FOI 26-377 Regulations and Frameworks

Freedom of Information Request

Reference
FOI 26-377 Regulations and Frameworks
Request Date
21 Aug 2026
Response Date
16 Sep 2026
Information Requested
  1. Legal and regulatory framework - the principal legislation and statutory instruments under which SAS operates and is supervised, and the body responsible for its oversight, licensing and quality regulation.
  2. Provision and financing - the funding streams for the service, and any recorded information on whether and how ambulance services are commissioned from third parties.
  3. Digital devices and technology - the electronic patient record (ePCR) system(s) currently in use; the standard mobile or digital devices issued on frontline vehicles; and any recorded information on telemedicine and clinical decision-support software in operational use.
  4. Vehicles and deployment - the vehicle standards applied (for example BS EN 1789) and the operational response models in use (for example paramedic-crewed ambulances, single responders, HEMS, community first responders).
  5. Workforce and qualifications - the clinical role and grade structure of operational staff (for example ambulance care assistant, technician, paramedic, specialist/advanced/consultant paramedic), the corresponding Agenda for Change bands, and HCPC registration requirements.
  6. Clinical directives and guidelines - the clinical guidelines or protocols governing non-physician staff (for example adoption of JRCALC), and the framework under which medicines are administered (for example Patient Group Directions and paramedic exemptions).
  7. Control room, dispatch and response times - the emergency number(s) and the triage/dispatch system used (for example AMPDS or NHS Pathways), and the current response-time standards or targets for the highest-acuity calls, together with the defined start and stop points of the response interval.
Response
  1. Legal and regulatory framework - the principal legislation and statutory instruments under which SAS operates and is supervised, and the body responsible for its oversight, licensing and quality regulation.

The Scottish Ambulance Service (SAS) is a Special Health Board of NHS Scotland, established under the Scottish Ambulance Service Board Order 1999 and operating within the wider framework of NHS Scotland legislation, including the National Health Service (Scotland) Act 1978 and subsequent amendments.  SAS is accountable to the Scottish Government Health and Social Care Directorates through NHS Scotland governance arrangements. The Board is appointed by Scottish Ministers and is responsible for the strategic direction and governance of the Service.  The quality and safety of NHS services, including those provided by SAS, are subject to scrutiny and inspection by Healthcare Improvement Scotland (HIS), Scotland's national healthcare improvement and assurance body. 

 

  1. Provision and financing - the funding streams for the service, and any recorded information on whether and how ambulance services are commissioned from third parties.

The Scottish Ambulance Service is primarily funded through NHS Scotland allocations provided by the Scottish Government. Information on the Service's funding, expenditure and annual accounts is published in the Scottish Ambulance Service Annual Report and Accounts.  The Service also commissions certain transport and support services from third-party providers where operationally required. Such arrangements are governed through formal procurement and contract management processes. Information on specific contracts is published through Public Contracts Scotland where applicable. 

  1. Digital devices and technology - the electronic patient record (ePCR) system(s) currently in use; the standard mobile or digital devices issued on frontline vehicles; and any recorded information on telemedicine and clinical decision-support software in operational use.

The Scottish Ambulance Service's electronic Patient Report Form (ePRF) solution is provided by Terrafix Ltd and is known as TerraPACE3. Recorded information held by the Service refers to the use of this platform for electronic patient record management.  

The Service deploys ruggedised tablet devices as standard across frontline vehicles. These are manufactured by GETAC and support operational and clinical applications, including the ePRF system. 

Telemedicine and clinical decision-support functionality is provided through the Priority Dispatch ProQA system and may be supplemented by the Manchester Triage Tool where clinically appropriate. 

  1. Vehicles and deployment - the vehicle standards applied (for example BS EN 1789) and the operational response models in use (for example paramedic-crewed ambulances, single responders, HEMS, community first responders).

The Scottish Ambulance Service operates vehicles that are designed and equipped for emergency and patient transport purposes and are maintained in accordance with applicable legislation, regulatory requirements and relevant industry standards, including: 

  • The Road Vehicles Lighting Regulations 1989 (as amended) 
  • Relevant European standards (CEN) 
  • BS EN 1789:2020+A1:2023 (Road ambulances and their equipment) 

The Service employs a range of response models to meet patient needs across Scotland. These include: 

  • Double-crewed ambulance resources. 
  • Single-crewed ambulance and rapid response vehicles. 
  • Specialist paramedic response units. 
  • ScotSTAR retrieval and transfer services, including neonatal, paediatric and adult critical care transport. 
  • Air ambulance and Helicopter Emergency Medical Service (HEMS) responses delivered in partnership with relevant providers. 
  • Community First Responders who provide an early response to certain emergency incidents within their local communities. 

Resource deployment is determined according to operational demand, clinical need, geography and service requirements. 

 

  1. Workforce and qualifications - the clinical role and grade structure of operational staff (for example ambulance care assistant, technician, paramedic, specialist/advanced/consultant paramedic), the corresponding Agenda for Change bands, and HCPC registration requirements.

The Scottish Ambulance Service employs a range of operational staff to deliver emergency, urgent and scheduled care services. Operational roles include, but are not limited to: 

  • Ambulance Care Assistant (ACA) 
  • Ambulance Technician 
  • Newly Qualified Paramedic 
  • Paramedic 
  • Specialist Paramedic 
  • Advanced Practitioner/Advanced Paramedic roles 
  • Consultant Paramedic roles 

These roles are employed under the NHS Scotland Agenda for Change pay framework, with grades varying according to role, responsibilities, qualifications and scope of practice. 

Where a role requires registration as a paramedic, staff must maintain registration with the Health and Care Professions Council (HCPC) and comply with HCPC standards of proficiency, conduct, performance and ethics. Technician and Ambulance Care Assistant roles are not currently subject to statutory HCPC registration requirements. 

Information on current HCPC registration requirements for paramedics is available at: https://www.hcpc-uk.org 

  1. Clinical directives and guidelines - the clinical guidelines or protocols governing non-physician staff (for example adoption of JRCALC), and the framework under which medicines are administered (for example Patient Group Directions and paramedic exemptions).

The Scottish Ambulance Service uses the UK Ambulance Service Clinical Practice Guidelines (JRCALC), which are publicly available at: https://www.jrcalc.org.uk 

Medicines are administered in accordance with the legal frameworks available to registered clinicians, including Patient Group Directions (PGDs), exemptions provided under the Human Medicines Regulations, and independent prescribing arrangements where applicable. 

  1. Control room, dispatch and response times - the emergency number(s) and the triage/dispatch system used (for example AMPDS or NHS Pathways), and the current response-time standards or targets for the highest-acuity calls, together with the defined start and stop points of the response interval.

Emergency calls are received via the 999 emergency telephone service and are clinically prioritised using the Scottish Ambulance Service's Clinical Response Model (CRM). The model categorises incidents according to clinical need as Purple, Red, Amber, Yellow and Green. Purple and Red categories represent patients with the highest risk of life-threatening illness or injury. 

The Service uses structured call-taking and triage processes to assess patient need, determine priority and dispatch the most appropriate resource. 

The current national response standard for the highest-acuity incidents (Purple calls) is a median response of 7 minutes. The Clinical Response Model was designed to prioritise these immediately life-threatening incidents while ensuring an appropriate response is provided to patients with lower-acuity conditions. 

 

For performance reporting purposes, response time is measured from the time an incident is categorised following call assessment to the time the first responding resource arrives at the scene. Reporting is based on the incident category assigned through the Clinical Response Model.  More info can be found on our website - Unscheduled Care Operational Statistics 

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