Ambulance service covering Sussex rated as ‘requires improvement’

Previously the overall rating for the ambulance service, which covers Sussex, was ‘good’, according to the CQC.

The CQC said inspectors carried out two comprehensive inspections in August to look at the trust’s urgent and emergency care and resilience teams, as well as to check the trust’s progress in meeting the requirements from a well-led inspection in February.

A spokesperson from the commission added: “At the February inspection CQC downgraded the well-led rating from ‘good’ to ‘inadequate’ and suspended other ratings until this inspection had been completed.

"Following this inspection, the trust’s overall rating has moved from ‘good’ to ‘requires improvement’ overall. The ratings for how safe, effective and responsive the trust are have moved from ‘good’ to ‘requires improvement’. Caring remains rated as ‘good’.”

The CQC’s network director Deanna Westwood said during the inspection inspectors found that staff on the front line were ‘doing their utmost to provide safe and effective care to people across Kent, Surrey and Sussex’.

The network director added: “However, additional pressures on the service, which included an increase in staff sickness and increased delays in handovers from partner organisations, meant that the quality of care we saw being delivered had declined. It was for this reason that we have changed their overall rating from ‘good’ to ‘requires improvement’.

“Leaders were very aware of our concerns in relation to the trust's performance and have showed a real sense of urgency in prioritising the issues which had been identified, which is encouraging.

“As flagged in CQC’s report published last week, ‘State of Care’, the South East like many other areas has a health and social care system that is gridlocked. The trust can’t solve all of their issues, such as handover delays alone, and I encourage the whole system to work together to find a resolution.

“We did have other, more specific, concerns that we have told leaders about. For example, they need to have better oversight on how often restraint was used and if it was done safely. Although staff knew what incidents to report and how to report them, they weren’t always reporting when somebody had been restrained.

“We also spoke with staff within the resilience team, who were frustrated and didn’t feel respected, valued or supported. There was low morale within the service and staff told us they didn’t feel appreciated by management at a senior level.

“We continue to monitor the service closely and will be returning to check on the progress of improvements that the trust has been told to make.”

The CQC said it also found that many staff were working beyond their hours and were not always getting breaks on time in ‘what were already long shifts’.

The spokesperson added: “Hazardous area response teams (HART) were expected to be made up of six HART operatives which included an operational team leader. This was based on the national ambulance resilience unit (NARU) recommendations for resilience services. The trust had made a decision to allow teams to continue to operate with a minimum of four HART operatives when required and these teams would be backed up by a second team, which provided a safer system of work. However, between January and July the trust had breached their staffing policy on 10 occasions.”

SECAmb said it has reaffirmed its commitment to making improvements.

The service explained that the February inspection rated the Trust NHS 111 service as ‘good’ but suspended other ratings until the latest inspection had been completed.

A spokesperson from the ambulance service said: “SECAmb is pleased the care provided by its staff was recognised with a ‘good’ rating and that inspectors found and were encouraged that trust leaders were showing a sense of urgency in prioritising the issues which had previously been identified.”

SECAmb interim chief executive Siobhan Melia added: “I am really pleased that the excellent care provided by our staff has once again been recognised and rated as ‘good’ by the CQC, despite the huge pressures they face every day. I am very proud of the high-quality care and compassion provided by our staff.

“We have already taken concerns around our culture and leadership extremely seriously and we are committed to making further improvements to ensure we improve our response to patients and the working lives of our staff. I know that there is much to do to get the trust to where it needs to be and we are working closely with staff, as well as partners both regionally and nationally, to make the necessary improvements highlighted in the report.”

The report found that there was additional pressure on SECAmb’s services which included increased staff sickness and increased delays in hospital handover, according to the ambulance service.

A spokesperson from the ambulance service added: “Inspectors recognised that SECAmb is unable to solve all of its issues alone and encouraged the trust to work with the wider health system to find resolutions.

“SECAmb has outlined an improvement plan focusing on four main areas; quality improvement, responsive care, sustainability, and people and culture. Work includes improving learning from incidents as well as further recruitment and greater retention of staff. It also involves growing the trust’s voice within the wider NHS system to support improved patient pathways, reduce hospital handover delays and develop new partnerships.”

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