13/04/2002
NHS Ambulance Fleet Faces Setback Due to Wheel Procurement Error
In a significant and frankly embarrassing blunder, the East of England Ambulance Service Trust (EEAST) has found itself in a costly predicament, having mistakenly purchased a fleet of 75 new ambulances fitted with the wrong type of wheels. This oversight has not only necessitated an immediate expenditure of over £133,500 to rectify the issue but has also, critically, led to a reduction in available emergency vehicles, potentially putting lives at risk by diminishing response capacity.
The core of the problem lies in the specification of steel wheels instead of the more appropriate alloy wheels for these high-speed emergency response vehicles. The trust's decision to retrofit alloy wheels stems from a recurring issue with steel wheels on emergency vehicles: the heat generated at the speeds required for 999 responses can cause the plastic indicator tabs, used to monitor the tightness of wheel nuts, to melt. This necessitates more frequent manual checks for steel-wheeled ambulances, leading to their temporary removal from operational service. Alloy wheels, on the other hand, mitigate this risk, reducing the need for such constant manual inspections.
The Procurement Oversight
According to reports, the EEAST's procurement team failed to specify alloy wheels in the original order for the new fleet. Consequently, the vehicles were delivered with steel wheels. A spokesperson for EEAST acknowledged the error, stating, "We have retrofitted alloy wheels to some of our ambulances as they were not included in the original procurement due to an error." They also clarified that the cost of retrofitting is no more than if the correct wheels had been fitted prior to delivery and that the work would be carried out in phases to ensure sufficient vehicle cover is maintained throughout the process. However, the statement also mentioned that "Many vehicles in our fleet have used steel wheels and there is no suggestion steel wheels on ambulances cannot withstand 999 response driving conditions," a point that has been met with skepticism by union representatives.
Union Criticism and Fleet Woes
The situation has drawn sharp criticism from union leaders, who are questioning the thoroughness of the trust's purchasing processes. Glenn Carrington, Unison's branch chairman at EEAST, described the mistake as "a costly mistake at a time the trust is supposed to be looking after every penny." He highlighted the impact on staff, for whom overtime is a crucial part of their income, and labelled the expenditure as "a real kick in the teeth." Carrington further pointed out that this incident is the latest in a series of fleet-related problems, which are draining the trust's resources and hindering its ability to serve the public effectively. "The trust urgently needs to get a grip on this fleet crisis," he urged.
Similarly, Donna Thomas, GMB regional organiser, condemned the error as "embarrassing and avoidable," attributing it to a "lack of due diligence and proper processes." She emphasised that vehicles being unable to enter frontline service due to management errors directly impacts response times, a critical issue given the trust is currently operating under an improvement notice from the Care Quality Commission (CQC), partly due to category two ambulance response times. Thomas argued that the £133,500 spent on retrofitting could have been better utilised to fund clinical staff. "There must be accountability for this error," she demanded.
Fleet History: A Pattern of Problems
This is unfortunately not an isolated incident for the EEAST. The trust has a documented history of fleet-related complications:
- Previous Fleet Issues: In the past, the trust has faced challenges with various vehicle types. A batch of new Fiat ambulances was found to have cabs too small for taller staff members, leading to the purchase of alternatives. It was reported that over 100 crew members were unable to drive these vehicles due to their height and build.
- Renault Master Vans: Last year, a dozen new Renault Master vans introduced during winter raised safety concerns among crews. Issues included carry chairs being positioned too high and a lack of multiple radios, hindering communication when crew members were separated.
- Fiat Ambulance Accelerator Pedal Malfunction: Back in 2019, a fleet of Fiat ambulances had to be withdrawn from service mere weeks after their launch due to a dangerous fault where the accelerator pedal became stuck.
