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Background The Health Care Act 2022 places mandatory duties on NHS organisations to reduce health inequalities. To support this, staff must be equipped with appropriate knowledge and skills. A service evaluation was undertaken across clinical and non-clinical staff and volunteers at NWAS, a regional NHS ambulance service, to assess awareness of health inequalities and Make Every Contact Count (MECC), to inform future training design. To date, there is limited evidence regarding the use of MECC in urgent and emergency settings, with findings indicated uncertainty on whether health promotion is part the role, and gaps in training.Methods Between March and April 2024, all NWAS staff and volunteers (approximately 7,415) were invited to respond to an anonymous structured survey, assessing their understanding of health inequalities and MECC, and their application in practice. The survey contained 41 closed questions with 4 open-ended for additional insights. Responses were anonymous, with only area, service line, and role collected. Recruitment was through self-selection sampling. Descriptive statistical analysis was applied to closed responses. Open-ended responses were analysed thematically.Results Of 393 valid responses (5.3% response rate), 62.1% responses were from patient-facing staff and volunteers. Across roles, responses were 20% Paramedic Emergency Services, 18% NHS 111, 17% Emergency Operations Centre, 17% Corporate roles, 14% Volunteers, and 12% Patient Transport Services.84% and 33% of respondents indicated they were familiar with the terms ‘health inequalities’ and ‘wider determinants of health’ respectively, highlighting a knowledge gap on health inequalities’ contributory factors.16.5% of respondents had received MECC or similar training. Among patient-facing staff, 82% agreed that signposting patients to local services would benefit health and wellbeing; 23% (in-person facing) and 10% (remote facing) reported doing this regularly.Thematic analysis of open-ended responses identified interrelated themes to barriers and opportunities, including that a MECC approach is not perceived as part of roles, a lack of training and confidence in abilities to do MECC, system limitations to do MECC, and improved access to a directory of available services.Overall, 82% of respondents agreed NWAS should play a role in improving population and workforce health.Conclusions This is the first known survey of its kind within NHS ambulance services. Study limitations include low response across roles, responses are subject to self-selection bias; quantitative analysis only uses proportional data, and qualitative analysis is only exploratory. Findings show strong workforce support for NWAS having a role in improving population health but reveal gaps in understanding of health inequalities and implementation of MECC. Future efforts should focus on tailored training and support.