PERFORMANCE: The East of England Ambulance Service Trust has been undermined by in-fighting, confusion and a “sense of helplessness” among senior managers, according to an independent report.

Serious concerns about many areas of the organisation were raised in the document, which was ordered by the Trust Development Authority in March after a sustained period of poor performance saw the trust miss a series of targets.

The report said individuals needed to be held accountable for “wrong doings” and highlighted financial problems, a lack of board-level accountability and the failure of senior management to listen to staff.

The report’s author, West Midlands Ambulance Service Foundation Trust chief executive Anthony Marsh, made 25 recommendations.

Mr Marsh wrote: “The current trust board and senior management team appear to have developed a sense of ‘helplessness’ i.e. it is what it is.

“There appears to be a lack of accountability throughout the organisation, partly due to a complicated organisational structure and confused managers within the trust.

“This has led to a lack of clarity on both accountability and responsibility, individually and collectively, therefore critical decision making has ceased in some areas.

“The trust has lost focus of the strategic objectives, which may partly be due to the board not fully understanding the purpose of the business.”

He also said there was “a feeling across the organisation that the trust board does not listen” and that there were examples “of conflict between operations, finance and the clinical departments”.

Some of the problems stemmed from the trust’s creation in 2006, by the amalgamation off three trusts, the report said. “It still feels like three trusts,” Mr Marsh wrote.

He expressed concern that plans to restructure operations would still see the trust retain three health emergency operations centres, effectively dividing the region in three.

Mr Marsh called for a major review of the three centres, including a review of enhanced clinical triage use of support software, as well as the “hospital delay desk”, care co-ordination, and other trust structures.

The trust’s new chairman Geoff Harris, who was appointed by the TDA, said its turnaround plan, published in April, “recognised many of the issues we need to address”. Dr Harris continued: “We are focussed on implementing this, together with recommendations from the governance review, to improve services for our patients.”