- Leased Vehicles Amidst Maintenance Crisis: More recently, the EEAST resorted to leasing 15 vehicles to cope with peak demand, amidst claims of a fleet maintenance "crisis." While these leased cars are not equipped for emergency responses (lacking blue lights, sirens, and markings), they are used for patient transport at normal speed limits. Unions have criticised this as a "sticking plaster" solution while a significant number of regular fleet vehicles are out of service for repairs. In October, almost a quarter of the trust's 500 ambulances were reportedly off the road, with the majority undergoing unplanned maintenance.
New Ambulances and Government Investment
Despite these ongoing fleet issues, there is a broader context of government investment aimed at improving ambulance services. The Department of Health and Social Care is rolling out new ambulances across England, with the East of England set to receive 29 new vehicles by March next year. This initiative is part of a wider £4.5 million government plan to provide nearly 500 new ambulances nationwide, alongside the establishment of new Same Day Emergency Care and Urgent Treatment Centres, and mental health crisis assessment centres. Health Secretary Wes Streeting stated that these new vehicles will "make a real difference to patients in the East of England, replacing old and tired vehicles and getting to patients in minutes, rather than hours." He acknowledged that "more than a decade of underinvestment and neglect" cannot be fixed overnight but expressed confidence in the current measures to deliver faster emergency care.
Understanding Ambulance Response Categories
It is important to understand the context of ambulance response times. Ambulance services categorise calls based on urgency:
| Category | Description | Target Response Time |
|---|---|---|
| Category 1 (C1) | Life-threatening emergencies; cardiac arrest, choking, drowning, severe trauma. | Average 7 minutes, 50% within 7 minutes, 90% within 15 minutes. |
| Category 2 (C2) | Emergencies requiring immediate assessment and urgent treatment; stroke, severe burns, chest pain. | Average 18 minutes, 90% within 40 minutes. |
| Category 3 (C3) | Urgent but not immediately life-threatening conditions; less severe burns, non-life-threatening injuries. | 90% within 1 hour. |
| Category 4 (C4) | Less urgent conditions; minor injuries, minor medical conditions. | 90% within 2 hours. |
The mention of the CQC improvement notice related to "category two ambulance response times" underscores the critical nature of having a fully operational fleet. The delay caused by the wheel issue directly impacts the trust's ability to meet these crucial response targets.
Frequently Asked Questions (FAQ)
Q1: Why were the new ambulances fitted with steel wheels instead of alloy wheels?
This was due to an error in the procurement process, where the requirement for alloy wheels was omitted from the order by the EEAST procurement team.
Q2: What is the cost of fixing the wheel issue?
The cost to retrofit the 75 ambulances with alloy wheels is £133,500.
Q3: How does this affect ambulance availability?
Dozens of ambulances have been taken off the road to allow for the retrofitting of the new wheels, which temporarily reduces the overall fleet capacity and response cover.
Q4: Why are alloy wheels preferred for ambulances?
Alloy wheels are preferred because they are less prone to issues with heat generated at high speeds, which can affect the plastic indicator tabs used to check wheel nut tightness on steel wheels. This reduces the need for frequent manual checks.
Q5: Is this the first fleet issue for EEAST?
No, the EEAST has a history of fleet problems, including issues with vehicle size, equipment, and mechanical faults in previous batches of ambulances.
Q6: Will all future ambulances have alloy wheels?
EEAST has stated that all future deliveries will be fitted with alloy wheels as standard, avoiding the need for further retrofitting.
Q7: What is the impact of these issues on patient care?
Reduced fleet availability can lead to longer waiting times for ambulances, potentially impacting the speed at which patients receive critical care, especially for time-sensitive conditions like strokes or cardiac events.
Conclusion
The procurement error leading to the retrofitting of ambulance wheels highlights significant systemic issues within the EEAST's fleet management. While the trust is investing in new vehicles and undergoing broader improvements, such fundamental oversights in purchasing directly undermine operational capacity and public confidence. The financial cost is substantial, but the potential impact on patient care due to reduced fleet availability is a far more serious concern. It is imperative that the trust implements robust checks and balances in its procurement and fleet management processes to prevent such costly and potentially dangerous mistakes from recurring.
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