An ambulance trust is to be placed in special measures after inspectors rated in inadequate and identified concerns related to its leadership, culture and ability to ensure patient safety.
The Care Quality Commission rated South East Coast Ambulance Service Foundation Trust as inadequate overall, and the trust was also given the lowest rating for its emergency and urgent care services, safety and leadership.
Chief inspector of hospitals Professor Sir Mike Richards said the trust had been through a period of “significant upheaval” following changes in its senior leadership.
He said leaders had not supported staff to do their jobs. “Staff told us there was a culture of harassment and bullying,” Sir Mike said. “We found in many cases there weren’t enough properly trained staff, or that the proper equipment wasn’t available to them.”
After inspecting the trust in July, the CQC issued a warning notice setting out six main areas of concern:
- The trust’s systems for deploying staff were not effective, which was affecting performance and fatiguing employees. The trust did not have information to enable it to review the staff mix.
- NHS 111 calls were not always responded to in a timely and effective manner. There was a “lack of strategic leadership” for improving performance.
- Processes to ensure equipment is properly maintained and secured were not adequate.
- Safeguarding arrangements were weak. Managers were unclear about their role in safeguarding patients, including when allegations were made against staff. There was a “lack of accountability” and trust leaders had a poor understanding of safeguarding issues.
- Systems were not operated safely and effectively. “The trust had allowed staff to develop practice outside national guidelines which put people using the service at risk,” the CQC said.
- Governance arrangements including systems to monitor and improve services were not effective.
Inspectors rated the trust as good for providing services that were caring. Sir Mike said: “Once care arrives, it is of a good standard – with dedicated and caring call handlers, ambulance crew, paramedics and other frontline staff working hard to ensure this…
“Throughout our inspection we heard how staff were giving their best, treating patients kindly, with dignity, care and compassion.”
NHS Improvement has confirmed the trust will be placed in special measures and it would appoint an improvement director.
South Central Ambulance Service FT is already providing the trust with “buddying” support.
Anne Eden, the regulator’s director for the South, said: “The serious concerns about care at South East Coast Ambulance Service need to be addressed quickly, which is why we are putting the trust in special measures.
“We will continue working with the trust to bring about rapid improvement to its urgent and emergency care services, so when they are ill or in need of immediate care, patients in the South East can be assured that they are getting the quality care they expect.”
The trust said in a statement it already has a recovery plan in place and has taken action across a number of areas to address concerns.
Acting chief executive Geraint Davies said: “I would like to reassure everyone we serve that I, along with my senior team, am committed and focused on ensuring these necessary changes continue. We are determined to implement the changes required to restore confidence in our service.
“I would also like to take this opportunity to point to the enormous amount of excellent work undertaken every day by our staff across our region, often in challenging circumstances, to respond to and treat patients, be it responding to a major road collision or saving the life of a patient in cardiac arrest.”
CQC and trust statements
29 September 2016