions against COVID-19 In older people

• Should I stay or should I go: NHS staff retention in a post Covid-19 world, challenges and prospects

• SWAP: Staff Wellbeing in Ambulance Personnel

• A survey of ambulance paramedics’ attitudes and experiences of identifying patients with end of life care needs and their awareness of the Gold Standards Framework Proactive Identification Guidance

Latest / significant publications

  • Aldhamy, H., Maniatopoulos, G., McCune, V. L., Mansi, I., Althaqafy, M., & Pearce, M. S. (2023). Knowledge, attitude and practice of infection prevention and control precautions among laboratory staff: a mixed-methods systematic review. Antimicrobial resistance and infection control.  Journal of Paramedic Practice [online], 12(1), p.57.  Available at: https://doi.org/https://dx.doi.org/10.1186/s13756-023-01257-5 
  • Aldhamy, H., Maniatopoulos, G., McCune, V. L., Mansi, I., Althaqafy, M., & Pearce, M. S. (2023).  Knowledge, attitude and practice of infection prevention and control precautions among laboratory staff: a mixed-methods systematic review. Antimicrobial resistance and infection control.  Journal of epidemiology and community health, 77(Supplement 1), A106 [online]. Available at: https://dx.doi.org/10.1136/jech-2023-SSMabstracts.220
  • Alghamdi, A., Hann, M., Carlton, E., Cooper, J. G., Cook, E., Foulkes, A., Siriwardena, A. N., Phillips, J., Thompson, A., Bell, S., Kirby, K., Rosser, A., & Body, R. (2023). Diagnostic Accuracy of Clinical Pathways for Suspected Acute Myocardial Infarction in the Out-of-Hospital Environment. Annals of emergency medicine [online], 82(4), pp.439-448. Available at: https://dx.doi.org/10.1016/j.annemergmed.2023.04.010  
  • Allen, M., Day, J., Ford, G., Grant, C., James, M., Laing, B., McClelland, G., McMeekin, P., Morris, J., & Pope, C. (2023). Specialist PrE-hospital rEDirection for ischaemic stroke thrombectomY (SPEEDY): a cluster randomised controlled trial with included health economic and process evaluations. International Journal of [online], 18 (1 Supplement), 99. Available at: https://dx.doi.org/10.1177/17474930221142512
  • Alotaibi, A., Alghamdi, A., Martin, G. P., Carlton, E., Cooper, J. G., Cook, E., Siriwardena, A. N., Phillips, J., Thompson, A., Bell, S., Kirby, K. L., Rosser, A., Pennington, E., & Body, R. (2023). External validation of the Manchester Acute Coronary Syndromes ECG risk model within a pre-hospital setting. Emergency medicine journal: EMJ [online], 40(6), pp.431-436. Available at: https://doi.org/10.1136/emermed-2022-212872  
  • Alqurashi, N., Alotaibi, A., Bell, S., Lecky, F., & Body, R. (2023). Towards exploring current challenges and future opportunities relating to the prehospital triage of patients with traumatic brain injury: a mixed-methods study protocol. BMJ open [online], 13(3), e068555. Available at: https://doi.org/https://dx.doi.org/10.1136/bmjopen-2022-068555  
  • Alqurashi, N., Bell, S., Wibberley, C., Lecky, F., & Body, R. (2023). A Qualitative Study to Explore Current Challenges wnd Future Opportunities Relating to the Prehospital Triage of Patients with Traumatic Brain Injury. Emergency Medicine Journal [online], 40 (Supplement 1), A8. Available at: https://dx.doi.org/10.1136/emermed-2023-999.18
  • Ashton, C., Mayoh, D., & Jones, A. (2023). Does the patient’s presenting condition influence the timeliness of stroke care in the pre-hospital setting. International Journal of Stroke [online], 18(1 Supplement), p.43. https://dx.doi.org/10.1177/17474930221142512
  • Barrett, J.W., Eastley, K.B., Herbland, A.,Owen, P., 4 ; Naeem, S., Mortimer, C., King, J., Foster, T., Rees, N., Rosser, A., Black, S., Bell, F., Fothergill, R., Mellett-Smith, A., Jackson, M. ; McClelland, G., Gowens, P., Spaight, R., Igbodo, S., Brown, M., Williams, J.(2024).  British Paramedic Journal [online], 8(4), pp.10-20.  Available at: https://doi.org/10.29045/14784726.2024.3.8.4.10
