National ambulance vehicle specification for English NHS ambulance trusts

Closed 1 Feb 2019

Opened 14 Dec 2018


Lord Carter’s 2018 review into operational productivity and performance in English NHS ambulance trusts found significant unwarranted variation in the national ambulance fleet and a lack of innovation at scale. This work was based on analysis of trust data, review of international ambulance fleets and engagement with frontline services.

His review considered that the sector could benefit significantly by adopting a standard vehicle specification and by procuring vehicles through a single channel. These actions would drive innovation on a national scale in partnership across the sector, and with suppliers and other expert groups. It made nine recommendations which were accepted in full by the NHS Improvement Board on 27 September 2018.

A key recommendation in the report is that “NHS Improvement should work with trusts boards and the Association of Ambulance Chief Executives to agree proposals to rapidly move to a standard specification for new fleet across England and deliver significant improvements in the way fleet is managed”.

The report identified that the 10 English NHS ambulance trusts use two main types of double-crewed ambulance (DCA) – a box DCA (on the left in the figure below), where a modular unit is added to a base vehicle chassis; and a van conversion (on the right), where the inside of the base vehicle is converted. There are 32 different specifications across those types.

From analysis of available data supplied by the 10 English NHS ambulance trusts, including purchase price, conversion price and whole-life costs, the report concluded that “van conversions appear to offer better value for money than box conversions”. The difference in whole-life cost is shown below. On that basis, the development of a single standardised specification is focused on the van conversion type of DCA.

Why We Are Consulting

The development of a single specification is the first step in moving towards a new model for managing fleet across the English NHS ambulance services and securing value for money in the procurement of ambulances. It will provide a consistent basis for engaging with the market and for developing a future procurement strategy.

The consultation document provides a high-level specification for a standard emergency DCA which we propose is adopted by all trusts from April 2019. It is deliberately high level to enable trusts to continue to make detailed design decisions at a local level. It does, however, specify that a van conversion ambulance is required.

The specification includes several development features not currently commonplace in specifications, which will improve safety and increase efficiency. These include black box technology, CCTV, 4G/Wi-Fi functionality, mis-fuelling safeguards and temperature-controlled drug storage.

The proposed specification is not intended to be finite. It is the first iteration of a single specification to allow work to start towards convergence and provides the basis for collaborative innovation. We intend to develop further iterations of the specification over the coming years to increase convergence and to drive innovation.

To develop the specification the four most commonly used van conversion DCAs were scored and commented on by fleet and operational representatives from all the English NHS ambulance trusts. Operational representatives included both paramedics and advanced paramedics, as well as clinical managers and local trust union representatives. An expert group formed from the sector worked with a sector procurement specialist and NHS Improvement to develop the proposed single specification for consultation.



  • Crown Commercial Service: Suppliers event

    From 17 Dec 2018 at 10:00 to 17 Dec 2018 at 16:00

    In addition to this online consultation, the Crown Commercial Service is hosting a supplier engagement event on 17 December 2018 on behalf of NHS Improvement and English NHS ambulance trusts. This event will give vehicle manufacturers and converters the opportunity to speak to the expert project team and other sector representatives. We envisage that this event will cover the specification from a supplier point of view and seek input on how to create value in the supply chain for the benefit of the sector as a whole. Vehicle manufacturers and converters are also invited to respond to this consultation.