All inspections: North East Ambulance Service NHS Foundation Trust

At our last inspection completed in July 2022 and September 2022, a section 29A Warning Notice was issued to the trust due to concerns with governance processes, medicines management and oversight, incident reporting and staff feedback highlighting concerns with the culture within the trust.

We carried out an unannounced focused inspection of Emergency and Urgent Care (EUC) services, as part of our continual checks on the safety and quality of healthcare services and to ensure that the trust had begun to implement adequate changes to facilitate significant improvement to address the concerns highlighted at our last inspection.

We also inspected some of the well-led key question for the trust overall, focussing on areas in the warning notice including upon the specific Leadership, Culture, Governance and Management of risk, issues and performance key lines of enquiry. As this was a focussed follow-up inspection in response to our previous enforcement action the trust well-led key question has been inspected but not rated.

At our last inspection in 2022 we rated the trust overall as requires improvement, with inadequate ratings applied to EUC and the well-led key question trust-wide.

We did not inspect Scheduled Care (Patient Transport Services), the Emergency Operations Centre, NHS 111 or Resilience (HART) services at this inspection.

As part of this focussed inspection, we inspected only one of the trust’s five core services as part of our follow-up to the section 29A warning notice which was issued at our previous inspection in 2022. We inspected and re-rated safe and well-led in EUC on this occasion.
We saw some improvements with medicine management systems. There was more structure and rigour in place to ensure oversight and incidents with harm were less.
We saw the beginnings of a safety culture emerging within the trust. There was more structure in reviewing and investigating incidents and patient safety concerns.
Freedom To Speak Up (FTSU) processes had been reviewed and additional freedom to speak up guardians (FTSUG) appointed by the trust.
There were indications that since our last inspection some staff felt more confident in raising concerns using the FTSU process.
We saw some improvements with the governance infrastructure and board processes had been reviewed to promote more thorough oversight.

However:

There were still inconsistencies and variability with medicines management across the trust, which included areas of improvement still being required in relation to service improvement and regards to individuals' professional practice.
There were still some issues with incident reporting processes and ensuring consistency with both quality and quantity of reporting trust-wide.
Further work was required with ensuring the trust meets the regulatory requirements of ensuring duty of candour is adhered to.
There remains a mixed picture with the overall culture within the organisation.
Additional time was needed to ensure new governance processes and improvement initiatives are optimised and embedded within the organisation.

How we carried out the inspection

The team that carried out the well led inspection included one inspection manager, one acute hospitals inspector, one assistant inspector and an inspection planner. In addition, there was one specialist advisor experienced in executive leadership of NHS trusts. The inspection team was overseen by Sarah Dronsfield, Deputy Director of Operations.

You can find further information about how we carry out our inspections on our website: www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection.

The North East Ambulance Service NHS Foundation Trust (NEAS) provides an emergency ambulance service 24 hours a day, 365 days a year across the North East of England.

The trust provides an emergency and urgent care (999) service and the NHS 111 service across the region. The trust also has a Hazardous Area Response Team (HART) and provides a patient transport service (PTS).

The trust covers just over 3,200 square miles, which includes across rural, urban and coastal areas, and serves a population of 2.7 million people.

The trust has just under 3,500 staff and volunteers, 55 ambulance stations and has a fleet of over 600 vehicles. Every year trust staff answer over half a million 999 calls and almost 1 million 111 calls, and transport around 300,00 patients to hospital and completes more than 500,000 PTS journeys.

We carried out this unannounced inspection of North East Ambulance NHS Foundation Trust as part of our continual checks on the safety and quality of healthcare services.

We inspected Emergency and Urgent Care, the Emergency Operations Centre and the NHS 111 service. We also inspected the well-led key question for the trust overall. We did not inspect PTS or Resilience (HART) services at this inspection.

At our last inspection in 2018 we rated the trust overall as good.

Our rating of services went down. We rated them as requires improvement because:

Overall, we rated safe and effective as requires improvement and caring and responsive as good. We rated well-led as inadequate.
We rated Emergency and Urgent Care as inadequate. We rated safe and well-led as inadequate. We rated effective and responsive as requires improvement and caring as good.
We rated the Emergency Operations Centre as requires improvement. We rated safe, effective and well-led as requires improvement and rated caring and responsive as good.
We rated NHS 111 as requires improvement. We rated safe, effective, responsive and well-led as requires improvement and rated caring as good. This report is published separately. The ratings are displayed in the ratings table in this report as ‘Ambulance Headquarters, Bernicia House’.
In rating the trust, we took into account the current ratings of the other core services that were not inspected this time.

