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The ambulance sector is in a precarious position and a new inspection of emergency care in Cornwall illustrates the grim consequences this has for patients.

A total of 29 patients with heart attacks, strokes, suspected sepsis and “extreme pain” died or suffered “severe harm” due to long waits for ambulances, during a three-month period last year.

The incidents, reported by staff at South Western Ambulance Service Foundation Trust to inspectors at the Care Quality Commission, make painful reading for leaders of the Cornish integrated care system, which is currently under “extreme pressure” for emergency care, the CQC said.

The CQC concluded that there was a “high level of risk to people’s health” when trying to access urgent and emergency care, which is an unusually stark message from the watchdog.

The report said Cornwall’s healthcare organisations must work closer together to solve some of the issues behind the emergency care failures, but local chiefs feel they are doing all they can and that the most meaningful changes will take time to implement.

Kate Shields, the ICS’s chief executive, said Cornwall’s biggest challenge was creating a “sustainable workforce, with a particular focus on domiciliary and adult social care staff”.

The truth about those chairs

In a wide-ranging interview, King’s College Hospital chief executive Professor Clive Kay has assured HSJ that moving to a joint chair with a neighbouring foundation trust is not an indicator that King’s is struggling.

King’s College Hospital and Guy’s and St Thomas’ FTs have confirmed that they will share a chair on a permanent basis, after Sir Hugh Taylor – who has been substantive chair of GSTT and was imposed as interim chair on King’s in 2019 – retires later this year. They have issued an advert for the substantive joint role.

Speaking to HSJ ahead of the announcement, Professor Kay said the move would foster better governance, and was not a reflection of KCH’s performance.

He said his organisation was in a different place from the trust he joined three years agoKing’s staff were pivotal to London’s overall pandemic response, and analysis indicates that mortality of covid patients at KCH and GSTT was among the lowest nationally.

Professor Kay said the prospect of a full merger between the organisations had now receded. Read his full interview with Ben Clover here.

Also on today

We report that a Midlands trust at the centre of a maternity scandal has been issued with another warning notice, and Julian Patterson’s latest despatch on NHS Blithering ICS finds the chief exec making some bold appointments to shake up the leadership team of the country’s most challenged health economy.