Scottish Ambulance Service

In 1948, the newly formed Scottish National Health Service (NHS) contracted two voluntary organisations, the St Andrew's Ambulance Association and the British Red Cross, to jointly provide a national ambulance provision for Scotland, known then as the St Andrew's and Red Cross Scottish Ambulance Service.{{Cite news|url=https://www.firstaid.org.uk/charity/about-us/history/|title=Our History - St Andrews First Aid|work=St Andrews First Aid|access-date=2017-08-10|language=en-US}}

After British Red Cross withdrew from the service in 1967, the service was renamed the St Andrew's Scottish Ambulance Service.{{Cite web |title=Our History |url=https://www.firstaid.org.uk/what-we-do/about-us/history/ |access-date=2022-09-07 |website=St Andrew's First Aid |language=en-GB}} In 1974, with the reorganisation of the Scottish health services, ambulance provision in Scotland was taken over by the Scottish NHS, with the organisational title being shortened to the current Scottish Ambulance Service.

St. Andrew's First Aid, the trading name of St. Andrew's Ambulance Association, continues as a voluntary organisation and provides first aid training and provision in a private capacity.{{Cite web|title=First Aid Delivered With Confidence - St Andrews First Aid|url=https://www.firstaid.org.uk/|access-date=2017-08-10|website=St Andrews First Aid|language=en-US}}

The organisation was established as a NHS trust on 1 April 1995 when it legally became known as the Scottish Ambulance Service National Health Service Trust.{{Cite web|date=25 November 1994|title=The Scottish Ambulance Service National Health Service Trust (Establishment) Order 1994|url=https://www.legislation.gov.uk/uksi/1994/2994/made|access-date=16 September 2021|website=legislation.gov.uk|publisher=The National Archives}} The trust was dissolved on 1 April 1999 and at the same time constituted as a special health board known as the Scottish Ambulance Service Board.{{Cite web|date=4 March 1999|title=The Scottish Ambulance Service National Health Service Trust (Dissolution) Order 1999|url=https://www.legislation.gov.uk/uksi/1999/653/made|access-date=16 September 2021|website=legislation.gov.uk|publisher=The National Archives}}{{Cite web|date=4 March 1999|title=The Scottish Ambulance Service Board Order 1999|url=https://www.legislation.gov.uk/uksi/1999/686/made|access-date=16 September 2021|website=legislation.gov.uk|publisher=The National Archives}}

The Scottish Ambulance Service now continues in its current form as one of the largest emergency medical providers in the UK, employing more than 5,000 staff in a variety of roles and responding to 740,631 emergency incidents in 2015{{ndash}}2016 alone.{{Cite web|url=https://www.scottishambulance.com/UserFiles/file/TheService/Annual%20report/SAS_Annual_Report_2015.pdf|title=SAS Annual Report 2015/2016}} The service, like the rest of NHS Scotland, is free at point of access and is widely used by both the public and healthcare professionals. Employing almost 1,300 paramedic staff, and a further 1,200 technicians, the accident and emergency service is accessed through the public 999 system.{{Cn|date=November 2022}} Ambulance responses are changing in Scotland and are now prioritised according to patient needs: a traditional, double-crewed ambulance, a single response car or a paramedic practitioner may attend different kinds of emergencies.{{Cn|date=November 2022}}

The Scottish Ambulance Service also maintains three command and control centres in Scotland, which facilitate handling of 999 calls and dispatch of ambulances; a further 350{{ndash}}400 staff employed as call handlers and dispatchers fulfil this role across three locations: Edinburgh, Glasgow and Inverness. These three centres (which, through use of software, operate as one integrated unit) have been in use since 2004 and handle over 800,000{{nbsp}}calls per year. The Advanced Medical Priority Dispatch System (AMPDS) is used for call prioritisation, and provides post-dispatch instructions to callers, allowing medical advice to be given over the phone, before the ambulance arrives.{{Cite web |title=Scottish Ambulance Service - Behind the Headlines - Ambulance Control Centres |url=https://www.scottishambulance.com/NewsDesk/acc.aspx |access-date=2017-08-10 |website=www.scottishambulance.com}} Clinical staff are present to provide clinical oversight and tertiary triage. Co-located with the Ambulance Control Centres (ACC) are patient transport booking and control services, which handle approximately 1{{nbsp}}million patient journeys per year.

