PERFORMANCE: The leadership of South East Coast Ambulance Foundation Trust could be replaced after Monitor found some patients were made to wait up to 10 minutes longer for an emergency response last winter.

The ambulance service ran a project between December 2014 and February 2015 that increased how long “red 2” patients – those that may have life threatening but not time critical needs – were waiting for ambulances by up to 10 minutes.

Ambulance trusts must deal with 75 per cent of red 2 calls within eight minutes, but the trust increased this up to 18 minutes to give it more time to assess patients’ conditions.

Monitor said the trust launched the project as a response to the high pressures it faced last winter.

The trust changed how it handled some NHS 111 calls under the red 2 category - they were transferred to the 999 emergency system to give the FT additional time to deal with more urgent calls.

Monitor found there was a clear failure of management processes and the trust’s board did not appear to be fully aware of these changes.

The regulator said it has concerns about how the trust is being run and how decisions are made. It has “reasonable grounds” to suspect that the trust is in breach of its licence to provide NHS services.

Monitor has also added a condition to the trust’s licence so that if sufficient progress is not made, further action could be taken. This could include changing the leadership team at the trust.

The regulator is working with the trust to identify how to review the impact the project could have had on patients.

The trust will also commission a review into the way it handled the project and more widely, how it makes decisions.

Paul Streat, regional director of Monitor, said: “Over the winter, there were significant demands on the NHS and it is understandable that trusts want to explore better ways of delivering the best possible care. But this project was poorly managed from the start, done without the proper authorisation and without enough thought given to how it might affect patients.

“We have asked the trust to review the action it took to make sure there was no harm to patients, and look again at the way decisions are taken to prevent something like this happening again.”

A trust spokesman said the service received “unprecedented call volumes” last winter, and “coupled with serious hospital handover delays” this led to “significant waiting times” for patients.

FT chief executive Paul Sutton said: “The process was undertaken to ensure that the right response was provided to patients and that we were able to respond promptly to the most seriously ill patients.”

“However, we recognise that it was not well implemented and we did not use our own corporate governance processes correctly. These are serious findings.

“We have already begun to take steps to address Monitor’s concerns and as part of this process, independent reviews will assess how decisions are made within the trust, governance processes and our approach to patient safety.”