In the ever-evolving landscape of ambulance services, effective leadership emerges as the crucial element driving teams towards success—especially amid the challenges of emergency situations, collaborative efforts across multiple agencies, and the ongoing pursuit of service enhancement. Paramedic leaders, tasked with influencing, guiding, and inspiring their teams, are instrumental in guaranteeing the smooth execution of critical missions (Future Leaders Study, 2009).
Leadership is not confined to the realms of management or administrative positions; it is a quality inherent in individuals across diverse roles. It is crucial to recognise that leadership embodies the spirit of catalysing change, whereas management and administration primarily focus on upholding established systems. Despite occasional negative perceptions associated with the term ‘management,’ particularly in the public sector, the concept of leadership presents a more optimistic viewpoint.
This perspective invites everyone, transcending traditional boundaries, to actively contribute to valuable initiatives like service reform. Hence, anyone willing to instigate change and partake in constructive endeavours can be considered a leader (O'Reilly and Reed, 2010). As we enter an era marked by the transformative impact of technology on healthcare, the incorporation of artificial intelligence (AI) introduces novel dimensions to the leadership conversation within the field of paramedicine.
Leadership principles within UK ambulance services
The leadership principles within the UK ambulance service are centred around several strategic points. These include enhancing leadership skills and abilities (Future Leaders Study, 2009), which involves filling gaps in leadership, as well as training and pinpointing crucial areas that can transform the service. There is a strong focus on investing in the growth of future leaders, considering opportunities for leadership development at both individual trust levels and within the wider healthcare system.
The Association of Ambulance Chief Executives (AACE) (2020) advocates for leaders to develop a collaborative approach to delivering urgent and emergency care, making ambulance services essential partners. The AACE highlights the importance of teamwork in improving service delivery and solidifying the relationship between ambulance services and other healthcare providers. The primary goal is improving services, requiring active engagement with stakeholders such as the community, service users, staff, service commissioners, and partners. The ultimate aim is to enhance the services available to the community (NHS England, 2023). Leaders are also tasked with guiding the service through changes and challenges, including the ongoing effects of COVID-19, in line with their future vision (Hopson and Mochrie, 2021). Collectively, these directives contribute to a broader vision of transforming ambulance services into a comprehensive mobile health resource for patients and the NHS as a whole (Future Leaders Study, 2009).
Integrating AI into UK ambulance services
Several initiatives are underway in the UK to integrate AI into ambulance services. The Welsh Ambulance Services NHS Trust is collaborating with Corti.ai to use AI to detect critical illnesses during emergency calls. The Assuring Autonomy International Programme at the University of York is working on a project called ASSIST (Assuring Safe Artificial Intelligence in Ambulance Service 999 Triaging). This project aims to improve the chances of surviving an out-of-hospital cardiac arrest by using AI to support ambulance service call centre staff. Additionally, the Northern Ambulance Alliance (NAA), a partnership between the four northern Ambulance Services, has initiated work to develop its thinking on the potential uses of AI support for ambulance services.
Collectively, these initiatives aim to leverage AI to enhance the efficiency and effectiveness of ambulance services, underscoring the transformative potential of AI in healthcare, particularly in urgent and emergency care scenarios. The future of healthcare is evolving, and these pilot projects mark a significant step forward in this transformative journey.
A global effort
The Global AI Safety Summit (2023) focused on three main goals: promoting a shared understanding of the risks associated with advanced AI, identifying potential areas for collaborative AI safety research, and showcasing how the responsible development of AI can contribute to global welfare. A major achievement of the summit was the Bletchley Declaration, signed by 28 nations, including the USA, China, and the European Union. This declaration emphasises the necessity of an international commitment to researching, comprehending, and mitigating the risks posed by cutting-edge AI technologies. It recognises that realising the potential benefits of AI requires a coordinated, global effort. The relationship between the Global AI Safety Summit and the UK ambulance service might not be immediately evident. However, it can be argued that the summit's goals and outcomes are pertinent in mitigating the risks posed by cutting-edge AI technologies for the future of public safety and emergency services.
Need for national guidance
Ensuring effective coordination between leadership and AI technologies in the UK ambulance services is vital. The absence of national oversight could result in several issues. There is potential for duplication of efforts; each region might end up independently solving the same problems and wasting resources. A national working group could help share solutions and best practices across regions. Without a national team, there might be inconsistencies in how AI technologies are implemented and used across different regions. This could lead to variations in service quality and patient outcomes. Some regions might have more resources to invest in AI technologies than others, leading to disparities in service quality. A national team could help ensure equitable resource allocation. Ensuring compliance with national and international regulations could be more challenging without a national team to oversee this aspect. Managing the changes brought about by the implementation of AI technologies could be more difficult on a regional level without the support and guidance of a national team.
Therefore, while regional teams are essential for addressing local needs and contexts, a national team could be crucial in ensuring a coordinated, effective, and equitable implementation of AI technologies across UK ambulance services. Ideally, the national team overseeing AI implementation in the UK ambulance service should be multidisciplinary, comprising individuals with diverse expertise. This team would work together to ensure that AI technologies are implemented safely, effectively, ethically, and legally—ultimately improving the quality of care the UK ambulance service provides.
Digital maturity
Drawing insights from the annual Digital Acceleration Index (DAI) conducted by The Boston Consulting Group (BCG) (2021), it becomes evident that digital maturity is a key determinant of organisational success. The study identifies ‘bionic’ companies at the forefront of digital advancement, consistently outperforming their peers in key performance indicators. Notably, transparent governance structures emerge as a hallmark of these high-performing entities, emphasising the importance of clear ownership and accountability in driving digital initiatives. The application of this governance model is particularly critical in the context of AI implementation within emergency medical services, as underscored by the BCG (2021) findings. Aligning with these insights, the establishment of a national oversight team for AI implementation in the UK ambulance service becomes imperative, providing a centralised and transparent governance framework for clear ownership and accountability in AI initiatives.
Advancing healthcare through AI integration
Leaders must grasp the potential advantages and risks, as well as how AI aligns with strategic plans within ambulance services. Communicating this understanding within the organisation is crucial for establishing a shared vision. There is also a need to dedicate ample resources, encompassing funding, skilled personnel, and technological infrastructure, to ensure the success of AI projects. Ethical issues surrounding AI, including data privacy, bias, and transparency, and guaranteeing the responsible development and deployment of AI systems with suitable controls and precautions, also require consideration. Leadership in AI integration goes beyond the immediate gains; it is about setting a trajectory for sustained progress.
While several initiatives are exploring the use of AI in ambulance services, it is unclear if a specific national workstream has been established to oversee AI integration within the UK ambulance services. The establishment of this national workstream would signify a commitment to a coordinated, responsible, and practical approach to AI integration. It would be a step towards positioning ambulance services at the forefront of technological innovation in healthcare.
In essence, the establishment of a national workstream dedicated to AI integration in the UK ambulance service is not just a technical endeavour but a commitment to advancing healthcare through innovative means. It is a forward-looking initiative that acknowledges the transformative potential of AI and seeks to position ambulance services as pioneers in adopting cutting-edge technologies for the benefit of patients and communities. This cohesion is vital—not just for the seamless integration of AI but also for fostering a culture of shared learning, continuous improvement, and leadership excellence in healthcare.