Trust CEO warns ‘I can’t afford people’ despite missing NHSE target

London Ambulance Service Trust has delayed the start dates for some paramedics and call handlers until the next financial year and has halted some other recruitment efforts.

Chief executive Daniel Elkeles told an HSJ roundtable he had cancelled call handler training and international recruitment “because I can’t afford people. And you think this is nuts because the only way of getting to 30 minutes is with more people”. He added that this was “the saddest thing”.

The trust, grappling with a 10 per cent increase in demand recently, has agreed with commissioners – including NHS England – that it will respond to category 2 calls in an average of 35 minutes and 57 seconds.

This is nearly six minutes above the NHSE target of 30 minutes, and almost twice the official target of 18 minutes.

Category 2 calls include suspected heart attacks and stroke, with ambulance services nationally having long struggled to meet the 18-minute target, since it was introduced before the pandemic.

Mr Elkeles said he would deliver a breakeven financial plan for the year and the agreed response time target but added: “it’s just about how many people we recruit and how much overtime and bank/agency I use”.

Despite LAS’ adjustment, other ambulance services are being held to a 30-minute target, with West Midlands Ambulance Service Foundation Trust warning it could end up with a £20m deficit if it prioritised meeting the target. At month three – the latest available – its deficit was £5.3m.

In a statement to HSJ, Mr Elkeles added: “Over the past couple of years, we have undertaken a record-breaking recruitment drive, taking the number of staff caring for patients to the healthiest numbers in our history.

“We have also focused on encouraging local people from more deprived areas of London to apply to work for us, with increasing success.

“At the same time, our retention rates have improved as we have made the service a better place to work. Because of this healthy position, and with NHS funding constrained this year, we have had to make the difficult decision to move the start dates for some 999 call handlers and paramedics to the new financial year.”

The trust held a careers fair and interviews in Newham recently, which attracted more than 600 people.

It said it has kept their details on file so it can contact them again when it is able to recruit.

LAS took on 1,600 staff on 2023-24, but now has a turnover of 9.5 per cent and has largely met its targets for recruiting staff this year.