National ambulance vehicle

specification for English NHS

ambulance trusts
Proposal for consultation
December 2018
We support providers to give patients
safe, high quality, compassionate care
within local health systems that are
financially sustainable.
 Contents
Introduction .................................................................................... 2
Purpose ................................................................................................................. 2
Context .................................................................................................................. 2
Standard specifications ......................................................................................... 2
National specification for a standard emergency double-crewed
ambulance ..................................................................................... 3
Definition ............................................................................................................... 3
Adoption ................................................................................................................ 3
Part 1: Base vehicle ....................................................................... 4
Part 2: Conversion ......................................................................... 7
A. General requirements ....................................................................................... 7
B. Body exterior ................................................................................................... 18
C. Technology ..................................................................................................... 19
D. Cab requirements ........................................................................................... 23
E. Saloon requirements ....................................................................................... 24
F. Emergency lighting and switches .................................................................... 31
G. Vehicle inventory ............................................................................................ 34
H. Vehicle markings and livery ............................................................................ 34
I. Compliance verification .................................................................................... 41

1 | Contents
 Introduction
Purpose
1. This document gives the proposed national ambulance vehicle specification
for English NHS ambulance trusts, to be mandated through the NHS Standard
Contract for ambulance services from 2019/20.

Context
2. Lord Carter’s 2018 review, Operational productivity and performance in
English NHS ambulance trusts: unwarranted variations, found significant
unwarranted variation in the national ambulance fleet and a lack of innovation
at scale.

3. His review considered that the sector could benefit significantly by adopting a
standard vehicle specification and by procuring vehicles through a single
channel. These actions would drive innovation on a national scale in
partnership across the sector, and with suppliers and other expert groups.

4. This document gives the high-level specification to be adopted by all English

NHS ambulance trusts and on which national procurement activity will be
based. It will be referred to in the NHS Standard Contract for ambulance
services.

Standard specifications
5. English NHS ambulance trusts use several vehicle types, reflecting the
different services they provide. Services include, but are not limited to,
responding to urgent and emergency 999 calls and providing patient transport,
including specialist paediatric transport.

6. The specification in this document is for a standard emergency double-

crewed ambulance.

2 | Introduction
 National specification for a
standard emergency
double-crewed ambulance
Definition
1. This specification is for a standard emergency double-crewed ambulance
(DCA), which is further defined in standard BS EN 1789:2007 + A2:2014 as a
type B emergency ambulance: a “road ambulance designed and equipped for
the transport, basic treatment and monitoring of patients”.

2. For clarity, this specification excludes any specialist/adapted vehicles used

solely to provide services to specific patient groups, eg bariatric and
paediatric.

3. Due to the specific and complex nature of a DCA, trusts commonly purchase
the base vehicle and its conversion separately, and this proposed
specification is in two parts:

• part 1: base vehicle

• part 2: conversion.

4. Providing the specification in two parts allows for separate procurement while
retaining a supplier’s ability to provide a turnkey solution.

Adoption
5. This specification is the high-level minimum standard for the purchase of new
DCAs. It allows local variation within the parameters provided. We expect that
with more collaboration across the sector, such as through formal/informal
alliances, local variations will converge. Furthermore, as the vehicles, their
design and the equipment they carry develop over time, largely through
collaborative innovation, this specification will need to become more detailed
and the parameters narrowed.

3 | National specification for a standard emergency double-crewed ambulance

 Part 1: Base vehicle
1. Vehicles and equipment supplied as part of this specification must comply with
standards BS EN 1789:2007 + A2:2014, BS EN 1865-4:2012, and the
European Community Whole Vehicle Type Approval (ECWVTA) 2007/46/EC,
with reference to the national ambulance specification service-level agreement
(SLA).

2. A letter of non-objection between the base vehicle manufacturer and the

converter must be provided to demonstrate compliance with the standards
and ECWVTA.

3. Table 1 below gives the requirements for a base vehicle.

Table 1: Base vehicle requirements for an emergency DCA

Base vehicle detail Specification

Regulation compliance BS EN 1865-4:2012, BS EN 1789:2007 + A2:2-014

ECWVTA compliance Letter of non-objection between manufacturer and

converter

Noise compliance Noise emission 86/188/EEC

Dealer supply Panel van

Colour RAL 1016 yellow

Engine 180 bhp Euro6

Acceleration 0 km/h to 80 km/h in 35 seconds

Weight limit 4,250 kg (written approval from manufacturer’s HQ if

applicable)

Exterior maximum height 2,850 mm

(exc flexible aerials and
antennas)

Exterior maximum width 2,300 mm

(mirror to mirror)

Exterior maximum length 6,000 mm

4 | Part 1: Base vehicle

 Base vehicle detail Specification

Salon interior minimum 1,900 mm

height

Tilt test 38o

Gearbox Manual or automatic

Suspension Standard with auto-levelling

Alternator High performance 200 A reinforced alternator

Traction Electronic stability control

Braking Brake assist and electronic brake force distribution

Wheels and tyres 16” alloy wheels with multiseason tyres

Passenger seat Dual adjustable

Driver seat Single fully adjustable

Airbags Driver and passenger

Cab climate control Auto climate control

Provision for rear climate Climate system in saloon (possibly supplied by

control converter)

Electrical interface supply Provided for use in conversion

socket

CAN gateway interface Provided

Fog lights Provided

Screen wash system Heated, active only while engine is running

Day running lights Provided

Cab technology Bluetooth, USB charger, suitable space for data

terminal

Locking Remote central locking + third key

Engine under tray protection Additional anti-corrosion protection

Spare wheel and jack Provided

5 | Part 1: Base vehicle

 Base vehicle detail Specification

Sensors Reverse parking

Alarm Fitted

Side door Nearside sliding door with window

Back door Twin doors opening to 270 degrees

Warranty 7 years to cover use as a 24/7 ambulance

Link to converter Turnkey or free issue to converter on embodiment loan

6 | Part 1: Base vehicle

 Part 2: Conversion
1. Please note that where we refer to equipment supplier names, part numbers
and other details in this specification, this is solely for the purposes of
identifying the equipment type and the performance levels required by the
trust. There will be no mandatory requirement for a converter to include this
specific equipment in any conversion offer it submits.

2. The conversion specification has nine parts:

A. general requirements
B. body exterior
C. technology
D. cab requirements
E. saloon requirements
F. emergency lighting and switches
G. vehicle inventory
H. vehicle markings and livery
I. compliance verification.

A. General requirements
Assurance

1. Vehicles and equipment supplied as part of this specification must comply with
UK standards BS EN 1789:2007 + A2:2014, BS EN 1865-4:2012 and the
ECWVTA 2007/46/EC, with reference to the national ambulance specification
SLA.

2. A letter of non-objection between the base vehicle manufacturer and the

converter must be provided to demonstrate compliance with the standards
and ECWVTA.

3. The converter must certify that at the time of delivery the completed vehicle
with all equipment fitted fully complies with all current vehicle legislative

7 | Part 2: Conversion
 regulations, British standards and the latest CEN requirement for type B
emergency ambulances and the national ambulance specification SLA.

