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St. John Ambulance is an international charity, based in England, dedicated to the teaching and practice of medical first aid. There are many groups (priories) across different countries, and the collective falls under the direction of the Order of St. John. The order's mottoes are Pro fide (For the faith) and Pro utilitate hominum (For the service of mankind).

The name "St. John Ambulance"

Members are sometimes asked by the public whether "St. John" was a real person and why he had an ambulance! In its modern guise, the "St. John" prefix refers to the Order of St. John rather than a specific individual and is used as an adjective. However, it is often assumed to be used as a noun, and this leads to the organisation being frequently incorrectly termed "St. John's Ambulance", a long standing source of irritation to some members. This is further perpetuated since members on duty are often referred to collectively as "St. John's". In terms of the Order, the original allegiance was to John the Baptist, however this allegiance is not inherited by St. John Ambulance.

International structure of the organisation

Falling under the direction of the Order of St. John, St. John Ambulance mirrors the structure of the Order. The Order is divided internationally into Priories, reflecting the monastic history of the original Knights Hospitaller. However, these modern priories are not monastic in nature and are used purely as terminology within the organisation. At present, the following priories exist worldwide:
  • The Priory of England and the Islands
  • The Priory of Australia
  • The Priory of Canada
  • The Priory of New Zealand
  • The Priory of Scotland
  • The Priory of South Africa
  • The Priory of United States
  • The Priory of Wales

The Priory of England and the Islands is the home priory of the Order, and any country which does not belong to its own dedicated priory is assumed into this home priory. Most of these are small commonwealth islands or countries where there is only a minor presence.

That said, the relationship between the Order of St. John and St. John Ambulance is not directly paralleled. Most members of St. John Ambulance are not themselves members of the Order and vice versa, so a major presence of the Order does not dictate a major presence of St. John Ambulance. Most notably, the Order of St. John is a Christian organisation, whereas St. John Ambulance is keen to ensure there is no allegiance to any particular religion or denomination, so as to remain available to all. This explains somewhat why a breakdown into Priories may not be tantamount to a breakdown of St. John Ambulance. St. John Ambulance works on a more geographical nature than the Order, and has to contend with the differing national laws, medical practices and cultures of countries.

St. John Ambulance is a ranked organisation, and members fall into a hierarchical structure of command. St. John Ambulance ranks run from Member, through Corporals, Sergeants and Officers all the way up to high national ranks. Ranks vary between Priories, however, and it is hard to generalise the structure too much from an international perspective.

St. John Ambulance in England and Wales

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 duties 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 English priory, 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. These are further subdivided into Areas (if the county is big enough to warrant it), and from there into Divisions, of which members join.

Within England, the ranked nature of the organisation has been reviewed in recent years. It was felt inappropriate that members who held high rank but low clinical qualification were able to hold authority over doctors and other healthcare professionals with little or no rank. As such, a move away from rank towards clinical governance has taken place, and whilst rank has been retained, it has taken a back step into a more ceremonial nature. Since the St. John Ambulance Brigade as a title ceased usage in 1968, the lowest rank has been changed to just "Member" or "St. John Member".

Additionally, the voluntary nature of the organisation makes strict observance of military rank difficult. These days, first names are generally used by those of all ranks, and formal titles such as 'Sir' are seldom heard. Similarly, members can still receive basic drill instruction, and parade is occasionally used for formal occasions with saluting, marching and falling in and out of order. Unlike a military organisation, however, this is largely regarded as eye candy for the public than to instill strict obedience.

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 HSE, through to advanced Emergency Ambulance Attendant training which covers many of the competencies of the National Health Service Ambulance Technicians. Members are also required to attend Manual Handling and Casualty Handling courses run by the organisation before being permitted to attend public duties. Once qualified, they are free to volunteer their time in public duty, covering a variety of public events such as major football matches, concerts and gigs, smaller community events such as 'fun days', and even (qualifications permitting) crewing of emergency ambulances. As a rule they are not paid for their time on duty, although expenses are met whenever possible.

