EEAST Ambulance availability report - November 2023

The EEAST board has been focused on the availability of our fleet of ambulances over the last six months to understand and address the number of ambulances we have off road and any potential impact this has on us being able to respond to patients.

We operate a fleet of around 500 ambulances and, based on our staffing, aim to use around 300 of these at any given point. This gives us spare vehicle capacity for breakdowns, servicing and other repairs as required.

Around 20-30 vehicles will be undergoing planned maintenance on any given day (e.g., servicing, MOT etc). This allows for 125-135 vehicles to be taken off road for unplanned issues without affecting the ability of our crews to respond to patients. In July we saw a spike in unplanned maintenance issues which utilised nearly all this capacity, this was for a variety of factors including:

• Supply chain issues, particularly for key engine and gearbox components.
• Delays with our parts supplier in getting resource to the right place.
• Delays with dealers for warrantee related vehicle fixes alongside capacity constraints within other workshops we use for repairs.

• New leadership of our fleet management team.
• 10 additional mobile mechanic units to speed up repairs.
• Increased our stock holding of slow-moving parts by around £500,000 to compensate for supply chain challenges.
• Increased the salary for our own workshop technicians to ensure we are more competitive and better able to attract and retain the right skills and capacity.

This work has increased the number of vehicles we have available, with 26 more vehicles available each day in September compared to August and we have seen a further increase in October, taking our spare capacity to around 34-44 vehicles per day.

Importantly we have a vehicle available to our crews 97% of the time. In the instance where a local station requires a vehicle, we endeavour to move them from elsewhere to meet this demand.

The Suffolk and North East Essex area has been particularly impacted by fleet availability due to a higher level of unplanned off-road rates than any other part of the region. An in-depth review is underway to understand the reasons for this.

Our fleet allocation for Suffolk and North East Essex is 96 vehicles, with 59 needed at the busiest time of day. This allows for 37 vehicles to be off road. Our current off-road rate for both planed and unplanned maintenance for this area is 37 vehicles.

To address this, we have completed a demand review across the whole of our region and have moved 10 underutilised vehicles to Suffolk to increase their fleet availability to ensure we are able to respond to patients when needed.

We have 89 new vehicles on order, 19 of which will be deployed in Suffolk and North East Essex. We are also considering extending the lease period on some older vehicles to increase our fleet numbers to support patients through a busy winter period.

In the month of October an average of 4% of our fleet was off road for planned maintenance and 19% off road for unplanned maintenance trust wide.

We are working nationally with colleagues to address concerns about the reliability of our Fiat fleet, which were identified as the national specification ambulance. This has fed into the new national specification for ambulances which is currently being retendered by NHS England, subject to this we will replace 240 vehicles by the end of the 2024/25 financial year.

A third our fleet is nearing the end of its planned operational life of five years. As such our budgeted fleet replacement programme is underway, with 89 new MAN and Ford vehicles on order which will start arriving with us in November and will increase our fleet of ambulances to 513. The new vehicles will be allocated across each of the integrated care board areas we cover. The indicative distribution of the new vehicles by ICB area is listed below:

Norfolk & Waveney

• November 0
• December 2
• January 2
• February 7
• March 18
• April 18

Suffolk & North East Essex

• November 2
• December 5
• January 5
• February 8
• March 19
• April 19

Mid & South Essex

• November 0
• December 2
• January 2
• February 7
• March 17
• April 17

Cambridgeshire & Peterborough

• November 0
• December 2
• January 2
• February 5
• March 13
• April 13

Bedfordshire & Luton

• November 0
• December 1
• January 1
• February 3
• March 7
• April 7

Hertfordshire & West Essex

• November 0
• December 3
• January 3
• February 6
• March 15
• April 15

Cumulative Total

• November 2
• December 15
• January 15
• February 36
• March 89
• April 89

Our additional stock holding of parts and increased number of mobile mechanics in post, alongside our fleet replacement scheme will increase our numbers of vehicles and ensure that more of them are on the road and available to respond to 999 calls.