National Workstreams

AMBULANCE BG Generic 825_A2The AACE oversees a broad range of national workstreams as outlined below.

Each workstream is overseen by a Chief Executive, who maintains a watching brief over the national group and associated sub-groups.


Chief Executive Lead: Garrett Emerson, London Ambulance Service

Lead: Mark Cotton, North East Ambulance Service


  • To provide specialist advice and support to the Association of Ambulance Chief Executives (AACE) on matters relating to strategic communications in supporting the direction of travel for ambulance services
  • To deliver against a pre-agreed milestone plan providing reports to the AACE every four months
  • To act as a community of interest to: share best practice, expertise and information; extend communications skills and knowledge; and provide mutual aid
  • To co-ordinate handling strategies (including media management and stakeholder engagement activities) to manage public perceptions and understanding of ambulance issues which seek to protect the positive reputation of ambulance services nationally
  • To provide specialist advice and support to the Association of Ambulance Chief Executives (AACE) on matters relating to strategic communications in supporting the direction of travel for ambulance services

Areas of focus:

  • Continued working with NHS England on the Ambulance Response Programme; in particular the spring review and introduction of formal measurement against the standards from September 2018.
  • NACOM will support NHS Horizons on Project A. This important piece of work will need NACOM involvement throughout the life of the project.
  • More work on ambulance use of social media, ensuring good governance, training and policies in place to maintain public confidence and increase use of digital channels for key messages.
  • Maintain our network and collaboration to ensure consistent approaches to media and FOI questions over the year.
  • Continue to learn and train around communications response to terrorist and major incidents/ sharing experience and learning.
  • Continue to share experience and learning around aspects of internal communications and staff engagement; such as reward and recognition.
  • Collaborate on media relations and media monitoring of national issues arising
  • Continual review of AACE key messages;
  • Continue to work with NHS England and Public Health England regarding health messages and, in particular, winter campaigns.
  • Support and co-ordinate activity to celebrate NHS@70
  • Support the Continuous Professional Development of NACOM members

Chief Executive Lead: Rod Barnes, Yorkshire Ambulance Service

Director Lead: Lorraine Bewes, London Ambulance Service


The purpose of the National Directors of Finance Group is to provide collective leadership for NHS finance in ambulance services in England working in collaboration with the Association of Ambulance Chief Executives (AACE).

It also has an important role in advising the AACE on specific topics as delegated to the Directors of Finance Group.  In addition, the Directors of Finance Group will make suggestions to the AACE on its proposed work programmes for individual financial years.

Areas of focus:

  • Relationships: with NHS Improvement
  • Engagement: respond to national consultations and discussion documents on financial matters
  • Procurement: review of current arrangements; recommendations to create further savings
  • Competition law: enhancing understanding of its impact upon ambulance services
  • Benchmarking: across the ambulance sector
  • Activity: consideration of growth across ambulance sector; review of  NHS 111 impact

Chief Executive Lead: Jason Killens, Welsh Ambulance Service NHS Trust

Director Lead: Ben Holdaway, East Midlands Ambulance Service


The purpose of the National Directors of Operations Group (NDOG) is to provide specialist advice and support to the Association of Ambulance Chief Executives (AACE) and to carry out specific work associated with the delivery of operational ambulance services.

Areas of focus:

  1. Reduce unwarranted variation

In line with the expectations of the Carter Review, NDOG will increase efforts to reduce unwarranted variation.  This will be achieved through developing a data set focusing on known areas of operational variance in order to better identify and share good practice.  NAIG support will be required with this objective.  NDOG will form task and finish groups as required to focus on developing national solutions replicating the success seen through the review of early predict processes.

  1. Harmonise operating models in accordance with the Ambulance Improvement Programme

NDOG will actively work together to develop an operating model that is common nationally with variance only where it is warranted by local conditions.

  1. Promotion of the sector and the ambulance/AACE brand

NDOG members will actively promote the national agenda of the group and will consider AACE strategic objectives when agreeing local strategies.

NDOG members will ensure compliance with the new duty to collaborate through sharing examples of successful collaborations and replicating them where they are in the interests of patients and where they deliver operational or financial efficiency.

  1. Maximise patient safety

NDOG will actively share patient safety incidents that can be learned from with particular focus on those which might shape common operating models.

