Peterborough’s ambulance service ‘requires improvement’ as patients ‘not kept safe’ due to staff shortage

The East of England Ambulance Service NHS Trust was also said to be in breach of regulations, including with the safe management of medicines.

The CQC has told the trust it must make a number of improvements following its latest inspection after a number of concerns were raised.

Among those was the high turnover of personnel in the senior leadership team and the feeling among some members of staff that their concerns were not being listened to.

The service, though, was said to be ‘outstanding’ at being caring and ‘good’ for being responsive, but ‘inadequate’ for being well led. One positive highlighted by inspectors was how staff saved a fire officer’s life at the scene of a fire.

The ‘requires improvement’ rating is the same as the one given after the previous CQC inspection in March 2018.

The CQC’s chief inspector of hospitals, Professor Ted Baker, said: “Our inspectors found that while some progress had continued at the East of England Ambulance Service NHS Trust, there were still a number of areas for concern where improvements were needed.

“We were particularly concerned that there had been significant turnover within the senior leadership team over the last 12 months. At the time of our inspection, key members of the board were in interim positions.

“We had concerns that the instability in the executive team could affect the trust’s ability to drive through necessary improvements.

“There continued to be a mixed culture at the trust. Not all staff felt that concerns were listened to and recently implemented strategies and initiatives, developed to improve performance, governance and staff welfare, were yet to be embedded.

“The services still did not have enough staff to care for patients and keep them safe despite a focus on recruitment and retention.

“People continued to wait too long for services and response times, although improved, were worse than the England average. While the quality of services had not declined - and there were signs of improvement in specific areas - there were continued areas of breaches in regulation, such as with the safe management of medicines.

“We have told the trust it must take act immediately to make those improvements.

“Despite this, we found that staff were overwhelmingly caring and dedicated to providing the best care they could.

“We saw outstanding practice in terms of the trust’s ability to respond to major incidents, with teams recognised for their work by external organisations. This included a certificate of appreciation from the chief fire officer for the trust’s HART team – the specialist team which deals with major incidents - which saved a fire officer’s life at the scene of a fire.”

The trust provides emergency medical services to Bedfordshire, Cambridgeshire, Essex, Hertfordshire, Norfolk and Suffolk - an area which has a population of around six million.

It has been told it must make a number of improvements including:

• The trust must ensure that systems and processes to safely administer, store, prescribe and medicines is consistently applied across the trust.

• The trust must ensure that it improves response times in emergency and urgent care and patient transport services.

• The trust must ensure that governance and risk management processes are embedded in all areas.

• The trust must ensure that processes in place for appraisals and supervision are consistently applied and demonstrate that staff are competent for their roles.

• The trust must ensure that it improves recruitment and retention to have enough staff to provide a safe and responsive patient transport service.

The trust’s board said it will be focussing on:

. Creating a stable leadership team including recruiting a permanent chair and CEO

. Embedding governance and risk processes across the trust

. Further improving staff engagement and the trust culture, including our successful safety huddles

. Strengthening the HR function

Ed Garratt, chief executive of Ipswich and East Suffolk CCG, the lead commissioner on behalf of a consortium of 19 CCGs in the area, said: “The paramedics, technicians, control room staff and volunteers should be rightly proud of the work they do.

“People call the ambulance service at some of the worst times of their lives, so to retain ‘outstanding’ for care and move to ‘good’ for being responsive is important progress. While there is much to do, the new chief executive and chairman are making clear improvements.”

Nigel Beverley, interim chair of the trust, said: “I am pleased to have joined EEAST at such an important stage in its improvement journey. There has been turnover within the trust board in the last few months. However, we are strengthening the leadership and rebuilding the senior team over the next 12 months.”

Dorothy Hosein, interim CEO, said: “I am delighted to see that this report rightly pays tribute to the outstanding care that our staff and volunteers deliver to patients on a daily basis. I am pleased that the inspectors noted the positive changes underway. Over the coming months my commitment is to ensure that our patients and staff really feel the impact of these improvements.”