4. The converter will be responsible for ensuring the converted vehicles operate
legally and are fit for purpose. This will include: all aspects of liaison, warranty
and support; setting agreements; and conformity/interface matters to do with
the base vehicle and equipment manufacture.

5. The converter will be responsible for assessing the vehicle build and
requirement, and at the earliest opportunity must identify and inform the
relevant trust about all issues/problems/non-compliance that may affect the
operation/use of the vehicle.

6. The converter for each build will supply the trust(s) with an assurance manual
and statement confirming the vehicle is fit for purpose and complies with the
stated requirements.

7. No base vehicle system or circuit will be tampered with unless a written letter
of non-objection to this is provided by the base vehicle manufacturer. All
electrical systems as part of the conversion must interface with the base
vehicle manufacturer’s CANbus system. The converter is responsible for
obtaining this written permission.

Durability

8. The conversion will be designed and constructed to withstand the rigours of

use as a 24/7 ambulance with a seven-year life. Wear items are to last seven
years.

Delivery

9. The converter will produce a delivery plan and meet all agreed target
timescales for each purchase order. Both the converter and trust(s) must
agree any changes to the timescales. The converter will deliver vehicles to the
locations designated by the trust(s).

Ergonomics and design

10. The converter must ensure that the design and layout of a fully operational
vehicle are fit for the purpose of ambulance use, and minimise manual

8 | Part 2: Conversion
 handling for trust staff and patients and risk of work-related musculoskeletal
disorders for trust staff.

11. The conversion must be ergonomically designed using computer-aided design

(CAD).

Environmental sustainability and innovation

12. Technologies that can reduce the vehicle’s environmental impact will be
considered. Innovation in design is required to improve aerodynamics and to
reduce weight, the need to operate the engine on standby and fuel
consumption.

Under-body protection

13. The complete vehicle will have under-body protection applied. All fittings or
alterations carried out by the converter must be de-rusted and treated to
prevent corrosion, including electrolytic corrosion.

Water test

14. Each converted vehicle must pass a high-volume, whole-vehicle pressure

water test. This is to be certified.

Tilt test

15. Each converted vehicle must pass a tilt test in line with CEN EN 107. The
vehicle will achieve a minimum tilt of 38 degrees without its outside wheels
losing contact with the tilt bed. This is to be certified.

Assessment of handling and stability

16. A competent independent authority will have assessed the complete vehicle’s
handling characteristics (fully operational) and in its report confirmed a
satisfactory assessment of the following:

• steady-state cornering
• straight line behaviour
• obstacle avoidance
• straight line braking

9 | Part 2: Conversion
 • braking in a turn
• negotiation of speed humps without grounding
• overall confidence and safety.

Electromagnetic compatibility test

17. The converter must certify that the complete vehicle with all communication
and medical equipment fitted (supplied by each relevant trust until common
equipment is agreed) fully complies with the latest and any pending
electromagnetic compatibility requirements.

Insulation

18. All cavities between the interior and exterior body mouldings (including the
rear doors) must be filled with suitable fire-retardant thermal insulation
material to ISO 3795, fitted in accordance with the manufacturer’s
recommendations. The insulation must extend into all relevant framing
members.

Noise test

19. The converter will ensure that a fully converted ambulance does not exceed
the Control of Noise at Work Regulations 2005 (Directive 86/188/EEC) or the
current standard of the day.

20. A noise test must be completed in a variety of environments and using only
test equipment that has been registered and fully calibrated. A compliance
report should be provided giving the maximum exposure for each road speed
tested.

21. The noise test involves:

• sirens switched on
• noise levels tested from both the driver and passenger seating positions
• test completed at road speeds of 30 mph, 50 mph, 70 mph and maximum
speed
• test repeated with the driver and passenger windows open.

10 | Part 2: Conversion
 Vehicle mass test

22. The converter must test that the vehicle is not overloaded as a whole, on an
axle or on a wheel position once it is fully constructed and loaded to its
operational mass. Operational mass must meet the requirements of BS EN
1789. As a minimum the operational mass must include: a fully equipped
operational vehicle with all equipment and medical items on board; one
person weighing 75 kg on each seat and on the stretcher; and a full tank of
fuel. Each trust will provide the non-supplied equipment.

23. The converter will calculate this mass before starting production, to confirm
the required test criteria can be met and avoid unnecessary cost and time. If
the design fails any test criterion, it will be reconsidered and the test repeated
until the design passes it.

24. The following test criteria must be met:

• total operating vehicle mass <95% of the base vehicle manufacturer’s gross
vehicle mass
• total operating axle mass <95% of the base vehicle manufacturer’s gross
axle mass
• no wheel position exceeds 60% of its axle mass rating.

25. The converter must produce a compliance certificate for each vehicle
confirming:

• gross kerbside mass

• gross vehicle mass
• operational mass
• each axle mass
• each wheel position mass.

Infection prevention and control (IPC)

26. To minimise infection, surfaces inside the ambulance must be white, easy-to-
clean, without material edging and clutter free. The design will follow the
principles of one-piece design theory with no dirt or finger traps, and have a
smooth, clean and tidy appearance overall.

11 | Part 2: Conversion
 27. The converter must use materials and construction methods that can
withstand deep, rigorous cleaning regimens in line with relevant IPC
requirements. For example, surfaces should be manufactured from materials
that can withstand daily wear and resist surface corrosion under extreme
cleaning regimes. Converters should consider using materials with anti-soiling
properties to meet BS EN ISO 11378-2, and anti-bacterial/fungicidal qualities.

Latex policy

28. As far as possible the converter must achieve a Latex-free environment, and
draw attention to any area of the conversion where Latex may be used.

Electrical

General

29. Before starting to build, the converter will carry out a full and complete
electrical calculation – that is, the electrical drain when all equipment is in use
– and compare this to the alternator output over the entire engine rev range.

30. The calculation must show the vehicle equipment and control systems are
adequate and suitably designed to maintain the battery. All batteries must be
protected against deteriorating below 11.7 V.

31. Power management and load shedding systems must be provided to optimise
battery condition and protect sensitive electronic equipment, including, but not
limited to, by reducing power demand from ‘parasitics’ based on priorities
agreed by each trust.

32. The inverter should be capable of running a minimum of two 230-V three-pin
sockets.

33. A shoreline with an external IP65-rated plug must be provided at a location to

be decided by each trust.

34. The vehicle will require a ‘run lock’ security system that shuts down the engine
when the vehicle’s handbrake is released. This system will allow the base
vehicle ignition key to be removed and the vehicle locked with this key, and
allow the engine to run at a speed that ensures the alternator output meets the

12 | Part 2: Conversion
 maximum current consumption. The run lock can be activated either through
the ‘arrive scene’ mode or a specific button on the power management control
panel.

35. The converter will provide each relevant trust with detailed electrical/wiring
diagrams for each batch of vehicles.

Emergency lighting and siren

36. Emergency lighting must comply with European regulations for blue lights and
meet ECE-R-65 Class 2 compliance as a system once fitted to the vehicle.
The table in paragraph 7.2 of this standard stipulates the minimum light output
values. Measured at a vertical angle of 0 degrees and a horizontal angle of
360 degrees, these are 120 cd (day) and 50 cd (night).