Beyond these, members can train in additional medical skills, such as administration of medical gases, and use of an Automated external defibrillator. For those wishing to go further still, the organisation runs two internal qualification courses known as Ambulance Aid levels 1 and 2. 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 perform patient transport duties (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.

St. John Ambulance owns a large number of flexible ambulances and transportation vehicles for PTS (Patient Transport Services) and emergency use. The recently designed Mark-4 Crusader is a highly versatile and professional blue-light emergency ambulance based on the Renault Master, which can be used in many situations by ambulance qualified members.

St. John Ambulance also runs courses for external individuals, in a variety of different skills and medical issues. The FAW (First-Aid At Work) course is used by many companies to train designated individuals as first-aiders, as required by employment laws. St. John Ambulance 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.

During 2004 St. John Ambulance volunteers in England helped over 128,000 patients, and the fleet of around 1,300 vehicles travelled over 900,000 miles supporting St. John Ambulance's First Aid and care work.

Youth within the organisation

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 sets are provided for younger children aged 6 to 10. These groups are similar to the scouts, although there is obviously 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.

Awards and Programme
Autumn 2004 saw the introduction of a new programme of training and activities for Badgers, Cadets and Youth (any member aged between 16 and 25 inclusive). This programme implemented new changes for the 'Super Badger Award' and 'Grand Prior Award', whilst also launching a new 'Amalfi Challenge Award'.

=Super Badger Award
= St. John Badgers involved in Badger Groups work ultimately towards their 'Super Badger Award'. This award consists of members completing 12 subjects in "Absolutely Everything!" The award is split into 5 sections:
  • Welcome Paw
  • Bronze Paw
  • Silver Paw
  • Gold Paw
  • Super Badger Award

=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 after around 50 years of retaining the previous programme. The award consists of completion of 24 subject areas over the period of cadet membership, and until the age of 21. There is no maximum time limit (other than age restricitions) upon completion of the award, however the award cannot be completed in less that 3 years from the commence date. The subject areas are vast and 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 the only badge, along with the Amalfi Challenge Award Badge, 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 Award
= 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 goals set by the individual. These subjects are categorised into service, relationships, society and challenge. Each participant has to undertake 12 subjects and at completion of 4, 8 and 12 subjects a badge is awarded.

Youth Leadership
Cadets in St. John Ambulance are encouraged to attend Young Leader Courses. These courses are progressive and intended to give Cadets the skills to take a more active role within their Divisions. "Leadership 1" teaches skills which enables Cadets to be promoted to NCOs (Cadet Corporal and then Cadet Sergeant) within their divisions and wear their rank on their uniform. They can then progress and attend a "Leadership 2" course at which they can further their skills. This second course is a necessary requirement for promotion to the rank of Leading Cadet.

LINKS Units
For members at university, there is often the option to join a LINKS unit at their university. These 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. Today, LINKS is one of the fastest growing sections of St. John Ambulance, and many LINKS members are completely new to St. John Ambulance when they join at university.

LINKS units differ from other sections in that they do not use a rank structure, instead having a democratically elected committee, in line with the constitutions of many Student Unions for student societies.

LINKS units offer Student Health Care Professionals the unique opportunity of working with qualified doctors and nurses, practicing more advanced pre-hospital skills with one-to-one support. Students can be seen at many large first-aid duties like music festivals, firework nights and street carnivals.

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 on duty, both for identification and to generally present a professional image. It is protected by law and may only be worn by registered and qualified members. Unlike many volunteer groups, the St. John uniform is relatively formal, and is similar to a British Police uniform -- for which they 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 (PTS), 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 for 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.

These days, high visibility garments, worn over the uniform, are sometimes required for outdoor duties, 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 divisions have adopted it for all duty work (see the Controversies section).

Uniform, equipment and kit are supplied by St. John Supplies, the trading wing of the organisation. This group sells First Aid and Health and Safety products both to members, divisions and the general public, and profits are returned to the organisation as a whole. Certain items are restricted to purchase by members, such as the uniforms.

