The London Ambulance Service is the busiest ambulance Service in the UK. Around 8,000 staff and volunteers serve a diverse population of over 9 million Londoners.
From April 2022 – March 2023 we answered over 2 million 999 calls. From the time a call is received, we asses the needs of the caller to provide every single patient with the most appropriate response with the services we have available.
Our emergency medical dispatchers (EMDs), triage every call using Advanced Medical Priority Dispatch System (AMPDS). For more complex calls our EMDs are supported by the Clinical Support Desk (CSD). The CSD is staffed by clinical team leaders, mental health nurses, midwives and other medical professionals, who are able to triage complex calls using a modified Manchester Triage Tool.
At the London Ambulance Service, a range of responses can be delivered to every call for help; most minor cases can be dealt with over the telephone by the Clinical Hub, who may give patients self-care advice or transfer them to an NHS 111 adviser. The LAS runs the NHS 111 Service in North East and South East London.
Where a vehicle is dispatched to a patient, responses may include; a two person crewed ambulance, a solo rapid response car, a cycle response or Helicopter Emergency Medical Services (HEMS). LAS clinicians who deliver a face-to-face patient response include Emergency Ambulance Crew, Paramedics, Senior Paramedics and Advanced Paramedic Practitioners. Different types of clinicians provide different levels of care, treatment and procedures.
The LAS also employs specialist non-Paramedic clinicians, such as midwives, who can assist in the most complex maternity issues, and mental health nurses. In 2022/23 our Mental Health Joint Response Cars attended over 3,000 incidents across London.
These different response options enable the LAS to deliver appropriate care to all patients in an efficient manner.
Research capabilities at the LAS
The London Ambulance Service research workforce comprises:
- Head of Clinical Audit & Research
- Clinical Research Manager
- Research Paramedics
- Research & Development Co-ordinator
- Research Facilitator
Current research projects
- Clinical Randomisation of Antifibrinolytic in Symptomatic mild Head injury in older adults (CRASH-4)
- Prehospital resuscitation decision (PROTECTeD)
- Spinal Immobilisation Study
- The RAPID-MIRACLE Study
Previously conducted research projects
- The ARREST Trial – A randomised trial of expedited transfer to a cardiac arrest centre for non-ST elevation out-of-hospital cardiac arrest
- Feasibility study of a pre-hospital extra-corporeal membrane oxygenation (ECMO) capable advanced resuscitation team at achieving blood flow within 30 minutes in patients with refractory cardiac arrest (SUB 30)
- Out-of-Hospital Cardiac Arrest Outcomes (OHCAO)
- Experiences of staff providing telephone CPR instruction
- Assessment of Impact of Real-time Continuous Glucose Monitoring on people presenting with severe Hypoglycaemia (AIR-CGM)
- Understanding COVID-19 outcomes for ethnic minority healthcare workers
- Staff Wellbeing in Ambulance service Personnel (SWAP)
- The COVID-19 Ambulance Response Assessment Study (CARA)
- MPDS maternity study
Latest / significant publications
- Baldi, E., Klersy, C., Chan, P., Elmer, J., Ball, J., Counts, C. R., … & OHCA-COVID study group. (2023). The impact of COVID-19 pandemic on out-of-hospital cardiac arrest: an individual patient data meta-analysis. Resuscitation, 110043.
- Evans, B. A., Khanom, A., Edwards, A., Edwards, B., Farr, A., Foster, T., … & Watkins, A. (2023). Experiences and views of people who frequently call emergency ambulance services: A qualitative study of UK service users. Health Expectations.
- Vadeyar, S., Buckle, A., Hooper, A., Booth, S., Deakin, C. D., Fothergill, R., … & 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. Resuscitation, 191, 109951.
- Patterson, T., Perkins, G. D., Perkins, A., Clayton, T., Evans, R., Dodd, M., … & Mamas, M. (2023). Expedited transfer to a cardiac arrest centre for non-ST-elevation out-of-hospital cardiac arrest (ARREST): a UK prospective, multicentre, parallel, randomised clinical trial. The Lancet, 402(10410), 1329-1337.
- Vadeyar, S., Buckle, A., Hooper, A., Booth, S., Deakin, C., Fothergill, R., … & Couper, K. (2022). Increasing use of intraosseous access at out-of-hospital cardiac arrest: a registry-based cohort study.
- Pareek, N., Beckley-Hoelscher, N., Kanyal, R., Cannata, A., Kordis, P., Sunderland, N., … & MacCarthy, P. (2022). MIRACLE2 score and SCAI grade to identify patients with out-of-hospital cardiac arrest for immediate coronary angiography. Cardiovascular Interventions, 15(10), 1074-1084.
- Hawkes, C. A., Kander, I., Contreras, A., Ji, C., Brown, T. P., Booth, S., … & Perkins, G. D. (2022). Impact of the COVID-19 pandemic on public attitudes to cardiopulmonary resuscitation and publicly accessible defibrillator use in the UK. Resuscitation plus, 10.
- Brown, T.P., Perkins, G.D., Smith, C.M., Deakin, C.D., Fothergill, R. (2022). Are there disparities in the location of Automated External Defibrillators in England?, Resuscitation, 170, pp. 28-35.
- Smith, C. M., Lall, R., Spaight, R., Fothergill, R. T., Brown, T., and Perkins, G. (2021). Calculating real-world travel routes instead of straight-line distance in the community response to out-of-hospital cardiac arrest. Resuscitation Plus,8, 100176.
- Kingsley, P., Merefield, J., Walker, R.G., Chapman, F., and Faulkner, M. (2021). Out-of-hospital resuscitation of a 3 month old boy presenting with recurrent ventricular fibrillation cardiac arrest: a case report. Scand J Trauma Resusc Emerg Med, 29(58).
- Fothergill, R.T., Smith, A.L., Wrigley, F., and Perkins, G.D. (2021). Out-of-hospital cardiac arrest in London during the COVID-19 pandemic. Resuscitation Plus, 5, 100066.
- Perkins, G.D., Ji, C., Deakin, C.D., Nolan, J.P., Scomparin, C., Regan, S., Long, J., Slowther, A., et al. (2018). A randomized trial of epinephrine in out-of-hospital cardiac arrest. New England Journal of Medicine, 379(8), pp. 711-721.
LAS research contact details
If you’re interested in doing research with the London Ambulance Service, please get in touch:
Professor Rachael Fothergill – Head of Clinical Audit & Research
For more information, please visit the LAS website.