• SECAmb’s CQC rating upgraded to “good” overall
  • Has been in special measures since 2016
  • Inspectors praise changes in leadership at the trust

A trust, which was at the centre of a scandal around diverting ambulances, is to exit special measures after nearly three years.

The Care Quality Commission has rated South East Coast Ambulance Service Foundation Trust “good”, up from “requires improvement”, while its emergency and urgent care were rated “outstanding” in a report released today. The trust was rated “good” on all of the five main measures – safety, effectiveness, caring, responsive and well-led.

The CQC also recommended – and NHS Improvement accepted – the trust be removed from special measures, which it has been in since 2016.

In particular, the report said changes in leadership at the trust – which has had multiple changes on its board over the last three-and-a-half years – “had a positive impact” and the trust had addressed behaviours which were not consistent with its values.

“Staff reported an improvement in the level and management of poor behaviours….such that it was no longer a concern,” the report read, adding that there was an open culture where patients, families and staff could raise concerns without fear.

The trust was placed in special measures in September 2016 when it was rated “inadequate” overall and for emergency and urgent care services, safety and leadership. The report also highlighted staff’s concerns about harassment and bullying.

Paul Sutton, the chief executive at the time, left his post shortly before the CQC report was released

Shortly before the 2016 report, the trust was involved in a scandal involving a policy which saw some ambulances deliberately delayed. Between December 2014 and February 2015, SECAmb ran a pilot where some calls to NHS 111 which were determined to need an ambulance response were retriaged within the 999 emergency system. This resulted in delays of up to 10 minutes in ambulance despatch. An NHS England-commissioned report criticised the policy, adding the scheme was not in line with NHS England’s 111 commissioning standards. 

A report in 2018 found South East Coast Ambulance Service FT had investigated 10 serious incidents related to call answering delays in 2017-18. In eight of these cases, the patients died, either at the scene or later. After investigation, two of these deaths were categorised as directly related to the trust’s involvement.

The CQC improved the trust’s rating to “requires improvement” last year but it remained in special measures as the CQC was not convinced the improvements it had made were sustainable.

Fionna Moore, the trust’s now acting chief executive, told HSJ the trust had since addressed bullying and harassment, strived to make staff feel valued, worked closely with unions, and had focused on the wellbeing of its staff. A wellbeing hub meant staff could get quick access to mental health practitioners and physiotherapists.

The trust has also benefited from significant investment in staff and vehicles, after local clinical commissioning groups agreed extra funding, and a new computer-aided dispatch system, she added.

CQC chief inspector of hospitals Ted Baker said SECAmb had made “excellent progress” and had embedded changes seen in the previous inspection last year. He added: “The credit must go to the hard work and commitment of the staff and the current management team.”

Anne Eden, NHS England and NHS Improvement regional director for the South East, said: “This is a significant improvement and one which staff across the trust have worked hard to achieve.”

Ms Eden added NHSE/I would be “putting in place support and oversight to ensure that improvements are maintained, any remaining quality concerns are addressed and that performance and governance arrangements are strengthened”. 

Dr Moore also praised frontline staff, who were judged as “outstanding” for caring, and added the report could help with recruitment. “We are nowhere near perfect by any means, but this report will give our staff a morale boost,” she said.

The trust has had several changes in its leadership recently. Daren Mochrie, who had been appointed chief executive in 2017 and was seen as driving through many of the changes, left to run the North West Ambulance Service Trust in April 2019.

Dr Moore will continue as acting chief until Philip Astle, currently chief operating officer at South Central Ambulance Service FT, takes over the role next month. At this point, Dr Moore will return to her role as medical director.