Our Structure

Strength through our people

NARU is a lean, effective organisation committed to delivering results on behalf of the NHS

The NARU service is constituted under a contract between NHS England and a host ambulance trust, currently London Ambulance Service NHS Trust (LAS)

Anthony Marsh is the National Strategic Advisor for Ambulance Services. He says:

“NARU plays a vital role in improving survival rates and clinical outcomes for patients who are involved in especially high-risk situations. By working closely with the ten English NHS ambulance services, the organisation ensures effective responses to complex emergency situations – which in recent years has included flooding, and sadly, terror attacks.

However, NARU also helps prepare these teams for many other challenging responses such as collapsed buildings, large scale transport crashes, incidents involving hazardous materials or dangerous chemical releases or where rescues must take place at height.  

Ensuring that our specialist ambulance responders are kept as safe as possible while doing this work is of paramount importance as these dedicated staff are frequently willing to head towards danger to provide care and save the lives of others. That’s why the work of NARU is so important; they provide the best training and skills available to keep staff as safe as possible.”

Anthony Marsh, CEO WMAS and National Strategic Advisor for Ambulance Services

“NARU is commissioned by NHS England to work with NHS ambulance services in England to provide a coordinated approach to specialist capabilities and emergency preparedness, resilience and response (EPRR) to improve patient outcomes in challenging environments and to strengthen national resilience. 

I’ve seen first-hand how NARU trained Hazardous Area Response Team (HART) and Special Operations Response Team (SORT) operatives responded in a highly realistic mass casualty exercise this year which involved more than 120 casualties.

It was reassuring to see how the delegates responded to the scenario and provided care to patients under extreme circumstances.”

Stephen Groves, NHSE Director of Emergency Preparedness, Resilience & Response


NARU’s Business Plan, including its strategic objectives and key deliverables, are agreed with NHS England as part of the contract mandate. NHS England monitor the NARU service and its outputs via a Steering Group and a Contract Management Group. These groups meet quarterly and monthly throughout the year.

The host Trust ‘administrates’ NARU and oversees performance of its obligations under the contract, including administration of NARU’s finances on behalf of NHS England and facilitating various procurement processes. The host Trust also facilitates the secondment or fixed term contracts used to employ NARU staff. These administration functions are managed through monthly meetings of the NARU Delivery Board.

The day-to-day management of NARU, including its agreed work programme, is managed by the NARU Central Management Team (CMT), Chaired by the NARU Director.


The Heads of NARU’s four main departments make up the NARU Central Management Team, with each department aligned to our strategic objectives.

Departmental and Strategic Objectives

Corporate Department:

Provide a well governed, patient focused, service that offers value for money and is delivered through a motivated workforce.

Operations Department:

Maintain the nationally interoperable capabilities ensuring they remain safe and operationally effective.

Education & Training Department:

Increase Ambulance Service preparedness for dealing with major and complex emergencies through the provision of high-quality training and education aligned to the national risk register and current doctrine.

Clinical Department:

Ensure all NARU activity remains patient focused and promotes the best patient outcomes.


Last year saw a significant restructure of NARU, driven by the new NARU contract requirements and the extensive challenges faced over the previous 12 months.  The main feature of the new structure is the development of the new Operations Department, which will improve the alignment of our resources to delivery our key outputs. 

This will serve to improve our organisational efficiency and put us in a better position to continue our high-quality service and meet future challenges.

Read more about our leadership team here.

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