Calls for greater investment as figures reveal Kent trust spent £11m on private ambulances last year
PUBLISHED: 00:01 19 September 2017
Chiefs say staff shortages combined with continued increases in demand are responsible for the high spending
More than £11m was spent on private ambulances last year by the trust running emergency transport in Kent, it has emerged.
South East Coast Ambulance Service NHS Foundation Trust (Secamb) racked up a bill of some £11.176m during 2016/17 - making it one of the biggest spenders in the country.
Private ambulances are hired from private firms as well as charities such as St John Ambulance and the Red Cross, according to a Freedom of Information request.
It comes just days after it emerged there were more than 1,700 complaints about Kent’s non-emergency patient transport service, run by G4S, since it won the contract last summer.
Experts said soaring demand for private ambulances was behind the need for them, as well as problems moving patients through hospitals, which means NHS ambulances cannot be freed up.
The Royal College of Emergency Medicine’s president, Dr Taj Hassan, said: “It is concerning that trusts are having to use part of their budget for private ambulances, and serves to highlight the current levels of demand emergency departments are facing.
“Under-resourced departments are struggling with overcrowding and ‘exit block’, when patients cannot be moved in a timely manner to a ward.
“This means patients are waiting longer to be seen and ambulances cannot offload patients quickly, because there is simply no room for them.
“Ambulances then have to queue outside emergency departments for longer than should be necessary, delaying them from getting back out into the community, and creating a need for private ambulances.”
Dr Hassan also expressed concern about the quality of training offered by private firms.
“The Care Quality Commission has previously highlighted that they may use less qualified staff or staff whose qualifications aren’t regulated or restricted,” he said. “They may be poorly equipped, have poor clinical governance, poor infection prevention, and a lack of or inappropriate equipment.”
Jonathan Street, spokesman for the College of Paramedics, said NHS ambulance staff were “under heavy pressure due to growing numbers of 999 calls”.
He added: “These services are increasingly reliant on paramedics and other ambulance clinicians within the private sector to meet the demand, which involves considerable cost.”
He said a high turnover of NHS staff was affected by levels of stress, increasing workloads and paramedics wishing to work in other areas.
He added: “Large numbers of students are currently studying degree-level paramedic education.
“The college is confident that increasing numbers of qualified paramedics in the next few years will see a reduction in the need for reliance on the private sector routinely, saving them for use only at times of surges in demand.”
Unison national ambulance officer Alan Lofthouse said: “The huge sums spent on private ambulance services expose the pressures on staff due to soaring demand.
“Experienced and highly trained employees are leaving because of the strain.
“The government must start investing properly in the ambulance service and its workforce.”
A spokesman for the Independent Ambulance Association said the main reasons for a rise in private ambulance use in the last two years are “staff shortages in NHS ambulance trusts combined with continued increases in demand”.
He said there were several benefits of using independent firms, including flexibility and good value for money as “it’s cheaper for the NHS than paying overtime”.
He said the standard of care was “no different” to that offered by the NHS, and all providers are registered with the Care Quality Commission and subject to the same inspection standard as NHS ambulance trusts.
A Department of Health spokesman said: “The ambulance service answers more than 10 million calls every year and the vast majority of patients get an excellent service.
“Occasionally, ambulance trusts use other providers including St John Ambulance to help with spikes in demand, and these providers are subject to the same rigorous safety and quality inspections as NHS ambulances.”
A Secamb spokesperson told us: “While we always prioritise using our own crews whenever possible, along with other ambulance services nationally Secamb uses private ambulance providers to manage high levels of demand.
“We have robust governance arrangements in place for the procurement of private ambulance services.
“While working on the trust’s behalf any private provider will be subject to a continuous monitoring and assessment process, to ensure they are providing a high level of service and all providers must be registered with the CQC.”