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£50,000 review probes ambulance service leadership capability

PUBLISHED: 05:30 11 July 2018 | UPDATED: 14:02 11 July 2018

Norman Lamb MP speaks at the Liberal Democrats Autumn conference in Brighton, Sussex.

Norman Lamb MP speaks at the Liberal Democrats Autumn conference in Brighton, Sussex.

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A £50,000 independent review into the region’s ambulance trust has looked at whether bosses are good enough after a winter crisis engulfed Norfolk’s health service.

Leadership at the East of England Ambulance Trust (EEAST) has come under pressure since the difficult winter period, where a senior whistleblower alleged patients had died or been harmed due to delays.

Data shows EEAST received an extra 32,184 calls between December and February compared to the year before, and a review found no patients died because of long waits.

But now a new review has looked into “whether there is the leadership capability and capacity to deliver high quality, sustainable care”.

And North Norfolk MP Norman Lamb, who has been critical of the trust’s bosses, has written to the Department of Health and Social Care raising a series of concerns. These included:

The new investigation

Whether a fresh investigation was value for money, as he pointed to six previous consultancy reports and asked whether they had actually led to the trust being better run.

But health minister Stephen Barclay said the most recent review, which will be carried out by Deloitte, would also look at whether there were “robust processes” in place for bringing in consultants and whether recommendations were carried out.

And an EEAST spokesman said: “Thanks to various reviews in recent years we have been able to make specific improvements, such as being able to share learning nationally and regionally to support better patient care and balance our books. The recent CQC report acknowledged improvements since the last inspection.”

Senior staffing positions

The number of senior staff leaving EEAST in a five month period - including three non-executive directors, the deputy chief executive (who was also the nursing director), the communications director, and the medical director. But he also said 16 new senior positions had been created. He said: “Has there been any examination [...] as to the effective use of resources at this trust creating so many new senior posts when the frontline has been so stretched?”

An EEAST spokesman said the post were a mix of exisiting posts and “restructured post titles”, and that “the senior posts in the new service delivery restructure are reducing”. They said: “Another recommendation in the most recent CQC report was to implement our restructure plans to stabilise the team which saves lives every day. Most of the posts you have shared with us, do just that, while others are working hard to make sure we recruit well, support a good culture, improve engagement with staff and the public and plan now to deliver the service of the future. It’s also worth noting that the NAO report from January 2017 chaired by Richard Bacon MP found EEAST had a low level of senior managers when compared to other trusts.”

Patient safety

That trust directors claimed no patient safety issues had been raised over the winter period, but Mr Lamb said he presented evidence that they were raised with chairman Sarah Boulton.

And that two cases where there were ambulance delays were not classified as serious incidents until reported by the media, including the circumstances surrounding the death of Brian Havard, from High Kelling, which was revealed by this newspaper. Mr Lamb said: “This raises questions about whether the trust would have declared these very serious cases as serious incidents without that media attention.”

The trust denied this was the case, and said the case of Mr Havard was declared a serious incident by the Norfolk and Norwich Hospital.

Mr Lamb said: “I’ve lost confidence in this leadership, I’ve never called for resignations before, I have always avoided it because I think the NHS hires and fires enough and I’m not calling for it at the N&N for example.”

But Robert Morton, EEAST chief executive, said: “We are a united board-level team with a wide range of expertise and experience to help us strengthen our service and help EEAST remain focused on our patients. The care we provide for them means we’re in the best position ever to provide the modern, high-quality and sustainable health services our communities need. With the right investment, including £11.5m of additional funding this year - we will get better and better.”

The results of the review have not yet been published but the trust said they would be in “due course”.

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