THE leadership and management of East of England Ambulance Service NHS Trust have been criticised and the service rated as 'requires improvement' after a Care Quality Commission (CQC) inspection undertaken in April and May.

The commission had expressed its concerns about the service in 2020 when a recovery support programme was put in place.

In August last year the service appointed its eighth chief executive in 15 years when Tom Abell, the man who led the proposals to shut down Orsett Hospital, took charge.

Almost a year on, though the latest report says there have been some improvements, the service rating remains the same.

Inspectors found senior leaders understood the issues facing the trust, but more action is needed to address them.

Inspectors also found staff also knew how to protect patients from abuse, but uptake of safeguarding training remained low.

As well as being rated requires improvement overall following the latest inspection, the trust is rated requires improvement for being safe, effective, responsive and well-led. It is rated good for being caring.

CQC has recommended to NHS England and NHS Improvement that the trust remains in the Recovery Support Programme to ensure support is continued to help the trust sustain its improvement.

Zoe Robinson, CQC's head of hospital inspection, said: "While there have been improvements at the East of England Ambulance Service, there is still work to do.

"Staff shortages remained and patient waiting times were unacceptable. Also, the time it took ambulances to reach people was well below national standards, and welfare calls to those waiting a long time weren't always made.

"These issues increased the risk to which people were exposed. 

"We also found staff didn't always feel respected, supported or valued. More work is needed to develop staff, enable them to innovate and bring about positive change within the service.

"However, the trust was working towards promoting an open culture, where staff could raise issues or give feedback without fear of any comeback.

"We also found staff were committed to continually learning and improving services.

"The trust's improvements are encouraging, and we have told it where it must do more.

"We continue to monitor the trust closely, including through future inspections, to assess whether it has embedded and sustained its progress."

The inspection found:

• The service didn't always have enough staff to ensure people's safety.
• People couldn't always access the service when they needed it, and they didn't always receive care in a timely way.
• Due to extreme pressures to the urgent and emergency care system, some patients were delayed in accessing the hospital from the ambulance.
• Compliance with mandatory training, including for safeguarding, was low.
• Leaders didn't always understand or manage the priorities and issues the service faced. They weren't always visible and approachable for staff.
• Staff didn't always feel respected, supported or valued.
• Managers didn't routinely review the work of their staff or provide development opportunities for them.
• There was a culture of uncertainty due to a constantly changing leadership structure.
• Not enough had been done to address the culture of bullying at the trust.

However:

• Staff treated patients with compassion and kindness, and they provided emotional support to patients, families and carers.
• Staff supported patients and their loved ones to make decisions about their care.
• Staff worked well as a team for the benefit of patients, and they provided practical support.
• Patient records were clear and stored securely.
• It was easy for people to give feedback and raise concerns.
• Concerns and complaints were treated seriously, investigated and shared with all staff to drive learning.
• Leaders operated effective governance processes throughout the trust and with partner organisations.

The full findings of the report can be found on the CQC website.