What we found

Leaders did not always understand or manage all of the priorities and issues the service faced and governance processes did not operate effectively across the organisation to ensure risk and performance issues were identified, escalated appropriately, managed and addressed promptly. We were not assured the board had sufficient oversight and focus on the operational risks or had effective systems to ensure incidents were consistently reported in line national patient safety reporting guidelines.
Although staff were focused on the needs of patients receiving care, they did not always feel respected, supported and valued. Some staff told us they did not feel they could raise concerns without fear of blame or reprisal and the trust did not have effective systems to seek and act upon feedback from staff and other relevant persons.
Although leaders actively and openly engaged with patients, equality groups, the public and local organisations to plan and manage services, engagement with staff was less robust.
The portfolios for executive leaders were large and corporate services teams lacked capacity to be able to provide appropriate support. There were also limited succession plans to support staff to develop their skills and take on more senior roles.
Services did not always have enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. Although the trust had a workforce plan and had secured additional funding to increase the number of staff in patient facing roles, the Emergency Operations Centre did not have enough health advisors or clinical staff, and we were not assured advanced call-handler experts had received appropriate training or competency assessments.
The trust monitored agreed response times to facilitate good outcomes for patients however, although the trust was one of the top performing ambulance services in the country for its response time to category one calls, performance did not meet the national target against this and other call category standards
The trust aimed to provide the right care in a timely way and prioritised life-threatening responses, however people could not always access the service when they needed it, in line with national standards.
Systems and processes for continually learning and improving services were not robust. Learning from complaints and incidents was not embedded across the trust and the pace of delivering improvement was slow.
Following this inspection, we served the trust with a notice under Section 29A of the Health and Social Care Act 2008. We told the trust it needed to make the following significant improvements: (1) to ensure governance systems operated effectively; (2) in listening, responding, and acting upon feedback from staff and other relevant persons; (3) in incident reporting, investigating and monitoring of actions to prevent re-occurrence ensuring improvements are made as a result; (4) in medicines management to reduce risks to patients.

However:

Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual cultural and religious needs. Staff provided emotional support to patients, families and carers to minimise their distress and supported and involved patients, families and carers to understand their condition and make decisions about their care and treatment.
The service provided mandatory training in key skills to all staff and made sure everyone completed it.
Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
All those responsible for delivering care worked together as a team to benefit patients. They supported each other to provide good care and communicated effectively with other agencies.
Staff promoted equality and diversity in daily work.
It was easy for people to give feedback and raise concerns about care received. The service treated concerns and complaints seriously and investigated them.

How we carried out the inspection

The team that carried out the well led inspection included two inspection managers, 13 inspectors, one assistant inspector and an inspection planner. In addition, there was an executive reviewer plus three specialist advisors experienced in executive leadership of NHS trusts, including the CQC national professional advisor for ambulance services. The inspection team was overseen by Sarah Dronsfield, Head of Hospital Inspection.

You can find further information about how we carry out our inspections on our website: www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection.

We were notified of patient safety concerns relating to the management of medicines, training, staff competencies, inappropriate triaging, doctor registrations and culture. During the inspection we found:

Medicines were managed in line with the North East Ambulance Service medicines policy.
Systems were in place to access and monitor each training module and identify any at themes or trends relating to training attendance. The training system followed a RAG (red, amber, green) coding system to highlight training that was completed, due or overdue. This allowed the trust good oversight of training compliance and no issues where found.
We found that 80% of all call handlers were dual trained and could work with both 111 and 999 calls. Staff operated on the basis that no matter what number the public called, they would be treated according to the most appropriate pathway.
There were call audits undertaken to monitor the 111 service and the 999 service. The trust was about to commence call audits for advanced practitioner and doctors clinical advice calls through a monitoring tool.
CAS was a new service procured against a national specification and piloted by the trust. Following the pilot the trust won the contract for the North East.
Appropriate induction and assessment processes were in place.
There were processes in place to monitor competencies and to address competency failings if they occurred.
North East Ambulance Service had created standards and competencies for advanced practitioners.
Staff told us that the culture within the emergency operation centre was very good and supportive.
We were advised that culture checks were undertaken through the annual staff survey and quarterly listening events were in place. Nothing of concern was highlighted by managers or staff within the service.
The trust had recent issues of bullying and harassment. However, we observed that the trust had dealt with these promptly.

