Background With millions of unscheduled patient contacts every year and increasing call outs clustered around the most deprived communities, it is clear the ambulance sector could have a role to play in improving population health. However, the application and value of a public health approach within the ambulance sector has not been comprehensively explored.

A rapid review was undertaken to explore the role of the ambulance sector in the delivery of public health interventions and what impact this has on population health and ambulance sector outcomes.

Methods A search strategy was developed to identify published and peer reviewed literature published since 2000 in OECD countries. Targeted grey literature, reference list, and citation searching was also carried out.

Search results were downloaded to Microsoft Excel and screened by three reviewers according to pre-determined inclusion/exclusion criteria. Data from included studies was extracted using a data extraction form and narratively synthesized.

Results 2,399 records were identified, with 49 references included in the final review.

Types of public health activity the ambulance sector is involved in were: public health education and advice; emergency medical services providing vaccines; paramedicine; screening tools and referral pathways; and health intelligence using ambulance sector data.

Conclusion

• Evaluations of public health interventions included in the review focused on demand management outcomes (e.g. ambulance call–outs) rather than longer term public health outcomes. Future evaluations need to include data from multiple health sectors (e.g. social services, primary care) to assess the impact of the initiative both by and beyond the ambulance sector

• The ambulance sector should make every clinical contact count, maximising opportunities for public health intervention, prevention, and education. However, this is contingent on the skills and willingness of the workforce to do so, and sufficient time within the role given significant system and operational pressures in the sector