37. The converter must fit an audible warning system comprising a wail/yelp/
piercer/bullhorn noise siren that faces out from the front of the vehicle but is
recessed so as not to cause injury. The minimum output from the yelp/wail/
piercer/bullhorn tone should be 100 W and be wired through and operated by
the vehicle road-horn control; a bullhorn button must also be installed for the
driver to use. For data logging of siren activity, the siren must provide an
interdomain routing output back to the power management system.

Link to base vehicle

38. The converter will be approved by the chassis manufacturer for chassis
conversion and will be responsible for ensuring that the chassis manufacturer
knows about all the installed auxiliary electrics. The converter will supply a
certificate of conformity as part of the contract document pack.

Auxiliary electrical demand

39. Although recommendations are given for minimum auxiliary battery capacities
and alternator size, the converter will be ultimately responsible for ensuring
that the auxiliary power system can support the auxiliary electrical demand on
the ambulance. In particular, supporting documentation including test data will
be supplied as part of the contract document pack on conclusion of the
contract. This will demonstrate that the vehicle can meet its on-board electrical
power requirements.

13 | Part 2: Conversion
 Wiring and installation

40. All DC and AC wiring must conform to current Institution of Electrical

Engineers (IEE) wiring regulations. On completion, the wiring system will be
inspected, tested to those standards and an NICEIC completion certificate
stating the chassis number of the ambulance issued by the authorised body.
This certificate will be supplied as part of the contract document pack on
conclusion of the contract, along with electrical schematics for both DC and
AC for the ambulance. In particular:

• All wiring will be multistrand, flexible PVC-covered cable that is identified

correctly by colour and protected by being run through appropriate trunking
or conduit. Where routed through bulkheads, wiring will be protected by
glands, and at points liable to chafing by grommets or rubber.
• Wiring terminations will be adequately protected and insulated.
• All circuits will be separately protected and installed in accessible positions,
and tested for insulation, non-contact and continuity.
• All underfloor wiring will be fitted into approved sleeving and all joints
sealed with PVC adhesive tape and must comply with British Standard
BS AU7:1963.
• DC cables must be protected by fuses or circuit breakers at source and
these must be rated for the current-carrying capability of the wire, and AC
cables protected by circuit breakers.
• Cables must be of the correct size for the current required by the circuit
they supply, to avoid overheating and excessive voltage loss.
• All wiring or appliances that require electrical warning or hazard
identification will display clear labels, in accordance with current
regulations.
• All auxiliary electrical components will be CE and ‘e-marked’ in accordance
with current regulations. If the component is not ‘e-marked’, it must be
supplied with an attestation with regard to annex I, 3.2.9. of 72/245/EEC as
amended BY 2006/28/EC.
• Except for the isolator switch, all switches in the cab must be within easy
reach of the driver and labelled appropriately.
• Where more than one vehicle is converted, all electrical components must
be mounted in identical locations and wiring routed uniformly.

14 | Part 2: Conversion
 • Wherever possible, electrical components will be mounted on
subassemblies using ‘plug and play’ connectors, to facilitate easy removal
and replacement if repair or maintenance is needed.

Quality control

41. Quality and build standard control will apply to a fully converted ambulance,
including the base vehicle and all components and systems identified in the
specification or related requirements. The converter will provide and ensure
quality control assurance throughout the build, including for all medical items,
equipment and components supplied. The converter must have a current ISO
quality control system that is relevant to the building of vehicles.

Warranty and support

42. The converter will provide a comprehensive seven-year parts and labour
warranty for the integrity and structure of the conversion, including specified
and purchased items, with a written procedure for warranty claims and
carrying out work. There should be a seven-year anti-corrosion warranty and a
minimum five-year warranty for electrical installations.

43. The medical gas pipeline system must conform to all applicable regulations
and standards.

44. A process should be in place for resolving matters urgently and priority given
to both the resolution and any associated works. Repairs and campaign work
should be available 24/7. Technical workshop support should be available 8
am to 5 pm, Monday to Friday, as a minimum. Support response times will be
subject to a managed SLA. Each relevant trust will require approval to conduct
work in its own workshops that is rechargeable to the convertor.

Specialist tooling

45. The converter will provide each relevant trust with a comprehensive list of
specialist tooling and with any specialist tooling required to maintain and
repair the converted vehicle.

15 | Part 2: Conversion
 Spare parts

46. The converter will provide each relevant trust with a comprehensive parts list
giving part numbers in electronic format. All parts must be available for a
minimum of seven years from date of manufacture. In addition, the converter
will provide an online system that gives access to parts listing and ordering,
and technical information/support; ideally this will be in the form of a dedicated
customer-specific web portal.

Training

47. The converter will provide the operational and workshop staff for each relevant
trust with on-site training. Operational training will cover the operational use of
the vehicle and its equipment, and workshop training will cover maintenance,
fault diagnosis and repairs.

48. An associated written training syllabus will be provided along with confirmation
certificates detailing who has been trained and what criteria they have met.

49. To support training delivery the converter will provide the following in
electronic form, in hard copy and online:

• an operational manual explaining operator use

• a copy maintenance manual for technical staff that includes:
– system hardware location schematics
– wiring diagrams
– fault diagnosis guidance information
– warranty claims process and contact information
– spare parts catalogue.

Build information pack

50. For each build batch the converter must supply each relevant trust with a
comprehensive manual (written and electronic copy) that contains:

• specification
• agreed changes listing
• CEN compliancy certificates

16 | Part 2: Conversion
 • proof of compliance with ECWVTA for the specific chassis type and vehicle
design
• statement confirming Disability Acts have been considered and adhered to
where applicable
• electromagnetic compatibility test and report
• build identification numbers for each chassis number
• operational and equipment manual
• training syllabus
• vehicle mass certificates
• noise, water and tilt test reports
• road handling test report
• other component/equipment certification as required
• warranty terms, contacts and procedure
• electrical wiring diagrams and location of components and connections in
the vehicle’s electrical system
• drawings of external and internal layouts
• letters of non-objection/certificates of conformity as required
• bill of materials.

Meetings

51. The converter and each relevant trust will hold meetings during the build
process at predetermined milestones or more regularly if required. Minutes of
meetings will be produced and distributed to an agreed circulation, including
representatives from all English NHS ambulance trusts.

52. The converter will attend user group meetings on a six-monthly basis or more
regularly if required, to establish working relationships and determine product
effectiveness. These visits will be used to improve the product and drive
innovation in vehicle design.

Production and conversion process

53. A fully controlled and documented construction process should be used that
accurately documents each stage of the build process to maintain quality and
traceability, and to provide accurate after-sales information. This will ensure
that all spare parts are correct and fit first time, every time.

17 | Part 2: Conversion
 54. Suppliers should provide proof of certification to the standards EN 1789, ISO
9001 and ISO 14001.

B. Body exterior
1. Exterior dimensions must meet the requirements set out in the base vehicle
specification and should not be compromised by the conversion.

