St John Ambulance Ranks and Insignia

From its beginnings, the St John Ambulance Brigade employed ranks and insignia to distinguish grades within its membership and management structure; these were extended across the wider organisation following its merge with the St John Ambulance Association to form St John Ambulance. Based upon the British Army officer and the British Army other ranks structure and insignia, the original ranks and insignia have been subject to several modifications over the history of the organisation.

The basic "star" or "pip" has at its centre the eight point Maltese Cross, the badge of the Order of St John. The crown used is also that of the Order. At the higher general list ranks, crossed stretchers are used rather than the crossed sword and baton of military use. Insignia are in silver, again symbolic of the Order of St. John.

Also officers who hold rank within the organisation at or above R4 wear a cockade in their hat (women) and have a silver bar (men), however at or above R3 wear a cockade and tuft (women) and silver bar and Wort cap (men).

Since the mid-1990s the former "Senior NCO" and "Warrant Officer" ranks have been abolished. These ranks, whose titles were "Staff Sergeant", "Corps Sergeant Major", and "County (or District or Bailiwick) Sergeant Major" were deemed too militaristic in form although a few previous incumbents remain. Their demise has gone hand in hand with a lowering of emphasis on parading and drill. The county Sergeant Major, if the county has appointed one, wears member rank slides and Warrant Officer Class 2 (St John Crown in laurel leaves) arm badges on the bottom of each arm. A purple stripe on the nurses epaulette (used to mean either midwife or psychiatric) was also abandoned. In 2012, one Warrant Officer Class 1 (wearing Royal Arms badges in silver on both arms) was appointed at National HQ to advise on ceremonial matters across St John Ambulance.

In December 2013, as a result of the rank review, a simplified rank structure was introduced, being fully implemented by the end of March 2014. The aim of the new rank structure is to ensure that rank is applied consistently throughout the organisation, and that it is applied only based on an individual's role. A number of ranks will cease to exist as a result of this change, and the requirements for many of the remaining ranks will change.[1][2]

In December 2016, it was announced that, effective 1st January 2017, no rank is to be worn on events, except by persons who are performing an operational management role at that event. Persons who are undertaking an operational management role, but who do not have rank, will continue to not wear rank. Persons who do have rank, but who are not in an operational management role at the event should not display their rank.

National variations

Whilst this article uses English St John Ambulance practice as standard, inevitably national variations in rank structure have occurred as the organisation has spread to other countries, and subsequently developed in those countries with a degree of autonomy. The English types are presented in the illustrative tables below. Ranks in other countries are usually similar, but adopt local terminology such as (for example) "Provincial Commissioner" instead of "County Commissioner". There may also be fewer ranks in smaller countries, as a result of the need for fewer rungs of management structure.

Unique Rank Slide Specifications

In 2013, St John Ambulance UK rolled out a new design of rank slide. While the insignia, colours and text font remain unchanged, the slides themselves are now much longer and wider, with insignia being much larger. This updated design for rank slides corresponds with the rise of the Service Delivery Uniform (SDU), rolled out in 2011. This is the first modification to the design of the rank slides since the change from cloth and thread to rubber-made rank slides with a new font for 'St John Ambulance' title on all slides.

This was later abandoned.

Role-Based Variations

In a similar fashion to the Police, St John Ambulance used to have a number of role-based variations on the standard rank markings detailed below. For large-scale events where a Gold, Silver, Bronze command structure is used, the Silver and Bronze commanders used to wear white and orange rank slides respectively.

The organisation has a number of specially trained Medical Response Team volunteers who operate in dense crowds. The teams operate in units of 3 with a designated Supervisor, Clinical Lead and an Operator. Overall command and control is maintained by a 'Bronze' officer. St John Ambulance Medical Response Teams remain unranked.

Rank tables

Operational Rank and Insignia

Ranks and Insignia of St John Ambulance (Colours which may also apply to all ranks shown below)
ColourRedGreyGreenBlue (Wales only)Black
medical practitioners
Registered nurses and midwivesRegistered paramedicsRegistered techniciansPersonnel without Healthcare
Professional registrations

Management Rank and Insignia

Ranks and Insignia of St John Ambulance (Officers up to Regional level)
RoleUniformed Front line Personnel
(including young people in SDU)
Uniformed unit management teamUnit ManagerUniformed Regional Management Team indirect report
(excluding Unit Manager)
Uniformed Regional Management Team direct report
(Including Area Manager)
Regional Management Team
(including District and Department Managers)
ReplacesBrigade MemberDivisional Officer or
Medical/Nursing/Ambulance Officer
Divisional SuperintendentArea Officer
or County Staff Officer
Assistant Commissioner
or County Staff Officer
County Commander
Accountable toUnit ManagerUnit ManagerArea ManagerFunctional RMT ManagerDistrict ManagerRegional Director
Ranks and Insignia of St John Ambulance (Officers at National Headquarters level)
RoleNational Advisers
not reporting to the SMT
National Advisers reporting to the SMT
and Principal Priory Officers
Chief Volunteer
ReplacesCounty CommanderDeputy Chief CommanderChief Commander
  • Note: At the end of 2012, the Counties of England merged into eight accountable "Regions", sub-divided into geographic "Districts"; each Unit (previously "Division") was grouped together with nearby Units to form numbered "Areas" within each District, under the oversight of an "Area Manager". Before this, "County" was the basic administrative unit for command purposes (in London the title "District" was used instead). For each of the Channel Islands of Jersey and Guernsey the title "Bailiwick" is used.

Unit Leadership Roles for Young People

Ranks and Insignia of St John Ambulance Cadets
Officers Cadet Senior NCOs Cadet Junior NCOs Cadets Recruits

St John Ambulance
Cadets ranks and epaulettes
No Insignia
No Equivalent Leading Cadet No Equivalent Cadet Sergeant No Equivalent Cadet Corporal No Equivalent Cadet Recruit
LCdt CdtS CdtC Cdt Rct
  • Note: Non-Commissioned Officer ranks, prior to the Rank and Role review 2013, were available to adult volunteers. Post the 2013 changes, NCO ranks are not applied to adult volunteers.

Rank review

In December 2013 St John Ambulance officially announced its conclusion of the rank review that it had undertaken, subsequently issuing advisory documents to its members with detailed explanations.

The review was developed to ensure that a consistent and appropriate use of rank for positions, from the Unit up to the senior volunteers at National Headquarters. All existing ranks were removed and the new structure applied.

Non-Commission Officer (NCO) ranks

As a result of this rank review it was decided to remove all NCO ranks for adult volunteers and staff across the organisation.

Whilst these ranks have been removed for adult volunteers and staff, they still remain in place for Cadets.

Assistants and deputies

As a result of this review, Assistants and Deputies are no longer permitted through St John Ambulance, however additional team members may be added for geographical coverage.


  1. Messinger, M. and Killen, S. (2013) 'Announcement about the conclusion of the rank review', [ELECTRONIC], accessed 17 Dec 2014.
  2. St. John Ambulance, People and Organisation (2013) 'Rank structure: Quick reference guide', [ELECTRONIC], accessed 5 Jan 2014.

See also

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