Members considered a report from
the South East Coast Ambulance Service (SECAmb) NHS Foundation
Trust, with a focus on the planning and preparation for winter
2022/23, performance across both the 999 and NHS 111 services, the
Care Quality Commission recommendations and subsequent Improvement
Journey, and ambulance handover delays since the Committee was last
updated in March 2022.
Members discussed the
– a Members asked whether
the Trust considered itself to be in crisis. SECAmb representatives
responded that crisis was difficult to define. The Trust was in an
extended recovery phase. The instability in the executive team was
acknowledged but progress had been made in the last 12
Current sickness levels
– Members were advised
that thesickness target was 7%
and levels were currently at 10.5%. This was not dissimilar to last
year and the Trust was not an outlier. There had been a general
increase in burn out across the NHS.
Quality Commission inspections – disappointment was expressed at
the conclusions of the recent CQC reports. The
Committee had been assured on several occasions on issues such as
bullying, staff morale and senior management stability yet the CQC
reports showed little progress. There had been comments from the
Trust’s Chief Executive about high levels of employee
relations issues and reports of staff feeling burnt out and not
getting breaks. SECAmb commented that they were disappointed in the
findings of the CQC report. The Trust took staff well being
seriously. The CQC recognised that staff provided an excellent
service. There was a detailed improvement journey which the Trust
was working on at pace. The Chief Executive’s comments had
been in relation to the national landscape. Trust in leadership was
low and there was a lack of a clear vision. Some training had been
cancelled due to the pandemic which had affected break patterns.
The latest inspection from the CQC in summer 2022 had changed the
rating to “requires improvement”. This and the lack of
any additional warning notices would hopefully assure Members the
Trust was moving in the right direction.
The Trust acknowledged it was not
in a healthy place culturally butculture changes took
time. There would be a focus on quality of care and people in next
In response to a comment that
the cultural issues
pre-dated covid, SECAmb acknowledged this but felt covid had been
an exacerbating factor.
Management – an assurance was sought
that senior management understood what changes needed to be made
and how to ensure staff felt valued and also eradicate poor
behaviour. A point was made that e-bulletins and video updates for
staff should be in person instead. SECAmb responded that financing
was a key challenge. Recruitment was on target but there had been
an increase in attrition since covid. The Trust was working with
commissioners to get sufficient staff to meet its targets. In terms
of the visibility of leadership team, the CQC inspection took place
at a time when staff were advised to work from home and
communications were mainly virtual. The E-bulletin had been
received positively as staff spent little time in stations. The
Trust was looking at how it could optimise communications with
staff as part of the improvement journey, particularly getting
better at listening to staff.
programme - why the Trust had paused the conversion of
the latest batch of Fiat ambulances while it undertook a review of
the design specification due to staff concerns was queried. Members
were advised that the Trust was moving to Fiat as part of a
national specification. It had quickly become clear that staff did
not think the programme was fit for purpose so it had been paused
to allow further work with Fiat. The Trust was now introducing
adapted vehicles based on staff feedback.
999 Category 4
performance – an undertaking
was given to share this data with Members.
Planning to meet
demand – whether the
Trust should be better at planning to meet higher demand was
queried. SECAmb advised that ideally they would plan to have the capacity to meet higher demand
but attrition could prevent this. However, the Trust was now in a
better place. It was not always appropriate to send physical
resource to an incident.
Suicide Postvention Group – SECAmb clarified that this
group was not advertised through the Trust and should not be seen
as an acceptance that suicides were inevitable. The focus was on
and at an early stage identifying people who were struggling. The
Trust had learnt lessons from police forces, fire services and
Staff retention -
SECAmb advised they had introduced
response units as one means to keep experienced paramedics engaged.
Exit interviews improved the Trust’s understanding of why
people were leaving. A retention plan had been approved but
turnover at contact centres was 40% and this needed to be tackled.
The Trust was looking at its recruitment processes to ensure the
right people for each role were recruited.
response to a query, Members were advised that the Trust
possibility of a staff representative on its Board and patient
representatives on Board sub groups.
The Committee agreed
briefing paper on safeguarding.
information on performance, including Category 4 999 calls would be
sent to Members.