East of England Ambulance service told it needs to improve.

The East of England Ambulance Services has been told it '˜requires improvement' following an inspection by the Care Quality Commission (CQC).
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England’s Chief Inspector of Hospitals has told East of England Ambulance Service NHS Trust that it must make improvements following an inspection by the Care Quality Commission.

East of England Ambulance Service NHS Trust was rated as Requires Improvement overall following an inspection which took place in April this year.

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The trust was rated as Outstanding for whether its services were caring and Requires Improvement for whether its services were safe, effective well-led and responsive.

The service covers Cambridgeshire, as well as Essex, Hertfordshire, Norfolk and Suffolk.

The trust employs around 4000 staff and 1500 volunteers who are based at more than 130 sites. The trust receives around 2600 calls from members of the public dialling 999 every day.

CQC’s inspection looked at three core services: Emergency Operations Centres, Urgent and Emergency Care including the Hazardous Area Response Team (HART) and Patient Transport Services.

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Heidi Smoult, Deputy Chief Inspector of Hospitals in CQC’s central region, said: “Our inspectors found that a number of improvements were needed at East of England Ambulance Service NHS Trust.

“All staff were passionate about providing the best possible service to patients. We consistently observed staff to be caring and compassionate and concerned for the welfare of patients. However, they also openly recognised they faced challenges. Some staff reported regularly working more hours than their shift allocation which had a negative impact on morale.

“Our main concern was whether services were protecting people from the risk of avoidable harm. The trust was under significant pressure and was failing to meet performance standards and targets for response to emergency calls.​​

“Prolonged delays at some hospital emergency departments reduced the capacity of front line staff to respond to patient’s needs. Frontline staff reported that sometimes no vehicles were available to attend ‘red’ calls, especially in rural areas. This happened when ambulance crews were responding to other calls and delayed in handing over patients to accident and emergency departments.

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“In addition, we were not assured sufficient training was in place to support staff or that supervision and appraisals were undertaken in order to provide staff effective guidance and training opportunities.

“The trust had not had a stable leadership base for several years. However, a new chief executive had been in place for seven months at the time of our inspection and substantive appointments had been made to the senior leadership team. The senior team were proactive in developing positive relationships with key stakeholders and commissioners.

“There were several areas we were impressed by. We saw many examples of staff acting with the utmost professionalism and supporting patients in the most trying of circumstances to provide positive outcomes. The trust should be proud of its Outstanding rating for being caring.

“Handovers between ambulance staff and hospital staff were extremely professional. Information shared regarding patients’ needs was comprehensive and of very good quality.

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“Hospital staff told us that the ambulance staff were extremely professional and easy to work with when bringing patients into their department. There was also positive engagement between staff in the clinical hub and call handlers and dispatchers. Each recognised the skills of the other and worked together to provide positive patient engagement.

“Since our inspection we have been monitoring the trust and working closely with NHS Improvement and other stakeholders.

“The trust leadership knows what it needs to do to bring about improvement and our inspectors will return at a later date to check on what progress has been made.”

Robert Morton Chief Executive at the East of England Ambulance Service NHS Trust (EEAST), said: “I want to pay tribute to our staff and volunteers and I am absolutely delighted that this report recognises the outstanding care we provide to patients, day in day out. It is a testament to all of our staff and volunteers whom provide care to patients, whether on the road or over the phone, that we are the only ambulance service to get an outstanding rating.”

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The CQC also interviewed more than 150 staff as part of the inspection, describing the feedback received as “positive” about working for EEAST.

Robert continued: “We have made huge steps forward over the last year and this progress is reflected in the report. We know we have more work to do, to move us from ‘requires improvement’ to ‘good’, and we have in place a plan to address the points raised by the CQC. The report identifies the need to increase our staffing levels so that we can respond to the increases in demand we are seeing, achieve national targets and meet the expectations of our patients, commissioners and regulators. We continue to work with our commissioners and the NHS to discuss and address this issue.”

Alongside an outstanding rating for the care it provides, the Trust was also rated ‘good’ in its emergency operations centres (999 control rooms) and had ‘good’’ ratings for being responsive in its emergency and urgent care work.

The Trust has developed an action plan in response to the areas identified for improvement. In addition, EEAST continues to engage with commissioners, NHS England and NHS Improvement to tackle the acknowledged capacity gap that exists.

In the meantime EEAST continues to recruit more frontline staff. If you are interested in a career in the ambulance service, a career that is rewarding and full of variety, visit www.eastamb.nhs.uk

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