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CQC recommends South East Coast Ambulance Service NHS Foundation Trust is taken out of special measures

14/08/2019

England's Chief Inspector of Hospitals has recommended that South East Coast Ambulance Service NHS Foundation Trust should be taken out of special measures following an inspection by the Care Quality Commission.

Professor Ted Baker and his inspectors found sufficient progress to make the recommendation to NHS Improvement.

A team of inspectors from CQC visited the trust in June and July 2019. This was to assess the quality of the core services: emergency operations centres; emergency and urgent care and the trusts out of hours and NHS 111 services. They also looked specifically at management and leadership to answer the key question: Is the trust well-led?

The trust was rated as Good overall and for providing safe, effective, caring, responsive and well-led services. Previously the trust was rate as Requires Improvement.

Full details of the ratings, including ratings for each individual service are given in the report when it is published online at: https://www.cqc.org.uk/provider/RYD

England's Chief Inspector of Hospitals, Professor Ted Baker, said:

"I am pleased to find South East Coast Ambulance Service NHS Foundation Trust has made excellent progress. The trust has embedded the improvements our inspectors saw at our last inspection in November 2018 and has also met the requirements we asked for.

"Nearly three years ago, we rated the trust as Inadequate overall because of concerns relating to patient safety, the organisational culture and governance. Since that time, we have been back twice to inspect and continued to monitor the trust closely.

"The credit must go to the hard work and commitment of the staff and the current leadership team. I congratulate them on their achievements. The overall rating of Good reflects a substantial improvement in the quality of services at the trust and I am happy to recommend that it is removed from special measures."

Inspectors found improvements in emergency and urgent care (ambulance service) which was now rated Outstanding. Staff showed a strong person-centred approach to care. They offered emotional support and treated people with compassion and kindness. Some patients told us staff often went the extra mile in proving excellent care.

During previous inspections in the emergency operation centre, inspectors observed that there was no clear oversight of patients who had fallen or those who had been lying waiting for some time. There was a now new dispatch system in place which gave better oversight to the age of the faller which gave a clearer indication of where the patient was, the environment around them and if they were supported. Staff told inspectors that this enabled them to triage and prioritise.

Inspectors also visited the trusts out of hours and NHS 111 service. They found staff in the centre worked together and with other organisations to deliver effective care and treatment. Patients were supported and empowered to manage their own health and maximise their independence. The service identified patients who may need extra support. For example, transfer to a mental health clinician or the pregnancy advice line. Where a patient's need could not be met by the service, staff redirected them to another service.

CQC had reported previously on a culture of bullying and harassment within the trust. The trust has worked hard to address this. Staff spoke about the improvements and steps taken by managers at all levels to address bullying. Staff now felt more confident to speak up if they observed behaviours which did not reflect the values of the trust.

Senior leaders and managers engaged with staff and listened to their views. The board demonstrated a genuine desire to understand what mattered to staff. They saw this as a key aspect of good leadership to ensure a sustainable and consistent service. Staff told inspectors they felt engaged and were confident their views and feedback were valued and acted upon.

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