St John Ambulance in England and Wales

St John Ambulance is a charity (registered in England and Wales), part of the wider international Order of St. John, dedicated to the teaching and practice of medical first aid. The charity's Latin formal motto is pro fide, pro utilitate hominum, translated as "for the faith and in the service of humanity".

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About the organisation

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^[4]) are also considered counties for the purposes of administration.

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.^[5]

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 will be made to the event organiser for attendance at commercial events.

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.

Training Services

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.

Transport Services

St John Ambulance employees and volunteers provide support to the busy NHS Ambulance Services in some areas of England, responding to 999 calls at busy times, and assisting the statutory emergency services during times of major incident.

St John Ambulance owns a large number of ambulances and transportation vehicles for commercial and charitable patient transport services and emergency use. The Mark-4 Crusader, based on the Renault Master, is used in many situations.

Youth Services

St John Ambulance is also a major youth organisation, with over half its membership being made up of those under 25. Cadet groups are run for those 10 to 18, and Badger setts are provided for younger children aged 6 to 10. These groups are similar to the scouts, although there is a greater emphasis on teaching first aid. Members aged between 16 and 18 are encouraged to transfer directly to adult units to continue their training, or transfer to LINKS units if they are attending university.

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 and Sovereign's Award, which may be retained on the adult uniform.

Every year a reception is held at Buckingham Palace and is attended by HRH Princess Anne to celebrate chosen individuals who have gained their Grand Prior Award.

Amalfi Challenge

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.

Cadet Leadership

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 a subject towards the Cadet's Grand Prior Award.

LINKS Units

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 and Wales. 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 new to St John Ambulance at 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 units within St John Ambulance, most units are societies within the universities 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.

First Aid and Medical Equipment Services (St John Ambulance Supplies)

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.

SJS is also the only approved supplier of St John Ambulance uniform, clothing and branded merchandise (see the Controversies section).

Volunteer Membership

Counties are subdivided into Areas, Sectors, Groups or Zones (if the county is big enough to warrant it), and from there into Divisions or Units, of which members join.

St John Ambulance is led by volunteers appointed to functional roles. Where considered appropriate a rank may be assigned to that role, ‘rank’ is use to describe a formal grade within the organisation conferring authority.

Training and skills

  Most members are volunteers, and complete a number of medical qualifications, ranging from a basic Emergency First aid course and the First Aid at Work (FAW) course recognised by the Health and Safety Executive, through to advanced Emergency Transport Attendant training which covers many of the competencies of the National Health Service Ambulance Technicians. Members are also required to attend training in Moving and Handling before being permitted to volunteer. Once qualified, they are free to volunteer their time at events, covering a variety of public events such as major football matches, concerts and gigs, smaller community events such as 'fun days', or crewing of emergency ambulances. Time volunteering is unpaid, although expenses are met on occasion.

Additional and enhanced skills

Beyond the initial qualifications, members can train in additional medical skills, such as administration of medical gases, and use of an Automated external defibrillator (AED). 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 Aid courses (especially the second) are sometimes undertaken or supplemented by the NHS Ambulance Services.

The different roles a volunteer may be certified as competent in include "first aider", "advanced first aider", "Neighbourhood First Responder", "Patient Transport Attendant" and "Emergency Transport Attendant".

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 who undertaking cycle response are additionally trained in commercial cycling courses, and demonstrate a reasonable level of fitness. They wear a dedicated cycle uniform, replacing the conventional operational uniform.

The St John Ambulance Uniform

The St John Ambulance uniform worn by members in England is well known by many people, and members are required to wear uniform when volunteering to provide first aid or transport services, both for identification and to present a professional image. It is protected by law^{[citation needed]} and may only be worn by registered members. Unlike many volunteer groups, the St John uniform is relatively formal, and is similar to a British Police uniform, for which members are sometimes mistaken.

There are presently 9 orders of dress intended for different situations. No.1 and No.2 are formal ceremonial dress uniforms, the former with a tailored uniform jacket, the latter without; No.3 and No.4 are less formal suitable for nursing duties in other medical establishments and during hot weather; No.5 is the basic operational uniform; No.6 is a casual uniform for training and informal events; No.7, No.8 and No.9 are operational uniforms for specific tasks, corresponding respectively to Patient Transport Services, Neighbourhood First Responder, and Cycle Responder.

The two most widely used are No.2 (dress uniform without tailored jacket) and No.5 (operational uniform), and these two are reasonably similar, consisting of:

• White uniform shirt with black badges and rank markings
• Black clip on tie (for safety as much as ease of use)
• Black trousers (optionally with combat/cargo pockets when worn as part of No.5 uniform)
• Black NATO style V-neck sweater with similar markings to the shirt
• Epaulettes to carry rank, with any special role indicated via colour (grey for a nurse, red for a doctor, and green for a paramedic)
• Men's peaked cap or ladies' hat, usually reserved for more formal occasions.

No.5 is essentially a more relaxed version of No.2, where more ceremonial items such as ties and caps are only worn if appropriate. In order to increase the appeal of the organisation to Islamic members, 2005 saw the addition of a uniform Kameez and Hijab. Cadet members may wear berets, or the recently introduced St. John baseball caps, also being phased in for adult members to replace the formal peaked caps.