  • Bell, S., & Hill, J. E. (2023). Diagnostic accuracy of early warning system scores in the prehospital setting. Journal of Paramedic Practice [online], 15(12), pp.516-519.  Available at: https://dx.doi.org/10.12968/jpar.2023.15.12.516
  • Bell, S., Pennington, E., & Hill, J. E. (2023). Video vs direct laryngoscopy for adults undergoing endotracheal intubation. Journal of Paramedic Practice [online], 15(6), pp.255-259. Available at: https://dx.doi.org/10.12968/jpar.2023.15.6.255  
  • Brunton, L., Soiland-Reyes, C., & Wilson, P. (2023). A qualitative evaluation of the national rollout of a diabetes prevention programme in England. BMC Health Services Research [online], 23(1), p.1043. Available at: https://dx.doi.org/10.1186/s12913-023-10002-y  
  • Chatzi, G., Whittaker, W., Chandola, T., Mason, T., Soiland-Reyes, C., Sutton, M., & Bower, P. (2023). Could diabetes prevention programmes result in the widening of sociodemographic inequalities in type 2 diabetes? Comparison of survey and administrative data for England. Journal of epidemiology and community health [online], 77(9), pp.565-570. Available at: https://dx.doi.org/10.1136/jech-2022-219654
  • Couper, K., Ji, C., Lall, R., Deakin, C. D., Fothergill, R., Long, J., Mason, J., Michelet, F., Nolan, J. P., Nwankwo, H., Quinn, T., Slowther, A. M., Smyth, M. A., Walker, A., Chowdhury, L., Norman, C., Sprauve, L., Starr, K., Wood, S.,  Bell, S., Bradley, G., Brown, M., Brown, S., Charlton, K., Coppola, A., Evans, C., Evans, C., Foste, T., Jackson, M., Kearney, J., Lang, N., Mellett-Smith, A., Osborne, R., Pocock, H., Rees, N. Spaight, R., Tibbetts, B., Whitley G.A., Wiles, J., Williams, J., Wright, A., Perkins, G. D. (2024). Route of drug administration in out-of-hospital cardiac arrest: A protocol for a randomised controlled trial (PARAMEDIC-3). Resuscitation plus [online], 17, 100544.  Available at: https://dx.doi.org/10.1016/j.resplu.2023.100544 
  • Fahmi, A., Palin, V., Zhong, X., Yang, Y. T., Watts, S., Ashcroft, D. M., Goldacre, B., Mackenna, B., Fisher, L., Massey, J., Mehrkar, A., Bacon, S., Hand, K., & van Staa, T. P. (2023). Evaluation of the impact of COVID-19 pandemic on hospital admission related to common infections. medRxiv [online]. Available at: https://dx.doi.org/10.1101/2023.07.16.23292723
  • Glover, S., Dutton, M., Tyrell, A., Bowman-Worrall, S., & Holland, M. (2023). PP60 Analysis of publishing trends within the NHS Ambulance Services in the United Kingdom using the amber repository. Emergency Medicine Journal [online], 40 (Suppl 1), A25-A25. Available at: https://doi.org/10.1136/emermed-2023-999.59  
  • Godley, N. D. (2023). Neurological assessment with FAST to better detect posterior circulation stroke. Journal of Paramedic Practice [online], 15(7), pp.272-279.  Available at: https://doi.org/10.12968/jpar.2023.15.7.272 
  • Hawkes, R. E., Sanders, C., Soiland-Reyes, C., Brunton, L., Howells, K., Cotterill, S., Bennett, C., Lowndes, E., Mistry, M., Wallworth, H., & Bower, P. (2023). Reflections of patient and public involvement from a commissioned research project evaluating a nationally implemented NHS programme focused on diabetes prevention. Research involvement and engagement [online] 9(1), p.42. Available at: https://doi.org/10.1186/s40900-023-00447-0 
  • Heys, S., Main, C., Humphreys, A., & Torrance, R. (2023). Displaced risk. Keeping mothers and babies safe: a UK ambulance service lens. British paramedic journal [online], 8(2), pp.52-56.   Available at:  https://doi.org/10.29045/14784726.2023.9.8.2.52  
  • Jones, L., Cullum, N., Watson, R., & Keady, J. (2023). Complexity and practice on NHS mental health in-patient dementia assessment wards. Quality in Ageing and Older Adults [online], 24(3), pp.103-114. Available at: https://dx.doi.org/10.1108/QAOA-07-2022-0043
