Trust’s vow to learn lessons after ‘damning’ report on ambulance pilot

South East Coast Ambulance Service crew
South East Coast Ambulance Service crew

A report into a pilot that led to delays in some ambulance response times last winter has been described as ‘damning’ by county councillors.

South East Coast Ambulance Service (SECAmb), which covers Sussex, Surrey and Kent, implemented the pilot in December 2014 which delayed sending help for certain 111 calls, transferring them instead to the 999 system.

Geraint Davies, acting chief executive of South East Coast Ambulance Service NHS Foundation Trust (photo submitted). SUS-160427-125056001

Geraint Davies, acting chief executive of South East Coast Ambulance Service NHS Foundation Trust (photo submitted). SUS-160427-125056001

Chairman of the ambulance trust Tony Thorne resigned in March and chief executive Paul Sutton has taken a leave of absence from the organisation.

Acting chief executive and director of commissioning at SECAmb Geraint Davies presented the findings of an independent ‘forensic report’ into the pilot highlighting poor governance, inadequate disclosure, and unclear clinical accountability to West Sussex County Council’s Health and Adult Social Care Select Committee (HASC) today (Wednesday April 27).

Mr Davies explained that the pilot was undertaken in ‘challenging circumstances in terms of operational pressures’ but the trust was determined to ‘learn the lessons from what we did last winter and be open and transparent moving forward’.

He added: “This is not a good report for the trust, our review has recognised that.

“We have accepted the findings in the report and the recommendations.”

A joint recovery plan is being agreed with the trust’s commissioners and Monitor, while a separate independent patient impact review is set to be published in June, but no harm has been identified from the pilot, Mr Davies said.

The ‘forensic report’, carried out by Deloitte, explains that the scheme, which ran from December 2014 to February 2015, saw calls classified as Red 2 and Green referred to the 999 service from NHS 111 to be ‘re-triaged’.

The pilot allowed for up to ten minutes for the re-triage of red 2 calls and up to 20 minutes for green calls before they were allocated for despatch.

James Walsh (LDem, Littlehampton East), vice-chairman of HASC, said: “The report is really quite damning. In it is a litany of what went wrong and was a shocking departure from normal governance procedures.”

Worthing borough councillor Tom Wye said: “I do think earlier statements that this was ‘not a good report for the ambulance service’ is probably the understatement of the year or the decade.”

He welcomed pledges from the trust to be open and transparent, but asked if any of what he described as ‘underhand work’ was deliberate and if so what action was being taken.

He added: “The general public do not deserve that sort of treatment and I think they have been very badly let down.”

In response Mr Davies explained that the report had been taken very seriously by the trust and disciplinary action was being taken against ‘respective members of the organisation’ but he was not able to comment on that in any detail.

Alan Pickering, a director at Healthwatch West Sussex, said that the patient impact review had to take into account not just physical harm, but stress experienced by patients and their families waiting for ambulances.

Mr Davies said that if Healthwatch had any feedback from patients it could be fed into the review.

Peter Evans (Con, East Preston and Ferring) described the pilot as a ‘masterclass in how not to implement change in an organisation’, but argued that there was a problem with too many people calling 999 and ambulances queueing at hospitals.

Anne Jones (Con, Burgess Hill East) echoed the point about ambulances queuing outside A&E departments, and called the report ‘dreadful’.

Geraldine Hoban, accountable officer at the Horsham and Mid Sussex Clinical Commissioning Group and the lead commissioner for SECAmb in Sussex, explained that handover delays played a significant role in SECAmb’s ability to get crews back out on the road quickly and ‘deliver the response times our patients deserve’.

Rather than conveying more patients being the primary cause, it was the flow through the hospital and congestion at A&E that often led to queuing ambulances.

She had written to all CCGs and leaders of the hospitals to state that as commissioners of the ambulance trust they supported adherence to national standards for handover times.

Meanwhile Amanda Jupp (Con, Billingshurst) said she was worried about the effect the pilot and the subsequent fallout was having on staff who might be ‘disillusioned’ with the trust.

Mr Davies explained they were regularly communicating with staff around what the report says and what the trust was going to do to address it, and he added: “This is not a reflection on our staff’s quality of care.”

After the meeting a SECAmb spokesman said: “We welcome the opportunity to report to the committee as previously agreed with its members.

“Our staff continue, as ever, to work hard to provide our patients with the high level of care they rightly expect and deserve.”

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