However;

Concerns were raised that not all staff followed the EOC standards during night shift break periods.
We found that the clinical job descriptions, rotas and clinical staff list did not reflect the new integrated role for GPs and doctors in CAS due to the incorrect usage of the GP job title and requested this been amended following the inspection.

During the inspection we found:

Medicines were managed in line with the North East Ambulance Service medicines policy.
Systems were in place to access and monitor each training module and identify any at themes or trends relating to training attendance. The training system followed a RAG (red, amber, green) coding system to highlight training that was completed, due or overdue. This allowed the trust good oversight of training compliance and no issues where found.
We found that 80% of all call handlers were dual trained and could work with both 111 and 999 calls. Staff operated on the basis that no matter what number the public called, they would be treated according to the most appropriate pathway.
There were call audits undertaken to monitor the 111 service and the 999 service. The trust was about to commence call audits for advanced practitioner and doctors clinical advice calls through a monitoring tool.
CAS was a new service procured against a national specification and piloted by the trust. Following the pilot the trust won the contract for the North East.
Appropriate induction and assessment processes were in place.
There were processes in place to monitor competencies and to address competency failings if they occurred.
North East Ambulance Service had created standards and competencies for advanced practitioners.
Staff told us that the culture within the emergency operation centre was very good and supportive.
We were advised that culture checks were undertaken through the annual staff survey and quarterly listening events were in place. Nothing of concern was highlighted by managers or staff within the service.
The trust had recent issues of bullying and harassment. However, we observed that the trust had dealt with these promptly.

However:

Concerns were raised that not all staff followed the EOC standards during night shift break periods.
We found that the clinical job descriptions, rotas and clinical staff list did not reflect the new integrated role for GPs and doctors in CAS due to the incorrect usage of the GP job title and requested this been amended following the inspection.

Our rating of the trust stayed the same. We rated it as good because:

We rated each domain of safe, effective, caring, responsive and well-led as good. Therefore, the overall rating of the trust remained the same as the last inspection.
At this inspection, we inspected two core services including the 111 service and emergency operations centre (EOC). We rated both of these core services as good which was an improvement from requires improvement overall for EOC at our last inspection.
In rating the trust, we took into account the current ratings of the services that we did not inspect during this inspection but that we had rated in our previous inspection.
We rated well-led for the trust overall as good. This was not an aggregation of the core service ratings for well-led.

NEAS had put in place a contingency plan, which had been frequently tested, to move to another building which took on average seven minutes to set up to dispatch ambulances in the event of system failure at Bernicia house. This was an improvement on the 20 minutes identified in the previous inspection report.
There were sufficient staff trained to deal with 999 and 111 calls and who could switch between calls dependent upon the demand and clinical need.
There were clear systems of report, audit and review in relation to serious incidents which included individual or organisational learning.
NEAS had performed above average against other NHS ambulance trusts in five of the seven measures on the new ambulance response programme which commenced November 2017.
NEAS had engaged with local communities in a variety of ways to promote health reducing demand on services.
EOC staff were subject to regular call audit which evidenced high levels of competence.
During the 65 live calls in the emergency operations centres listened to, all the staff involved were observed to be calm, professional and considerate of the patient’s needs.
NEAS had reviewed complaints linked to caller expectations. A script for call takers had been devised to be used to manage expectations which resulted in a 30% drop in those type of complaints.
There was a clear mission statement, vision and values which were displayed on notice boards in corridors and offices. They were included as part of the recruitment and appraisal systems.
There were clearly defined strategic priorities and three strategic aims supported by a quality strategy.
NEAS had a board assurance framework with six identified areas of risk, each issue had been risk assessed and managed appropriately with a clear audit trail of accountability.
NEAS had developed an action plan following the 2017 staff survey. The action plan had an overall aim to improve the overall staff engagement score.

North East Ambulance Service NHS Foundation Trust (NEAS) covers the areas of County Durham, Northumberland, and Tyne and Wear, along with the boroughs of Darlington, Hartlepool, Middlesbrough, Redcar and Cleveland and Stockton-On-Tees covering almost 3,230 square miles. The trust employsover 2,700 staff and provides 24-hour emergency and healthcare services to a population of 2.71 million people.

The trust provides an accident and emergency (A&E) service to respond to 999 calls, a 111 service for when medical help is needed fast but it is not a 999 emergency, patient transport services (PTS) and Emergency operation centres (EOC) where 999 and NHS 111 calls are received, clinical advice is provided and from where emergency vehicles are dispatched if needed. There is also a Resilience and Hazardous Area Response Team (HART).

