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Lack of staff forces CQC to place London’s ambulance service in special measures

London Ambulance Service NHS Trust has been placed in special measures by healthcare regulator the Care Quality Commission (CQC) due to concerns around inadequate staffing levels, poorly trained staff, slow response times and a lack of equipment.
Responding to the CQC’s decision, published in a report today, the trust said it is boosting staffing levels and has recruited 167 additional staff, while 200 are undergoing training since the CQC’s June inspection.
Other staffing-related issues uncovered in the CQC report include:
  • a national shortage of paramedics, leading the trust to launch a recruitment drive for paramedics from Australia and New Zealand over the past six months
  • ambulance crew members the CQC spoke to said there were insufficient numbers of appropriately trained staff with the necessary skills mix to ensure that patients were safe and received the right level of care 
  • during the CQC inspection of 280 ambulances scheduled to be operational, only 234 were operational due to staff shortages
  • problems with staff retention due to pressure of work with increased responsibility and a lack of opportunity for career progression
  • high average staff turnover rates for 2014/15 of 15% within the emergency operation centre department, 28% for emergency medical dispatcher level 1 staff (EMD) and 41% for nursing staff 
  • serious concerns around how the trust had been fulfilling its responsibility to deliver a Hazardous Area Response Team (HART) capability to National Ambulance Resilience Unit (NARU) specifications. Team members told the CQC that they did not meet this specification. Managers also told the regulator they struggled to meet this specification, but that HART staffing was “risk assessed” and always “capable”. However, the CQC said its examination and initial analysis of rotas for May 2015 led it to believe that the trust was not always able to fully provide this function. 
Meanwhile, staff praised the trust’s introduction of a staff bank for staff wanting to work flexibly or take overtime. Bank staff said they were satisfied with the pay and conditions of their contracts. 
Trust chief executive Dr Fionna Moore said in a statement: “I am, along with my leadership team, completely focused on addressing the challenges highlighted in this report.
“We accept that we need to improve the way we measure and monitor some important standards and processes but we would like to reassure Londoners that we always prioritise our response to our most critically ill and injured patients and, in the event of a major incident, we are ready to respond and CQC recognise this.”
Recruiter contacted the trust for further comment on the progress of its staff recruitment drive but had not heard back by deadline.
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