'Tension and mistrust' is creeping into merger plans involving three trusts in the east Midlands, according to the chief executives involved.

The proposal for Leicestershire, Nottinghamshire and Derbyshire ambulance services has produced 'uncertainty at all levels of

management', adds the statement.

'While this is understandable, given the scale of the project and the perceived risk to individuals, there is no doubt it is hindering progress.'

An independent 'facilitator', supported by Trent regional office, will be appointed to help negotiations.

A regional office spokesperson said it was 'very happy' with the progress being made on the merger, which grew out of a review of the five ambulance trusts in Trent in 1997.

Ambulance services in Cleveland, Humberside and North Yorkshire are preparing a case for merger. The three trusts argue merger would provide 'substantial benefits'.