In addition to the standard uniforms, LINKS units have an exception to wear their own uniform designs. Usually these consist 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 is 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. This uniform is strictly restricted to LINKS members, and all other adult members, and LINKS members not covering on-campus events almost always have to wear No.5 uniform (operational). In the West Midlands, however, LINKS members wear polo shirts to several non-LINKS duties, including the Birmingham Carling Academy nightclub.

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

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 either the monarchy or the Christian faith. Cadet members do still make this pledge, however this is again largely seen as tradition.

St. John Ambulance enjoys very positive relations with the Red Cross, with which they often serve alongside. However, St. John Ambulance places a greater focus on first aid training and duty, 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 defacto guide for emergency first aid.

Controversies

One of the major disagreements between members is that of the uniform. Many feel it 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 and even 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 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 ambulance trained. Because most 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.

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 in the British Forces

St. John Ambulance now has British divisions running in areas where there is 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 it 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" which shows that they are directly linked 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 (AA2); however, in addition to gaining their FAW certificate, they are able to undertake certain elements of the AA2 including Medical Gases, Pre-Hospital Fracture Management, 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 current have several ambulances available for public service. The latest addition to their fleet was a donated ambulance on loan from APMS Services in the UK, which work in tandam with British Forces St. John Ambulance. 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 only just provide medical cover events for British Forces Communities, 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 in Canada

In Canada, St. John Ambulance (SJA) has become a very well known organization and today is the most successful non-profit first aid training organization, world wide. In Canada, SJA is divided into two major groups, the Branch and the Brigade.

The Branch focuses on training the general public and depending on the province, offers courses from Emergency First Aid to the level of Emergency Medical Responder or First Responder, the first level of advanced medical care.

The Brigade in Canada is very similar to that in England, Brigade members in Canada bear very much the same uniform, and are trained to what is known as the Brigade Training System (BTS). A new program in Canada, however, is changing this. The Advanced Medical First Responder-1 (AMFR-1) is an advanced level of first aid, allowing members to perform first aid individually and giving them more advanced skills to better serve the public.

Youth in SJA Canada are a very important part of the organization as well. The proficiency program allows youth members to gain the Grand Prior's award, as well as work toward the Duke of Edinburgh's Award. The program is designed to meet the requirements of the Grand Prior's Award, and also give youth valuable life skills. In addition to this, youth members are given the opportunity to perform community service and patient care, provided that they are supervised by adult members and hold a valid Emergency First Aid certificate or higher.

In times of emergency, SJA Canada is on standby, waiting to provide Disaster Relief and Emergency services to the area. Exactly what procedure is taken greatly depends on what area a division or member resides in and varies due to training and availability or supplies and equipment.

www.sja.ca is the national website, but you can search if there is a St. John Ambulance division in your area.

St. John Ambulance in New Zealand

A branch of the St John Ambulance was first founded in Christchurch, New Zealand in 1885. Branches quickly spread across the country providing first aid and patient transport and in 1945, due to the efforts of St John in New Zealand during the Second World War, the organisation was elevated to a full Priory, with the Governor-General of New Zealand as the Prior.

During the 1970s and 1980s much restructuring took place in response to changing social and economic conditions, moving away from the traditional militaristic structure and resulting in the current modern organisation.

Today, St John New Zealand is a major health service provider in New Zealand. They provide around 85% of the emergency and non-emergency ambulance cover for the New Zealand population, emergency care and first aid at public events, support phonelines for the elderly and house-bound, hospital patient transport, public first aid training, health products and a successful youth programme.

St. John Ambulance Australia

Main article: St John Ambulance Australia

On the 13 June 1883 a public meeting was held in the Melbourne Town Hall to form a local branch of the association. By the end of June 1883, a centre had been established under the leadership of Edward Neild. The first Australian division of the St John Ambulance Brigade was established at the Sydney suburb of Glebe in 1903. In 1987, the organisation adopted a single public title, "St John Ambulance Australia".

