The College of Paramedics has criticised the NHS's spiralling reliance on private ambulance services to plug the gap between NHS services and patient demand. Public spending on private ambulances has soared, increasing by more than 150% in the last four years to almost £60 million. Spending on ambulances provided by volunteer services, including St John Ambulance and the British Red Cross, has increased by a similar margin. 

The problem is a national one, with the South Central Ambulance Service having the highest total spend on private and volunteer ambulance crews. London has seen the most significant increase in spending, with four times as many paramedics leaving the London NHS service in 2013/14 compared with just three years earlier.  

In contrast, the East of England Ambulance Service reported that it has now stopped using private ambulances, having recruited enough students to increase its frontline staffing.  

Increased public demand, insufficient training places and staff leaving the profession are all factors that have contributed to a greater reliance on private and volunteer services and on recruitment from overseas. Overall, the College of Paramedics warns that there are not enough paramedics to provide a safe and effective service.  

Andrew Clayton of Penningtons Manches’ clinical negligence team explains: "The increased reliance on private and volunteer ambulance services raises significant concerns for patient safety. The College of Paramedics itself warns that there is a lack of trained staff, affecting the quality of care and the speed with which paramedics can deliver that care. We know from our experience of advising clients that patient outcomes are compromised by slow ambulance response times and inadequate paramedic care.  

"Increased spending on short-term solutions such as using private and volunteer services fails to address the underlying problems. In the case of ambulance services, the College of Paramedics is clear that investment in recruiting, training and retaining staff is key; not only to patient safety but also to more efficient public spending.  

"The Government has recently revealed that it is considering how to reduce the legal costs it has to bear for the NHS's negligent treatment of patients. The public would be better served by a greater focus on the proper reallocation of resources so that the NHS can deliver the care patients are entitled reasonably to expect and reduce the claims it faces. It would do well to heed the College of Paramedics' clear warning."