'Poor leadership', 'bullying' and 'sexual assault allegations' uncovered at East of England Ambulance Service in damning inspection report

The Care Quality Commission (CQC) has recommended the service be placed in Special Measures, as well as making a referral to the Equality and Human Rights Commission (EHRC).

CQC inspected the service between June 25 and July 15, prompted by a tip-off from seven whistleblowers.

In evidence, the inspection found: "The board was aware of at least ten incidents that had occurred from April 2019 to March 2020 that related to serious allegations of sexual assault, harassment or inappropriate behaviours. However, they had failed to take appropriate actions to ensure the safety of patients and staff.

"Between April 2019 and March 2020, the trust had thirteen instances of staff members - including staff sub-contracted by the organisation - referred to the police for allegations relating to sexual misconduct and predatory behaviour, including allegations of staff abusing patients."

Bosses failed to take action after an independent report into one worker's "predatory" sexual behaviour towards a patient. In a 2019 staff survey, East of England Ambulance Service scored worst out of all ambulance trusts for bullying and harassment.

The inspection found that the trust’s leadership did not encourage transparency, with bosses adopting a "combative and defensive" approach when questioned.

They noted: "Some members of the executive leadership team adopted a combative and defensive approach, expressing a view that sexual harassment and inappropriate behaviours were endemic to the ambulance service nationally and as issues were historical, they could not be held accountable.

"There was a lack of recognition of the seriousness of the concerns and impact on patient and staff safety amongst the executive team."

Staff were described as "undervalued" and "treated disrespectfully" when they spoke out about problems.

Overall, the trust was rated as "Requires Improvement" by CQC as well as in most sub-categories. It was rated "Inadequate" in the sub-category of leadership, and "Outstanding" in the sub-category of caring.

As a consequence of inspectors’ findings, CQC has forced the trust to overhaul its safeguarding processes and report back to CQC about the issues it must address.

Ted Baker, England’s chief inspector of hospitals, said: "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. 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:

• Implement effective safeguarding systems;

• Review its current policies about allegations made against staff;

• Undertake adequate pre-employment checks;

• Ensure the safety and effectiveness of subcontracted private ambulance services;

• Action the findings of its own review into inappropriate behaviours and manage concerns, grievances and disciplinaries;

• Address long-standing concerns regarding bullying and harassment within the organisation.

East of England Ambulance Service insists it has now updated its safeguarding policies, as well as offering new mentoring and support systems for staff.

Some 700 people have been recruited this year, although it is not clear whether there has been any turnover among the managers and leadership team criticised in the report.

The trust states its executive team "absolutely recognise the seriousness" of the concerns raised by CQC.

Nicola Scrivings, chairman of East of England Ambulance Service, said: “Today’s report calls out where we need to improve and we will now do everything possible, as fast as possible, to make the improvements required.

“We are working closely with the CQC, NHS colleagues and other partners to take action right now to address these concerns and put this right for the long-term.

“The trust aims to provide outstanding quality of care and performance for patients and be an exceptional place to work, volunteer and learn. In a message to staff today, the executive team has again reinforced its commitment to listen to and support anyone who raises concerns.

“It is clear from the CQC staff survey that the majority of staff at the Trust are proud to work for EEAST. The role of the leaders is to make sure every member of the team feels that pride, with the support and culture they deserve.”