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The Association of Ambulance Chief Executives has published a position statement setting out how it sees the future commissioning of ambulance services by the reformed NHS Integrated Care System in England.
This comes after the demise of NHS England as it moves to the Department of Health and Social Care later this year and cuts that are seeing existing Integrated Care Boards (ICB) having to substantially reduce their operating budgets. An ambulance commissioning review is underway this year with a view to changes being implemented during 2026/27.
“The current challenges directly result in compromised patient outcomes and inefficient, sub-optimal service delivery, ultimately undermining the quality and effectiveness of care.”
Established in July 2022, there are 42 ICBS across England. A small number of lead ICBs commission ambulance services on behalf a group of ICBs as one ambulance service area will cover many ICBs.
The commissioning position statement sets out what AACE calls the case for change from the existing arrangements. It says that the lead ICB model: “creates a situation where lead commissioners coordinate rather than lead, with limited ability to implement strategic initiatives across regional footprints.”
“Ambulance services across regional footprints span multiple commissioning boundaries, yet discussions about resource allocation occur primarily with a single commissioner which will typically have a bias to their own system sustainability.”
This is, says AACE, a pivotal opportunity to resolve longstanding commissioning barriers to optimal patient care delivery.
“This paper presents a unified sector position to inform the development of a commissioning framework that enables ambulance services to fulfil their evolving role within integrated healthcare systems.”
Anna Parry, Managing Director of AACE said that commissioning should be a priority to ensure the ambulance service’s contribution to urgent and emergency care.
“Our commissioning position statement is designed to help and inform key stakeholders in Government and across the health service who can help effect these changes, against the backdrop of national review of current arrangements.”
Anna Parry, MD, Association of Ambulance Chef Executives.
The full 16-page statement Commissioning NHS Ambulance Services provides more detail including case studies.
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