AMBULANCE call-outs in Yorkshire are the most expensive in England, according to a report out today.

The study by the National Audit Office also reveals Yorkshire Ambulance Service (YAS) failed to meet national target response times to arrive within eight minutes to the most serious cases in 2015-16 - but the service also achieved the best overall response time to 999 calls in the country at 23 minutes.

Ambulance call-outs in Yorkshire cost an average of £339 each, £119 more than in the West Midlands, says the NAO report which looked at performance rates and costs of England’s ten ambulance trusts and concluded they are struggling to cope.

In 2015-16, Yorkshire ambulance crews managed to get to 70.8 per cent of the district’s most urgent incidents within eight minutes, the national target is 75 per cent.

The NAO says rising demand for urgent and emergency services are contributing factors, including more elderly patients with multiple conditions, an increasing number of alcohol and mental health-driven issues, the availability of primary care services in the community and how patients seek help.

Martin Flaherty, managing director of the Association of Ambulance Chief Executives (AACE), said: “It is no secret that the significant challenges facing the service at present must be addressed urgently if the service is to transform, along with the rest of the NHS, in order to cope with rising demand and provide the most appropriate responses for patients through new models of care.”

Mr Flaherty added that changes in the way ambulance services are commissioned and operate, to transform the delivery of out-of-hospital urgent care, were essential if the ever-increasing numbers of patients were to receive the right care, in the right place, at the right time.

Fifty per cent of calls to YAS were answered in one second with 99 per cent being picked up within one minute.

Turn-around times show that while Yorkshire ambulances were ready for the next call within 15 minutes 82 per cent of the time hospitals were only able to receive patients from paramedics inside the expected 15 minute limit 71 per cent of the time.

Other figures highlighted by the report revealed YAS spent £8 million on private ambulances and had a 5.6 per cent sickness absence rate among its employees.

In 2015, England’s Chief Inspector of Hospitals told YAS it had to improve its safety and effectiveness following an inspection by the Care Quality Commission.

Between 2009-10 and 2015-16, the number of ambulance calls and NHS 111 transfers increased nationally from 7.9 million to 10.7 million but increased funding for those services has not matched rising demand and future settlements are likely to be tougher, warns the NAO.

Ray Gray, Unison regional organiser for Yorkshire, said: “Wasted time with crews sitting outside A&Es unable to take patients in has got worse as demands and pressures have increased on hospitals.

“If they are stuck outside waiting they are not able to answer other calls quicker.

“Ambulance crews are stretched, they need more staff and more resources.

“The whole of the NHS and social services needs looking at as a whole, not just the ambulance service in isolation. It’s good to see what’s being said in the report rather than us saying it for a change.”

He added: “I am surprised at the difference between costs of call outs across England with Yorkshire having the highest. It seems a lot. I’d like to see how that is broken down.”

Amyas Morse, head of the National Audit Office, said: “Ambulance services are a vital part of the health service but much of their ability to work better greatly depends on other parts of the health system.

“Until clinical commissioning groups see ambulance services as an integral part of that system it is difficult to see how they will become sustainable and secure consistent value for money across the country.”

A pilot scheme to gives call handlers longer to assess problems over the phone and to allow ambulances extra time to reach people suffering conditions such as strokes or fits is being tested by Yorkshire and two other trusts which could lead to the current system of other than very serious calls being responded to within eight minutes being scrapped.

NHS managers argue that the move will rectify problems within the service, including several ambulances being sent to one address or ambulances being stood down once it becomes apparent they are not actually needed.

Figures in the NAO report suggest between four per cent and 46 per cent of ambulances are called back before reaching the scene.

The most serious cases - such as somebody not breathing, choking or suffering a cardiac arrest - would still have an ambulance dispatched within eight minutes but call handlers would be given extra time to assess other calls, such as for people suffering chest pains, having a stroke, sepsis or suffering a major burn.

At present, an ambulance is automatically dispatched 60 seconds into the 999 call, but this would be scrapped in favour of call handlers having up to four minutes to assess the seriousness of the situation, less serious cases might have to wait even longer.

Call handlers will also be expected to resolve more calls over the phone without sending an ambulance, while ambulance crews will be encouraged to treat at the scene rather than taking people to A&E.

Labour MP Meg Hillier, chairman of the Committee of Public Accounts, said: “The issues highlighted in this report are yet another sign of the huge pressures facing the NHS.

“Demand for ambulance services has increased by an average of five per cent a year since 2011-12, while funding has simply not kept pace, and trusts struggle to recruit and retain paramedics for this life-saving service.”

The National Audit Office also pointed to staffing issues, with most ambulance trusts carrying a large number of vacancies and one in ten posts unfilled nationally.

Councillor Vanda Greenwood, chairman of Bradford Council’s health & social care overview and scrutiny committee, said it was examining the state of emergency care in the district.

“We need to be mindful of the fact that these figures cover the whole of Yorkshire, so we’ll need to look in finer detail at the services on a more local level,” she said.

“That’s why we’ll be looking at the whole issue of urgent and emergency care in our district at a future Bradford scrutiny meeting, which will cover A&E, 111 and out-of-hours care as well as ambulance services.

“The last report on this was examined by scrutiny in October and it showed the different performances across specific areas. This issue warrants careful scrutiny as it’s obviously an important issue for local people.”