• Former Tory health minister “shocked by lack of real leadership” at trust
  • George Freeman joins calls for East of England ambulance trust leadership change
  • It follows CQC criticism of leadership and worsening response time performance

Former health minister George Freeman today joined fellow senior local MPs calling for a “change in management” at the East of England Ambulance Services Trust and said he was “shocked by the lack of real leadership” at the provider.

Mid Norfolk MP Mr Freeman, Conservative MP Richard Bacon and Liberal Democrat MP Norman Lamb, also a former health minister, released a joint statement which said they wanted “a change of leadership at the [trust]”.

The intervention followed the Care Quality Commission raising concerns this month about a “lack of leadership” after an inspection prompted by whistleblower allegations about patient harm and deaths caused by significant ambulance delays.

Mr Freeman, a health minister between 2014 and 2016, said in the joint statement: “There are many dedicated and hardworking staff at the trust, but I and my fellow Norfolk MPs are all shocked by the lack of real leadership and the continued failure of the people in management.

“They are paid a lot of money to manage the service, and they are failing patients and frontline staff. That is why a change of management is needed.”

The joint statement said the MPs were concerned that response times performance had deteriorated in recent months. The statement added: “In particular, for the top category of life threatening conditions [category 1 calls], response times are the worst in the country”.

The trust said the MPs “appear not to recognise the context our emergency service core business operates” (see full statement below). It also cited the findings of a leadership review which is due to be published next week, saying this found “cohesive leadership from the CEO and chair”.

NHS England data published yesterday showed the trust’s performance has deteriorated each month between April, May and June, and that performance had not improved since the risk summit in February for category 1 calls. C1 is the most urgent call category. It has a seven minute mean response time target (See chart).

The official data shows the trust recorded the worst performance of the ten mainland English NHS ambulance trust in May and June and the third worst in April for C1 calls.

C1 East of England performance 2018

Mr Lamb and Mr Bacon refreshed their calls for leadership change following their first joint call in May when they exclusively raised concerns to HSJ.

Mr Lamb said: “The performance since the risk summit has been really troubling. The CQC state that performance is improving but the data seems to tell a different story.”

South Norfolk MP Mr Bacon, who also sits on the influential public accounts commission, said: “The ambulance trust has some amazing staff, some of whom come to see me and other MPs to explain what they believe is taking place. What the trust does not have – but badly needs - is good leadership and management at the top. This is where there needs to be a change.”

The trio’s intervention followed Norwich North MP Chloe Smith also raising concerns about the leadership in the local media last week.

The Eastern Daily Press reported that Ms Smith said: “This is not about money… It is about the quality of leadership…The report says the ambulance leadership knows what the challenges are and are already working to put things right.”

There are more than 50 MPs in the East of England.

The mounting pressure on the trust’s leadership followed a chaotic winter in which there were 138 “significant” ambulance delays between 17 December and 16 January alone.

An external review of 22 serious incidents identified by the trust concluded in May that nobody had died as “a direct consequence” of the delays. HSJ revealed last month that one of the incidents involved a 91-year-old stroke patient who waited nearly 19 hours for an ambulance.

The CQC rated the trust requires improvement overall and requires improvement on its well-led domain. 

But governance concerns, “a culture of low morale, late shift finishes, and disengagement between front line staff and the senior management team” were also highlighted in the report.

The report added: “The majority of staff we spoke with felt the temporary management roles contributed to a lack of leadership [and] openness”.

Inspectors did however state: “The leadership of the organisation was aware of the challenges the trust faced and was focused on improving the service to patients as well as improving working conditions and experience for staff. The executive team worked towards a clear vision.”

Trust statement:

“Our united board-level team has a wide range of expertise and experience to help strengthen our service and ensure focus remains on patients. We’re in the best position ever to provide the high-quality and sustainable health services our communities need. With the right investment, we will get better and better. 

“The leadership responsibility involves regularly meeting with, and briefing, 56 MPs across the region. We take part in robust meetings to answer the key questions and constructive criticism these parliamentary colleagues have. We are accountable to the millions of residents in the eastern region who are our past and future patients, and we do that most effectively with MPs who understand the ambulance service operations and commissioning, and who view the system challenges and solutions together. 

“It’s disappointing these three Norfolk MPs appear not to recognise the context our emergency service core business operates within. Norfolk is a highly rural area and doesn’t commission national standards and the trust continues to work with commissioners to be able to improve this  - we would encourage these MPs to work closely with us and our commissioners to fully understand where their support could be best placed. 

“To reiterate, we are not currently commissioned to deliver national standards of performance either at a regional or local level and so to draw comparisons is misleading. We focus our attention on getting to the sickest patients first as quickly as we can and we have exceeded our commissioned target of getting to nine out of 10 patients about one minute quicker during the first quarter of the year.

“During May, EEAST was the best performing trust at helping lower acuity patients get a more appropriate response, such as through Hear and Treat in our control rooms. Meanwhile, patient handovers at hospitals are improving so that we can get back out into the community.  It is important that we are focussed on patients rather than on just hitting targets which we know in the past, has led to the wrong operational behaviours nationally. 

“By working with our staff on rotas to improve their working patterns and ensure ambulances are available when patients need them most – these improved rotas launch from next February – and using £11.5m investment for 330 additional frontline staff over the next three years, we will see positive changes, but training up new paramedics, for example, takes time and our hard-working patient teams do everything they can each day to place patient safety and good outcomes at the heart of what they do.”