Damning Report Rates Leadership At SECAmb "Inadequate" And Highlights Culture Of Bullying

A report carried out by the Care Quality Commission to rate the services of South East Coast Ambulance Service has found leadership of the NHS Trust "inadequate".

However, in the report, staff at the foundation trust were praised for their "outstanding" emergency and urgent care, with other categories - looking at the "safe," "effective," "caring," and "responsive," areas of the services - all rated "good". 

The inspection, which took place in February, looked in particular at management and leadership but also at the Emergency Operations Centres (EOCs), which "requires improvement" and at NHS 111 service, which retained its "good" rating.

Highlights from the report noted:

• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs and helped them understand their conditions. They provided emotional support to patients, families and carers.

• Despite the immense pressure faced every day, staff were kind, compassionate and supportive.

However, leadership of the trust was called in to question for the majority of the report, highlighting the lack of staff needed to ensure patients were safe, an expectation of staff to work overtime despite exhaustion, lack of support leading to low morale and staff not feeling visible or appreciated by  senior leadership, 

Some staff also told the CQC that they did not feel "respected, supported or valued," they felt they could not raise concerns without fear and that leaders did not support staff to develop their skills, expecting staff to take on professional development in their own time. 

The report found:

Trust wide

• Leaders had the experience, capacity and capability to lead effectively. However, the current leadership style and relationships in the executive team were not operating as effectively or cohesively as it should.
• Communication at all levels was poor. Staff provided us with many examples of this during the inspection.
• Leaders were out of touch with what was happening on the front line, and they were not always aware of the challenges in the service
• Leaders were not visible and did not act in line with the trust’s own values when staff raised concerns
• Not all staff felt respected, supported and valued. Staff were focused on the needs of patients receiving care
• Not all staff felt they could raise concerns without fear of reprisal
• Staff reported low levels of satisfaction and high levels of stress and work overload
• We found high levels of bullying and harassment, inappropriate sexualised behaviour and a high number of open grievances.

In response to the report South East Coast Ambulance Service NHS Foundation Trust (SECAmb) released a statement this morning, saying it was  committed to making improvements.

The statement added that they would be rolling out an "important campaign"- 'Until It Stops' - to address "inappropriate behaviours" saying it was "committed to working with colleagues across the organisation to implement changes and ensure they view SECAmb as a place at which they want to work and deliver high-quality care to our patients".

"The serious concerns surrounding culture and leadership highlighted by the CQC are being taken extremely seriously and we have already begun the work to implement improvements at pace, taking on board early feedback from the CQC as well as feedback from our own staff survey."

As part of the statement SECAmb announced it had appointed a new Interim Chief Executive, starting on July 12. They added:

"Our Leadership Team has set out the key priorities for the year, including building a culture that fully reflects our values, supports our vision and ensures the satisfaction and wellbeing of our people and embeds quality improvement across everything we do."

SECAmb Interim Chief Executive Fionna Moore said:

“It is clear from this report that SECAmb has a long way to go to ensure our staff feel properly supported to perform their roles. The whole Leadership Team is committed to doing everything we can to make SECAmb a better place to work, so that our staff are best placed to respond to our patients.

“However, I am pleased that, despite the issues highlighted in the report concerning leadership at the Trust, the hard work and dedication of our staff and volunteers did not go unnoticed.

“I look forward to working closely with Siobhan Melia, our newly appointed Interim Chief Executive, as we first build and then embed the necessary improvements at SECAmb.”

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About the trust:

South East Coast Ambulance Service NHS Foundation Trust (SECAmb) was established on 1 July 2006. On 1 March 2011 SECAmb became a Foundation Trust.

The trust covers 3,600 square miles which includes densely populated urban areas, sparsely populated rural areas and some of the busiest stretches of motorway in the country. It serves a population of over 5 million people.

The trust employs over 4,500 staff working across 110 sites in Kent, Surrey and Sussex. Almost 90 per cent of the workforce is made up of operational staff – those caring for patients either face to face, or over the phone at the trust emergency dispatch centre where the trust receive 999 calls.

Patients range from the critically ill and injured who need specialist treatment, to those with minor healthcare needs who can be treated at home or in the community.

As well as a 999 service, the trust also provides the NHS 111 service across Kent and Sussex. The trust also has a Hazardous Area Response Team (HART) which was not inspected at this time.

Information provided by the CQC.