High visibility garments worn over the uniform are sometimes required for outdoor events, adopting the yellow/green two-tone generally accepted for emergency medical services. An alternative No.5 operational uniform is a green two-piece suit, similar to those of paramedics and technicians from many other ambulance organisations. This has traditionally been worn by members operating as an ambulance crew, however it is now becoming more common amongst first aiders, and recently some counties and units have adopted it for all event cover and/or transport work (see the Controversies section).

Until recently, LINKS units had an exception to wear their own uniform designs. Usually these consisted of a polo shirt and/or sweatshirt with the LINKS logo, and the name of the unit placed on the front, and 'FIRST AID' screen-printed on the rear. This uniform was normally only permissible for duties undertaken at student events such as discos at the Student Union bar, which often have their first aid cover provided by the university LINKS unit. Since introduction of the new corporate identity, stricter uniform rules have been placed on LINKS units. A white polo shirt with the St John Ambulance logo is now operational uniform.

Other priories and countries have various regional variations of uniform, but most are loosely based on the same design as the English uniform.

St John Ambulance in the British Forces

St John Ambulance now has British divisions running in areas where there are a large amount of British Servicemen and Service 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 "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.

Because duties are currently restricted to "on-camp" activities unless special insurance has been taken out, members are generally not trained up to the Advanced Accident and Emergency Crew standard (ETA); however, in addition to gaining their FAW certificate, they are able to undertake certain elements of the ETA course including Medical Gases, Manual Handling and so forth.

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.

They currently have several ambulances available for public service. Current attempts are being made to raise funds to purchase the new 'Crusader' Ambulances that St John Ambulance are using in the UK to further benefit the forces communities.

St John Ambulance does not just provide medical cover for events on camp, 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 lone 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 equally assist St John Ambulance at British Events on military areas where a high number of 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 enjoys very positive relations with the British Red Cross, with which they often serve alongside. However, St John Ambulance places a greater focus on first aid training and event cover, whereas the Red Cross focuses more on general humanitarian aid. St. Andrew's Ambulance Association is the equivalent organisation in Scotland. Together these three Voluntary Aid Societies publish the official First Aid Manual, the de facto guide for emergency first aid.

Controversies

The black and white uniform

One of the major disagreements between members is that of the uniform. Many feel the traditional black and white uniform is old-fashioned and impractical, whilst others regard it as an important aspect of the identity and history. The introduction of Police Community Support Officers, whose uniforms are sometimes near-identical, has complicated matters further, and led to members being mistaken for Police Officers, PCSOs and Traffic Wardens. Whilst St John Ambulance is well-recognised within certain areas and social groups, as Britain becomes increasingly multicultural, large sections of the population are unaware of the existence of the organisation, and thus understandably assume that members are performing some sort of policing or security service. In certain communities, where Police hatred is high, this can be a potentially dangerous situation.

A number of counties and divisions have suggested adopting the green two-piece suit (known as 'greens') as the primary operational uniform, using the black and white uniforms only for ceremonial activities. This is further justified by the fact that green is a recognised medical uniform colour, the two-piece suits are more practical to wear in emergency medical situations, and can be washed at a higher temperature. Conversely, others have argued that dressing all members in 'greens' creates confusion as to who is and isn't ambulance trained. Because many members are only trained in first aid, the concern is that people will mistake them for Paramedics or Ambulance Technicians. This concern is probably unwarranted, however, since many NHS ambulance trusts use greens for PTS and non-clinical roles such as dispatchers or managers without encountering problems.

Another alternative is the use of black two-piece suits (known as 'blacks') which also offer a practical alternative to 'greens' or the more tradition uniform. However it has been commented that they are not as easily identifiable as a medical provider as the 'greens' are.

The uniform debate goes on, but has rarely caused major problems, as the relaxed nature of the organisation makes strict enforcement of uniform protocols unusual in all but ceremonial activities. For example, many duties stipulate that wearing of ties and caps is optional, sometimes even discouraged.

St John Ambulance Supplies

As St John Ambulance Supplies returns all surplus made to the organisation, there is a policy that counties and units should not purchase goods externally which could be purchased from SJA Supplies^[6]. This is intended to save costs as much as possible. However, whilst this is a good strategy from a collective point of view, many members and units do not individually see this benefit, and so to them SJS is no different than any other supplier.

Many individuals have raised objection that the goods supplied by SJS are considerably more expensive than the units could source from elsewhere despite SJS' ‘Price Promise’ price-match policy^[7].

Also of note is that SJS cannot always supply all items a unit many require (such as specialist goods or services), although counties and units are authorised to buy from other suppliers in such circumstances, such activity has resulted in a number of members and units buying uniform items from other suppliers, which do not accord with St John Ambulance regulations or, more seriously, may not comply with the legislative requirements for the safety of members^[8].

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 formed 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 ceased to operate in Scotland and St. Andrew's Ambulance Association ceased 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 introduced to celebrate 100 years since the formation of the Brigade
• April 2, 2007: St John Ambulance launched its new corporate identity (CI)

References

See also

• St. John Ambulance
• Venerable Order of St. John
• St. John Ambulance Brigade of Ireland

Other related websites

• St John Ambulance Supplies
• St. John Supplies Wales
• Caring on the Home Front A website dedicated to the memories of St John Ambulance and British Red Cross volunteers during World War II.