Scottish Ambulance Service Advanced Practitioners in Critical Care (APCC) are based at Raigmore Hospital, Newbridge Ambulance Station in Edinburgh and Glasgow Airport.{{Cite web |title=FOI 1138 Response Letter.pdf |url=https://www.whatdotheyknow.com/request/753429/response/1812612/attach/html/8/FOI%201138%20Response%20Letter.pdf.html |access-date=2022-08-31 |website=www.whatdotheyknow.com|date=8 May 2021 }} They are considered a Yellow level response in relation to the trauma network.{{Cite web |title=FOI 1138 Advanced Practitioner Critical Care Job Description.pdf |url=https://www.whatdotheyknow.com/request/753429/response/1812612/attach/html/3/FOI%201138%20Advanced%20Practitioner%20Critical%20Care%20Job%20Description.pdf.html |access-date=2022-08-31 |website=www.whatdotheyknow.com|date=8 May 2021 }} They carry injectable medications not usually available to Scottish Ambulance Service paramedics,{{Cite web |date=2022-11-19 |title=SAS {{!}} Advanced Practitioners in Critical Care - a Freedom of Information request to Scottish Ambulance Service |url=https://www.whatdotheyknow.com/request/sas_advanced_practitioners_in_cr |access-date=2023-09-27 |website=WhatDoTheyKnow |language=en}} including:

• File:Jellyfish SAS.pngKetamine, 200mg in 20ml (0.1-1mg/kg)
• Ketamine, 500mg in 10ml (4mg/kg of ideal body weight)
• Salbutamol 500mcg in 1ml (Adults; max dose 1mg, Children 2-12 years 15mcg/kg)
• Magnesium 5g in 10ml (Asthma: 2g, Pre/Eclampsia: 4g, toxidrome: 2g)
• Calcium Gluconate 10% w/v in 10ml (Toxidrome & hyperkalaemia: up to 20mls)
• Sodium Bicarbonate 8.4% w/v in 100ml (Toxidrome & hyperkalaemia: up to 100mls)
• Haloperidol, 5mg in 1 ml (1.25mg to 10mg).

They can undertake a number of advanced interventions, including:

• DC cardioversion
• Transthoracic pacing
• Sedation
• Surgical airway
• Thoracostomy
• Advanced clinical assessment
• Advanced decision making
• Point of care ultrasound
• Paediatric intubation

Advanced Practitioners in Urgent & Primary Care (APUC) are located more widely across Scotland. Specifically at the following ambulance stations: Lerwick, Kirkwall, Stornoway, Benbecula, Lairg, Inverness, Lochcarron, Elgin, Aberdeen, Oban, Pitlochry, Callander, Perth, Dundee, Campbeltown, Paisley, Glasgow (Castlemilk fire station), Kilmarnock, Hamilton, Stranraer, Newton Stewart, Dumfries, Biggar, Melrose, Prestonpans, Edinburgh, Livingston, Falkirk, Stirling, Dunfermline, Cupar and Leven.

Scottish Ambulance Service employ a number of Specialist and Advanced Retrieval Practitioners as part of the ScotSTAR service.{{Cite web |title=Retrieval Practitioners |url=https://www.emrsscotland.org/retrieval-practitioners |access-date=2023-09-27 |website=Emergency Medical Retrieval Service |language=en-GB}}

The Scottish Ambulance Service coordinates the pre-hospital and inter-hospital transfer elements of the Scottish Trauma Network. This response comes from the Scottish Ambulance Service and a number of partner agencies. These are sometimes categorised as Red, Yellow and Green resources;{{Cite book |last=Parke |first=Tim |url=https://www.nhsscotlandnorth.scot/uploads/tinymce/STN%20Minimum%20Requirements%20for%20Pre-Hospital%20Care%20v1.1.pdf |title=Minimum Requirements for Prehospital Care |publisher=Scottish Ambulance Service |year=2017 |location=Scotland}} of these, Medic One and BASICS Scotland are registered charities.{{Cn|date=September 2023}} The use of Yellow and Red categorisation is also applied to the enhanced skills offered by different teams or clinicians.{{Cn|date=September 2023}}

The service also uses a number of volunteer responders in conjunction with BASICS Scotland and the Sandpiper Trust.{{Cn|date=September 2023}} These responders are doctors, nurses and paramedics who volunteer their time to respond on behalf of the ambulance service and help the sick and injured.{{Cite web |title=BASICS Scotland Responders – BASICS Scotland |url=https://basics-scotland.org.uk/basics-scotland-responders/ |access-date=2022-08-12 |language=en-GB}} Equipment is provided to these responders by both the ambulance service and BASICS Scotland, with assistance from the Sandpiper Trust.{{Cn|date=September 2023}} These responders may be able to offer enhanced "Yellow" skillsets and advanced interventions to assist the other emergency services. Such skills offered by BASICS Scotland responders may include: endotracheal intubation, procedural sedation, advanced analgesia, nerve blocks, cardioversion and thoracostomy with or without drain insertion.{{Cite journal |last=Mallinson |first=Tom |date=2021-06-28 |title=A year as a prehospital physician in the Outer Hebrides, Scotland |url=https://www.rrh.org.au/journal/article/6115/ |access-date=2023-02-10 |journal=Rural and Remote Health |volume=21 |issue=2 |page=6115 |language=en |doi=10.22605/rrh6115|doi-access=free |pmid=34176277 }}

There are also a number of Community First Responder schemes across Scotland which support the ambulance service.{{Cn|date=September 2023}} These are voluntary responders with basic medical training who are deployed to 999 calls, mostly cardiac arrests.{{Cite web |title=Community First Responders |url=https://www.scottishambulance.com/your-community/community-first-responders/ |access-date=2022-09-07 |website=www.scottishambulance.com |language=en}}

