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Chief Inspector of Hospitals rates East of England Ambulance Service NHS Trust as Requires Improvement

4 July 2018
East of England Ambulance Service NHS Trust
  • Media,
  • Ambulance services

England's Chief Inspector of Hospitals has told East of England Ambulance Service NHS Trust that it must make improvements following an inspection by the Care Quality Commission.

East of England Ambulance Service NHS Trust was rated as Requires Improvement overall following an inspection which took place in March this year.

The trust was rated as Outstanding for whether its services were caring and Requires Improvement for whether its services were safe, effective well-led and responsive.

This means the trust’s ratings remain unchanged since CQC’s previous inspection in April 2017.

CQC’s Chief Inspector of Hospitals, Professor Ted Baker, said:

“Our inspectors found some progress had been made at the East of England Ambulance Service NHS Trust, since our previous inspection, but that a number of improvements were still clearly needed.

“We found improvements had been made with regard to safeguarding, staff understanding of the Mental Capacity Act and incident reporting procedures. But the trust still did not meet national ambulance response standards and over the winter period delays resulted in a number of serious incidents.

“We were also concerned that, at the time of our inspection, staff morale was low. People working at the trust described a culture of late shift finishes, frustration at not being able to provide the service they wanted to due to pressures on the trust and disengagement between front line staff and the senior management team. People said they did not always feel valued, particularly after what had been an exhausting winter.

“However, we found a number of areas of outstanding practice and that staff were overwhelmingly caring and dedicated to providing the best care they could to patients. People who used the service also gave positive feedback.

“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.”

CQC’s inspection team informed the trust of its findings immediately after the inspection so that it could take steps to make any improvements.

There are several areas where improvements must be made, including that the trust must improve its performance and response times for emergency calls and ensure processes and procedures are consistently applied across the trust.

Risk registers must be reviewed and staff must be appropriately mentored and supported to carry out their roles.

Inspectors also witnessed outstanding practice across the trust including a clinical app which gave staff an excellent resource for ensuring they had the most up to date clinical guidance and access to information about care pathways in different areas of the trust.

An escalation policy to reduce the times in handover delays had been introduced and, while this had been introduced late in winter, it was seen as good practice to have an identified escalation tool in place. Additionally, the trust had introduced a Patient Safety Intervention Team (PSIT) to ensure that handover delays were minimised.

The Freedom to Speak Up Guardians were passionate about giving staff support to raise concerns and have them addressed, and they were supported by the board in their work.

The East of England Ambulance Service NHS Trust is one of ten ambulance trusts in England providing emergency medical services to Bedfordshire,

Cambridgeshire, Essex, Hertfordshire, Norfolk and Suffolk; an area which has a population of around six million. The trust employs around 4,000 staff and 1,500 volunteers.

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Last updated:
04 July 2018

Notes to editors

Whenever CQC inspects it will always ask the following five questions of every service:
  • Are they safe?
  • Are they effective?
  • Are they caring?
  • Are they responsive to people’s needs?
  • Are they well-led?

Under CQC’s current programme of inspections, we aim to inspect every NHS trust at least once between June 2017 and spring 2019. We use information that we hold on each trust to inform our decision about when and what to inspect.

During the unannounced inspection we will normally look in detail at certain core services - based on previous inspection findings, as well as wider intelligence - followed by an inspection of how well-led a provider is.

Our previous inspections of NHS trusts have shown a strong link between the quality of overall management of a trust and the quality of its services. For that reason, all trust inspections now include inspection of the well-led key question at the trust level.

Each inspection team is led by a member of CQC’s staff and includes specialist professional advisors such as clinicians and pharmacists. Where appropriate, an inspection team will also include Experts by Experience. These are people who have experienced care personally or experience of caring for someone who has received a particular type of care.

How CQC monitors, inspects and regulates NHS trusts

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.