First fully electric ambulances cutting carbon emissions from patient transport in England

Context

More frequent and severe floods and heatwaves, and worsening air pollution are among the impacts the UK is already experiencing as a result of the changing climate. Outdoor air pollution is responsible for between 28,000 and 36,000 deaths in the UK every year, leading to and worsening a range of health problems, including increasing incidence of – and hospital admissions for – respiratory and cardiovascular diseases.

The National Health Service (NHS) in England provides publicly funded health services – including hospital, ambulance, community, mental health and primary care – and is Europe’s largest employer. NHS England provides national leadership for the NHS.

In October 2020 the NHS became the world’s first health system to commit to reaching net zero emissions with two targets, to be net zero by 2040 for emissions the NHS directly controls and to be net zero by 2045 for emissions that the NHS influences.

The NHS has the second largest fleet (after Royal Mail) in the country, consisting of more than 20,000 vehicles travelling over 460 million miles every year.

The first purpose built, fully electric ambulance to respond to emergency 999 calls went out on its maiden voyage from the London Ambulance Service on New Year’s Eve 2023.

 

Implementation process

The new bespoke ambulance is reducing operational costs incurred from fuel and maintenance, as well as improving air quality for Londoners to help reduce the prevalence of major diseases in the capital.

The vehicle is one of at least twelve fully electric ambulances that will be piloted by NHS England in partnership with London Ambulance Service and four other ambulance trusts and will enable the collection of “real-life” data. This will be used to inform the wider rollout of zero emission emergency ambulances in the future.

Daniel Elkeles, Chief Executive at London Ambulance Service (LAS), said:

“This is a game changer for ambulance designs across the world.

“We’ve had electric patient transport vehicles and support vehicles, but until now we haven’t had an electric ambulance responding to life-threatening emergencies in London.

“Not only will these ambulances help us deliver outstanding care to our patients, they are critical to our efforts to cut our environmental impact and play our part improving London’s air quality.”

 

Lessons learned

The scale, complexity and operational planning model of ambulance fleets means greater support is likely to be required to support electrification.

To build on the success of these initiatives, the NHS Travel and Transport Strategy sets out that all ambulance trusts will:

• Plan effectively - develop a sustainable travel strategy. These should include an infrastructure requirement assessment, including recharging.
• Innovate and evaluate - conduct pilots of the first suite of zero emission ambulances followed by evaluation and at-scale transformation. This will ensure continuation of high levels of patient safety, while delivering wider rollout.
• Update specifications - work with the National Ambulance Programme Board to develop and publish new national specifications for zero emission dual crewed ambulances and rapid response vehicles.
• Sustainable procurement - integrate the purchasing of zero emission vehicles into procurement practices.

 

Challenges

Ambulances and other emergency response vehicles play a critical role in providing emergency care and must always be able to respond rapidly. To enable this, these vehicles have distinct operational demands, vehicle design specifications, and associated infrastructure requirements. As such, the interventions outlined in the NHS Net Zero Travel and Transport Strategy for ambulances ensure the continuation of high-quality care and patient safety, whilst enabling the necessary innovation and evaluation in the transition to electric emergency vehicles.

Success factors

The new vehicles are lightweight and include more accessible features for crews to convey patients with a powered trolley bed system, a powered carry chair and an integrated scanning system that scans the vehicle and informs the crews whether the ambulance is fully stocked after each patient they’ve treated. There is also enough battery capacity to keep the ambulance operational throughout each 12-hour shift.

As part of its programme to renew its fleet with greener vehicles, London Ambulance Service are working with hospitals, including Guys and St Thomas’ Hospital and Kings College Hospital, to provide high-powered electric vehicle charging ports so crews can charge their vehicles at hospitals. London Ambulance Service also now has 56 charging stations at ambulance stations for their electric vehicles.

 

Key resources

• NHS England Net Zero Travel and Transport Strategy
• NHS England Net Zero Travel and Transport Roadmap