From flooding to finance: NHS ambulance‐assisted evacuations of care home residents in Norfolk and Suffolk, UK

Focusing on the counties of Norfolk and Suffolk (UK), this investigation examines the effect of coastal and fluvial flooding on the use of ambulance service vehicles in the assisted evacuation of care home residents and quantifies the cost of this service to the NHS under flood conditions. This was completed using GIS Network Analyst functions to identify the impacts of flood probability (high: 1 in 30, medium: 1 in 30 to 1 in 100, and low: 1 in 100 to 1 in 1000) and target ambulance response-times (7, 18, 120, and 180 min) on ambulance service area, road network accessibility, the number of vulnerable care homes and their accessibility, the appropriateness of pre-identified evacuation routes, and the drive-time based evacuation cost to the National Health Service (NHS). The results indicate that approximately 68 care homes and 2,320 residents in Norfolk and Suffolk are at risk of inundation, and care home accessibility, in addition to ambulance service area, decreases with shorter ambulance response-times and lower flood probabilities. Additionally, the use of pre-identified evacuation routes, by the ambulance service, promotes efficient navigation between ambulance stations, care homes, and rest centres, but can unfavourably cause network clustering if unmanaged. In association with these routes, an estimated cost of evacuation based on ambulance drivetime was calculated at £34,000–£42,000 depending on flood probability. The importance of this research is highlighted by the current lack of identified flood evacuation and accessibility maps for emergency responder use, and the associated lack of evacuation cost estimations to be used by the government and NHS to budget for aid assistance during these natural disasters. Therefore, the application of this approach at a national level in the flood emergency planning process would be beneficial to promote strategic efficiency and financial preparedness of ambulance services for the purpose of ambulance-assisted flood evacuations.