The Highland PICT Team is based at Raigmore Emergency Department, Inverness and respond to a round 150 patients a month.{{Cn|date=September 2023}} It was formed in 2016 to address a lack of physician-led pre-hospital care in the Highlands.{{Cite web |title=Award Winning Highland Emergency Response Team |url=https://www.nhshighland.scot.nhs.uk/News/Pages/AwardWinningHighlandEmergencyResponseTeam.aspx |access-date=2022-08-11 |website=www.nhshighland.scot.nhs.uk}} It uses a doctor and advanced practitioner model, providing advanced care and extending the capabilities of the Scottish Ambulance Service.{{Cite web |date=2022-08-04 |title=Trauma team providing specialist pre-hospital emergency care saved from funding cuts |url=https://www.inverness-courier.co.uk/news/trauma-team-providing-specialist-pre-hospital-emergency-care-283402/ |access-date=2022-08-11 |website=Inverness Courier |language=en}} They were winners of the Highland Heroes award in 2022,{{Cite web |date=2022-03-25 |title=Emergency response team delighted with 'wonderful' award |url=https://www.strathspey-herald.co.uk/news/emergency-response-team-delighted-with-wonderful-award-270190/ |access-date=2022-08-11 |website=Strathspey Herald |language=en}} with the team's founder and clinical lead receiving an international award for his work in rural pre-hospital medicine in 2021.{{Cite web |date=2022-03-30 |title=Big award for Raigmore medic involved in trailblazing trauma team |url=https://www.ross-shirejournal.co.uk/news/big-award-for-raigmore-medic-involved-in-trailblazing-trauma-270647/ |access-date=2022-08-11 |website=RossShire Journal |language=en}}{{Cite web |title=Medic of the Year 2021 – CoROM |url=https://corom.org/medic-of-the-year-2021/ |access-date=2022-08-11 |language=en-GB}} One of the team's advanced nurses was also nominated for a Scottish Health Award for his part in the care and rescue of a child with traumatic injuries from a mountain.{{cn|date=September 2023}}

File:Highland PICT car.jpg

Medic One is a charity team formed in 1980 which deploys from the emergency department in Edinburgh.{{Cite journal |last=Mackenzie |first=Roderick |date=2018-03-01 |title=Brief history of Pre-Hospital Emergency Medicine |url=https://emj.bmj.com/content/35/3/146 |journal=Emergency Medicine Journal |language=en |volume=35 |issue=3 |pages=146–148 |doi=10.1136/emermed-2017-207310 |issn=1472-0205 |pmid=29463631|s2cid=3408899 |url-access=subscription }}{{Cite web |title=Edinburgh Emergency Medicine - About |url=https://www.edinburghemergencymedicine.com/medic1-about |access-date=2022-08-11 |website=Edinburgh Emergency Medicine |language=en-GB}} In 1998 a charitable trust was set up, aligned to the Medic One team, to facilitate learning and development of Edinburgh hospital staff. It has a fast response car, but relies on the Scottish Ambulance Service sending a driver to the hospital in order to attend 999 calls.{{Cite book |last=Moultrie |first=Chris |title=East / South-east Scotland pre-hospital emergency critical care (PHECC) service service development project: Phase 1 SBAR report: Current state analysis and initial recommendations. |publisher=Scottish Trauma Network |year=2023 |location=Scotland}} The usual composition of the team is an emergency medicine consultant with a middle grade doctor, with one or two emergency nurses. They attend around three patients a month. In 2020 Medic One declared their intention to cease operations and it was noted that their training and governance was unlikely to meet current standards.

The Scottish charity air ambulance is a Scottish charity which since 2013 has worked to provide additional air ambulance resources to support the work of the ambulance service.{{Cn|date=September 2023}} They transport around 1 patient a day.{{Cite news |date=2022-01-14 |title=Scotland's Charity Air Ambulance records busiest ever year |language=en-GB |work=BBC News |url=https://www.bbc.com/news/uk-scotland-tayside-central-59941738 |access-date=2023-05-10}} The helicopter is crewed by 1 or 2 paramedics and a pilot.{{Cn|date=September 2023}}

The Tayside Trauma Team is an enhanced care team working out of Ninewells Hospital, Dundee.{{Cite journal |last1=Maddock |first1=A |last2=Donald |first2=M |date=February 2014 |title=Caseload of a land-based trauma team |url=http://journals.sagepub.com/doi/10.1177/0036933013518151 |journal=Scottish Medical Journal |language=en |volume=59 |issue=1 |pages=45–49 |doi=10.1177/0036933013518151 |pmid=24413928 |s2cid=206428497 |issn=0036-9330|url-access=subscription }} They attend around six patients a month. The team is made up of staff from the Emergency department, however they have no team capability to drive on blue lights, so need to be given a lift from another agency. This results in a variable mobilisation time: average time from 999 call to the team leaving the hospital is 25 minutes, with a range of 6 minutes to 1 hour 40 minutes. In 2020 the Tayside trauma team stated they would soon cease to operate and it was noted that their governance and training could be deemed inadequate by current standards.

