• Ambulance trust carrying out new probe into “underlying factors associated with” sudden deaths of three employees
  • Deaths happened while trust was “transitioning” to new staff welfare provider
  • Fresh probe is second investigation into staff welfare issues within months

A troubled trust has launched a new investigation into the “underlying factors associated with” the sudden deaths of three of its employees in November, HSJ has learned.

A whistleblower alleged last year that staff at East of England Ambulance Service Trust were at risk of suicide because of the trust’s “completely toxic culture”. A month after his allegations were reported in October, three young staff members died suddenly in 11 days.

The staff who died were ambulance dispatcher Luke Wright, aged 24, and paramedics Christopher Gill, from Welwyn Garden City, and Richard Grimes from Luton.

Speaking publicly for the first time on the record, the whistleblower who raised these concerns, former equalities lead Paul Fitzgerald, told HSJ he was speaking up now because he was still concerned about the risk of staff suicides.

Six current EEAST staff had contacted him about their suicidal thoughts in recent months, he said. He added the trust was “an accident waiting to happen” (See below: ‘Staff suicide risk remains’, warns former equalities lead).

HSJ has also established the three deaths happened after cuts were made to the trust’s inhouse wellbeing team last summer and during what the organisation called a “transition period” as it moved the service to a private provider, which began its contract this month (See below: Questions about welfare care as trust outsourced service).

Investigations will not be published, says trust

The trust has refused to disclose the identity of the “external independent investigator” who is carrying out the review into the circumstances surrounding the employee deaths. It told HSJ it will not publish a full version of the review, only committing to making its own summary of the report public, when it is completed.

The trust said it had appointed “a single independent external investigator, who has undertaken a formidable number and range of serious incident investigations”. It said their evidence would be reviewed by a “panel of experts [who] have been drawn from public health, mental health, commissioning, education and safeguarding specialist areas”.

The statement added: “They were appointed during December 2019 and January 2020… We are aiming for a draft report to be available to the panel by the end of February 2020. In the spirit of transparency, we will make a clear summary of the findings and recommendations publicly available.”

The trust’s decision to commission the review comes after it triggered a separate investigation into the whistleblower’s concerns, to be carried out by HR consultant Martin Tiplady, last year. The trust told HSJ the former police HR director had completed his investigation in January, but his findings would also not be made public.

The trust confirmed Mr Tiplady’s review “did not investigate the circumstances behind any of the three sudden deaths of employees”, as was reported by some media before Christmas.

‘Staff suicide risk remains’, warns former equalities lead

The whistleblower who raised the concerns about the risk of suicide among the trust’s staff was former equalities lead Paul Fitzgerald, who left in October after four years at the organisation.

Speaking for the first time on the record, he told HSJ there was a high risk of staff suicides because of its “completely toxic culture” and “wholly inadequate” welfare support.

He said: “In nearly 30 years of working in the NHS I have never witnessed anything like the completely toxic culture at the trust. I was absolutely horrified and I am very worried about the welfare of the staff there. There is a very real risk of more staff committing suicide.

“Six other staff members raised concerns about having suicidal thoughts [in recent months], but the wellbeing support provided by the trust for them is wholly inadequate. Last year they disbanded the health and wellbeing and outsourced the function to a private company.”

He continued: “The trust has told me that I will not be able to see a copy of the investigation it commissioned Martin Tiplady to do and that it would not be released publicly.

“This is symptomatic of their attitude to transparency and I have no confidence it will be anything other than a whitewash. The trust is just paying lip-service to investigating the problems I have highlighted.

“The only way to really try and sort the trust out is to hold a public inquiry.”

He added: “The cultural problems start right at the top, from board level, and also at regional level. There are some good people at the trust, but there is an element of learned helplessness. The whole place is a mess.”

HSJ has spoken to several other staff members at different levels of the organisation who vouched for Mr Fitzgerald’s “integrity” and agreed with his concerns about staff wellbeing and the depth of cultural problems.

Mr Fitzgerald now works for University Hospitals of Leicester Hospitals Trust and East Midlands Ambulance Service Trust.

Questions about welfare care as trust outsourced service

Mr Fitzgerald’s allegations about the “wholly inadequate” welfare provision focus on the trust’s decision to cut back its inhouse welfare team and outsource the function. The inhouse team had seven members, until summer last year when it was significantly cut back.

The three staff deaths in November happened during what the trust called a “transition” period following the winding down of the inhouse support and before a contract with its new occupational health service supplier, Kays Medical, began on 2 January.

HSJ asked the trust why it cut back its inhouse health and wellbeing team. The trust said: “We take staff welfare very seriously. This is why we have reviewed the service and now have an enhanced service in place provided by Kays Medical.

“Our new contract (which has just commenced) provides additional proactive wellbeing support for our staff. We have also engaged additional services from a range of agencies to support staff’s mental health and wellbeing.”

The trust also said there had been adequate arrangements in the “transition” period through other external agencies and services.

It added: “These were in place to support staff during the transition… Some were also used again to offer specific support to staff following the deaths of our three colleagues.”

The trust’s response

EEAST chief executive Dorothy Hosein said: “We were deeply saddened by the deaths of our colleagues in autumn 2019.

“The board has commissioned an independent investigation into the underlying factors associated with those deaths. Our commitment to our people is to provide optimal wellbeing and welfare support. We are continuously reviewing and improving this and recently enhanced our provision.

“We regularly undertake extensive engagement and listening exercises with our staff to address their issues. We have significantly improved the way in which we listen and ensure that when they raise concerns with leaders within the trust these are acted upon.”

A trust statement added: “Staff welfare is one of our highest priorities. The trust has put every effort into working with staff to understand the impact the job can have on their wellbeing and continues to improve its understanding of the increased risk of suicide in some parts of the ambulance service workforce.

“The [ambulance] sector commissioned research in 2016 to better understand suicide within the ambulance service workforce in its entirety and is now undertaking research to increase awareness and knowledge of what staff wellbeing policies are most effective within the sector.

“EEAST has participated in both these research studies alongside all other UK ambulance services and is working towards best practice and recommendations.”