UNISON, the major UK health union, yesterday blamed the government for the crisis over dirty ambulances and issued a call ‘for urgent action to get dirty ambulances off the road’.

Sam Oestreicher, UNISON National Officer for Ambulance Staff said: ‘The government recently announced extra money for deep cleaning hospitals, but ambulances seem to have been forgotten.

‘They are part of the patient care package and no one should have to travel or work in a dirty ambulance.

‘Ambulance cleanliness is a key factor in the battle against healthcare related infections and the standards laid down should be strictly applied and monitored. The guidance on ambulance infection control is comprehensive, but in practice the essential resources necessary to keep vehicles clean and infection-free are not being provided.

‘In many trusts ambulance crews are responsible for cleaning their own vehicles and this is a waste of their time and training. They should be out there saving lives not mopping out the back of a dirty ambulance.

‘Existing voluntary guidelines should become mandatory standards, including a rigorous monitoring and inspection regime.

‘The additional funding needed to bring all ambulance services up to scratch should be made available by the Government and not provided at the expense of other ambulance or NHS services.’

Ambulance crews are deeply worried about the risk that dirty ambulances pose in spreading MRSA and other healthcare-acquired infections.

They point to government-imposed targets, time, and money pressures as the reasons behind differences in cleaning practices from Trust to Trust.

The union wants ambulance cleanliness standards to be properly applied and monitored, because of wide variations in the way Ambulance Trusts across the UK tackle the problem.

A recent investigation by UNISON shows that the London Ambulance Service is one Trust leading the way in dealing with the problem, with a ‘make-ready’ system.

The service takes the issue very seriously and has on-site cleaners who work throughout the night, deep-clean and routinely clean the fleet. They also restock ambulances with fresh kit. This takes away the need for crews to spend time washing and restocking vehicles. Crews bring in a dirty vehicle and leave with a cleaned one.

By contrast, the situation in the North West is very different, with no dedicated cleaning staff or cleaning time.

Crews report that they don’t get time to check the vehicles, let alone clean them. The vehicles are never deep cleaned, and at best, if they know a patient is infected with Clostridium difficile – the ambulance will get a quick mop out.

In Scotland, there are dedicated cleaners in some of the City Stations. Some stations get the time to do a weekly clean on their vehicles while others are simply too busy.

This is a situation that the Service takes seriously and is currently looking at different ways of working. One proposal involves using cleaners from NHS Boards who have the correct training for cleaning ambulances.

Scottish stations also have protocols involving which cleaning materials to use to ensure no cross infection in the station i.e. colour-coded mops.

In the South West, crews report little headway on this issue. There was a commitment to address the problem by employing some staff to deep clean vehicles and stations where necessary but the cost is causing delays.

In Wales there is a strong belief amongst ambulance crews that not enough is being done to ensure vehicles are kept routinely and consistently clean.

This has led to the responsibility for ambulance cleanliness to be part of the role of new team leaders. In addition, following pressure from staff and the union, the service is looking at a ‘make-ready’ scheme, similar to the one in the London Ambulance Service. This would involve new super-stations where ambulances would be cleaned and made ready for crews to swap over.

The North East Ambulance Service has been proactive in tackling the problem of dirty ambulances for some time.