Ambulance trust rated ‘requires improvements’ by CQC
PUBLISHED: 00:01 04 July 2018
The region’s ambulance service has been told it must improve after inspectors found high demand had left staff burnt out and performance targets missed.
The East of England Ambulance Service NHS Trust (EEAST) has been rated ‘require improvements’ overall by the Care Quality Commission (CQC) following a visit in March this year.
This means the trust’s rating is unchanged from its previous inspection in April 2017, but the watchdog recognised that some progress had been made in areas such as safeguarding.
The report raised concerns about a “culture of low morale” among staff, with half of all shifts finishing late and “disengagement” between front line workers and senior managers.
The CQC rated the trust as ‘requires improvements’ in four of the five areas of assessment: effectiveness, responsiveness, safety and leadership, but gave it ‘outstanding’ for its care.
Inspectors praised staff and their willingness to go the “extra mile” for their patients, but found there were not enough of them to meet the increasing demands for services.
The report said: “There had been a period of relentless demand that had left staff feeling tired and unappreciated.”
The CQC highlighted “significant delays in response” over the busy winter that led to serious incidents and said EEAST had not fully followed national escalation procedures during this period. These concerns were the subject of a national risk summit.
The trust has been told it must work to improve performance and response times for emergency calls and to support and mentor staff to carry out their roles.
However, inspectors also identified outstanding practice across the trust including an app which gave staff a resource for ensuring they had the most up to date clinical guidance and information.
The CQC commended EEAST for introducing measures to tackle handover delays at hospitals, and for the encouragement it gave staff to speak out about any concerns they had.
CQC’s chief inspector of hospitals, Professor Ted Baker, said: “We fed our findings back to the trust immediately after our inspection, citing the areas where improvements must be made as a priority, and we have been monitoring the trust, working closely with NHS Improvement and other stakeholders, to help drive through improvements.
“The trust leadership knows what action it must take to bring about improvement and we will return to inspect and check on its progress.”
EEAST chief executive Robert Morton said the CQC inspection came during “the most challenging winter” on record, and when staff were “extremely tired and under pressure”.
“There will always be room for improvement,” he added. “We are aware of the many challenges we face here in the east. Engaging with our staff, across a virtual organisation which is spread out across a an area of 7,500 square miles, can be a huge task.
“Our workforce are highly mobile and travel approx 12 million miles a year supporting or delivering the best care we can to patients.
“We are working to ensure the leaders at every level in our organisation are given the time and space to build effective, communicative teams at a local level – particularly during tough periods like winter.
“Given the highly virtual and mobile nature of our workforce, we must be innovative about how we can engage our workforce who do not work in a single large site like a hospital.”
Mr Morton said the trust’s board team were “united” and had the right expertise and experience to strengthen services.
He pointed out that EEAST had been given additional funding to help improve services.
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