{{Bar chart

| title = Graphical Prehospital Workload by Resource

| label_type = Prehospital Resource

| data_type = Patient's Attended per Month

| bar_width = 35

| width_units = em

| data_max = 150

| label1 = PICT†

| data1 = 150

| label2 = EMRS Team†

| data2 = 12

| label3 = Tayside Trauma Team†

| data3 = 5.6

| label4 = MEDIC1*

| data4 = 3

| label5 = Individual BASICS Scotland Responder*

| data5 = 3

}}

† NHS Funded * Charity Funded

File:Scottish Ambulance Service Mercedes-Benz Sprinter at Sumburgh Airport.jpg box ambulance at Sumburgh Airport, March 2023]]

The Scottish Ambulance Service maintains a varied fleet of around 1,500 vehicles.

Emergency response vehicles include ambulances,{{Cite web|url=https://www.scottishambulance.com/UserFiles/file/TheService/Fleet%20Business%20Case%202016-2020%20V0%208%20Public%20Version%20.pdf|title=Fleet Replacement Business Case 2016/2017}} and single-response vehicles such as cars and small vans for paramedics. There are also patient-transport ambulances, which are adapted minibuses, lorries and support vehicles for major incidents and events, and specialist vehicles such as 4x4s and tracked vehicles for difficult access.{{Cite web|url=https://www.whatdotheyknow.com/request/112225/response/271387/attach/html/3/response%20vehicle%20list%20030412.XLS.xls.html|title=FOI Scottish Ambulance Service Vehicle List|date=April 2012}} The service also has three bicycles, which are only utilised during events at which Scottish Ambulance Service crews are present.

The geography of Scotland includes urban centres such as Edinburgh and Glasgow, areas of relatively low population density such as Grampian and the Scottish Highlands, and inhabited islands. Thus the fleet provision has to be flexible and include different kinds of vehicle. In the past, 4x4-build ambulances on van chassis were used in more rural areas, and traditional van conversions in more urban areas.

When a large fleet upgrade project was commissioned in 2016, the business case was made to move to a solely box-body on chassis build, to provide some flexibility and more resilient parts procurement. Most of these replacement ambulances have been based on either Mercedes or Volkswagen chassis, with a mixture of automatic or manual transmissions. The equipment used on board Scottish Ambulance Service vehicles broadly falls in line with NHS Scotland and allows for interoperability in most cases. Equipment is standardised nationally and replaced at regular service intervals; for example, high-cost items such as defibrillators are costed and changed every seven years according to clinical need.{{Cite web|url=https://www.scottishambulance.com/TheService/PapersView.aspx?ID=809|title=SAS Corporate Asset Management Strategy}}

The uniform is in line with the NHS Scotland National Uniform standard,{{Cite web|url=https://www.gov.scot/Topics/Health/NHS-Workforce/Uniforms|title=NHS National Uniforms|publisher=Scottish Government|date=2012-07-03|website=www.gov.scot|language=en|access-date=2017-08-11}} which is in keeping with the uniform standard described by the National Ambulance Uniform Procurement group in 2016.{{Cite news|url=https://emergencyservicestimes.com/new-national-ambulance-uniform-will-save-nhs-3-4m/|title=New national ambulance uniform could save the NHS £3.4m - Emergency Services Times|date=2017-01-13|work=Emergency Services Times|access-date=2017-08-11|language=en-GB}} Amongst cost and comfort considerations, all Scottish Ambulance Service Staff now wear the national uniform which comprises a dark green trouser/shirt combination.{{Cite web|url=https://www.whatdotheyknow.com/request/368362/response/901925/attach/html/2/Signed%20response%20and%20attachment.pdf.html|title=FOI Response - Scottish Ambulance Service Uniform|date=31 October 2016}} Personal protective equipment (boots, helmet and protective jackets) is issued to all staff and denote rank/clinical rank by way of epaulette and helmet markings.

File:Scottish Ambulance Service, Edinburgh, Scotland, May 2008 (13718219384).jpg van ambulance pictured in 2008]]

File:SASDivmap copy.jpg

The national headquarters is located at Gyle Square, South Gyle, on the west side of Edinburgh.{{Cite web|date=16 September 2021|title=The Scottish Ambulance Service|url=https://www.healthcareimprovementscotland.org/our_work/inspecting_and_regulating_care/nhs_hospitals_and_services/scottish_ambulance_service/the_scottish_ambulance_service.aspx|access-date=16 September 2021|website=Healthcare Improvement Scotland}}

There are five divisions within the service, namely:

File:Sashonda4x4rru.jpg 4x4]]

The Patient Transport Service carries over 1.3 million patients every year.{{cite web|title=Scottish Ambulance Service|url=https://www.scottishambulance.com/TheService/Default.aspx|website=Scottish Ambulance Service|access-date=4 November 2017}} This service is provided to patients who are physically or medically unfit to travel to hospital out-patient appointments by any other means so that they can still make their appointments. The service also handles non-emergency admissions, discharges, transport of palliative care patients and a variety of other specialised roles.{{cite web|title=Scottish Ambulance Service|url=https://www.scottishambulance.com/whatwedo/pts.aspx|website=Scottish Ambulance Service|access-date=4 November 2017}}

