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Troubled SECAmb trust placed in special measures

South East Coast Ambulance (SECAmb), the trust at the heart of ongoing safety concerns, has been placed in special measures by NHS Improvement.

The decision was recommended by the CQC after a team of inspectors rated the trust ‘inadequate’.

Inspectors said that trust staff were unable to deliver a safe level of service because of the uncertainty caused by changes in leadership at the trust.

Anne Eden, executive regional managing director for the south at NHS Improvement, said: “We know that more people than ever are requiring urgent or emergency care this year and that the demand is challenging trusts across England. However, the serious concerns about care at South East Coast Ambulance Service need to be addressed quickly, which is why we are putting the trust in special measures.

“We will continue working with the trust to bring about rapid improvement to its urgent and emergency care services, so that when they are ill or in need of immediate care, patients in the South East can be assured that they are getting the quality care they expect.”

SECAmb’s chief executive went on voluntary leave in June this year and, in March, its chair resigned after it emerged that the trust had secretly introduced a protocol to automatically downgrade 111 calls in order to meet performance targets.

A follow-up CQC inspection found that the trust was still failing to answer 111 calls on time, and the trust has also lost contracts to provide non-emergency patient transport services.

CQC inspectors said the trust did not have adequate staff levels or the resources to review the impact, and was not meeting national performance times.

Professor Sir Mike Richards, chief inspector of hospitals, said: “South East Coast Ambulance Service NHS Foundation Trust has been through a period of significant upheaval following changes in its senior leadership.

“It is to the credit of the staff that they have continued to provide a vital service to the people of Kent, Surrey and Sussex – dealing with almost a million emergency calls a year alone. Throughout our inspection we heard how staff were giving their best, treating patients kindly, with dignity, care and compassion.

“It was apparent that the leadership had not been supporting staff to do their jobs effectively. Staff told us there was a culture of harassment and bullying. We found in many cases there weren’t enough properly trained staff, or that the proper equipment wasn’t available to them.”

The report found that equipment wasn’t maintained and secured, managers were unsure how to respond to allegations against staff, and there was a lack of accountability for safeguarding concerns.

The CQC’s recommendations to the trust included ensuring “effective and fit for purpose” governance, improving the reporting of low harm and near miss incidents, managing the risk of infection, and ensuring the safe storage of medicines and patient records.

Areas of improvement

Prof Richards said that while trust executives were not “pulling in the same direction” as staff, the interim chair and new members of the board were trying to implement improvements.

The CQC also found other areas of good practice, including additional training provided for paramedics, the trust’s collaboration with local stakeholders and commissioners, and support for patients to manage their own health in non-emergency situations.

Geraint Davies, acting chief executive of SECAmb, said: “While we are pleased that the dedication and care of our staff is highlighted as good in this report, we are sorry that we have not met the standards expected in a number of other areas.

“Following initial feedback from the CQC we have already been working on and implementing a number of improvements. I would like to reassure everyone we serve that I, along with my senior team, am committed and focused on ensuring these necessary changes continue. We are determined to implement the changes required to restore confidence in our service.”

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