2. The complete exterior must be finished in RAL 1016 yellow.

3. Wheels and bumpers must be left in factory finish. Rear bumpers must have
underside stainless steel skid plates (2 mm) fitted.

4. Wheel nut retention devices must be fitted.

5. A mis-fuelling safeguarding device must be fitted.

6. If the base vehicle is not fitted with an OE rubbing strip, a suitable protective
rubbing strip must be fitted on each side of the vehicle.

7. All external door locks must have a central locking facility and the extra facility
that enables the vehicle to be locked while on run lock. This function should
be controlled by the manufacturer’s key fob.

Body exterior windows

8. Body window(s) must be tinted to Venus 10, be able to prevent inward vision
and provide an emergency means of escape in line with CEN regulations.

9. The nearside sliding door should have one window with Venus 10 tint and a
top slider overlaid with a solid opaque lower section; the slider should have
10-mm opaque strips. The glass design should be such that if the door sliding
mechanism fails no part of the door will contact the glass and break it.

10. Break glass hammers will be provided.

18 | Part 2: Conversion
 C. Technology
1. The converter will install a black box system to a specification agreed by each
trust until a national specification is defined. The system will record a range of
inputs from the vehicle’s chassis and saloon.

2. Poling rates should be configurable, but as a minimum report every five

seconds for routine driving, every one second when blue lights are activated,
and multiple inputs per second when the vehicle is in crash phase.

3. Accelerometers at 100 Hz must record in X, Y and Z directions up to + and

–16 g to an accuracy of ± 0.01 g. This could include linked low and high range
accelerometers (eg ± 0 to 3 g and 3 to 16 g).

4. The system should collect information for the entire trip, showing:

• start and stop times throughout the trip

• positional information at relevant stages throughout the trip (breadcrumbs)
• ability to develop geofences
• detailed speed information
• detailed idle times
• odometer readings
• detailed fuel usage and levels
• siren activation
• blue light activation
• emergency/non-emergency miles
• chassis lights information
• seat belts engaged information
• windscreen wipers information
• brake lights information
• dash warning lights information
• steering wheel position
• throttle position
• X, Y, Z accelerometer inputs.

19 | Part 2: Conversion
 5. The system should be able to identify drivers as determined at individual trust
level.

6. The black box equipment should be installed in a secure space that can be
accessed by engineers but not routinely by unauthorised personnel.

7. The converter will consider black box systems that integrate with other data
systems and communication devices in the vehicle, to provide the foundation
for a connected digital ambulance. The system will also integrate with back
office systems and have a standalone reporting portal.

8. The converter will supply and install a tamper-proof, two-way intercom system
between the cab and the saloon area that is powered when the ignition is on.
This device should have an open-speech facility from the saloon to the cab
and a press-to-talk button should be fitted in the cab for the driver’s use. It
should be possible to control volume from the cab but not to turn off the
device. The intercom system should be correctly calibrated to provide clearly
audible communications.

9. The converter will fit an audible reverse warning device operated by the
gearbox-mounted reverse lamp switch. This device will be used to alert
pedestrians that the vehicle is reversing and will be fitted with a night isolation
switch. An ultrasonic reversing aid with two sensors connected to a reversing
proximity warning device will be provided to give the driver audible and visual
(a tri-colour light-emitting diode (LED) will be located on the right of the main
instrument console) warning of any obstruction at the rear. The device must
not to be sensitive to emergency vehicle LED lights.

10. A rear (reversing/incident) camera that operates when reverse gear is

selected will aid reversing; the rear image is displayed on the dashboard
monitor. This camera must be positioned high up under the rear light bar
where it gives a wide-angle image across the rear of the vehicle that includes
the ramp and about 3 m to the rear of the vehicle.

11. The converter will install a CCTV system for staff protection and to provide
evidence in any incident/collision.

• VDRHD 12 channel recorder:

– records up to 12 cameras at resolution 720 × 576

20 | Part 2: Conversion
 – records vehicle G force data in three separate axes, each individually
adjusted
– records vehicle GPS data for integration with mapping in playback
software
– records vehicle GPS speed
– logs use of left/right indicators and brakes, with all functions individually
searchable in playback software
– integrates with ambulance management system outputs to record use of
sirens/blues/HLF/panic alarm – system should differentiate between
sirens armed and sirens emitting noise
– programmable shutdown delay
– programmable/switched video output
– removable 500-GB hard drive with dedicated lock
– lockable front cover
– fault LED visible to engineering staff
– fault output for third-party integration
– front accessed monitor output for set-up and testing
– event search function allowing operator to search and view specific
recorded scenarios, eg only those recordings when the vehicle’s blue
lights are active, or the vehicle is travelling at a certain speed, or any
combination of multiple events
– SD card back-up recording function
– SD card recording of driver behaviour data such as acceleration, braking
and speed
– option for 4 G/Wi-Fi connection to vehicle to view live images and
download recorded footage
– ability to review footage on PC direct from the removable hard drive and
remote from the vehicle
– option to auto-convert encrypted format footage to AVI format directly
from playback software
– ability to display all external camera images simultaneously on the
monitor in the saloon.
• Forward-facing camera:
– mounted behind the rearview mirror looking forwards

21 | Part 2: Conversion
 – cameras to record when vehicle is in operation and for a predetermined
time after ignition (to be agreed by trust).
• Nearside and offside externally mounted micro-dome cameras:
– mounted nearside and offside at the rear of the vehicle facing forwards
– external cameras mounted on micro-dome base
– high resolution with minimum day/night function of 600 TVL
– vandal resistant with lockable rim
– cameras to record when vehicle is in operation and for a predetermined
time after ignition (to be agreed by each trust).
• Saloon micro-dome cameras:
– two flush mounted into the ceiling above the bulkhead cabinet and at the
foot end of the stretcher
– high resolution with minimum day/night function of 600 TVL
– vandal resistant with lockable rim
– camera to record when the saloon panic button is pressed; passive
recording function set to capture footage one minute before activation
– associated microphone installed in saloon area that is turned on with a
switch that includes a visual warning (red LED light) that recording is
active. Crews should also be able to leave this in continuous record
mode during a city centre nightshift, for example. When activated in this
mode, no voice warning in the saloon is required – that is, it will operate
in covert mode.
• Rear camera:
– mounted at the rear of the vehicle, in the centre. This camera is used as
a reversing aid and to record events at the rear of the vehicle. The
converter will ensure this is wired in such a way that there is no delay
between selection of reverse gear and footage being displayed on the
dashboard screen
– camera to record while the vehicle is in operation and for a
predetermined time after ignition (to be agreed by each trust).
• Camera extension cables:
– as required.
• Accident review service:

22 | Part 2: Conversion
 – CCTV supplier to offer option to recover or receive accident footage and
to prepare an independent expert report on the circumstances, possible
causation and liability.
• Footage preparation service:
– CCTV supplier to have process to retrieve footage from trust locations in
a timely manner (within 24 hours) or receive incident footage required for
third-party purposes such as police request. Footage is to be prepared in
a format that meets Home Office guidelines for download of CCTV in
accordance with data protection laws and that fulfils appropriate audit
trail guidelines.

