Inspectors uncover sexual abuse and bullying at ambulance trust
PUBLISHED: 08:24 30 September 2020 | UPDATED: 16:31 30 September 2020
Bullying was “normalised” at the region’s ambulance service and its leaders failed to act when staff were accused of sexual predatory behaviour towards patients, inspectors revealed today.
In a damning report, regulator the Care Quality Commission (CQC) found the leadership of the East of England Ambulance Service Trust (EEAST) “fostered” abuse.
Following the inspection, the EEAST has been recommended for “special measures”, meaning it will be given extra support by NHS England - and ordered to make changes.
Chief executive Dorothy Hosein pledged to turn the troubled organisation around when she took over in 2018.
Last year it was given the second lowest rating of “requires improvement” by the CQC.
Its staff were praised for providing “outstanding” care, but its leadership was rated as “inadequate”.
When more concerns were raised earlier this year, the CQC returned.
Inspectors visited in June and July after tip-offs from whistleblowers about the safeguarding of patients and staff from sexual abuse, harassment and inappropriate behaviour.
They found that the EEAST’s leadership was “combative and defensive” when challenged.
“Staff were undervalued, not empowered to raise concerns and treated disrespectfully when they spoke out about problems,” they said in a statement.
They found some of the EEAST’s management were not up to the job.
They said they 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,” the inspectors added.
“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.”
After the inspection, the CQC used its enforcement powers to order EEAST to overhaul its safeguarding processes.
The CQC also referred the Trust to the Equality and Human Rights Commission (EHRC), due to a potential breach of the Equality Act.
NHS England said it has already begun to put a package of support measures in place after England’s chief inspector of hospitals, Ted Baker, recommended that the Trust entered special measures.
Mr Baker said: “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.
He said there was a “negative culture” and “bullying was normalised, and put patient and staff safety at risk.
Mr Baker added: “We continue to monitor the trust closely. We will return to inspect it, to determine whether improvements have been made.”
The CQC has told the EEAST it must make several improvements, including to its safeguarding procedures, how it deals with allegations against staff and undertaking proper pre-employment checks.
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They must also review the safety of private ambulances they use and address “long-standing concerns regarding bullying and harassment within the organisation”.
Norwich South Labour MP Clive Lewis said: “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.”
•What the ambulance service says
In response, the EEAST said its leadership has taken steps to improve the culture, strengthen safeguarding, and tackle inappropriate behaviour.
Since the inspection it has updated safeguarding policies and its complaints procedure.
It will also survey all staff on their experience of the Trust’s culture including inappropriate behaviour.
Chairman of EEAST, Nicola Scrivings, who was appointed in October 2019, 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.”
Asked if the leadership should resign, she said: “This leadership team has delivered improvements over the past year with better performance and more staff on the ground, but it is clear that there is more to do on culture.
“A stable leadership team is an important part of driving cultural change and we are getting extra support from the NHS and elsewhere to help the leadership team succeed.”
She added: “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.”
•Analysis: Leadership changes, but problems remain
The East of England Ambulance Trust has lurched from one crisis to the next over the last few years, but several changes of management have failed to solve its problems.
Its current chief executive, Dorothy Hosein, was appointed in 2018 and came in after a whisteblower released a dossier which claimed patients had died because of long response times over the previous winter under its last chief executive, Rob Morton.
The trust has long struggled to hit response time targets, particularly in rural areas.
It has also suffered from recruitment problems, something Ms Hosein recognised when she was appointed.
Most recently it was under the spotlight for staff welfare after three employees died suddenly in 11 days in November last year.
The inquest into one of the deaths, Luke Wright, found he had taken his own life.
That again prompted the service to pledge changes.
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