The ambulance services market - France

The global ambulance services market has seen moderate growth, with a CAGR of 2.69% in 2021, peaking at nearly 34% cumulative growth. Market dynamics have been influenced by an aging population, the rise of chronic diseases and the transition to ambulatory care, all of which are contributing to increased demand for medical transport services. Despite these growth factors, the market faces challenges related to operating costs. These include inflationary pressures, which have led to a minimum wage increase of over 12% in two years, and a significant rise in fuel prices.

These cost increases have had an impact on operating margins, especially as service rates are tightly regulated and increases are not in line with escalating operating costs. In 2021 alone, demand for medical transport has risen by 21.7%, driven by a backlog of medical procedures postponed due to the COVID-19 pandemic.

The French ambulance services market remains highly fragmented, but trends point to gradual consolidation, with a stable number of establishments but a 26.5% increase in employees by 2022. However, staff shortages persist, with an estimated 15,000 vacant ambulance positions by 2022. Major market players such as Transdev (7.7 billion euros in 2022) and Keolis (6.7 billion euros in 2022) are expanding, while regional operators are forming strategic groupings to maintain their market presence.

Despite the constraints, the sector's demand indicators suggest a structurally guaranteed growth trajectory, notably due to demographic changes and healthcare consumption patterns.

Trends in the French ambulance services market

In France, the ambulance services market remains an essential component of the healthcare system, meeting the needs of patients requiring emergency medical transport and assistance with scheduled or recurrent treatments. The market has been growing steadily, with an average annual growth rate of around 2.7% to 2021, representing cumulative growth of almost 34%.

One of the main drivers of this growth is the ageing population, which is set to increase significantly, with the number of people aged 60 and over expected to rise by around 33% by 2050 compared to 2022. This demographic shift is a structural guarantee for growth in demand for ambulance services, as an ageing population generally corresponds to an increased need for medical transport due to rising health complications and regular medical appointments.

The market is also influenced by the "ambulatory shift", a trend towards outpatient care that reduces hospital stays and brings healthcare services closer to patients' living environments. The number of full hospitalization beds fell by 7% in 2021, while partial hospitalization capacity increased by almost 14%. This development has contributed to an increase in demand for medical transport services, which are not limited to ambulances but also include light medical vehicles (VSL) and contracted cabs.

Spending on healthcare and medical products has also risen significantly in France, from around €180 billion in 2012 to over €225 billion in 2021, representing growth of around 25%. Even the ambulance services sector alone has recorded growth of 500 million euros in 11 years. This increase in healthcare spending reflects the growing demand for medical transport as an essential service in the wider healthcare landscape.

The market structure reveals a high level of fragmentation with consolidation trends, with regional operators forming strategic groupings to balance the influence of market leaders. The sector's workforce has grown by around 26.5% in 2022, despite a slight decrease in the number of companies in operation.

Nevertheless, the sector faces staff shortage issues, with around 15,000 unfilled ambulance positions by the end of 2022. Sector regulations require strict compliance, with companies having to obtain approval from the Agence régionale de santé (ARS) and comply with health insurance fund agreements. Ambulance service providers must have a sufficient number of qualified staff and a fleet that complies with regulations, including at least one ambulance. Despite this strong growth, the ambulance services sector is in full expansion.

The pillars of the sector

In France's bustling ambulance services market, several notable players have carved out a place for themselves, consolidating their position through diversified strategies and service offerings. These entities illustrate not only the commercial prowess of this crucial healthcare sector, but also the dynamic landscape where adaptability and service excellence are paramount.

• TRANSDEV is a multi-dimensional transportation giant, encompassing not only emergency medical services, but also a wide range of mobility solutions. Its extensive network and operational expertise enable it to offer reliable ambulance services as part of its vast transportation repertoire.
• KEOLIS marks its presence with a focus on public transport services, and as part of this, it provides vital ambulance services. Its operations cover various modes of transport, underlining its ability to integrate emergency medical transport into its wide range of services.
• The VYV GROUP presents a multi-faceted healthcare ecosystem that goes beyond the provision of ambulance services. With its involvement in health insurance, services and facilities, it brings a holistic approach to healthcare, emphasizing the vital role of medical transport in the continuity of patient care.
• ETOILE SECOURS, a specialist provider in this field, emphasizes its commitment to emergency medical services. Their focused approach underlines their commitment to providing fast, efficient ambulance services that meet the specific needs of medical transport.
• With a regional focus, VAR ASSISTANCE makes a significant contribution to the communities of southern France. Their dedication to the local community ensures that ambulance services remain accessible and efficient, tailored to the unique geographical and demographic needs of the region they serve.
• The GROUPEMENT AMBULANCIER DU GRAND NORD demonstrates the power of collaboration, as the group's companies join forces to strengthen their presence in the northern regions of France. Their collective resources and expertise are leveraged to provide robust ambulance services throughout the region.
• GROUPE LOUDANE is proud of its regional influence and is recognized in the industry for the reliability and responsiveness of its ambulance services. Their local knowledge and service delivery are a testament to their adaptability and commitment to patient care.
• Finally, TRANSPORTS SANITAIRES D'OCCITANIE operates with a regional footprint, emphasizing its role in the healthcare pathway of its community. Thanks to their specialized ambulance services, they play an essential role in medical accessibility in the Occitanie region.

These major players, each with distinct qualities and areas of specialization, collectively contribute to the fabric of the ambulance services market in France - a spectrum of companies ranging from large corporations to medium-sized enterprises.

Inforamtion

• Number of pages : 30 pages
• Format : Digital and PDF versions
• Last update : 15/09/2023

Summary and extracts

List of charts

• Number of establishments providing ambulance services in France.
• Number of employees in establishments providing ambulance services in France.
• Number of people over 60
• Nombre de personnes en affectation longue durée
• Number of full and partial hospital beds in France (2014-2021)
• Consumption of healthcare and medical goods in France (2012-2021)
• Breakdown of health care and medical consumption since 1950
• The amount of annual consumption allocated to ambulance services.
• Breakdown of medical transport expenditure
• Trends in demand for medical transport services in France
• Average quarterly price of diesel and unleaded 95 in France
• Gross monthly minimum wage in France (35/h week)
• Breakdown of expenditure by mode of transport in 2011