Patient Transport Vehicles come in a variety of forms and are staffed by ambulance care assistants, who work either double- or single-crewed. They are trained to look after patients during the journey, and to provide basic emergency care.{{cite web|title=Scottish Ambulance Service|url=https://www.scottishambulance.com/UserFiles/file/healthprofessionals/easyread.pdf|website=Scottish Ambulance Service|access-date=4 November 2017}}

{{Location map+|Scotland| AlternativeMap =Scotland location map.svg||float=right|width=250|caption=Air ambulance bases in Scotland
Key: Ch=Charity SAS=Scottish Ambulance Service|places=

{{Location map~|Scotland|lat=57.2025|long=-2.1981|mark=Green pog.svg|position=top|label=Aberdeen (SAS & Ch)}}

{{Location map~|Scotland|lat=56.4411|long=-3.3739|mark=Green pog.svg|position=top|label=Perth (Ch)}}

{{Location map~|Scotland|lat=55.8719|long=-4.4331|mark=Green pog.svg|position=bottom|label=Glasgow (SAS)}}

{{Location map~|Scotland|lat=57.5425|long=-4.0475|mark=Green pog.svg|position=left|label=Inverness (SAS)}}

}}

File:G-SASC-KingAir-1002.jpg

File:EC145 G-SASN IMG 1843 (19639002395).jpg-operated H145, with the callsign 'Helimed 02']]

The service has the only government-funded air ambulance service in the UK,{{cite web |url=https://www.scottishambulance.com/WhatWeDo/TheParent.aspx |title=What we do: Air ambulance |publisher=Scottish Ambulance Service |access-date=20 December 2014}} operated under contract by Gama Aviation. The fleet consists of two Airbus H145 helicopters{{cite news|url=https://stv.tv/news/highlands-islands/1324082-technical-difficulties-put-stop-to-air-ambulance-island-tour/ |title='Technical difficulties' put stop to air ambulance's island tour |work=STV News |date=3 July 2015|access-date=8 April 2016}} and two Beechcraft B200C King Air fixed-wing aircraft, which provide emergency response and transfers of patients to and from remote areas of Scotland.

The two previous H145 helicopters were operated under sub-contract by Babcock Mission Critical Services Onshore until May 2020.{{cite news | url = https://www.pressandjournal.co.uk/fp/business/north-of-scotland/2230703/gama-takes-on-scottish-air-ambulance-missions/ | work = The Press and Journal | title = Gama takes on Scottish air ambulance missions | date = 2 June 2020 | author = Stan Arnaud }}

In 2015{{ndash}}2016, the air ambulance crews flew 3,849 missions. One helicopter and one King Air are based at a Gama Aviation facility at Glasgow Airport. The other operating bases are Inverness Airport (helicopter) and Aberdeen Airport (King Air).{{cite web|url=https://www.scottishambulance.com/WhatWeDo/aircraft.aspx|title=What we do: Aircraft |publisher=Scottish Ambulance Service |access-date=2 June 2016}}

The aircraft based in Glasgow are regularly used by the Emergency Medical Retrieval Service (EMRS).{{cite web|url=https://www.emrsscotland.org/|title=Emergency Medical Retrieval Service|access-date=9 April 2019}} The air ambulance service was occasionally featured as part of the Channel 5 television documentary series Highland Emergency.{{Cn|date=September 2023}}

In late 2010, a charity, Scotland's Charity Air Ambulance (SCAA), was founded to provide a further air ambulance, based at Perth Airport to work alongside the state-funded aircraft.{{cite news| url=https://www.bbc.co.uk/news/uk-scotland-tayside-central-20498405 |title=Perth base for Scotland's charity air ambulance |work=BBC News |date=27 November 2012 |access-date=8 April 2016}}

SCAA commenced operations in May 2013 with a MBB Bo 105 helicopter. Since November 2015, SCAA has operated a Eurocopter EC135.{{cite news |url=https://news.stv.tv/tayside/1331709-new-helicopter-unveiled-for-scotlands-charity-air-ambulance/ |title=New helicopter unveiled for Scotland's Charity Air Ambulance |work=STV News |date=30 October 2015 |access-date=8 April 2016}} The EC135 was previously operated by the state-funded service, until they replaced the fleet with H145 aircraft.{{Cn|date=September 2023}} The helicopter is crewed by Scottish Ambulance Service paramedics, tasking is from the SAS ambulance control centre at Cardonald.

