Inspectors have found high levels of bullying, harassment and discrimination at an ambulance service in England after whistleblowers raised concerns over the safeguarding of patients and staff.
The Care Quality Commission (CQC) health watchdog recommended on Wednesday that the East of England Ambulance Service NHS Trust be placed in special measures.
“There were continued high levels of bullying, harassment and discrimination and the organisation had failed to take adequate action to reduce this,” inspectors wrote in a report on the service.
“There was a failure by the executive team to identify and recognise the risk and impact to staff and patient safety from the poor culture throughout the organisation.”
CQC inspected the trust between 25 June and 15 July this year following information from sources, including whistleblowers, about the safeguarding of patients from sexual abuse, inappropriate behaviour and harassment.
Inspectors said the trust’s leadership did not cultivate a transparent culture and some senior leaders adopted a “combative and defensive approach” when challenged.
They added that staff were undervalued and not empowered to raise concerns, with some being treated disrespectfully when they spoke out about issues with the trust.
CQC also said some leaders lacked adequate skills, knowledge and experience for their roles and the trust had failed to learn from incidents of sexual harassment directed towards staff in one of its workplaces, even after recommendations were made in an independent report.
The commission has used its enforcement powers to order the trust to overhaul its safeguarding processes.
NHS England and NHS Improvement has begun to put a package of support measures in place to help the trust address the serious concerns raised.
“The trust's leaders did not adequately promote the wellbeing of their patients and staff because their processes did not enable problems to be identified and addressed,” Ted Baker, England’s chief inspector of hospitals, 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 added: “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.”
The chief inspector said CQC would continue to monitor the trust closely and return for a further inspection.
“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,” Nicola Scrivings, chair of the East of England Ambulance Service, said in response to the recommendations.
The trust has been ordered to renew its policies to deal with allegations made against staff and to undertake adequate pre-employment checks.
It must also ensure the safety and effectiveness of subcontracted private ambulance services and their staff and address long-standing concerns regarding bullying and harassment within the organisation.
Additional reporting by PA