Agenda item - South East Coast Ambulance NHS Foundation Trust: CQC Inspection Report

Report of The Executive Lead Strategy, Governance and Law, on the recent CQC inspection of SECAmb.

33.1    This item was introduced by Geraint Davies (GD), Acting Chief Executive, South East Coast Ambulance NHS Foundation Trust (SECAmb).

33.2    In response to a question from Caroline Ridley (Community Sector representative) on the CQC’s finding that some SECAmb staff did not fully understand their job roles, GD told members that SECAmb acknowledged this problem. The trust is taking a number of steps to address this: for example, by ensuring that managers are no longer required to crew ambulances at times of very high demand – allowing them to concentrate on their managerial role. The trust is also introducing a better escalation process for staff concerns; has introduced a new system of appraisal that focuses on quality; and regular ‘temperature check’ meetings with front-line staff.

33.3    In answer to a query from Cllr Marsh on when permanent board appointments would be made, GD told the committee that the new CEO will take forward the appointment of senior managers within the trust to address the interim roles and work with the board/council of governors to appoint a new chairman.

33.4    In response to a question from Cllr Taylor on whether trust leaders had been aware how serious some of the problems facing the trust were, GD told members that although it was known that the trust was facing significant challenges, the full extent of these was not necessarily known as there was significant staff under-reporting of issues. The trust had not been fully aware of governance shortcomings until the Deloitte report on the Red 3 scheme was released earlier in 2016.

33.5    In response to a question from Cllr Allen about safeguarding, GD informed the committee that SECAmb took the CQC’s findings on safeguarding very seriously, and had already instituted changes – for example in how the trust Board deals with safeguarding alerts. However, some of the poor safeguarding performance identified by the CQC was not in fact due to under-reporting of safeguarding concerns, but the use of terminology in staff reporting that the CQC did not recognise as relating to safeguarding.

33.6    In answer to a question from Cllr Allen about how much ambulance capacity was being lost due to handover delays at hospital, GD told members that delays amounted to 3% of total ambulance capacity. This is unacceptable, but is a system problem not just a problem for hospital trusts.

33.7    In response to a question from Cllr O’Quinn on ambulance crew mix, GD told members that the trust endeavours to buddy new staff with experienced people. However, it is important to understand that all the paramedics employed by SECAmb are fully trained graduates, many of whom will have done their training with SECAmb.

33.8    GD told the committee that the trust is experiencing significant problems with staff retention. Part of the problem is that ambulance paramedics are being actively recruited into primary and secondary healthcare, often at much better pay than the ambulance service can offer.

33.9  Cllr Peltzer Dunn thanked GD for attending the meeting, noting that it was refreshing to get such a candid and open response to service failure.

33.10  The Chair suggested that the HOSC should see the SECAmb action plan in response to the CQC’s finding as soon as it became available. This was agreed by members.

33.10  Cllr Peltzer Dunn proposed an amendment to the report recommendations: to insert at point 2.3 the following: “that there be regular reports back to the HOSC for information and/or decision. No formal powers shall be delegated to the working group.” The amendment was seconded by Cllr Bennett and agreed by HOSC members.

33.11RESOLVED - That the report be noted; that HOSC members agree that scrutiny of the implementation of SECAMb quality improvement measures in response to the CQC report findings be undertaken by an informal joint working group representing all the interested HOSCs in the SECAmb ‘region’; and that there be regular reports back to the HOSC for information and/or decision. No formal powers shall be delegated to the working group.