In April 2018, it was announced by the charity that a drive was underway to raise funds to secure a second helicopter.{{cite news |url=https://www.scaa.org.uk/news/second-charity-air-ambulance-helicopter-planned-for-scotland |title=Second charity air ambulance helicopter planned for Scotland |work=SCAA |date=24 April 2018 |access-date=23 May 2018}} This aircraft is now operational at Aberdeen Airport.{{cite news|url=https://www.bbc.co.uk/news/uk-scotland-north-east-orkney-shetland-49636158 |title=Air ambulance helicopter contract signed for Aberdeen service |work=BBC News |date=9 September 2019 |accessdate=28 July 2024}}

• On 19 May 1996, a Britten-Norman BN-2 Islander aircraft operated by Loganair for the Scottish Ambulance Service crashed short of the runway at Lerwick/Tingwall Airport in Shetland while turning to final approach at night during strong and gusting winds. The pilot was killed, and the physician and flight nurse were injured. There was no patient on board at the time.{{cite web|last1=Air Accidents Investigation Branch|title=BN2A-26 Islander, G-BEDZ, 19 May 1996|url=https://www.gov.uk/aaib-reports/bn2a-26-islander-g-bedz-19-may-1996|website=GOV.UK|publisher=Department for Transport, Air Accidents Investigation Branch|accessdate=31 December 2015}}
• On 15 March 2005, a Britten-Norman BN-2 Islander aircraft operated by Loganair crashed into the sea while descending toward Campbeltown Airport in western Scotland. The aircraft was operating an air ambulance flight on behalf of the Scottish Ambulance Service. The pilot and paramedic both died in the crash.{{cite web | url = http://news.bbc.co.uk/1/hi/scotland/4349523.stm | title = Air crew search called off | work = BBC News | date = 15 March 2005}}

The SORT service is similar to the Hazardous Area Response Team in other parts of the United Kingdom.{{Cn|date=September 2023}} SORT paramedics have the same scope of practice as a regular paramedic, however have an enhanced scope of practice in relation to Personal protective equipment and other rescue equipment. They do not however carry nor administer ketamine.

In 2010, the service established three teams of specialist accident & emergency ambulance personnel who were given specialist training.{{cite news|url=https://www.bbc.co.uk/news/uk-scotland-edinburgh-east-fife-10938624 |title=Ambulance disaster teams created |work=BBC News |date=11 August 2010}} This £4.3{{nbsp}}million initiative was to provide additional preparedness to be able to respond to large-scale hazardous incidents, such as those that might involve chemical, biological, radiological or nuclear material.{{cite web|last1=Stephen|first1=Phyllis|title=Scottish Ambulance Service – major incident response boosted|url=https://www.theedinburghreporter.co.uk/2010/08/scottish-ambulance-service-major-incident-response-boosted/|website=theedinburghreporter.co.uk|date=12 August 2010|access-date=19 September 2017}} The work was in concert with the UK government. In 2019, the SORT services responded to 1,200 calls requiring specialist intervention, and supported a further 9,000 calls.{{Cite web |date=2018-10-31 |title=Scottish Ambulance Service |url=https://emseurope.org/scottishambulanceservice/ |access-date=2023-03-09 |website=EMS2022 Scotland |language=en-US}}

{{As of|2017|October}} there are five SORT teams; three full-time based in Edinburgh, Glasgow, and Aberdeen, and two on-call teams in Inverness and Dumfries.{{Cite web |date=2017-10-09 |title=Special Operations Response Team |url=https://techieryan.wordpress.com/2017/10/09/sort/ |access-date=2022-09-07 |website=TechieRyan |language=en}} These teams provide a specialist response to major incidents, and provide paramedic care in hostile environments.{{Cn|date=September 2023}} The team provides capability in arenas such as water rescue, safe working at height, search and rescue including the use of breathing apparatus, and confined space working. The SORT teams also provide a full-time emergency decontamination and inner-cordon capability.{{Cn|date=September 2023}}

With the remote towns and villages in Scotland often being hours away from advanced medical treatment, Scottish Specialist Transport and Retrieval (ScotSTAR) was setup incorporating paediatric and neonatal retrieval and transfer teams and the two adult Emergency Medical Retrieval Service teams (EMRS). The ScotSTAR service was set up on 1 April 2014 and transported 2,654 patients 2014{{ndash}}2015. The service uses multiple vehicles, either owned by the ambulance service or other organisations: specialist ambulances and cars, five air ambulances and HM Coastguard helicopters. The service is based in Glasgow.{{Cn|date=November 2023}}

EMRS (The Emergency Medical Retrieval Service) was created in 2004 by ten emergency medical consultants from Glasgow and Paisley.{{Cite web |title=Emergency Medical Retrieval Service |url=https://www.emrsscotland.org/ |access-date=2022-09-07 |website=Emergency Medical Retrieval Service |language=en-GB}} Initially, the service provided aeromedical cover to six isolated hospitals within Argyll and Bute. The ten consultants only had £40,000 worth of funding for medical equipment. In its first year the service transported 40 patients. In years to follow, the clinical crew began to gather evidence for the life-saving impact and cost effectiveness of the service. Following a successful 18-month trial period in the West of Scotland funded by the Scottish Government, in 2010 the service was opened up to the whole of the country, after securing permanent funding. The service is currently staffed by 47 part-time retrieval consultants,{{Cite web |title=Consultants |url=https://www.emrsscotland.org/consultants |access-date=2022-09-07 |website=Emergency Medical Retrieval Service |language=en-GB}} 14 retrieval practitioners,{{Cite web |title=Retrieval Practitioners |url=https://www.emrsscotland.org/retrieval-practitioners |access-date=2022-09-07 |website=Emergency Medical Retrieval Service |language=en-GB}} and 4 registrars,{{Cite web |title=Registrars |url=https://www.emrsscotland.org/registrars |access-date=2022-09-07 |website=Emergency Medical Retrieval Service |language=en-GB}} carrying out around 1000 missions every year.

