AN ambulance trust has been told to improve its services to people living in rural areas.

In the first inspection by the Commission for Health Improvement (CHI), the Tees, East and Yorkshire Ambulance Service (Tenyas) is criticised for focusing too much on towns at the expense of country areas.

The ambulance service, which covers a huge area including the Yorkshire Dales, the North York Moors, Teesside, Whitby and Scarborough also comes under fire for not checking ambulances have the correct amount of equipment and drugs on board.

Inspectors expressed concern that technicians - ambulance crew with life-saving skills - do not receive regular training and ambulances are sometimes sent to incidents with two technicians rather than the preferred mix of a technician and a fully-trained paramedic.

The focus on the urban population "has had an impact on the level of service available to patients in rural areas," according to CHI.

While the inspectors acknowledge efforts to improve response times, such as the Yorlife community response team launched at Castle Bolton, in Wensleydale, last year, they say there is a lack of direction in planning such schemes.

CHI also noted concerns about the low priority given to patient transport services.

In some cases, information sent by GP surgeries was lost, resulting in patients missing their appointments.

But inspectors noted the staff commitment and public praise for their standard of care.

CHI was impressed that the trust is developing a one-stop shop that will mean ambulance, NHS Direct and out-of-hours GP services will all be handled by one call centre.

Tees, East and North Yorkshire NHS Direct, the 24-hour health helpline run from the Tenyas headquarters, was also assessed by CHI as providing a professional service.

Peter Homa, chief executive of CHI, said the trust must ensure that it is delivering a fair service to all patients, no matter where they are located.

David Taylor, chairman of Tenyas, said: "We welcome publication of the CHI report. Its findings hold few surprises and are broadly in line with our own perceptions.

"We were particularly pleased to note the recognition by CHI and the public, concerning staff commitment in caring for patients."

The trust has put together an action plan to address the issues raised by CHI, said Mr Taylor.

He said he was sure some of the problems reported by CHI were isolated cases