Each year, Remembrance Sunday invites us to remember with pride those brave individuals who lost their lives during times of conflict. At poignant ceremonies across the UK and beyond, the poppy remains a powerful symbol of the First World War. Over time, it has also come to represent all British and Commonwealth military personnel who have died in conflict, including the Second World War and in more recent times. On this solemn day, we think about the courage, sacrifice and humanity of the armed forces, medics, volunteers and ordinary people of years gone by. This includes the selfless first aiders who rescued, treated and comforted the wounded, without expecting personal recognition.
The story of the ambulance drivers, first responders, St John’s Ambulance volunteers and paramedics who followed soldiers fearlessly into battle is interwoven with patriotic wartime service, civic duty and the evolution of medical care itself.
Humble Beginnings: Horse-drawn Carriages and Volunteers
Patient transport has existed for centuries. For example, in medieval times, there was no formal battlefield medical system, but horses were frequently used to carry the injured to safety. Supported on a makeshift stretcher attached between two animals, the wounded were placed on a frame (known as a travois) and dragged behind a horse or packed into a basic cart with other fallen soldiers.
In Britain, the earliest organised ambulance service was launched in 1867 by the London Metropolitan Asylum Board. Funded by the Hospital Carriage Fund, it started with horse-drawn carriages designed for transporting infectious patients to fever hospitals during outbreaks of smallpox and cholera. In 1879, the Metropolitan Asylums Board had six horse-drawn ambulances to serve the whole area, with each hospital maintaining its own carriage.
St John Ambulance, founded in 1877 by the Venerable Order of St John, began by training ordinary people in first aid. Stretchers and healthcare equipment were kept within local communities, where trained volunteers could respond to accidents and injuries. The simple equipment started with one bandage, a stretcher and a wheeled litter, but soon expanded into providing ambulance services at public events, accidents and emergencies. Volunteers were motivated by compassion and the belief that ordinary people could make a difference.
History of Paramedics
When war came, the ambulance services were tested in ways no civilian could foresee. During the First World War, organisations such as Voluntary Aid Detachments, St John’s Ambulance and the Red Cross were thrust into frontline service. They staffed casualty stations, drove ambulances, nursed the wounded and transported soldiers from battle zones to field hospitals. Many of the early ambulance workers were women and volunteers, risking their lives amid bombardment.
Motorised ambulances began to replace horse‑drawn carriages during WWI, revolutionising casualty evacuation. During WWII, the integration of civil defence, air-raid protocols and civilian medical services brought even more demand for transport. During the Blitz, beginning in September 1940, St John Ambulance and the British Red Cross were coordinated by the Joint War Organisation to provide ambulances, first aid posts in bomb shelters and casualty transport under blackout and bombardment. St John’s volunteers including ambulance drivers, first‑aiders and stretcher-bearers served both military and civilian casualties. Many were decorated for bravery after the war.
The Rise of the Paramedic
A pivotal moment in ambulance history came in 1948, with the founding of the National Health Service. For the first time, Britain committed to care for all residents free of charge. Ambulances would no longer be a stand-alone service driven by volunteers, but rather integrated into the NHS. Local authorities were responsible for ensuring emergency ambulance provision, with voluntary services such as St John’s providing assistance.
Over the decades, the ambulance service evolved and training standards became more rigorous. Initially, ambulance crews were trained to transport and stabilise, carrying oxygen, basic splints and bandages, but as medical science advanced, they began to carry more equipment, administer medication and perform advanced lifesaving procedures in transit. Although regulated training took years to formalise, the seeds of the role appeared in the 1960s and 1970s, when some ambulance staff began to take on expanded responsibilities beyond conveyance, carrying breathing apparatus and oxygen. In contrast, modern paramedics have defibrillators, ECG machines, advanced airway tools, pulse monitors and a cabinet of drugs.
Vehicles, Equipment and Uniforms then and now
In London’s ambulance museum collection, you can still see horse-drawn carriages alongside early motorised vehicles. In 1904, the first petrol ambulance travelled at speeds of up to 15mph. Gradually, they became faster and more reliable. Over the decades, they were fitted with radios, lighting, emergency sirens and much more. Control rooms evolved from simple despatch boards to digital systems linking 999 calls to paramedics in the field.
Volunteers once wore simple uniforms or plain clothing, but as services became more professional, distinct uniforms signified role, rank and specialisation. Today’s paramedics wear protective, practical, functional gear such as high-visibility jackets, durable boots and, importantly, gloves to improve safety. Medical standard disposable vinyl gloves, nitrile gloves and latex gloves protect both caregivers and patients from cross-contamination, infection and bodily fluids, providing a barrier against harmful bacteria and symbolising care and safety, in the same way that PPE for doctors and nurses evokes a sense of trust and professionalism in hospitals.
The 999 Emergency Number
Prompted by a tragedy in 1935, when five women died in a house fire because calls to fire services were blocked when the line was engaged; the unique 999 emergency telephone number was introduced in 1937, allowing people to summon fire, police, or ambulance in one unified system. Over time, 999 has become integral to British emergency response. Automation, mobile phones and digital systems have enhanced its reach and speed. By 1976, the automatic system expanded nationwide, and by 1986, mobiles could dial 999 directly. The emergency number turned the fragmented network of volunteer and local ambulances into a coordinated, responsive emergency service.
Remembering the Ambulance Service Pioneers
Today, the ambulance service may be the youngest of the UK’s three main emergency services, but it is vital. Demand is immense, resources are stretched and every call is a test of professionalism and resilience.
From horse-drawn carriages to electric ambulances, one constant remains; the brave people who answer the calls, or who rush in to treat the injured in conditions of stress, danger and heartbreak, whether on the battlefield, or during a house fire.
On Remembrance Sunday, we honour not only those who died in uniform, but those who served behind them - the ambulance drivers, paramedics and volunteer first-aiders whose roles were quiet but indispensable. Their work saved lives and today, their legacy carries on. Their sacrifice, courage and kindness will inspire others, as we remember their vital role through the ages at this year’s Remembrance Sunday services.
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