Almost £10m was spent on private ambulances for 999 and non-urgent work last year as the region's ambulance service's reliance on private transport has doubled.

Research by PA news agency shows England's ambulance trusts spent more than £92 million in the last year on private ambulances and taxis to transport patients.

The East of England Ambulance Service NHS Trust (EEAST) spent £9,535,027 on private ambulances for 999 and non-urgent work in 2018/19, double the £4,791,155 the year before.

Its reliance on private ambulances to attend 999 calls rose, with more than double the number of 999 incidents resulting in a private ambulance being sent to the scene.

Some 26,428 incidents in 2018/19 involved a private ambulance being required, up from 12,947 the year before.

Private ambulances were sent to 5.21pc of all 999 incidents in 2018/19, up from 2.59pc the year before.

The East of England Ambulance Service NHS Trust said it had hired hundreds of new staff but used private ambulances for overtime and spikes in demand, such as in winter.

It added: "It takes three years to qualify as a paramedic and we use private services to fill gaps in budgeted capacity whilst student paramedics complete their university studies and whilst we fill vacancies.

"Recruiting trained staff, particularly registered paramedics, is extremely challenging and whilst we continue to recruit and train a significant number of patient-facing staff, we continue to use private ambulance services so that we can respond to patients as quickly as possible and give them the best possible service."

Earlier this year, the Care Quality Commission (CQC) published a damning report warning that patients were being put at risk by private ambulances.

It found that some firms were failing to obtain references or carry out criminal records checks while a lack of staff training was leading to serious patient harm.

Unison national ambulance officer Colm Porter said: "Spiralling costs for private ambulance hire are siphoning tens of millions from squeezed NHS budgets that would be better spent elsewhere.

"Research suggests private firms are cutting corners and failing to provide the level of care needed for patients.

"The NHS sorely needs investment to address staff shortages and stem the flow of departures from the ambulance service, rather than papering over the cracks."

The CQC report in March warned that patients were being put at risk from private ambulances.

The regulator found "ongoing issues with poor recruitment, training and safeguarding processes, with evidence of incidents of serious harm to people from staff that had not been properly recruited and vetted."

It added: "Many providers had no, or very limited, training for their staff."

In one example, inspectors heard how a driver believed he could drive the wrong way down a one-way street if he had a blue light on.

In another, "an extremely confused dialysis patient was found wandering in the street" after crews failed to make sure he got into his home safely.

A statement from the Independent Ambulance Association (IAA) said: "The support provided by independent ambulance providers to NHS ambulance trusts is vital in ensuring that the emergency needs of patients are met, particularly where there are peaks in demand."

It said private providers must be registered with the CQC and are "subject to additional and rigorous checks by NHS trusts.

"Our view is that monies spent on independent ambulance providers by NHS ambulance trusts are an investment to ensure the highest standard of care is provided; it's also very cost-effective."

The IAA said it was consulting on a quality framework for its members "that will provide greater assurance for those commissioning services in areas not currently covered by the CQC".

Recruiting trained staff 'challenging'

The East of England Ambulance Service NHS Trust (EEAST) said private transport is used due to ongoing issues with recruitment.

A statement from the trust said: "Over the last few years, the trust has hired hundreds of new staff to improve the service for our patients and to meet growing demand.

"As well as overtime, we use private ambulance services as a flexible resource to meet spikes in demand, such as winter when we see far more demand.

"It takes three years to qualify as a paramedic and we use private services to fill gaps in budgeted capacity whilst student paramedics complete their university studies and whilst we fill vacancies.

"Recruiting trained staff, particularly registered paramedics, is extremely challenging and whilst we continue to recruit and train a significant number of patient facing staff we continue to use private ambulance services so that we can respond to patients as quickly as possible and give them the best possible service.

"Like the vast majority of UK ambulance services, we use Care Quality Commission (CQC) registered private ambulance services so that we can respond to patients as quickly as possible.

"Alongside the requirement to be officially CQC accredited, each provider we use is also subject to our own internal approval processes and regular quality reviews."