NHS spending over £1m a week on private ambulances for 999 callouts, says UNISON

In the South East region South Central Ambulance Service spent £19m over the past financial year on private emergency services, with South East Coast Ambulance Service spending around £6m a year.

The NHS is spending at least £61 million a year – over £1m a week or £167,000 a day – hiring private ambulances to attend emergency calls, says UNISON today (Monday) as its annual health conference opens in Bournemouth. 

North West Ambulance Service spent more than £15m between January and December 2022 on private emergency services, according to data obtained by the union. 

South Central Ambulance Service spent £19m over the past financial year, North East Ambulance Service is paying just under £7m annually, and South East Coast around £6m a year.

East Midlands Ambulance Service predicts a £9.5m spend in the financial year between 2022 and 2023, and the latest figures from Yorkshire Ambulance Service show the trust paid out £4.5m between 2021 and 2022. 

The figures are based on responses from two thirds* of ambulance trusts in England that pay commercial companies to provide cover for critically ill patients.  

More than a dozen private companies are being commissioned by ambulance trusts across England to fill widening gaps in services and to meet response times amid overwhelming demand, says UNISON.   

Trusts are booking private emergency vehicles and crews up to a year in advance to be available to respond to emergency incidents such as road traffic accidents and stroke patients. 

However, UNISON says spending tens of millions on private 999 cover is a short-term fix, not a long-term solution to the crisis in ambulance services.  

With demand on ambulance services soaring, the union says this failed policy means that millions of pounds of public money are going into the pockets of private firms rather than being invested in more highly trained ambulance staff and better ambulances. 

The money for private cover comes from one-off government ‘crisis management’ payments that are not guaranteed from year to year.  

The union says this approach deters some ambulance trusts from investing in their own additional NHS vehicles and staff because of the ongoing costs incurred.    

UNISON says private firms are capitalising on the crisis in ambulance services, by tempting paramedics and other crew away from NHS work. The boosted hourly rates might seem attractive but risk leaving staff without sick pay and pensions, the union adds.

In some cases, privately employed crews are being paid to stay with patients in hospital corridors until a bed can be found. 

For example, University Hospitals Dorset NHS Foundation Trust has hired this additional cover known as ‘cohorting’ to allow NHS ambulances to leave queues outside A&E and get back out on the road to respond to 999 calls. 

Responding to the figures, UNISON head of health Sara Gorton said: “This spend on private 999 services shows a lack of long-term planning and is a shocking waste of money. It’s nothing more than a sticking-plaster solution. 

“Ambulance services are in a desperate state because the government has failed to invest long term. 

“Patients are waiting ages for help to arrive or worse still dying before crews can reach them. Others are stuck in emergency vehicles outside hospitals for hours and hours on end waiting for a bed. 

“This is a crisis of the government’s own making that can only be resolved with a long-term plan. Ministers must step up and come up with proper funding to tackle increasing demand and pay staff properly.” 

Notes to editors:

– UNISON’s annual health conference opens today in Bournemouth and runs until Wednesday (19 April). Over the three days, health workers from all across the UK will come together to take part in debates on a wide variety of topics including pay, pensions, childcare, hospital food, ambulance pressures, mental health and challenging racism. UNISON general secretary Christina McAnea will give a speech to delegates at 2pm on Tuesday. Other speakers include Anita Charlesworth from the Health Foundation and Kate Bell from the TUC. The event takes place at the Bournemouth International Centre, Exeter Road, Bournemouth BH2 5BH. The conference opens at 9.30am on Monday and closes at lunchtime on Wednesday.

– *A total of 9 out of the 10 NHS ambulance trusts in England commission private 999 services. These include London Ambulance Service which did not provide a specific figure, South Western which only provided figures for 2019 to 2020, and East of England which did not provide figures. 

– Staff employed by private firms for emergency cover include emergency care assistants, technicians, and paramedics. 

– UNISON is the UK’s largest union and the largest union in the NHS and in the ambulance sector, with more than 1.3 million members providing public services – in education, local government, the NHS, police service and energy. They are employed in the public, voluntary and private sectors.