D. Cab requirements
1. The cab design will maximise crew comfort and leg room for both driver and
passenger.

2. No fittings in the cab will restrict the range of seat adjustment provided by the
manufacturer.

3. The dashboard must be designed to appropriately incorporate the additional

electrical switching, warning and communication equipment and the mobile
data terminal. This should be achieved with robust extra moulded cowls that
do not obstruct routine maintenance tasks. The final design must be suitably
ergonomic, look tidy and clean, and comply with construction and use
regulations.

4. If present, the cab overhead shelf will be removed and the site made good.

5. A floor-mounted console will be installed in the centre between the passenger

and driver seats to provide maximum storage, and including space for
document storage, drinks holders and a waste bin.

6. Two rechargeable torches will be installed at positions both crew members

can easily reach. The charging system will operate in a way that preserves
torch battery life for as long as possible to reduce through-life cost.

7. Two coat hooks will be fitted.

23 | Part 2: Conversion
 8. A non-slip wear plate will be supplied and fitted on the cab floor below the
driver’s pedals. This must be sealed around its edges to prevent ingress under
the plate.

9. Bump pads will be fitted around the cab door apertures to minimise head
injuries.

10. One 2.0 L, aqueous film forming foam visible gauge, controllable flow fire
extinguisher will be positioned within easy reach of the driver and also from
outside the vehicle, and not at head height. Its bracket will be a complete
base, not two pronged. The fire extinguisher will be of a type that requires no
ongoing maintenance and labelled with month and year of next inspection.

11. Supplementary cab-dimmable strip lighting will be fitted above the driver and
passenger seats, for completion of paperwork.

12. Two 12-V USB outlets, or as appropriate, will be fitted for charging of aux
devices and to supplement the base vehicle fitted outlets.

13. Strengthening plates will be supplied and fitted to the driver and passenger
doors with check strap mounting points at the ‘A’ pillar.

14. Tailored infection control seat covers will be fitted to the driver and passenger
seats. These will be made according to the base vehicle manufacturer’s digital
patterns and have a maximum tolerance of 0.02 mm to ensure a perfect fit.
Where airbags are fitted for the original seats, they must conform to applicable
TVU crash safety standards.

15. Two grab handles will be fitted to aid entry to the driver and passenger sides
of the cab.

E. Saloon requirements
1. The bulkhead will have one square (1,430-mm2 minimum), left-side opening
window in line with CEN requirements.

2. The saloon interior roof (including its components) must be at a height not
lower than 1,900 mm.

24 | Part 2: Conversion
 3. The saloon interior design must allow specialist medical chairs to pass
between the wheel arch/nearside seating and the stretcher in its locks, with
attendant seats in stowed position.

4. The vehicle must be able to carry a bariatric stretcher in the fixed floor
stretcher mountings without any equipment needing to be moved.

5. The bulkhead must have no protrusions that touch a person sitting in the seat
when in its most rearward position.

6. The original base vehicle cab dimensions must not be compromised during
the construction of the bulkhead; in particular, the geometry relative to the
driver and passenger seating must be maintained.

7. All seats coverings will be made from a single piece of material and have
sealed seams to prevent the ingress of body fluids for infection control
purposes and to protect against damage.

8. Appropriate storage in cabinets and overhead cant lockers will be provided.

Locker lift-up doors will be made of a clear material of 8-mm minimum depth,
with strong hinges and two gas struts per locker.

9. All lockers will have contents identification labels.

10. Sufficient grab rails will be appropriately positioned and finished in RAL 1016
yellow.

11. Sufficient head impact and bump pads will be appropriately positioned,
finished in pantone 5535C green.

12. Each locker and cupboard door will have a reset device that indicates if it has
been opened.

13. The converter will provide suitable and secure storage for controlled drugs,
including key-only access. Details will be confirmed at individual trust level.

14. The converter will provide options for temperature-controlled storage of

suitable size, as determined by each trust. Options should also consider a link
to black box technology to allow remote monitoring.

25 | Part 2: Conversion
 15. All saloon door entrances will have grab rails/handles to aid entry/exit. Such
devices must be strong enough to take the weight of heavy persons and be
finished in RAL 1016 yellow powder coating or rubber. As a minimum, there
should be two at the side door and two at the rear doors.

16. Assisters will be fitted to the rear doors, to aid opening and to hold the doors
open.

17. Warning red LED lights must be fitted to all doors, to warn moving traffic
around the vehicle that a door is open.

18. Suitable illumination to entries will be provided; this is turned on through door
activated micro-switches. To provide a combined puddle, alley and blue lights
will be fitted above the driver and passenger doors.

19. Nearside, offside and rear scene lights that can be switched on independently
will be provided. The side-scene lights will have a 45-degree alley lights facility
or separate light. (Note: scene lights must be switched off when road speed is
above 10 mph.) Scene lights will be positioned on each rear door to illuminate
each rear corner of the vehicle and to aid reversing – all scene lights need to
come on when reverse gear is selected and the vehicle’s headlights are on.

20. Nearside and offside alley lights will be mounted above the driver and
passenger doors. (Note: scene lights must be switched off when road speed is
above 10 mph.)

Floor construction

21. The floor covering will be made from a single piece and have antibacterial
properties. Its edges will be sealed to make washout easy and to enhance
infection control. The floor must be of a non-slip quality that complies with
Department for Transport R10 regulations, and resilient enough to withstand
high wear rates.

22. The stretcher fastening must be tested according to EN 1789. Floor mountings
must be fitted using the stretcher manufacturer’s approved jig to ensure all
vehicles are built to the same standard.

26 | Part 2: Conversion
 23. The underside of the floor panel will be coated with Teroson underseal or
equivalent.

24. The wheel arch sections will be treated with KTL stone ship protection or
equivalent.

General design

25. Figure 1 below divides the saloon into seven indicative zones for positioning of
cabinets and cupboards, storage of equipment and medical items. The exact
location of equipment may vary by trust, but it will always be in the same zone;
therefore, a variable mounting system will be required. The final design will be
agreed at individual trust level.

Figure 1: Indicative saloon layout

Zone A

26. This zone will be used to store equipment and bags that need to be quickly
accessed from inside the vehicle or through the side sliding door. The storage
facility must have open shelving with stainless steel sheet protection to allow
access from the side door, and a door(s) for access from inside the vehicle.

27 | Part 2: Conversion
 This zone will hold the following items: response bags including AED, oxygen,
drugs, resuscitation equipment and extrication equipment.

27. Further design features in this zone will be determined by individual trust
requirements.

Zone B

28. This zone will include provision for IPC-friendly, UN rigid clinical and domestic
waste containers, including a sharps box and all associated markings. In
addition, brackets and poles to hold and support clinical equipment will be
required. Details will be determined at individual trust level. Further design
features are possible in this zone as determined by individual trust
requirements.

