Private Ambulances

An apparent increase in the use of private ambulances in the NHS is a risk to patient safety, Labour has warned.
It says freedom of information requests show spending on private vehicles by three English ambulance services rose by millions over two years.

This is amusing to me as it was Labour who started the privatisation of the ambulance service whne they were in power. I remember the LAS losing a lot of patient transport contracts as private companies could ‘do it better and cheaper’. At one hospital I remember the private ambulance company lost their contract because none of their staff had been through criminal record checks…

I had reason to need an ambulance to transport a patient to hospital as an urgent case a little while ago. We booked the private ambulance to do the job and thought that was that. Later that day I had a phone call from the company saying that they wouldn’t do the job as it wasn’t booked with 24 hours notice. I told them that they should go ahead and book it for the next day, to which they replied that they still needed twenty four hours notice – I explained that they were actually getting twenty-six hours notice.

In the end we decided that as the patient needed to be in hospital we should use the LAS urgent service.
I was waiting at the house so that the crew could gain entry and was less than surprised to see a private ambulance turn up.

The figures showed an increase in spending of (in London) more then £3.8m, from less than £400,000, in 2010/2011, to £4.2m, in 2012/2013.

When I was still working in the hospital I was surprised that, when I went outside the A&E doors (normally looking for a member of staff who’d gone outside for a crafty cigarette), I would often see more private emergency ambulances than LAS ones.

As for the increase in private ambulances – could it have anything to do with something I wrote about previously – the decimation of the LAS?

While I am ideologically against the privatisation of the NHS (and the evidence would seem to back me up), the more practical concerns with respect to private ambulance services are, how well are they trained and kitted? Do they have clinical updates, CRB checks? Who does their staf training? What are the legal issues of them driving on blue lights and claiming the excemptions that the NHS services claim? In the effort to cut costs (and thereby increase profits for shareholders and owners) are they compromising patient safety?

I know that private ambulance services are monitored by the CQC, but we know how well staffed and effective they are.

The quality of the work of ambulance services are hard to track, it’s why the main gauge of ‘efficiency’ is ‘how fast did they get there’ – so I wonder how well the private services are being monitored.

My guess would be ‘not very well’.

One thought on “Private Ambulances”

  1. I worked as a Paramedic for a Private Ambulance Service used by LAS and I think I could shed some light on why you saw more Private Vehicles outside E.D. than LAS ones. LAS have set some strict practice limitations on private ambulance crews with regards to non-conveyances and discharge at scene.

    Private ambulance crews, should they wish to not convey a patient, must ring and speak to the clinical support desk and ‘green light’ the non conveyance with the paramedic supervisor on duty. This is often a long and tedious process that invariably leads to a conveyance because it can sometimes be difficult to adequatly describe, over the phone, the rationale for the non conveyance and your point of view. In fact, some CSD supervisors won’t entertain the idea of a private crew leaving a patient at home and will simply require the crew to take the patient to hospital.

    As you can see, as LAS staff can discharge a patient on scene and not go through CSD to do so, this leaves private crews with very little choice sadly.

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