 Since NWAS was formed in 2006, the trust adopted Blue epaulettes to by worn by its staff to denote their clinical grade and rank (examples of these are found in Image 1).Prior to this, Greater Manchester Ambulance Service (GMAS) staff wore bottle-green epaulettes matching the colour of their uniform.Following the creation of a National NHS Ambulance Service Uniform in 2015/2016, NWAS like many other trusts changed their epaulettes to dark green in order to match the colour of the new uniform (see image 2) which it gradually integrated alongside a structure change.