The service has its own dedicated training academy within the campus of Glasgow Caledonian University, which opened in June 2011.{{cite news |url=https://www.dailyrecord.co.uk/news/health/nicola-sturgeon-unveils-new-scottish-1106546 |title=Nicola Sturgeon unveils new Scottish Ambulance Academy at Glasgow Caledonian University |work=Daily Record |date=27 June 2011 |access-date=8 April 2016}} The facility has purpose built classrooms, lecture theatres, syndicate rooms and a clinical simulation area that recreates a 16-bed hospital ward and Accident & Emergency department allowing realistic interaction with other trainee healthcare professionals.{{cite press release| url=https://www.scottishambulance.com/News/NewsItem.aspx?NewsID=118| title = New Academy is a major milestone for Ambulance professional development| publisher=Scottish Ambulance Service| date=8 February 2011| access-date=12 May 2014 | archive-url=https://web.archive.org/web/20120202173312/http://www.scottishambulance.com/News/NewsItem.aspx?NewsID=118| archive-date=2 February 2012}}

From 1996 until April 2011, the service used its own dedicated training college located at Barony Castle in Eddleston near Peebles. Set in {{convert|25|acre|m2}} of formal gardens and woodlands, Barony was a residential training and conference centre with 78 bedrooms that allowed the service to carry out all its training in house. Between 1985 and 1996 it used the former Redlands women's and children's hospital in Glasgow's west end and prior to that the training school was based at Bangour Hospital before moving to Gartloch Hospital.{{Cn|date=September 2023}}

In year ended 31 March 2020, the service:{{cite web| url=https://www.scottishambulance.com/media/lbodg32k/2020-07-27-signed-annual-report-and-accounts-2019-20.pdf| title=Scottish Ambulance Service Annual report 2020| publisher=Scottish Ambulance Service| access-date=9 April 2021}}

• Responded to 542,213 accident and emergency incidents.
• Carried out 606,015 non-emergency patient journeys.
• Flew 3,732 air ambulance missions.

• In 1999 it emerged that the Financial Director of the Scottish Ambulance Service had previously been jailed for fraud.{{Cite web |title=999 CHIEF IS A THIEF; SCANDAL OF EX-CON IN CHARGE OF pounds 80m AMBULANCE BUDGET. - Free Online Library |url=https://www.thefreelibrary.com/999+CHIEF+IS+A+THIEF;+SCANDAL+OF+EX-CON+IN+CHARGE+OF+pounds+80m...-a060360698 |access-date=2022-07-15 |website=www.thefreelibrary.com}}

• In 2018 it was revealed that frontline staff had been working "dangerously long hours", with one staff member working a 36 hour long shift.{{Cite web |last=Archive |first=STV News |title='National scandal' as ambulance worker pulls 36-hour shift |url=https://archive.news.stv.tv/north/1430863-national-scandal-as-ambulance-worker-pulls-36-hour-shift.html |access-date=2022-07-15 |website=STV News Archive |language=en}} This was described as a national scandal at the time.
• In 2020 both the Tayside Trauma Team and Medic 1 announced their continuing existence was unsustainable and the services would be terminated, removing this physician led resource from the ambulance services capabilities.{{Cite book |last=Moultrie |first=Chris |title=East / South-East Scotland Pre-Hospital Emergency Critical Care (PHECC) Service Development Project. Phase 1 SBAR Report: Current State Analysis and Initial Recommendations. |publisher=Scottish Trauma Network |year=2023 |pages=3}}

