Ten NHS trusts ‘wasted £235m to hire private ambulances’

England’s NHS trusts have spent almost a quarter of a billion pounds on private ambulance services in the last three years as emergency 999 calls and sickness rates among health service paramedics rise.

According to figures obtained under the Freedom of Information Act, South Central Ambulance Service spent almost £69m on private providers; South East Coast Ambulance Service spent more than £35m; and North West Ambulance Service spent almost £30m. In total, the 10 trusts spent £235m on private ambulances over the period.

The GMB union estimates the same trusts spent about £146m on private ambulances between 2011 and 2013. “The fact ambulance trusts spent almost a quarter of a billion pounds on private ambulance services in just three years is a disgrace,” said Rachel Harrison, GMB national officer.

“This is cash used not just to transport patients, but to cover accidents and emergencies as well. This is money that could and should have been spent on recruitment and retention of staff and the purchase and operation of new vehicles to replace the ageing fleet in many trusts.

“GMB has members in these private companies and they tell us of underequipped ambulances poorly maintained, staffed by overworked and underpaid – and sometimes untrained – staff.”

Alan Howson, executive chairman of the Independent Ambulance Association, acknowledged that since 2012 there had “been a huge increase in the provision of ambulance services by independent ambulance providers”.

However, he said they were subject to stringent monitoring by the Care Quality Commission, ensuring they had to provide the same levels of service as the public sector. They are also subject to spot inspections by the NHS ambulance trust using them.

“We would say using the independent sector does provide value for money,” Howson said. “For example, the NHS doesn’t have to pay ongoing employment costs such as pensions [for private sector staff]. It just buys in capacity to meet peaks in demand.”

Last year up to 15% of emergency calls were dealt with by private sector ambulances. This figure has declined since April, when, in a bid to relieve pressure on the 999 service, the government introduced new criteria to define what constituted an emergency call. But pressures are again rising.

Harsh working conditions and allegations of bullying have led to an exodus of ambulance staff and high rates of absenteeism among those who remain. NHS data suggests ambulance trusts have one of the highest rates of abstenteeism among NHS providers.

Howson suggested the public’s shifting perception of the ambulance service was also a contributing factor. “As a society we have become way more consumerist and pretty much everyone has a mobile phone. One consequence of this is that people can easily dial 999 and we believe we have a right to something and we want it and we want it now. McDonald’s can give you a burger within 30 seconds of going into their restaurant, so why not an ambulance now because my GP can’t see me?”

A recent report by Lord Carter, a non-executive director at NHS Improvement, concluded that “too many patients are being unnecessarily taken to ED [emergency departments] by ambulances”.