Zone C

29. This zone will include two forward-facing seats fitted on the left-hand side.

• Each seat will recline and swivel (locking at a maximum of 45 degrees) and
be able to fold against the side of the vehicle.
• Both seats must have a headrest, adjustable armrests and a three-point
retractor seat belt with the tongue attachment on the right side. Seat belts
long enough to secure a child seat or accommodate a bariatric patient will
be provided.
• Seat squabs will be 470 mm above the floor.
• An enclosure will be created for the front forward-facing seat and under no
circumstances should the seat base be drilled to fix a shroud.
• These seats should be designed and positioned to ensure maximum
comfort, accessibility and ergonomic movement, and to maximise effective
care of a patient lying on a stretcher.
• A stainless-steel plate must be fitted to the nearside wall of the vehicle to
protect the interior liner from damage by the seats.
• The seat edges should be fitted with protectors to prevent damage to seat
covers from contact with equipment – for example, stretchers and carry
chairs.
• Space must be sufficient to allow the forward-facing seat to be oriented to
face the stretcher and with enough leg room between the seat and

28 | Part 2: Conversion
 stretcher. With the forward-facing seat orientated to face the stretcher, a
person must be able to comfortably occupy the rear seat in its forward-
facing position.

30. The converter will supply and fit vertical grab handles, one near the side door
and one near the rear door. Grab handles will have recess areas large enough
to accommodate large hands.

31. Further design features in this zone will be determined by individual trust
requirements, including the secure storage of medical equipment.

Zone D

32. In this zone a cupboard in the right-hand rear corner will accommodate
medical gases as determined by each individual trust. The cylinders will be
vertically mounted with the pressure gauges visible though a suitable window
from all seating positions, along with a suitably positioned mirror to assist
viewing. (All cylinder mountings and cupboard enclosures require crash
testing approval.)

33. Further design features in this zone will be determined by individual trust
requirements, including the secure storage of medical equipment.

Zone E

34. In this zone a rearward-facing attendant’s seat will be fitted at the head end of
the stretcher.

• This will be an all-ages seat and seat belt configuration, and ideally include
Isofix child seat fittings.
• The seat squab will be 470 mm above the floor.
• A padded panel will be fitted above the seat for head protection.
• The seat edges should be fitted with protectors to prevent damage to seat
covers from contact with equipment – for example, stretchers and carry
chairs.
• It must be possible to move the seat forward and aft for easy cleaning
behind it.

29 | Part 2: Conversion
 35. Further design features in this zone will be determined by individual trust
requirements, including the secure storage of medical equipment.

Zone F (interior roof)

36. Two infusion bag rails will be provided along the roof or on the underside of
cabinets above the stretcher.

37. A full-length driver alert strip will be fitted in the roof lining to activate a buzzer
in the cab and additional strips positioned adjacent to and within easy reach of
the attendant and rear saloon seats. This system must have a cancel button in
the cab area that is within easy reach of the driver.

38. An extract/intake fan will be provided that works in conjunction with the
extraction fan mounted low down on the nearside of the saloon.

Zone G (interior floor)

39. The saloon floor must be constructed from a lightweight composite material
and finished according to the flooring specification previously detailed. It will
have anti-soiling properties to meet BS EN ISO 11378-2 and anti-
bacterial/fungicidal qualities. It must be laid with coving at the edges wherever
possible and with reinforced corner radii. All floor covering edges will be
sealed.

40. The floor will be RAL 7035 light grey.

41. The stretcher fixation device will be, at a minimum, a two-point lock. The
fixation point will be strategically positioned to accommodate an emergency
stretcher, an incubator and a critical care trolley, and with space for the
attendant to walk between the stretcher and side seats when these are
stowed.

42. Four independent fixation devices will be fitted in the floor (flush fitting and
easy fit) at the foot end of the stretcher to secure the aortic balloon.

30 | Part 2: Conversion
 F. Emergency lighting and switches
1. All lights will be latest generation LED – maximum light for minimum voltage –
and incorporated into front and rear aerodynamically profiled pods, to reduce
their impact on the aerodynamics of the base vehicle.

2. A front light bar and a rear light bar will be provided to the specification
determined by each trust.

3. High-level blue lights that emit light all around the ambulance body will be
fitted.

4. Two high-level rear red lights with an interlock to the handbrake (to prevent
operation while the vehicle is in motion) and a dashboard warning light will be
fitted.

5. Two blue/white combination flashing lights (grill mounted) and two blue
flashing lights (side facing wing mounted) will be fitted.

6. A multi-random flash headlamp system will be fitted. The headlamps must

flash on high beam and be wired so that they cannot operate when the base
vehicle headlamp switch is in the on position.

7. A number plate plinth with blue flashing lights will be fitted at each side.

8. Two blue flashing lights will be fitted at the rear of the vehicle above the rear
lights.

9. Multifunctional lights will be fitted above the cab doors to give puddle, alley
and blue flashing light.

10. Red LED lights will be positioned in all door apertures to be visible from the
rear of vehicle when the doors are open.

11. A speed enforcement camera identification blue light will be fitted to the rear.

12. All body builder fitted accessories will be fed directly from the vehicle
manufacturer’s electrical interface. Items that function only in conjunction with
side lights or ignition will be supplied by relays activated by an appropriate
vehicle system.

31 | Part 2: Conversion
 Electrical switch layout

13. The switches will be housed in a one-piece panel in zone C that provides
touch control and mounted in the roof-mounted pod, in the centre and angled
to aid easy visibility of the controls. The switch panel facia will have an
infection control barrier cover.

14. The converter will provide a solution that safely and securely mounts each
relevant trust’s MDT screen to the dashboard without obscuring access to the
radio controls. The screen will be angled at about 12 degrees to the driver’s
side.

15. Switch panel specification: the vehicle will be fitted with a load management
system and associated switch panels. The backboards will be manufactured
by the company producing the power management system. All electrical
backboards/systems will have access panels for viewing system integrity and
easy access reset as required. For clarity, the converter will purchase a
complete solution.

16. The following list describes the functionality of the cab switch control panel
and rear saloon panel (navigation between one panel and another will be
provided via a menu option and thus operated from each seat position):

• Cancel all mode.

• Pre-check sequence:
– five seconds after activation with the ignition and the handbrake on, each
function that can be visually inspected is activated, individually and in a
predetermined order, to allow it to be inspected. All mode functions will
be checked, and a warning given if defective
– this ‘health check’ links to the black box technology where applicable.
• 999 mode: activates all emergency lights, the siren and headlight flash.
• Rear emergency lights: activates rear emergency lights only, including the
flashing reds.
• Arrive scene mode:
– disables all emergency lighting, sirens and headlight flashing and the
999 function, but not other functions
– the ignition security feature is activated first, allowing the driver to
remove the keys and leave the engine running securely; depending on

32 | Part 2: Conversion
 the specification the engine rpm may increase from idle. If the handbrake
is released the engine stalls or the vehicle moves when the system is
activated.
• Leave scene mode: activates saloon lights, grill lights, dashboard light wing
lights and head light flash.
• Hospital arrive mode: deactivates emergency lighting and 999 function, and
activates saloon lights that switch off if the vehicle is stationary for 20
minutes (plip key operation can override this).
• Head lamp flash: activates the headlight flash. This can only be selected
when the side lights are off and is otherwise disabled.
• Left scene/alley light: activates the 45-degree alley lights.
• Rear scene light: activates when the handbrake is on and the vehicle is
stationary.
• All-scene light: activates when the handbrake is on and the vehicle is
stationary.
• Saloon-light master: deactivates the saloon light dimming device.
• Siren: activates the siren
• Left saloon lights: activates the left saloon lights and deactivates the saloon
light dim.
• Right saloon lights: activates the right saloon lights and deactivates the
saloon light dim.
• Saloon light dim: activates the saloon dim lights.
• Stretcher light bright: activates the above-stretcher specialist lights.
• Climate control: activates and deactivates the climate control system.

