Chemist4U Report: NHS Bariatric Ambulance Bill
The UK is now one of the heaviest countries in Europe. Around 64% of adults are overweight, and 28% are obese, double the number from 1990, when only 14% of adults were classed as obese.
Hospital admissions linked to obesity have also shot up. In 2017–2018, there were 711,000 hospital visits where obesity was a main or secondary diagnosis. By 2022–2023, that number had nearly doubled to just over 1.2 million.
As obesity rates rise, the NHS has had to make changes, including using bariatric ambulances, which are specially built to carry heavier patients safely. These ambulances have stronger stretchers, wider doors, and reinforced lifts to help move patients comfortably and reduce the risk of injury to ambulance crews.
Here, we look at what’s driving these rising rates, how the NHS is responding, and what this means for the future of obesity care in the UK.
Key points:
- Bariatric ambulances are designed to safely transport people who are obese or have limited mobility.
- The NHS has spent over £20.7 million on these ambulances, services, and equipment since 2020.
- That’s about £3.4 million each year, roughly the same as hiring 100 new nurses.
- Spending on bariatric transport rose by 123% between 2023 and 2024, going from £2.2 million to nearly £5 million.
The total spend on bariatric ambulances, services and equipment by NHS Ambulance Trusts (2020-2025)
| Authority Name | Total spend on bariatric ambulances, services and equipment in GBP (2020-2025) |
| North West Ambulance Service NHS Trust | 14,198,313 |
| South Central Ambulance Service NHS Foundation Trust | 2,288,889 |
| West Midlands Ambulance Service University NHS Foundation Trust | 1,440,888.68 |
| East of England Ambulance Service NHS Trust | 1,256,803 |
| London Ambulance Service NHS Trust | 1,162,537.92 |
| East Midlands Ambulance Service NHS Trust | 191,518.86 |
| Northern Ireland Ambulance Service Health and Social Care Trust | 75,529.44 |
| Yorkshire Ambulance Service NHS Trust | 53,994 |
| Isle of Wight NHS Trust | 28,894 |
| South East Coast Ambulance Service NHS Foundation Trust | 8,035 |
| Total | £20,705,402.92 |
A Freedom of Information request by Chemist4U found that NHS Ambulance Trusts spent around £20.7 million on bariatric ambulances, services, and equipment between 2020 and 2025.
North West Ambulance Service NHS Trust
Between 2020 and 2025, the North West Ambulance Service spent £14.2 million on bariatric ambulances, services, and equipment. This is more than double the total spending of all other NHS trusts combined.
In 2025, this included the purchase of eight MAN chassis cab vehicles costing £416,976. These vehicles will be converted into bariatric ambulances later in the year.
| Supplier | 20/21 | 21/22 | 22/23 | 23/24 | 24/25 | 25/26 to M3 (June) |
|---|---|---|---|---|---|---|
| 360 Ambulance Service Ltd | – | – | – | – | 6,298 | 32,397 |
| 365 Secure Care | – | – | – | 88,179 | – | – |
| AFJ | 10,271 | – | – | – | – | – |
| Ambulnz Community Partners | 41,730 | 260,951 | 28,019 | – | – | – |
| Echo Fire & Medical | 9,743 | – | – | – | – | – |
| ER Systems | 279,697 | 405,966 | 273,252 | – | 578,969 | 128,035 |
| ERS Medical Ltd | – | 298,281 | 192,780 | – | – | – |
| Jigsaw Medical Services Ltd | 443,471 | 19,273 | – | – | – | – |
| HATS Group Ltd | 9,554 | 598,203 | 793,226 | 126,999 | 49,154 | 73,880 |
| Medipro | – | 5,400 | – | – | – | – |
| Medrescue Group | 1,016,859 | 300,664 | 172 | – | – | – |
| Mersey Medical Services Ltd | – | – | – | – | 1,100 | – |
| North West Private Ambulance Liaison Services | 208,893 | 304,647 | 189,230 | 307,718 | 467,450 | 39,496 |
| Norwest | 290,733 | 145,872 | 64,678 | – | – | – |
| OSR Medical Ambulance Service | 577,701 | 462,183 | 394,599 | 141,794 | – | – |
| Private Ambulance Services Ltd (PAMS) | 197,226 | 48,420 | – | – | – | – |
| Spark Medical | 182,625 | 320,156 | 462,092 | 543,624 | 912,550 | 228,787 |
| UK Event Medical Services | 321,487 | 64,591 | 23,222 | 224,043 | 417,298 | 113,703 |
| YorMed Ambulance Service | 470,975 | – | – | – | – | – |
| Total: | 4,060,965 | 3,234,606 | 2,421,269 | 1,432,356 | 2,432,819 | 616,298 |
The table above, provided by the North West Ambulance Service, shows that bariatric vehicles were procured through 19 private providers. However, these vehicles were not always used exclusively for bariatric patients.
Medrescue Group had the highest contract value at £2.65 million, followed by ER Systems at £1.67 million and HATS Group Ltd at £1.65 million. The trust’s highest annual spend on bariatric vehicles was in 2021/22, reaching £4.06 million.
