That gap between intention and reality was the problem I wanted to explore.
On 24 February 2026, I undertook an observer shift with East of England Ambulance Service (EEAST) at King’s Lynn Ambulance Station. The shift was facilitated by EEAST following discussions through their Head of Procurement. The aim was to better understand how our procurement decisions land at the coalface and what really makes a difference operationally.
The challenge of designing vehicles for people, not freight
Ambulances need to be converted from vans. The challenge we aim to solve with the Hub’s Double‑crewed ambulance base vehicle mini‑framework and Double‑crewed ambulance conversions mini‑framework is converting them into safe, usable clinical environments for patients and crews, often for crew shifts of twelve hours at a time.
Spending a full day in a double‑crewed ambulance brought that challenge into focus. The vehicle operated as a mobile clinic, office and rest space, often on poor road surfaces. Crews lived out of the vehicle, balancing patient care with documentation while constantly on the move.
Seeing this operational reality changed how I think about vehicle design and conversion. Decisions about vibration control, noise reduction and layout are not technical details. They directly affect comfort, fatigue and safety in the cab and saloon (clinical area) of the vehicle. People are not freight, and how we specify and convert ambulances has a direct impact on patient care and staff wellbeing.
Equipment that shapes how care is delivered
From a procurement perspective, equipment selection can appear straightforward. On the road, every design decision has practical consequences.
During the shift, equipment was used continuously. The power stretcher was well liked for being lightweight, although minor issues were noted with the toe lift mechanism. The defibrilator functioned well and supported care effectively, but its size and weight highlighted the trade‑offs of all‑in‑one equipment that must be carried into homes and public spaces.
This connected directly to the Hub’s Emergency Medical Consumables and Equipment (EMCE) framework. The framework does more than provide compliant access to products – it influences how paramedics move, what they carry and how quickly they can adapt to different environments.
One observation related to a needleless connector commonly used in hospital but not carried on the ambulance. Crews sourced it from hospital stock when needed. Following this feedback, EEAST requested samples through NHS Supply Chain to assess suitability for wider use. This is exactly how insight from the frontline should inform procurement decisions.
Medical gases and the reality of a busy shift
Medical gases are another area where desk‑based assumptions can quickly unravel.
One patient with pain received Entonox following attendance by a rapid response vehicle. During the hospital handover, ambulance staff continued Entonox administration while awaiting a hospital prescription. Clinical pressures delayed the handover and the cylinder remained with the patient for comfort, which resulted in the crew almost leaving without it. This observation sits within the Total Pharmaceutical Gas Solutions framework where Ambulance services are included in lot four. Experiencing this scenario in practice illustrated how cylinder losses are not carelessness. They are a by‑product of busy, high‑pressure environments where patient care quite rightly comes first.
These moments prompted a broader reflection. Do our frameworks hold up in practice? Are we covering what services actually need on all counts? In this case, the answer was yes.
Everyday cases, exceptional professionalism
All the cases I observed were routine ambulance work, yet each required calm judgement, strong communication and efficient handover.
What stood out was how crews managed expectations. They listened to frustrations about the National Health Service without losing focus. Questioning was purposeful and directed at identifying the underlying clinical issue.
Access to up‑to‑date patient records, both GP and acute, supported better decisions and smoother handovers. That connectivity makes a real difference to patient outcomes.
Joining the dots between insight and action
This observer shift helped me connect frameworks, specifications and lived experience. It deepened my understanding of what happens at the coalface and why procurement decisions must be grounded in operational reality.
I am grateful to the teams at the King’s Lynn Ambulance Station for their openness and professionalism, and to EEAST colleagues for organising and facilitating the shift. I am also pleased that further observer shifts are planned by others in our procurement team, including with East Midlands Ambulance Service. This kind of insight benefits everyone.
For me, the takeaway is clear. If we want our frameworks to deliver value, reduce risk and support patient care, we need to keep testing them against real working conditions.
Next steps
If your organisation is facing similar pressures, or you want to explore how our frameworks support frontline delivery, the Hub is happy to have a conversation with you.
Email [email protected] to start the conversation.
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Written by Martin Taylor, Assistant Director of Procurement – Ambulance and Training