  • Jones, L., Cullum, N., Watson, R., & Keady, J. (2023). Introducing the ‘3 Fs model of complexity’ for people with dementia accessing a NHS mental health inpatient dementia assessment ward: an interpretive description study. Dementia (London, England), 22(1), pp.85–104. Available at: https://doi.org/10.1177/14713012221136313 
  • Maddocks, N. (2023). Neonatal abstinence syndrome: paediatric case report. Journal of Paramedic Practice [online], 15(3), pp.100-104. Available at: https://doi.org/10.12968/jpar.2023.15.3.100
  • Pennington, B., Bell, S., Wright, A., & Hill, J. E. (2023). Impact of COVID-19 on out-of-hospital cardiac arrest care processes [Commentary]. Journal of Paramedic Practice [online], 15(2), pp.74-77. https://doi.org/10.12968/jpar.2023.15.2.74 
  • Pogson, R., Henderson, H., Holland, M., Sumera, A., Sumera, K., & Webster, C. (2023). Determining current approaches to the evaluation of the quality of healthcare simulation-based education provision: a scoping review. [version 1; peer review: 1 approved, 2 approved with reservations]. MedEdPublish [online], 13(207). Available at: https://doi.org/10.12688/mep.19758.1
  • Preston, N., Cockshott, Z., Potts, K., Wiseman, C., Wells, A., Varey, S., & Walshe, C. (2023). Advance Care Planning Training for Generalist Health Care Staff: Developing and Evaluating a Novel Online Resource. Palliative medicine [online], 37(1 Supplement), p.136. Available at: https://dx.doi.org/10.1177/02692163231172891
  • Preston, N., Remawi, B., Potts, K., Blackmore, T., & Simpson, J. (2023). How to Improve Paramedic Responses for Patients Dying at Home: A Theory of Change-based Approach. Palliative medicine [online], 37(1 Supplement), p.235. Available at: https://dx.doi.org/10.1177/02692163231172891
  • Rees, S. (2023). Carrying out research, critical appraisal, ethics and stakeholder involvement. Journal of Paramedic Practice [online], 15(11), pp.456-460. Avilabel at: https://doi.org/10.12968/jpar.2023.15.11.456 
  • Rees, S. (2023). Mitigation of risk, effective communication and scene management of major incidents [CPD Module]. Journal of Paramedic Practice [online], 15(10). Available at: https://dx.doi.org/10.12968/jpar.2023.15.10.CPD1
  • Romano, V. (2023). Peer support after exposure to trauma: an evaluation. Journal of Paramedic Practice [online], 15(7), pp.286-293. Available at: https://doi.org/10.12968/jpar.2023.15.7.286
  • Simpson, J., Remawi, B. N., Potts, K., Blackmore, T., French, M., Haydock, K., Peters, R., Hill, M., Tidball, O.-J., Parker, G., Waddington, M., & Preston, N. (2023). Improving paramedic responses for patients dying at home: a theory of change-based approach. BMC emergency medicine [online], 23(1), pp.1-7. Available at: https://doi.org/10.1186/s12873-023-00848-0  
  • Tankel, J. W., Ratcliffe, D., Smith, M., Hindley, C., Mullarkey, A., Dee, W., Andrea, R., & Darren, G. (2023). A whole healthcare system mortality review of the second wave COVID-19 pandemic response, were lessons learned? Acute medicine [online], 22(1), pp.39-46. Available at: https://dx.doi.org/10.52964/AMJA.0932
  • Thompson, S. (2023). Mass casualty triage: using virtual reality in hazardous area response teams training. Journal of Paramedic Practice, 15(10), pp.418-427. Available at: https://dx.doi.org/10.12968/jpar.2023.15.10.418 
  • Vadeyar, S., Buckle, A., Hooper, A., Booth, S., Deakin, C., Fothergill, R., Chen, J., Nolan, J. P., Brown, M., Cowley, A., Harris, E., Ince, M., Marriot, R., Pike, J., Spaight, R., Perkins, G., & Couper, K. (2023). Trends in use of intraosseous and intravenous access in out-of-hospital cardiac arrest across English ambulance services: a registry-based, cohort study. In Resuscitation [online], 191, 109951. Available at: https://doi.org/10.1016/j.resuscitation.2023.109951  

The NWAS R&D team also supports student research and service evaluation projects that take place at the Trust.

Contact details

If you’re interested in working with NWAS, please email us at research.development@nwas.nhs.uk

Follow us on X @NWAmb_Research for news and updates.