South Central Ambulance Service NHS Foundation Trust
Ranking second for bariatric vehicle and equipment spending is the South Central Ambulance Service NHS Foundation Trust, with a total of £2.29 million. The trust’s highest spending year was 2023/24, reaching £665,716, more than three times the £193,284 spent in 2021/22.
However, despite this significant investment in bariatric-capable vehicles, the fleet was reportedly used for only 13 callouts, 7 in 2024/25 and 6 so far in 2025/26.
A South Central Ambulance spokesperson said:
"When required, it can take additional time to get the equipment to the patient's location, and such callouts can also require additional manpower resources not just from SCAS, but also from other services, such as fire and rescue, for example, if getting the patient out of their location is challenging.
“As part of our demand management planning and forecasting, we continue to monitor bariatric patient activity so that our procurement strategy ensures we have the right levels of vehicles and equipment to meet the expected demand. We are anticipating that such demand will increase, but remain small relative to overall demand, in the medium term as levels of obesity in the wider population continue to increase.”
West Midlands Ambulance Service University NHS Foundation Trust
In third place, the West Midlands Ambulance Service University NHS Foundation Trust has spent £1,440,888.68 on bariatric ambulances, services, and equipment since 2020. This includes 15 vehicles and £169,678.39 spent on bariatric equipment alone.
The trust’s highest annual spend was in 2021/22, at £769,312.50, which covered both equipment and the purchase of seven bariatric-equipped vehicles costing £655,218.59.
A West Midlands Ambulance Service spokesman said:
“Like all ambulance trusts, West Midlands Ambulance Service has a specialist bariatric capability for those patients who require it.
“All of our emergency ambulances are bariatric-capable, but in addition, we have 15 vehicles - one for each hub - that come with additional capabilities. They are fitted with a specialist stretcher and are equipped with a lifting and handling kit over and above that carried on our standard ambulance fleet.
“These vehicles are used within normal day-to-day operations and respond to any 999 call. In addition, our Hazardous Area Response Team also has a specialist bariatric capability should crews require additional support.”
Which NHS Ambulance Trust has spent the most in 2025?
In 2025, the East of England Ambulance Service recorded the highest spending on bariatric ambulances and equipment, at £623,928. This was followed by the North West Ambulance Service at £616,298, and the South Central Ambulance Service at £153,407.
Across all years analysed, 2024 saw the highest total spend, with ambulance services recording £4,983,581.36 spent on supporting the transport of obese patients. Comparing spending increases over 2020–2024, 2022–2024, and 2023–2024, ambulance services have raised their spending by an average of 66.10%.
The biggest jump came from the East Midlands Ambulance Service, where costs rose by 1,138.96% between 2022 and 2024, increasing from £3,606 to £44,676.84. Another large rise came between 2023 and 2024, when the West Midlands Ambulance Service University NHS Foundation Trust saw its spending increase by 386.37%, from £18,620.86 to £90,566.60.
Jason Murphy, Head of Pharmacy at Chemist4U, comments:
“The 66% increase in spending on bariatric ambulances and equipment highlights the growing impact of obesity and weight-related health issues across the UK. To help reduce this financial burden, we should focus on improving access to effective weight management support and services for those who need them.
“Simply expecting to solve the national obesity crisis by suggesting to people they should just eat less and move more is out-of-date thinking and not effective for so many. Instead, embracing new health developments like weight loss injections as a tool to help combat this disease is the only way we are going to have a significant impact on the number of people who are unhealthily overweight.
“Reducing the number of obese people in the UK will not only cut spending on specialist equipment like bariatric ambulances but also on treating other diseases and conditions linked to obesity, including heart disease, diabetes and some cancers.
“Prevention and effective treatment are the best long-term solutions for patient health and NHS spending. With improved access to weight loss medications, we could be the generation that stops obesity in its tracks and helps protect the NHS for future generations.”
Sources
[1] BBC | Why are Brits the fattest in Western Europe?
[2] NHS England | Statistics on Obesity, Physical Activity and Diet, England, 2019
[3] NHS England | Statistics on Public Health, England 2023
[4] BBC | South Yorkshire fire crews trained for obese rescues
[5] Nurses.co.uk | The UK Nursing Salary and Pay Scale Guide - 2025 *
* Based on the cost of hiring a Band 5 nurse with 0-1 years of experience (£31,048)
Methodology
- Chemist4U sought to uncover the amount of spending on bariatric ambulances and equipment as well as the number of callouts where a bariatric ambulance was deployed from 2020-2025 across the UK.
- In order to gather their data for the purposes of this study, Chemist4U sent a Freedom of Information (FOI) request to local authorities.
- The following data was requested:
- The total cost (in GBP) of bariatric ambulances purchased or leased, broken down by calendar or financial year.
- The total cost (in GBP) of all bariatric equipment purchased or leased, broken down by calendar or financial year.
- The total number of callouts where a bariatric ambulance was deployed, broken down by calendar or financial year.
- Once the data was received, it was combined and analysed to reveal total spend, as well as year-on-year increases.
- The study is based solely on the information provided by the authorities listed. Chemist4U assumes no responsibility for any inaccuracies resulting from erroneous data provided.
- The data provided is for the period of 2020 to 2025. All data is correct as of October 2025. The full dataset is available upon request.