St. John Ambulance Australia is Australia's leading provider in emergency first aid services, and showed this when a team of 5000 members helped treat 1500 casulties at the Melbourne 2006 Commonwealth Games.

Hong Kong St. John Ambulance

Hong Kong St. John Ambulance has been serving the community since 1884. It is dedicated to provide first aid and ambulance services in emergency, dental care for the handicapped, and courses of instructions on first aid and home nursing for the general public.

After the handover in 1997, the organisation answers directly to the Chief Executive of Hong Kong. As from 2005, the Chief Executive is Donald Tsang. The organisation has since been running on an independent basis from the UK.

The Hong Kong Island Headquarters is at 2 Macdonnell Road, which has been reconstructed to accommodate a hotel to guarantee a financial income.

The Kowloon headquarters is located next to Kowloon Hospital, and to date has a footdrill ground and simple classrooms for activities.

The New Territories' headquarters is located in Fan Ling.

Ambulance and Nursing Cadets

These are organised so that the cadet divisions are attached to their own schools.

Controversies

The uniform of the Hong Kong St. John Ambulance Cadets is still made of thick material similar to the historical British counterpart, and includes a jacket designed to withstand temperatures at around 5°C in its winter uniform. This may be deemed unsuitable for Hong Kong's sub-tropical climate, where winter temperatures rarely fall below 10°C, sometimes going up above 20, and summer temperatures regularly exceeding 30°C.

St. John Ambulance in India

St. John Ambulance (SJA) was established in India in 1873. In 1912 the St. John Ambulance Association was granted autonomy and the Council was established. The first Nursing Division was established in 1913. The first Cadet Division was established in 1925. Prior to 1934, St John Ambulance and the Indian Red Cross maintained separate identities although they undertook joint relief work. The two organisations became affiliated in 1934 to ensure harmonious relations between the two bodies, to avoid overlapping and to ensure that ambulance work was given its rightful place in conjunction with Red Cross responsibilities. At independence in 1947, the Indian St. John Council was granted entire control over the work that was being carried out by 526 Divisions. St. John and the Indian Red Cross share a joint headquarters and staff in Delhi. There are now more than 2,000 St. John Ambulance Divisions in India. There are particularly active organisations in the states of Maharashtra, West Bengal, Tamil Nadu and Karnataka.

Activities

SJA programmes in India include: Public Duties, permanent First Aid Posts at railway stations and bus stations, First Aid training for commercial and industrial students and members of the public. training of Police Force and personnel in other public organisations, home nursing training, community health care, immunisation work, the blood donation service, disaster preparedness to supplement medical services in emergencies and war, and ambulance services. St John members also work at government homes children in Chennai (Madras) and they are active in eye hospitals and caring for the aged in Kolkata (Calcutta). In Tamil Nadu, the State Government insists that all commercial drivers hold First Aid certificates, and St. John Ambulance runs 93 types of First Aid course in the State.

Youth

There are currently around 10,000 Cadets in India.

International Links

St. John India has links with the Priory for Wales and Greater Manchester since a training visit in 1994.

The Ophthalmic Hospital in Jerusalem

Another foundation the Order of St. John maintains is the, The Ophthalmic Hospital in Jerusalem which provides comprehensive patient care and nursing treatment to sufferers from eye disease in the Jerusalem region.

Key dates within the history of St. John Ambulance

  • 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
  • March 1922: Cadet units are started
  • 1968: The Association and Brigade merge to form a unified St. John Ambulance
  • January 1987: Badger sets introduced to celebrate 100 years of the Brigade

See also

External links

Official and international websites

Other related websites

First aid | Voluntary organisations | Health charities in the United Kingdom | Youth organisations of the United Kingdom

Johanniter-Unfall-Hilfe | Johanniter-Unfall-Hilfe

 

This article is licensed under the GNU Free Documentation License. It uses material from the "St. John Ambulance".

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