St John clinical director Dr Tony Smith said ambulance officers were often the first to arrive at the scene and see first hand the devastating impact of crashes especially when passengers were not wearing seatbelts. "Our view that seatbelts on buses of an agreed definition should be compulsory remains unchanged; we believe safety belts should be worn to prevent fatalities and serious injuries including fractured and amputated limbs. " In 2018, St John urged the government to make wearing seatbelts compulsory on some bus services after two people died and many others were injured in a spate of accidents - but the calls fell on deaf ears.