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Kent’s troubled ambulance service to remain in special measures

PUBLISHED: 00:01 05 October 2017 | UPDATED: 09:48 05 October 2017

Ambulance

Ambulance

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Secamb has been hit by a series of scandals over the last two years

Kent’s troubled ambulance service will remain in special measures despite improvements in performance, a watchdog has said.

South East Coast Ambulance Service (Secamb) has been hit by a series of scandals over the last two years, with particular concerns raised over the treatment of some staff.

An independent report published in August revealed hundreds of staff at the trust had experienced bullying and harassment.

The report told stories of staff having “only two tea breaks in three years”, having instructions “bellowed as if they were a sergeant major in the army” and of employees being “genuinely fightened” about speaking out over bullying.

There was also a consistent view that a “boys club” culture exists at the trust with “questions of sexual harassment and sexual grooming occurring in some parts of the Kent area”.

Secamb was placed into special measures last September and while the Care Quality Commission, which recently carried out an inspection, recognises some improvements have been made, it says further progress is needed.

Inspectors looked at two core services: emergency operations centres which has been rated ‘Requires Improvement’ and emergency and urgent, including resilience and the hazardous area response team care which has been rated ‘Inadequate’.

The trust’s overall rating of ‘Inadequate’ remains unchanged, chief inspector of hospitals, Professor Ted Baker said.

CQC have also inspected the NHS 111 service provided by the trust which has been rated as ‘Good’.

At the CQC inspection in May 2016, it rated Emergency and Urgent Care (EUC) as ‘Inadequate’ and both the Emergency Operations Centre and Patient Transport Services were rated as ‘Requires Improvement’ and a warning notice detailing the areas where the trust needed to make improvements was also issued.

Inspectors found the trust had made some improvements in many of the concerns previously mentioned in the May 2016 inspection, particularly around reporting of incidents, and staffing levels during busy periods. A new board was tackling the issues but further progress is still needed.

However, staff were found to be consistently compassionate, treating patients and callers with kindness and respect including those in mental health crisis.

Although some staff did indicate improvements in the trust culture and there was a reduction in bullying and harassment, there still remained concerns about the overall culture within the trust.

Professor Baker said: “Although we have seen some areas of improvement, South East Coast Ambulance NHS Foundation Trust has not yet made enough progress for me to recommend that it should leave special measures.

“I am concerned that the previous leadership had not fully addressed longstanding cultural issues and in particular the historical problems of bullying and harassment.

“While the problem is now being addressed there is still work to be done here and in the management of medicines.

“It is clear there have been deep rooted problems and the trust would now benefit from a period of stable management to address these issues.

“I am aware that there has been a recent appointment of a new chief executive who has considerable experience within the ambulance service and should bring that renewed stability.

“The board have assured us that they are focussed in supporting the Chief Executive to carry the improvements that are needed.

“In the circumstances however, I have advised NHS Improvement that the trust should continue to receive the additional oversight and support provided by special measures until such time we can report on significant and sustained improvement.”

Responding to the verdict, Secamb chief executive Daren Mochrie said: “While I am disappointed that not enough progress has been made for us to improve our overall rating, I am confident that progress is being made and that this will continue.

“I believe that the pace of improvement has picked up since the CQC visit in May 2017 but I am very aware, as is our senior team, that there remains a significant amount of work to be done.

“Our updated Improvement Plan focuses on the areas where we are determined to make major improvements in the months ahead.

“We are working with our local commissioners to ensure that we are funded appropriately and have the right resources to meet the demand we are facing.

“Right across the trust, staff are working flat out to ensure the necessary improvements continue to be made and I am pleased that staff told inspectors that they feel more positive about the organisation and that we are heading in the right direction.

“There are some positives to build on. In recent months we have successfully delivered a number of key projects, including moving to our new Emergency Operations Centre and HQ at Crawley [in West Sussex] and introducing a new Computer Aided Dispatch system.

“The success of projects such as these will ensure we are providing the right foundation for a better service in the future.”

Chair Richard Foster added: “The trust board acknowledges that not enough progress had been made since the last CQC inspection in May 2016.

“During that time there have been a number of changes at executive and at board-level and the leadership team now in place is committed to delivering the vigorous improvement programme already under way.”

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