A vision for the UK NHS ambulance sector

AACE logoThe Association of Ambulance Chief Executives has conducted an exercise with our member services to look ahead and describe how the sector may look in the years to come – what services we can provide better and how we can contribute to improving the whole picture of urgent and emergency healthcare provision within the systems that we operate.

Paramedic driving ambulance

We know that the NHS is slowly emerging from the most challenging of times it has faced since its inception: a global pandemic, followed by the lasting effects of that on population health and our economy, on top of other world events – climate change, wars, and conflicts – that are having an additional adverse impact on societies.

And, to cite The King’s Fund (May 2022), ‘Even before the Covid-19 pandemic the NHS was facing a significant funding shortfall because of increasing demand for services and years of funding settlements that were both below the long-term average and excluded important areas of spending like long-term capital investment (including spending on buildings and equipment) and the education and training of clinical staff’ (NHS funding: our position | The King’s Fund (kingsfund.org.uk)).

New approaches are needed to overcome the pressures we currently face and build sustainable ways of working together in the context of the current societal and global realities.

>> Contributions to our vision are welcomed.  Please share your thoughts here. 


We learnt a great deal from our experiences in responding to the pandemic, identifying things that worked well at the time, and things we need to improve on across the health sector: greater professional collaboration at pace; the use of digital solutions in communicating with patients and partner providers where appropriate; improving equality of access for all patients to services; how we can provide more appropriate responses to match patient needs; finding technical and operational solutions for the provision of mutual aid in times of peak demand; how we can build in greater resilience to be better prepared for unexpected and unprecedented occurrences, and more.

Emergency Call Advisor at desk

We need to build on these positive experiences. In many cases they provide emphasis to the objectives and plans we were all working on prior to the pandemic to fulfil the strategic goals of the Long Term Plan.

Despite the current challenged position for the NHS, ambulance services have great potential to help solve some of the key system pressures, reduce the risks for patients and address inefficiencies within their health systems. They can make better use of scarce clinical resources across wider footprints, working with their systems to implement the models of care that make most sense for their particular population needs.


AACE NHS ambulance sector vision - front coverOur vision as a conversation starter

We have produced an outline of our ambulance sector vision as a conversation starter, with ideas that we believe could, over time, make a tangible difference to patient care, experience, and outcomes, as well as facilitating a more positive culture with supportive and productive working environments for our workforces across sectors.


The ambulance sector interfaces with each and every part of the health and care system – primary care, mental health, community services, allied health professions and secondary care, social care, other emergency services, voluntary services, local authorities, charities, private providers, and our commissioning bodies.

We are working with our colleagues in NHS Providers and NHS Confederation to engage with our partners above to promote understanding of our ideas and stimulate constructive thinking and collaboration in supporting each other to provide the best possible services for our populations.

Paramedic working in a house

We are confident that the ambulance sector has much more to offer the rest of the NHS in improving urgent and emergency care provision in the UK. We would like to engage with national, regional and system leaders, and our partner providers, to explore the possibilities of enhancing the ambulance role within urgent and emergency care and promote collaborative cross-sector planning and implementation of a long-term strategy to deliver meaningful change for patients and our people.

The core remit of any NHS ambulance service will always be to provide emergency response to those who have a life-threatening health need, and to major incidents. This will not change, but it is a small proportion of the demand on our services and could be improved.


In addition to our provision of urgent and emergency care response, ambulance services have a pivotal role in:

  • simplifying access to care
  • coordinating care navigation
  • assessing more people remotely
  • enhancing mobile care
  • integrating care pathways
  • reducing avoidable conveyance and admission to hospital
  • sharing data and learning across systems

Throughout 2024-25 we will continue these discussions and aim to bring further clarification of our ideas, which we will share on this website.

Contributions to our vision are welcomed.  Please share your thoughts here. 

Read our vision for the ambulance sector here.