Clive Lewis, MP for Norwich South, is ‘extremely disturbed by chronic safeguarding failures resulting in ambulance trust being put into special measures’: He said: “The details of why the Ambulance Trust has been put so rapidly into Special Measures and referred to the Equality and Human Rights Commission (EHRC) are deeply disturbing. It is almost beyond comprehension how a service so trusted to come to our aid when we are at our most vulnerable could also fail to protect patients and staff from sexual abuse, inappropriate behaviour and harassment. My heart goes out to everyone who has been touched by what I think is fair to describe as a fully-fledged scandal at this trust. My staff and I will do our best to support any constituents who have been affected and I will keep a close eye on developments.
In the end, the buck for this kind of thing ultimately stops with ministers and central government. I have no doubt they will try and distance themselves from this failure and put it all down to a few ‘bad apples’ at a provincial NHS Trust. However, this is far from being an isolated incident and is also one of the many consequences of foisting competitive market and business principles onto our public services.”
This comment follows on from this press release from the CGQ:
CQC takes action at East of England Ambulance Service and recommends it enters special measures, following inspection
The Care Quality Commission (CQC) has used its enforcement powers at the East of England Ambulance Service NHS Trust, following an inspection which found poor leadership had fostered bullying and abuse.
CQC inspected the trust between 25 June and 15 July 2020, prompted by information from sources – including whistleblowers – about the safeguarding of patients and staff from sexual abuse, inappropriate behaviour and harassment.
The inspection found that the trust’s leadership did not cultivate a transparent culture, with some senior leaders adopting a combative and defensive approach when facing reasonable challenge. Staff were undervalued, not empowered to raise concerns and treated disrespectfully when they spoke out about problems.
Some of the trust’s leaders lacked adequate skills, knowledge and experience for their roles. Their inability was compounded by their weak use of processes to understand and respond to the challenges they faced.
These shortcomings manifest themselves in the trust’s failure to learn from sexual harassment directed towards staff in one of its workplaces, including after recommendations were made in an independent report. Leaders also failed to act decisively when staff faced allegations of predatory sexual behaviour towards patients.
As a consequence of inspectors’ findings, CQC used its enforcement powers to protect people and hold the trust to account. This included requiring the trust to overhaul its safeguarding processes and report back to CQC about issues it must address.
CQC also referred the trust to the Equality and Human Rights Commission (EHRC), due to a potential breach of the Equality Act 2010.
Following the inspection, England’s chief inspector of hospitals recommended that the trust enters special measures. This means it will be inspected again in line with CQC’s regulatory processes. If insufficient improvement has been made at that stage, CQC will use its enforcement powers further.
NHS England and NHS Improvement (NHS E/I) has already begun to put a package of support measures in place to help the trust address the serious concerns raised.
Ted Baker, England’s chief inspector of hospitals, said:
“The trust’s leaders did not adequately promote the wellbeing of their patients and staff because their processes did not enable problems to be identified and addressed. Leaders did not have oversight of the challenges they faced, and some senior managers did not have the right skills and abilities for their roles.
“Some leaders adopted a combative approach which deterred staff from speaking out, including on serious issues such as safeguarding and abuse. This fuelled a negative culture, where bullying was normalised, and put patient and staff safety at risk.
“Following the inspection, we reported our findings to the trust so its leaders know what they must address. We used our enforcement powers, to keep people safe, and made a referral to the EHRC.
“I have also recommended that the trust enters special measures, so that it can receive the support it needs. NHS E/I has already begun to put some of this support in place to help the trust make the necessary improvements.
“We continue to monitor the trust closely. We will return to inspect it, to determine whether improvements have been made.”
CQC has told the trust it must make several improvements, including:
• Implementing effective systems to identify and assess safeguarding issues, and monitor staff Disclosure and Barring Service renewals
• Reviewing policies to deal with allegations made against staff
• Undertaking adequate pre-employment checks
• Ensuring the safety and effectiveness of subcontracted private ambulance services and their staff
• Actioning the findings of its review into inappropriate behaviours and implementing effective processes to manage concerns, grievances and disciplinaries
• Ensuring all required oversight and governance arrangements are in place
• Addressing long-standing concerns regarding bullying and harassment within the organisation.
Full details of the enforcement action CQC has taken are available here: https://www.cqc.org.uk/provider/RYC/registration-info
This focused inspection assessed the trust in respect of one of CQC’s five key questions: ‘is it well-led?’. This entailed considering whether its leadership, management and governance processes supported the delivery of high-quality and person-centred care.
As this was not a comprehensive inspection – where the trust and its services would be assessed for being safe, effective, caring, responsive and well-led – the trust’s ratings are unchanged from CQC’s last comprehensive inspection, the findings of which were published in July 2019, and it remains rated Requires Improvement overall.
Although CQC suspended its routine inspections in March 2020 to support care providers to deliver safe care during Covid-19 pandemic, inspections are still taking place where there is evidence suggesting people may be at risk of harm.
CQC continues to collect insight and intelligence about services from its data sources – including providers, healthcare staff, stakeholders, and the public – and it is working closely with its partners to ensure additional support is in place where needed. If there is evidence that people are at immediate risk of harm, CQC is taking action to ensure that people are safe.
People can give feedback to CQC via the details below:
• Telephone – 03000 616161
• Give feedback on care webform (www.cqc.org.uk/give-feedback-on-care)
The Care Quality Commission (CQC) is the independent regulator of health and social care in England. They make sure health and social care services provide people with safe, effective, caring, well-led and responsive care, and encourage care services to improve. They monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and publish what findings to help people choose care.