  1. Ambulance Radio Programme

NDOG will work together to support the successful roll out of the ambulance radio programme, sharing experiences and good practice and offering mutual support.

  1. Business continuity, resilience and winter planning

NDOG will share good practice and consider where national approaches to planning will improve national resilience.  Specifically NDOG will support any work led by the IM&T Group to provide inter-operability between CAD systems.

National Ambulance Diversity Forum

Chief Executive Lead: Will Hancock, South Central Ambulance Service NHS Foundation Trust


To provide strategic leadership in relation to equality, diversity and human rights to English ambulance services.

Areas of focus

  • Create resources to develop culturally competent diverse workforce
  • Ensure fair, compliant procurement, tendering and commissioning processes
  • Consistency of national patient data reporting and monitoring through use of Diversity Monitoring Toolkit
  • Effective community engagement models for ambulance services
  • National Conferences: sharing good practice and forum development plan
Human Resources

Chief Executive Lead: Helen Ray, North East Ambulance Service

Director Lead: Melanie Saunders, South Central Ambulance Service NHS Foundation Trust


The purpose of the National Directors of Human Resources’ (HRD) Group is to provide specialist advice and support to the Association of Ambulance Chief Executives (AACE) and to carry out specific work associated with the delivery of human resource, organisational development, education, training and development activity throughout ambulance services in England.

Areas of focus:

Alongside the National Ambulance Diversity Forum, to recruit, develop and support a workforce that is representative of the communities we serve:

  • To develop and deliver the requirements of the Workforce Disability Equality Scheme
  • To develop and deliver the requirements of the Workforce Race Equality Scheme
  • To review and deliver improvements across the equality indicators in the staff survey

To improve the workforce planning and supply for the ambulance sector:

  • To ensure the sector has access to an available supply of clinicians through Health Education England, internally and other partners
  • To implement the requirements of the Paramedic Implementation Agreement
  • To lead on the implementation of the Ambulance Improvement Programme (Workforce)
  • To seek opportunities to broaden the role and scope of the current workforce (Health and Social Care, rotational roles)

Developing the culture of the workforce:

  • Identify leadership opportunities to embed a more inclusive leadership style for the sector
  • Look at areas of the staff survey results to improve the sector to continue to be a great place to work and receive treatment by improving staff engagement
  • Provide a workplace that supports staff from violence, bullying and harassment

Improving the health and wellbeing of the workforce:

  • Implementation of the physical and mental well-being programme developed during 2017/18
  • To seek to improve available flexible working opportunities to support staff in balancing work and home life
National Digital Leaders' Group

Chief Executive Lead: Richard Henderson, East Midlands Ambulance Service

Director Lead: Tim Bishop, South Western Ambulance Services NHS Foundation Trust


The purpose of the Information Management and Information Technology (IM&T) Leads’ Group is to support the implementation of local IM&T workstreams by monitoring national programmes and sharing best practice across the ambulance services.

Areas of focus

  • Ambulance Digital Strategy: collaboration and joint working and “taking up” of others’ capabilities
  • Continued, supported national progression across: NHS number: recording and use; summary care records and patient care plans: routine accessibility; ePCR: across all ambulance trusts; best practice examples and evaluation of use of technology in patient assessment: sharing nationally
  • Feedback from the global digital exemplar (GDE) projects in SCAS, NEAS & WMAS, and the outcome of the NHSI control room review to form the basis of activity in 2018/19

Chief Executive Lead: Martin Flaherty, AACE MD

Director Lead: Fenella Wrigley, London Ambulance Service


The purpose of the National Ambulance Services Medical Directors’ Group (NASMeD) is to improve clinical safety and quality of care by reducing unwarranted variation and sharing best practice across the English ambulance services.

Areas of focus

  • To lead on behalf of the English/UK ambulance services the development of AACE UK ambulance service clinical practice guidelines.
  • To act as the point of reference for clinical related issues for UK ambulance services and represent UK ambulance services on clinical matters at the request of other external bodies such as the Department of Health (DH) and NHS England
  • To provide specialist clinical advice to the Association of Ambulance Chief Executives (AACE) and relevant sub groups
  • To lead on specific projects/areas of work to support the delivery of AACE’s strategic priorities.
  • To provide information and advice on emerging relevant legislation and guidance.
  • To promote evidence based practice that will provide value for money, and improve effectiveness/ efficiency.
  • Oversees the work of the National Ambulance Research Steering Group (NARSG) read more here.
Quality, Governance and Risk

Chief Executive Lead: Philip Astle, South East Coast Ambulance Service NHS Foundation Trust

Director Lead:  Jenny Winslade, South Western Ambulance Service


The purpose of the Group is to provide a leadership role to UK ambulance services in relation to quality, governance and risk management, within the overarching strategic framework of the Association of Ambulance Chief Executives (AACE).