The comprehensive inspection of the ambulance service took place from 18 to 22 April 2016 with an unannounced inspection carried out on 4 May 2016. We carried out this inspection as part of the CQC’s comprehensive inspection programme.

We inspected five core services:

Emergency Operations Centres

Urgent and emergency Care

Patient Transport Services

Resilience Services including the Hazardous Area Response Team

111 services.

Overall, we rated all of the five key domains as good which meant the overall rating for the trust was also good.

Our key findings were as follows:

There was generally a culture of passion and enthusiasm with a focus on the patient. However, there were differences in culture across the different geographical patches. The trust had recently undertaken a cultural survey which had identified some concerns regarding management support. Actions had been identified and were being implemented to address this; an example was the management essentials programme.

Most staff we spoke with confirmed there had been a shift in emphasis toward patient engagement and staff wellbeing. This was reinforced by the NHS Staff Survey 2015 where it was reported trust management had shown an interest in staff health and wellbeing which was better than the England average.

The relationship between the executive team and union representatives had improved and we were told by both sides that there was now a more open dialogue and discussion regarding meeting the needs of staff and the service.

The emergency care clinical managers were front line leaders who supported staff and supervised operations. This recently established role was to ensure staff received appropriate clinical leadership, which was documented and evidenced via quarterly one to one meetings. However this had been implemented in the urgent and emergency care service, whereas the Patient Transport Service had Team Leaders.

Throughout the inspection and across services we found that patients received care in a clean, hygienic and suitably maintained environment.

Patients on the whole told us they were happy with the care they received and the attitude of staff. We observed staff engaging with patients in a caring and respectful manner.

The trust was experiencing difficulties recruiting to paramedic vacancies and information provided by the trust before the inspection indicated there was a vacancy of 102.49 wte paramedic posts which equated to vacancy rate of 16%.

There were concerns identified during the inspection regarding the emergency operations centre in relation to the management of clinical risks when the ‘stack’ of calls was increasing.

Concerns were raised regarding the business continuity plans for the emergency operations centre in the event of a major disruption of services. There would be a delay in the setting up of the dispatch function of this service.

Data showed that between April 2015 to March 2016 out of the eleven national ambulance trusts NEAS was the joint worst performing ambulance service in NHS with responses within the target for Red 1 performance. There was a downward trend in the proportion of Red 1 calls responded to within 8 minutes between June 2015 and March 2016.

There had been a backlog of complaints that had resulted in delays to responding to complainants. The trust had reviewed the complaints process and had taken steps to address this problem. We saw that improvements had been achieved as a result of the changes.

Patient Transport Services provided resilience to support the emergency and urgent care service, both operationally and within the Emergency operations centre. The trust was in the process of implementing a project to integrate PTS with emergency care to create an integrated care and transport service. This meant additional capacity would be created to support the transportation of urgent care patients.

The trust took into account local events which increased demands on the service. Information provided by the trust highlighted that staffing demands for local events were planned in advance and staffing rotas were adjusted as required.

There was a lack of clarity in the line management and governance arrangements for the community first responders. The responders told us that there had been many changes recently, which had left them unclear about who managed them.

We saw several areas of outstanding practice including:

The trust had enrolled in the Mind blue light mental health programme and had encouraged staff to take on training to support colleagues with their mental health.

The trust provided national support for a motorcycle application; this was a mobile phone application, that used smart phone technology to identify if a motorcyclist had had an accident, and sent location data to the NEAS EOC, allowing staff to contact the nearest appropriate ambulance service to arrange an emergency response. The trust had been recognised at a national level for this.

The resilience service developed strong working relationships with the Sports Ground Safety Authority (SGSA) following innovative approaches to improving medical safety standards at stadia events such as premier league football matches and music concerts.

The advanced paramedic programme was an area of work that would benefit patient care and improve treatment pathways for patients.

The trust research and development team were involved in a number of trials which were underway at the time of the inspection. These included for example trailing a device that regulated intrathoracic pressure during resuscitation and the PASTA trial which was a multi-centre randomised controlled trial to determine whether a Paramedic Acute Stroke Treatment Assessment (PASTA) pathway could speed up access to stroke patients.

The Trust had pioneered a Flight Deck methodology for the North East. This was a capacity management system intended to support improved whole system awareness of capacity, quicker and safer diverting of patients to appropriate receiving care locations, and enhanced whole system learning.

