Morale is at rock bottom at the region's ambulance service, according to unions, while one of the region's MPs says he has “serious concerns”. Although management and unions have now agreed to work more closely together, the Unison union says not much has changed since its branch committee wrote a damning letter to the chief executive earlier this year.

Morale is at rock bottom at the region's ambulance service, according to unions, while one of the region's MPs says he has “serious concerns”.

Although management and unions have now agreed to work more closely together, the Unison union says not much has changed since its branch committee wrote a damning letter to the chief executive earlier this year.

The letter said that the situation “is spiralling out of control” and that there is “a disturbing level of disharmony amongst staff and all levels of management”.

It says that the national response time targets are causing “intolerable pressure”, causing “patient care to become secondary”, and that meeting targets is “more important than staff welfare”.

It follows the departure of several senior members of staff in recent months, including medical director Peter Scott and Suffolk chief operating officer Rob Lawrence, and complaints from the union that they are excluded from the confidential part of board meetings.

Unison branch secretary Kevin Risby said that the core issues raised in the letter have not improved. He said: “We have got almost unachievable government targets, all energies are focused on achieving them, it has taken away from the things we should be doing.”

Senior union officers have recently met the management to try and improve the partnership between the union and the organisation. Mr Risby said: “I think the meeting went ok. We got a clear commitment from the management side that they want to work closely with us and try to improve things. We will see how things go from here.”

Norman Lamb, North Norfolk MP and Liberal Democrat health spokesman, said: “I have serious concerns about the ambulance trust - the leadership of it and the way it is operating, that it has failed to reach targets for response times in Norfolk and Suffolk, and apparent higher investment in the south of the region and more urban areas, and a feeling there is neglect in the rural areas.

“I am conscious of the haemorrhaging of senior respected staff which will have implications for patient care.”

An ambulance spokesman said: “Board members have met Unison senior officers and agreed a way forward which includes a review of our practical partnership working arrangements.

“Nationally we are performing well and are regularly in the top three best performing ambulance services in the UK and currently achieving the best response times ever. We achieved financial balance at the year end. We have just over 4,100 employees (and a further 3000 volunteers who support us).

“Our staff turnover for the financial year ending March 31 2009 was 6.84pc, 4.09pc less than in the previous financial year when it was 10.93pc. If there were serious morale issues within the Trust we would expect to see this figure increase rather than decrease.”