Areas of focus:

  • Reduce unwarranted variation
    • Strengthen the role and function of NASPEG in developing and benchmarking patient experience across the sector
    • QGARD to develop and strengthen relationships with the Carter programme board in securing quality outcomes
    • Strengthen the role of the CQC learning sub-group ensuring that learning is shared across the service


    Wider roles: urgent and emergency care/ prevention

    • Support the development of the prevention agenda


    Workforce recruitment, equality & wellbeing

    • Support the development of the multi-professional ambulance workforce including nurses and therapists


    Patient safety

    • With NASRF develop the Proclus system developing opportunities for learning from serious incidents
    • Support NASRF in development of consistent definitions for Serious Incidents and the development of benchmarking data form patient safety incidents
    • Support the Infection Prevention and Control Group
    • Develop benchmarking data opportunities for Health and Safety


    Promote reputation of the sector and the ambulance/AACE brand

    • Develop a quality framework for ambulance services providing clear objectives in support for QGARD sub-groups
    • Develop closer links with NASMED in supporting AACE strategic goals particularly for quality and safety
    • Review the risk framework for ambulance services developing a common currency for the sector enabling best understanding of the regulators
    • Continue to work with the Model Ambulance workstream

Chief Executive Lead: Dr Anthony Marsh, West Midlands Ambulance Service

Director Lead: Keith Prior, Director, National Ambulance Resilience Unit (NARU)         


NARU will support the resilience objectives of NHS England, the Association of Ambulance Chief Executives and Ambulance Commissioners. In addition NARU will also provide support to the UK’s Civil Resilience and counter-terrorism (CONTEST) strategies and the Health commitments and the National Security Council.

Areas of focus

  • Respond to any changes in policy or Government guidance in respect of emergency preparedness, resilience or response (EPRR) including major incident planning and response to high priority risks as identified through the National Capabilities Programme and the National Risk Assessment
  • Liaise with and advise Ambulance Chief Executives regarding any changes to policy and expected ambulance response
  • Horizon-scan for potential operational requirements for EPRR capabilities, including developments in equipment technology, research and clinical interventions
  • To contribute to the review and revision of DH and NHS England policy and guidance specific to EPRR
  • Provide ambulance contribution to public enquiries and reviews, for example, 7/7 inquest outcomes, and ensure lessons are shared and implemented
  • Advise and coordinate development of any new pre-hospital clinical interventions in respect of major incidents involving specialist operations or assets
  • Respond to outcomes and decisions regarding the  Joint Emergency Services Interoperability Programme
National Ambulance Strategy and Transformation Group

Chief Executive Lead: Pauline Howie, Scottish Ambulance Service

Director Lead:  Will Legge, East Midlands Ambulance Service


The purpose of the National Ambulance Strategy and Transformation Group (NASAT) is to provide the National Ambulance sector, through AACE, with guidance, advice, recommended strategic direction and positioning in relation to the Urgent and Emergency environment (U&EC).

Areas of focus:

  1. Produce a refreshed publication describing the NHS Ambulance Service vision within the integrated UEC system
  2. Monitor the impact of the IUC specification and how this is being implemented across the country
  3. Develop a suitable ‘value calculator’ model to assist in demonstrating the impact of ambulance role in IUC in terms of finance, quality and performance
  4. Review of the development, operation and delivery of ambulatory pathways as a realistic alternative to the Emergency Department for ambulance patients
  5. Identify challenges for patients in accessing unscheduled primary care services. Work with providers and national stakeholders to resolve these, and identify opportunities for ambulance services to provide solutions.
  6. Develop methods to be able to interpret ambulance sector knowledge over our regional footprints to identify and advise STPS/ICSs of service gaps
  7. Ensure that ambulance services and acute trusts understand the requirements of the new 999 specification, including IFT/HCP aspects – produce guidance where necessary
  8. Continue to input into the multi-professional workforce framework as this is developed by QGARD

For more information about the Workstream Groups click here.