Inspectors say Nottinghamshire’s ambulance service is making progress but still ‘requires improvement’ because of slow response times and potential bullying of staff.
East Midlands Ambulance Service was first given the rating by the Care Quality Commission in 2015 after checks found it didn’t have enough staff to cope with demand.
Some of its key services were criticised – including emergency and urgent care, which were graded as ‘inadequate’ on safety and effectiveness at the time.
As a result the trust which runs the service faced enforcement action from the commission, which required it to draw up a detailed improvement plan.
Inspectors returned to check progress in February this year and their findings have now been made public.
While the overall rating for the trust is unchanged, inspectors found a number of “significant improvements” had been made in key areas.
The safety and effectiveness of emergency and urgent care services are no longer rated as ‘inadequate’ for safety but one better at ‘requires improvement’.
The commission’s chief inspector of hospitals, Professor Sir Mike Richards, said: “Significant improvements had been made, and there were a number of areas of outstanding practice, but we still had some concerns.”
He added: “Response times for some identified calls fell short of the national target, which meant patients were not receiving care as quickly as they should. There were variable standards of incident investigation and a lack of learning at an organisational level in relation to those incidents.
“We found action had been taken to increase the number of front line staff, standards of cleanliness had improved and the majority of equipment and vehicle checks were appropriately completed. The number of vehicles delivering emergency and urgent care services had increased and potential risks to the service were anticipated and planned for.”
The report itself says there are ‘pockets of concern’ about potential bullying and harassment of staff who did not have the confidence to report it.
It added: “Generally most staff told us things had improved although a small number of staff in specific areas raised concerns with us during this inspection in relation to bullying and harassment by middle managers. We escalated this and the trust began immediate action to address the concerns.”
Inspectors from the commission will return at a later date to carry out more checks.
EMAS Chief Executive Richard Henderson said in a statement: “During its inspection the Care Quality Commission found that patients were overwhelmingly positive about our caring and compassionate staff across all levels and specialities of our service.”
He added response times were improving, but apologised for the service’s failure to meet targets.
“I am sorry that some patients experienced unacceptable waits,” he said.
“During the year we have invested in new ambulance vehicles and our electronic patient record system, recruited more staff to our frontline, and improved the clinical outcomes for many of our patients.
“Despite sustained challenges, the CQC recognised that we have made significant improvements since the November 2015 CQC inspection and I am pleased that the CQC has identified no new areas of concern, whilst identifying several areas of outstanding practice at EMAS.”
Addressing the allegations of bullying in the report, a spokesman for the trust said: “We have established policies and procedures in place to address any concerns raised in respect of bullying and harassment, and these ensure appropriate investigation and action is taken to address concerns raised.
“In addition, we have an education and training programme to raise awareness of professional behaviour in the workplace. The CQC report acknowledges that staff engagement and satisfaction had improved since their last inspection.”
EMAS chairman Pauline Tagg added: “We know what needs to be done at EMAS and we continue to progress our improvement plans.”
EMAS covers Derbyshire, Nottinghamshire, Leicestershire, Rutland, Lincolnshire and
Northamptonshire – with a population of 4.8 million people. The trust employs 3,290 staff over 60 locations.