17. At least five spare outlets will be provided.

18. A run lock activation function that is independent of all the functions
mentioned above will be provided.

19. A battery link emergency start function will be provided.

33 | Part 2: Conversion
 G. Vehicle inventory
1. Details of equipment/consumables carried and their layout in the zones
described above will be provided to individual trusts until a national common
standard equipment and consumables load list is developed.

H. Vehicle markings and livery

1. All markings will be in the universally recognised format:

• hazard warnings – black lettering on a yellow background

• mandatory instruction – white lettering on a blue background
• prohibition signs – white lettering on a red background
• exit/safe condition signs – white lettering on a green background
• equipment location signs – red lettering on a white background.

Exterior

2. Exterior marking specification will be as per the ATAG National Battenberg

specification.

3. The following markings in a suitable polyester base under printed film are a
guide to what should be applied; final detail will be confirmed at individual trust
level.

• on both side and rear door.

• If applicable: ‘CAUTION – STAND CLEAR SIDE STEP

DEPLOYS AUTOMATICALLY AS DOOR IS OPENED’
in black 12-mm lettering on a white warning sign with a
45-mm yellow warning triangle must be fitted to the
outside of the external side sliding door.

• With a design similar to the ‘Patient Assessment’ sign above, a 400-mm

wide, ‘KEEP CLEAR – PATIENT LOADING PLEASE LEAVE 3.5 METRES
SPACE BEHIND THIS VEHICLE’ on the rear door.

• 100-mm green Hazchem sign for compressed gas on rear door to meet
current legislative requirements.

34 | Part 2: Conversion
 • 12.5-mm red lettering on a white background, ‘BATTERY
ACCESS’, on compartment panel plus multiple hazard warning
‘DANGER BATTERY CHARGING AREA, WEAR PERSONAL
PROTECTIVE EQUIPMENT, NO SMOKING, NO NAKED
LIGHT’.

• 12.5-mm red lettering on a white background, ‘DIESEL ONLY’,

adjacent to fuel filler, plus warning triangle.

• on hinged doors above door handle.

• on side sliding door above outer door handle.

• 10-mm red lettering on a white background on rear left side, near switch
location, ‘PATIENT LOADING MANUAL OVERRIDE CONTROL’.
• 10-mm black lettering, ‘TYRE PRESSURE ## PSI’ on front and ‘TYRE
PRESSURE ## PSI’ on rear, over each wheel arch. Note: to be agreed
after mass testing has been completed and approval obtained from the tyre
manufacturer.
• 10-mm black lettering, ‘WHEEL NUT TORQUE ### Nm’, over each wheel
arch.
• 10-mm red lettering on a white background, ‘KERB WEIGHT #### KG’,
along bottom of right-hand cab door.
• 75 mm × 15 mm gauge numbers surrounded by a box 200 mm × 100 mm ×
5 mm gauge, in the centre of the front over-cab area, towards
the windscreen top, and rear towards the right side, and below
right-hand rear door window. Each trust to confirm fleet numbers.
• Battery charging notice, 110 mm × 90 mm, with black print on a yellow
background, to be attached on the cab adjacent to the mains charging
point.

Interior

4. The following markings in a suitable polyester base under printed film are a
guide to what should be applied to firm surfaces where possible; final detail
will be confirmed at individual trust level.

35 | Part 2: Conversion
 • on hinged doors above door handle.

• on side sliding door adjacent to the inner door

handle.

• Nationally recognised ‘NO SMOKING’ signs to be conspicuously

positioned in the cab and saloon.

• ‘SEAT BELTS MUST BE WORN’ in both the cab and saloon,

plus BS5378 blue 83 mm × 100 mm pictogram.

• ‘MIND YOUR HEAD’ above the side and rear doors, and
on both cab doors.

• ‘EMERGENCY EXIT’ on the side and rear doors,

and ‘BREAK GLASS WITH HAMMER
PROVIDED’ on the side windows.

• Fire equipment sign adjacent to each fire

extinguisher, highlighting its location and
appropriate use.

• ‘STOP ABUSE’ red hexagonal stop sign in clear view at the

front and on both saloon walls.

• ‘DANGER COMPRESSED GAS’ on the gas compartment door

and Entonox bottle location.

• ‘HOT AIR OUTLET DO NOT OBSTRUCT’

adjacent to the saloon heater outlets, plus
yellow warning triangles and ‘AIR INLET DO
NOT OBSTRUCT’ adjacent to the duct.
• 10-mm red letters on a white background, ‘SEATING FOR TWO
PASSENGERS ONLY’, on left-hand side below window.
• Patient loading system operating instructions near to control panel; supplied
by loading system manufacturer.

36 | Part 2: Conversion
 • 7.5-mm red letters on a white background giving vehicle dimensions
(length, width and height in metric and imperial units), positioned on the
windscreen’s shaded out area, centred in the right half and adjacent to the
overhead mirror.
• 5-mm red letters on a white background ‘± WITH 12 VOLTS DC’, positioned
above screw terminals.
• 5-mm red letters on a white background, ‘12 VOLTS DC’, directly below
LSU terminals and cigar-type socket.
• 5-mm red letters on a white background, ‘240 V AC,’ directly adjacent to the
13 A socket.
• 10-mm red letters on a white background, ‘DOMESTIC WASTE ONLY’,
adjacent to the container.
• 10-mm red letter on a white background, ‘CLINICAL
WASTE ONLY’, adjacent to the container, plus a pictogram
biohazard symbol.
• 10-mm red letter on a white background, ‘SHARPS ONLY’,
adjacent to the container, plus a pictogram biohazard
symbol.
• 12.5-mm red lettering on a white background, ‘ISOLATOR SWITCH’,
adjacent to the switch.
• Reflective edge markings in 3M 3DG fluorescent yellow and red film to
lower vertical surface of side and rear steps.

• Tiger stripe anti-slip floor markings at floor

edge next to entry/exits or suitable
alternative, and in a conspicuous location, ‘CAUTION – MIND
THE STEP’.

• In front of the passenger seat in the cab, on the windscreen

in a clearly visible position but outside the windscreen
wipers swept area and not obstructing the driver’s vision,
‘CAUTION AIRBAG HAZARD DO NOT PLACE FEET ON
DASH’.

• For CCTV, in clear view opposite the saloon-side

entry door, a Data Protection-compliant CCTV
warning sign, and visible on entry to the rear doors, a
CCTV in operation caution sign.