• 2021 saw the Scottish Ambulance Service struggle to staff frontline ambulances;{{Cite web |last=Hutcheon |first=Paul |date=2021-12-30 |title=Humza Yousaf under fire as Scottish Ambulance Service struggles to fill shifts |url=https://www.dailyrecord.co.uk/news/politics/humza-yousaf-under-fire-scottish-25806771 |access-date=2022-07-15 |website=Daily Record |language=en}} seeking help from firefighters,{{Cite web |title=Firefighters to provide emergency support to Scotland's ambulance service |url=https://www.thenational.scot/news/19594001.firefighters-provide-emergency-support-scotlands-ambulance-service/ |access-date=2022-07-15 |website=The National |date=21 September 2021 |language=en}} the military,{{Cite web |date=2021-09-22 |title=Army to be deployed to struggling ambulance services in Scotland from Saturday |url=https://www.itv.com/news/border/2021-09-22/army-to-be-deployed-to-struggling-ambulance-services-in-scotland-from-saturday |access-date=2022-07-15 |website=ITV News |language=en}}{{Cite web |title=More than 100 military staff to help ambulance service, Humza Yousaf says |url=https://www.thenational.scot/news/19595552.humza-yousaf-100-military-staff-help-ambulance-service/ |access-date=2022-07-15 |website=The National |date=21 September 2021 |language=en}} and non-medical trained drivers{{Cite web |title=Emergency Driver - Bank : Various locations within Scotland |url=https://apply.jobs.scot.nhs.uk/displayjob.aspx?jobid=83134&Source=JobtrainFacebook |access-date=2022-07-15 |website=apply.jobs.scot.nhs.uk |language=en}} to crew ambulances attending 999 calls. A number of tragic stories emerged highlighting the personal cost of this crisis, including one patient who died after waiting 40 hours for an ambulance,{{Cite web |date=2021-09-16 |title=Scotland NHS: 'Our father died after a 40 hour wait for an ambulance' |url=https://www.itv.com/news/2021-09-16/scotland-nhs-our-father-died-after-a-40-hour-wait-for-an-ambulance |access-date=2022-07-15 |website=ITV News |language=en}} and an elderly man who died on his driveway after waiting four and a half hours for an ambulance.{{Cite web |last=Aitken |first=Vivienne |date=2021-08-21 |title=Pensioner dies in driveway of Scots home after waiting four hours for ambulance |url=https://www.dailyrecord.co.uk/news/scottish-news/four-hour-ambulance-delay-death-24806868 |access-date=2022-07-15 |website=Daily Record |language=en}} In the same year it was also revealed that a number of senior NHS managers from the ambulance service were running a camper van hire business during work hours, while planning for the COP26 international conference.{{Cite web |last=Ferguson |first=John |date=2021-09-19 |title=Ambulance row as Scots bosses run camper van hire firm from NHS HQ |url=https://www.dailyrecord.co.uk/news/scottish-news/ambulance-row-scots-bosses-run-25018301 |access-date=2022-07-15 |website=Daily Record |language=en}}{{Cite web |date=2022-05-08 |title=Ambulance bosses leave campervan bustle after being exposed - lifedesignjournals.com |url=https://lifedesignjournals.com/ambulance-bosses-leave-campervan-bustle-after-being-exposed/,%20https://www.dailyrecord.co.uk/news/scottish-news/ambulance-bosses-step-down-campervan-26903020/ |access-date=2022-07-15 |language=en-US}}

• Research published in 2022 demonstrated that four out of five Scottish paramedics were considering quitting their jobs. It also revealed that 87% of staff do not feel valued by the Scottish Ambulance Service.{{Cite web |title=Four in five Scots ambulance staff consider quitting as morale 'deteriorates' despite huge recruitment drive |url=https://www.glasgowtimes.co.uk/news/national/scotland-today/20209145.four-five-scots-ambulance-staff-consider-quitting-morale-deteriorates/ |access-date=2022-07-15 |website=Glasgow Times |date=14 June 2022 |language=en}} The same report highlighted a third of staff working shifts lasting 15–20 hours. The same year, a story was published in which a member of the public was asked to perform CPR on their relative, alone in the back of the ambulance without help from the ambulance crew while en route to hospital.{{Cite web |first=Vidushi |last=Tiwari |date=2022-07-05 |title=Partner asked to perform CPR on patient alone during cardiac arrest |url=https://news.stv.tv/scotland/scottish-ambulance-service-ordered-to-apologise-after-partner-gave-cpr-to-patient-alone-in-ambulance |access-date=2022-07-15 |website=STV News |language=en-GB}} In the summer of 2022 it was claimed that an ambulance service senior manager was suspended as a result of requesting that a member of control-room staff leave their post and collect him (and his family) from Glasgow Airport.{{Cite news |last=Correspondent |first=Helen Puttick, Scottish Health |title=Boss of 999 centre accused of asking call handler for airport pick-up |newspaper=The Times |language=en |url=https://www.thetimes.com/uk/scotland/article/boss-of-999-centre-accused-of-asking-call-handler-for-airport-pick-up-qttrm0bfr |access-date=2022-08-11 |issn=0140-0460}} In 2022 it also came to light that EMRS have been deploying as a “Red Team” for the Scottish Ambulance Service without a Consultant on board.{{Cite web |last=Scottish Ambulance Service |title=FOI Request |date=18 July 2022 |url=https://www.whatdotheyknow.com/request/879854/response/2102601/attach/3/FOI%201597%20Response%20Letter.pdf?cookie_passthrough=1}}

• In April 2024, the ambulance service was criticised for being 'under-resourced' and using an elderly fleet of 337 ambulances, registered before February 2019, out of a wider fleet of 1,298 ambulances. The oldest ambulance in active service with the Scottish Ambulance Service, registered in 2005, was noted to be based in Dumfries.{{cite news |title=Quarter of ambulances more than five years old, figures show |url=https://news.stv.tv/scotland/quarter-of-scottish-ambulance-service-vehicles-more-than-five-years-old-figures-show |access-date=16 May 2025 |work=STV News |date=20 April 2024}}

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