NEW DELHI: In a first, India has launched a comprehensive national framework for planning, operating, and monitoring ambulance services across the country to ensure timely, safe, and quality emergency medical transport for every citizen.
The national operational guidance on National Ambulance Services (NAS), 2026, which was launched by Union Health Minister JP Nadda on Monday, provides a comprehensive framework for standardising ambulance services and strengthening emergency medical transport systems across the country.
The 172-page guidelines make it clear to states and UTs that the aim is to reach the patient as early as possible and preferably within 20 minutes, with a long-term goal of 10 minutes in busy urban and peri-urban areas.
It also mentions that all the ambulances in any state/UT should be accessible through a single Emergency Number 112 to enable faster and more coordinated emergency response and mandates that for efficient utilisation of available resources, all ambulances should be GPS-enabled, networked and interconnected through a centralised call centre.
In India, medical emergencies, including road traffic injuries (RTIs), are among the leading causes of death, with RTIs alone contributing to around two lakh deaths annually. Delays in recognising emergencies, arranging transport, and accessing appropriate facilities all contribute to avoidable deaths and complications.
As ambulances serve as the backbone of India’s emergency care ecosystem and act as the first responders that stabilise and transport patients during the critical ‘golden hour,’ thus improving survival rates and health outcomes, it was felt that a comprehensive guideline is needed in the country.
The guideline thus aims to ensure quality, accessibility, efficiency, and responsiveness of ambulance services across the country.
It also sets up norms in ambulance categorisation, population-based deployment planning, equipment, medicines, vehicle maintenance protocols, training of manpower, recruitment process, skill standards for Emergency Medical Technicians (EMTs), infection prevention and control measures, performance monitoring systems and grievance redressal mechanisms.
The guidelines also mandate compliance of all ambulances with the AIS-125 standards, ensuring enhanced safety, quality and standardisation of emergency medical vehicles.
The aim is also to provide equitable access to quality emergency care, even in the most underserved and remote areas.
Stressing that ambulance services constitute the first critical link in the emergency medical response chain, providing pre-hospital care, ensuring timely access to life-saving interventions, patient stabilisation, safe transport and timely referral to appropriate healthcare facilities, the operational guidelines suggest states decide the number, type and location of ambulances based on population, geography, case load and response-time requirements.
Highlighting the importance of the first hour after the incident or “golden hour”, which is crucial to save the life of a patient, it suggests to all district and block teams to place the ambulances in accident-prone locations, highway junctions, industrial areas and busy market stretches.
The guidelines state that patrol vehicles, Crash Rescue Vehicles (CRVs) and ambulances should work in coordination in accident/trauma cases – like at highway stretches.
It also specifies that ambulances should give only essential pre-hospital care like airway, breathing, circulation, control of external bleeding, immobilisation and move quickly to the appropriate facility.
Stating that response time - the time between receiving the call and the ambulance reaching the patient – is a key indicator of ambulance performance, it suggested that district teams should regularly review response time data with the call centre and service provider, identify “slow” areas, and adjust base locations or routes accordingly.
To further strengthen emergency referral systems, the guidelines envision GIS-enabled mapping of health facilities, referral centres, ambulance base locations, accident-prone and high-risk areas, bed availability and critical care readiness. This integrated approach will enable dispatch teams to identify and transport patients to the most appropriate healthcare facility in the shortest possible time.
Recognising the importance of evidence-based planning, the guidelines recommend scientific ambulance deployment based on analysis of emergency call volumes, accident hotspots, referral patterns, traffic conditions, terrain and geographical accessibility, thus ensuring optimal utilisation of ambulance resources and improved response times.
It has been suggested that public emergency management agencies like the Police and Fire Service should be integrated into the real-time information system for guidance, monitoring, and other necessary actions.
As of December 2025, the National Health Mission (NHM) supports 28,472 ambulances, boats: 19, bikes: 81 and others 5701 (neonatal ambulances, Free Hearse Services/ Mortuary Vans, etc.) across the country.
The guideline also mentions the global scenario of the arrival of ambulances on receiving distress calls.
In the US, the average ambulance response time for an emergency medical service (EMS) unit to arrive on the scene from the time of a 911 call was 7 minutes. The emergency response time increased to more than 14 minutes in rural settings. In the UK, it is 8 minutes for the ambulance to arrive if the call is life-threatening or an emergency.