Published: 22/04/2004, Volume II4, No. 5902 Page15

Staff slate ambulance trust managers - but some are learning lessons

What is wrong with ambulance service managers?', will be the question on the lips of many who read this week's HSJ People (pages 32-33). Our analysis of the recent NHS staff survey carried out by the Commission for Health Improvement (now the Healthcare Commission) shows that the senior managers of ambulance trusts are held in very low regard by those who work with them.

As ranked by the answers to five questions about the quality of senior management, 19 of the 30 lowest-rated organisations were ambulance trusts. Given that over 600 trusts of all types were surveyed and that there are only 32 ambulance trusts in England, this is a truly awful performance.

There are some mitigating circumstances: a demanding performance agenda, thin management structures and major staff reforms - in particular, Agenda for Change. But these are factors impinging on many NHS organisations which have a much better relationship with staff.

During our research, HSJ came across ambulance managers who were dismissive of the views of their staff and whose attitude in general was redolent of the rigidly hierarchical approach which has blighted the ambulance service for so long. There was also a general unwillingness to learn from other ambulance trusts and NHS organisations. There are too many ambulance trusts where enlightened modern management thinking is disparaged and feared.

But there is hope. Witness the performance of London Ambulance Service trust, for so long a byword for staff unrest. It recorded the best score of any ambulance trust and achieved a respectable mid-table ranking overall. Significantly, its score for the 'vision' of senior management placed it in the top 20 per cent of NHS organisations. Other ambulance trusts should investigate London's success and learn all they can. l