37 | Part 2: Conversion
 Livery

5. Livery to be provided that meets relevant NHS branding guidelines and fitted
in line with current guidelines and legislation, including the guidelines
published by the Association of Chief Police Officers.

6. Converter to provide trust crests and name identification.

7. Markings must be applied and positioned consistent with the artwork supplied
by each individual trust for continuity across the trust’s fleet, until national
guidelines are published.

Regulations

8. The use of reflective films and design of livery must comply with the relevant
Vehicle Lighting and Safety Regulations, current Regulation 11 of The Road
Vehicles Lighting Regulations 1989 and the Variation order to Section 44 of
the Road Transport Act, 1988.

Materials

9 Retro-reflective material.

10. High performance material.

11. All sections laser-edge sealed.

12. Non-metallic construction to prevent corrosion.

13. Application of mixed materials should be minimised.

Warranty on livery

14. Seven-year performance warranty.

15. No cracking.

16. No fading.

17. No peeling.

18. No loss of adhesion.

38 | Part 2: Conversion
 19. No ingress.

20. Must provide a livery parts catalogue/drawing identified by a unique reference.

Side livery application

21. The side panels must cover the entire length of the vehicle but not exceed half
the total height of the vehicle. Where possible the livery will be positioned
below the lower line of the cab window.

22. The application of the livery will start with a green panel at the midpoint of the
length of the vehicle.

23. The panel size will be chosen so that:

• there are seven panels in the top row

• the widths of each panel on the top row are equal, except for the front most
and rear most, which are a minimum of two-thirds the size of the main
panels
• the height of the panels on the top row is half their length; the panels on the
bottom row can be a reduced height to fit/fill the side of the vehicle.

24. Fluorescent retro-reflective yellow panels will be fitted to either side of the
central top row green panel, with alternating colours to the front and rear of
the vehicle, ending with yellow panels.

25. The pattern will then be extended downwards, starting with a yellow panel
vertically below the central green panel on the top row and extending
horizontally to the front and rear of the vehicle. The bottom row may be of any
height to fit/fill the side of the vehicle.

26. The material will not be folded over the edges but cut short of all edges and
cut-outs.

27. The edge of the 'A' pillar must be silver/white or white. The cab, body edges
and roofline will be outlined in 25-mm wide, yellow retro-reflective material.

28. In a position above the Battenberg livery and below the boarder trim, the
words 'EMERGENCY AMBULANCE’, service title, crown, star of life and NHS
logo will be positioned.

39 | Part 2: Conversion
 29. National NHS communication messages will be displayed on the rear third of
the side panel, with the ability to change these as required without damaging
the vehicle, or other decals or livery.

Rear livery application

30. The rear of the vehicle will have a full height chevron pattern. The angle of the
chevrons will be determined by the width of the vehicle.

31. Throughout the highest-grade fluorescent and retro-reflective material of width

150 mm will be used.

32. The materials will be applied as follows:

• The centre point of the rear panels/doors will be located and a line drawn
from this point to the outer edges of the vehicle, half height from the bottom
edge of the vehicle.
• From the centre point, lines will be drawn to the bottom corners of the rear
of the vehicle and orange strips applied below and to the edge of the lines.
The strips will be cut around any vehicle fittings.
• Yellow strips will be applied above and below the orange strips, to the full
height of the vehicle.
• As much of the remaining area as possible will be filled with additional
strips in alternating colours.

33. In 125-mm red letters, the word 'AMBULANCE' will be positioned above the
rear windows.

34. In 50-mm red letters, the words 'KEEP CLEAR' will be positioned midway
between the lower window line and ground level, centred across the rear
doors.

35. The vehicle fleet number will be applied on the right-side upper area (75 mm ×
15 mm gauge numbers surrounded by a box 200 × 100 × 5 mm gauge). Fleet
numbering to be advised by each trust.

36. A compressed gas hazard diamond will be positioned on the left-side panel of
the rear markings.

40 | Part 2: Conversion
 37. The relevant trust’s Crown Decal will be positioned on the right-side panel of
the rear markings.

Front livery application

38. The bonnet, cab roof and any other forward-facing surfaces above cab level
will be painted yellow.

39. The word 'AMBULANCE' in reflective green (mirror image) will be positioned
at the front of the bonnet, in the middle. A small trust crest will be included on
the front-facing roof section if there is enough space.

40. The vehicle fleet number will be applied to the middle of the panel above the
windscreen on the front of the vehicle, at the bottom. Decal to include a black
border (75 mm × 15 mm gauge numbers surrounded by a box 200 mm × 100
mm × 5 mm gauge).

Roof marking application

41. The word ‘AMBULANCE’ will be added to the panel above the windscreen in
reflective green.

Internal rear door

42. The chevron pattern must be applied to a proportion of the internal rear doors
dependent on the surface available, and a strip of red reflective tape applied
to the edge of the doors.

Colour and finishing

43. All interior surfaces in the saloon will be fully colour impregnated white during
the lay-up process, with upholstery finished in pantone 5535C green.

I. Compliance verification
1. The convertor will demonstrate compliance with technical aspects of the
specification as follows:

2. Body electrical power calculation:

41 | Part 2: Conversion
 • Tenderers should supply a body electrical power calculation test datasheet
with their tender submission.
• The datasheet should include power consumption in:
– 999 mode
– arrive scene mode
– leave scene mode
– hospital arrive mode.
• The datasheet should be based on a five continuous call basis to replicate
the vehicle not being shoreline charged. The call outs should be based on:
– 10 minutes urban travel to incident
– 20 minutes on scene (with differential between engine running and
engine off and run lock applied shown)
– 10 minutes urban travel to hospital
– 20 minutes at hospital.

3. Body tilt and axle bias:

• Tenderers should supply a theoretical body tilt and axle bias calculation
datasheet with their tender submission and undertake formal testing with an
independent authority on the initial build unit.
• The datasheet should include:
– total centre of gravity
– calculation of axis
– symmetry of axis
– height of centre of gravity
– tilt angle
– limiting velocity.

4. Subjective handling test:

• Tenderers will be required to provide a report from an independent authority

of a subjective handling test on one of the first completed units by
arrangement with each trust and at the converter’s expense.
• The report will confirm that the following key handling issues are
satisfactory:
– steady-state cornering

42 | Part 2: Conversion
 – straight line behaviour
– obstacle avoidance
– straight line braking
– braking while turning
– negotiation of speed humps without grounding
– overall confidence and safe handling.

• Testing will include a tilt test in which the completed vehicle will achieve a
minimum tilt of 35 degrees without the outside wheels losing contact with
the tilt bed.

Environmental sustainability

5. An overview of the deconstruction process and an end-of-life environmental

impact assessment of conversion components should be provided with the
tender response. This must conform to current legislation and applicable
standards.

43 | Part 2: Conversion
Contact us:

NHS Improvement
Wellington House
133-155 Waterloo Road
London
SE1 8UG

0300 123 2257

[email protected]
improvement.nhs.uk

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© NHS Improvement 2018 Publication code: C 22/18