CQC welcomes improvements at South East Coast Ambulance Service

South East Coast Ambulance Service NHS Foundation Trust (SECAmb) provides emergency ambulance services to people across Brighton & Hove, East and West Sussex, Kent, Surrey, and North East Hampshire.

This inspection was carried out to assess whether the trust had made improvements since their previous inspection, when CQC found three breaches of regulations relating to safe care and treatment, staffing and overall management of the services. The trust has made significant improvements and is now only in breach of one regulation, relating to overall management of the urgent and emergency care service.

Following this inspection:

• Emergency operations centre service – CQC has upgraded the ratings for safe, effective, responsive and well-led from requires improvement to good. Caring has been re-rated good.
• Emergency and urgent care service – CQC has upgraded the ratings for safe, effective and responsive from requires improvement to good. Caring has been re-rated good. Well-led has been re-rated requires improvement.

Amanda Williams, CQC deputy director of hospitals, secondary and specialist care in the South East, said: “At this inspection, we were pleased to find South East Coast Ambulance Service NHS Foundation Trust had made some significant improvements since our last visit.

“It was positive to see the trust putting people at the heart of their care and treatment. In emergency and urgent care, people told us staff had been kind and respectful and they felt safe. In one example, we saw an ambulance crew caring for someone with dementia, who thought they were in a busy shopping centre instead of an emergency department. The crew went along with this, which kept the person calm and reduced their anxiety.

“Leaders had also fostered a positive learning culture, where managers investigated incidents and shared learning with staff to promote good practice and continuous improvement. For example, managers in the emergency operations centre noticed clinical assessments for people with mental health needs were often delayed, so they trialled prioritising these calls. Early data indicated this was resulting in positive outcomes for people.

“However, we saw there were still areas for development. The trust was implementing significant changes to how it was organised and run, and staff described an ongoing disconnect between senior leaders and frontline teams, who didn’t feel fully included in decision-making. Staff wellbeing can impact the standard of care people receive so it’s important leaders address this.

“We also found some concerns with the systems leaders had in places to monitor and make decisions about the services and we’ve told them where these need to be more robust.

“The trust should look to build on these improvements and we’ll continue to monitor them to ensure this happens.”

Inspectors found:

• Leaders ensured there were enough experienced staff to provide safe, person-centred care and staff worked effectively together, and with NHS staff in emergency departments.
• Staff had a strong understanding of how to protect people from abuse and applied safeguarding processes consistently.
• Leaders had worked hard to improve the culture across both services. The 2024 staff survey showed that 50 per cent of staff would now recommend the organisation as a place to work, a significant improvement from 31 per cent in 2022.

However:

• The service was cleaning ambulances less often, so there was visible dirt in some areas and traces of blood on one ambulance’s stretcher.
• It was unclear how the service was managing risks or taking important decisions. For example, leaders hadn’t ensured a risk assessment was carried out when they suspended the deep cleaning of ambulances and hadn’t fully involved specialist teams in the decision-making process.
• A significant proportion of staff still lacked confidence that leaders would respond effectively when concerns were raised.

The report will be published on CQC’s website in the coming days.