CQC says patient waiting times 'unacceptable' at East of England Ambulance Service - despite improvements being made

Improvements have been made at the East of England Ambulance Service – but CQC inspectors have said more work needs to be done by management.

The report said that patients sometimes had ‘unacceptable’ waiting times as the service didn’t always have enough staff to ensure people’s safety.

The CQC carried out the inspection on the service – which covers Peterborough, Cambridgeshire, Bedfordshire, Hertfordshire, Essex, Norfolk and Suffolk – earlier the year, with the report published this morning.

The trust was given an overall rating of ‘requires improvement’ – the same rating as the previous inspection, which was carried out in 2020.

“Staff were focused on delivering the best level of care they could”

In their report, the CQC praised front line staff, saying: “All staff were focused on delivering the best level of care they could for their patients. They took the time to understand their patients individual needs to deliver high quality, personalised care.”

But inspectors said more training was needed for the staff, saying: “The service must ensure it provides mandatory training in key skills to all appropriate staff and volunteers.

"The service must ensure that it has enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and or to provide the right care and treatment.”

“Not enough done to address culture of bullying”

The inspection also found that while some work had been done to tackle bullying in the service, not enough had been done to ‘address the culture of bullying.’

The report said many staff were suffering from ‘burn out’ from the pandemic and delays at emergency departments – with low levels of staff satisfaction and high levels of stress and work overload.

As well as being rated requires improvement overall following the latest inspection, the trust is rated requires improvement for being safe, effective, and responsive. It is rated good for being caring.

However, the CQC found the Trust had made a ‘marked improvement’ on significant and long-standing cultural issues that had led to it being placed in special measures just under two years ago, and, as a result, the Trust moves from an inadequate rating for ‘well-led’ to requires improvement.

"The trust’s improvements are encouraging, and we have told it where it must do more.”

Zoe Robinson, CQC’s head of hospital inspection, said: “While there have been improvements at the East of England Ambulance Service, there is still work to do.

“Staff shortages remained and patient waiting times were unacceptable. Also, the time it took ambulances to reach people was well below national standards, and welfare calls to those waiting a long time weren’t always made.

“These issues increased the risk to which people were exposed.

“We also found staff didn’t always feel respected, supported or valued. More work is needed to develop staff, enable them to innovate and bring about positive change within the service.

“However, the trust was working towards promoting an open culture, where staff could raise issues or give feedback without fear of any comeback.

“We also found staff were committed to continually learning and improving services.

“The trust’s improvements are encouraging, and we have told it where it must do more.

“We continue to monitor the trust closely, including through future inspections, to assess whether it has embedded and sustained its progress.”

"We recognise that this is only the first step in our work to improve our culture and our service”

East of England Ambulance Service Trust (EEAST) chief executive officer Tom Abell said: “I am pleased the CQC has recognised that hard work of our people under significant pressure – and that we have made marked improvements on what we have needed to address from previous inspections, which highlighted significant issues with our culture that left staff feeling unable to raise concerns.

“We have focussed on providing our people with a safe and supportive workplace and there are early indicators this is beginning to have a positive impact – making significant progress to tackle bullying and harassment.

“However, we recognise that this is only the first step in our work to improve our culture and our service and we have a 3-5 year plan in place to fully address all of the challenges we face. The CQC rightly identified several areas for improvement that we are continuing to address, including improving staff morale and access to training, the impact of the Trust being on heightened surge levels for extended periods of time, and the challenges of staffing our ambulance operations centres.

“We have taken this feedback very seriously and will continue to work hard to address these issues.”

"We have made some positive early steps”

EEAST Chair Nicola Scrivings added: “We have made some positive early steps to improve the culture of the Trust, but we recognise there is much more still to be done. We have strengthened our leadership team and have a stable Board in place, which will progress the improvement and change needed across the Trust in future.”

The trust also said they have seen a reduction in number of staff reporting experiencing bullying and harassment and a 900% increase in people feeling able to speak up, and have introduced 45 measures to better support staff, including an increase in mental health provision, ‘welfare wagons’ to support staff with food and refreshments at hospitals and access to physiotherapy.

The full report will be available at https://www.cqc.org.uk/provider/RYC