Spending on private ambulances in region soars to £1.4m per month

Thanks to the Freedom of Information Act, this newspaper can today reveal a large rise in the use of private ambulance services, by the East of England Ambulance Service NHS Trust. Between November 2015 and October 2016 the trust's spending on this has rocketed from around £341,000 per month to £1.4m per month.

However figures for the same 12 months show no improvement in Red 1 calls and only a marginal improvement in Red 2. Red 1 and Red 2 calls feature the most seriously ill and injured patients – and all ambulance trusts are expected to reach those patients in eight minutes or less in 75pc of cases.

Those targets are not being met by EEAST – a problem mirrored across England with all ambulance trusts missing the target in October, the latest month for which figures are available.

EEAST's response times hit rock-bottom in March - prompting bosses to increase the use of private ambulances as part of an action plan to improve performance. Since then the trust has spent £8.5m more than budgeted on private ambulance services since April 2016, according to the latest publicly available figures.

While performance has improved since March, Red 1 responses for October 2016 were still lower than in November 2015. Red 2 performance has improved over those 12 months by just 3.3pc and the trust is still far off hitting the 75pc target.

It comes at a time when EEAST are experiencing record levels of demand, with the number of Red 1 and Red 2 calls nearly 5,000 higher in October 2016, compared to November 2015. The spending on private ambulance services has impacted on EEAST's finances.

The trust, which recorded a £158,000 surplus in 2015/16, looks set to finish 2016/17 in deficit.

Fraer Stevenson, Unison branch secretary, said: 'It's very worrying that the trust is spending such large sums on private providers and it does raise the question why they're not putting more energy into supporting their existing staff and tackling retention issues. Our vacancy rate and the loss of experienced staff from the frontline has a massive impact on patient care.

'The student paramedic issue is one example where the trust has recently failed to act fairly or consistently – this massively impacts on morale and retention.

'Over the past few months the trust also made changes meal breaks at peak times, which left hundreds of staff without a meal break for their entire shift. It is hard to see how the trust can justify that.

East of England Ambulance Service NHS Trust Response

• Why has spending on private ambulances increased by more than £1m in one year? Is this trend set to continue in the next 12 months?

'The use of private ambulance services (PAS) contracts and expands according to our needs... Demand is now at record-breaking levels; this New Year's Day alone we took 30pc more calls than the same day last year. That equates to more than 1,000 additional 999 calls in one day. And in another 24-hour period we received an unprecedented 4,000+ calls. Lost hours due to handover waits after arriving at hospital across the region are at least 50pc worse than the same period last year. We also have to release student paramedics to return to university each week which often results in thousands of hours being replaced with PAS. We've got some immense efforts going into recruiting more people to patient-facing roles so that our use of PAS decreases further wherever possible. However, while there continues to be a gap between capacity and demand, the reality is that we need, and will continue, to use private ambulance services to respond to these levels of demand, add to our capacity, and make sure that despite the huge increase in 999 calls, our patients still receive a good and safe service.'

• If the aim was to improve performance of response times, has this been worth the money spent given the results quoted above?

'The number of responses to our most seriously-ill patients – the Red 1 category – within eight minutes is on a constant upward trend and we continue to respond to more patients more quickly than ever before. The primary focus of our service is to provide a safe and effective service and use the additional PAS to ensure more ambulances are available to respond and that patients with life-threatening conditions are not waiting for prolonged periods.'

• How much money did the trust anticipate spending on PAS for 2016/17 financial year, and how much has it spent so far (from April-Dec)? According to your October board papers spending was £8.5m cumulatively over budget – what has caused this?

'Regulators and commissioners recognised that the significant increase in demand, the hours lost due to handover waits, and the need to release our student paramedics to university, meant we would have to spend up an average of £1.7m per month.'

• What is the latest available monthly figure for spending on PAS after October 2016?

Nov – £1,378,658; Dec – £743,379