The trust had been nominated for a national innovation award for the development and use of the electronic communication system.

However, there were also areas of poor practice where the trust needs to make improvements.

Importantly, the trust must:

The trust must review and ensure there are appropriate arrangements in place to provide dispatch in the event that Bernicia House was unavailable to operate as a dispatch centre.

The trust must ensure at all times there are sufficient numbers of suitably skilled, qualified and experienced staff.

The trust must ensure all staff have completed mandatory and role specific training relevant to their role.

The trust must ensure all staff receive an appraisal and are supported with their professional development. This must include support to maintain the skills and knowledge required for their job role.

The trust must continue to address the complaint and incident backlog and ensure systems and processes are put in place to prevent a re-occurrence.

The trust must ensure that clinical records are stored securely.

In addition the trust should:

The trust should ensure all relevant staff have received appropriate major incident training.

The trust should ensure staff within the emergency operations centres are involved in the development of the strategy and vision of the service.

The trust should ensure staff are supported and encouraged to report incidents and feedback is provided to staff on the outcomes of the incident investigation.

The trust should review the training requirements for operational staff for vulnerable groups such as patients living with dementia and patients experiencing mental health concerns.

The trust should ensure there is a robust system in PTS to monitor the daily cleanliness of vehicles and ensure deep cleans are carried out to planned levels.

Professor Sir Mike Richards

Chief Inspector of Hospitals

North East Ambulance Service NHS Foundation Trust (NEAS) covers the areas of County Durham, Northumberland, and Tyne and Wear, along with the boroughs of Darlington, Hartlepool, Middlesbrough, Redcar and Cleveland and Stockton-On-Tees covering almost 3,230 square miles. The trust employs over 2,700 staff and provides 24-hour emergency and healthcare services to a population of 2.71 million people.

The trust provides an accident and emergency (A&E) service to respond to 999 calls, a 111 service for when medical help is needed fast but it is not a 999 emergency, patient transport services (PTS) and Emergency operation centres (EOC) where 999 and NHS 111 calls are received, clinical advice is provided and from where emergency vehicles are dispatched if needed. There is also a Resilience and Hazardous Area Response Team (HART).

The comprehensive inspection of the ambulance service took place from 18 to 22 April 2016 with an unannounced inspection on 4 May 2016. We carried out this inspection as part of the CQC’s comprehensive inspection programme.

We inspected five core services:

Emergency Operations Centres
Urgent and Emergency Care
Patient Transport Services
Resilience Services including the Hazardous Area Response Team
111 services.

Overall, we rated all of the five key domains as good which meant the overall rating for the trust was also good.

Our key findings were as follows:

There was generally a culture of passion and enthusiasm with a focus on the patient. However, there were differences in culture across the different geographical patches. The trust had recently undertaken a cultural survey which had identified some concerns regarding management support. Actions had been identified and were being implemented to address this; an example was the management essentials programme.
Most staff confirmed there had been a real shift in emphasis toward patient engagement and staff wellbeing. This was reinforced by the NHS Staff Survey 2015 where it was reported trust management had a real interest in staff health and wellbeing which was better than the England average.
The relationship between the executive team and union representatives had improved and we were told by both sides that there was now a more open dialogue and discussion regarding meeting the needs of staff and the service.
The emergency care clinical managers were front line leaders who supported staff and supervised operations. This recently established role was to ensure staff received appropriate clinical leadership, which was documented and evidenced via quarterly one to one meetings. However this had only been implemented in the urgent and emergency care service.
Throughout the inspection and across services we found that patients received care in a clean, hygienic and suitably maintained environment.
Patients on the whole told us they were happy with the care they received and the attitude of staff. We observed staff engaging with patients in a caring and respectful manner.
The trust was experiencing difficulties recruiting to paramedic vacancies and information provided by the trust before the inspection indicated there was a vacancy of 102.49 wte paramedic posts which equated to vacancy rate of 16%.
There were concerns identified during the inspection regarding the emergency operations centre in relation to the management of clinical risks when the ‘stack’ of calls was increasing.
Concerns were raised regarding the business continuity plans for the emergency operations centre in the event of a major disruption of services. There would be a delay in the setting up of the dispatch function of this service.
Data showed that between April 2015 to March 2016 out of the eleven national ambulance trusts NEAS was the joint worst performing ambulance service in NHS with responses within the target for Red 1 performance. There was a downward trend in the proportion of Red 1 calls responded to within 8 minutes between June 2015 and March 2016.
Patient Transport Services (PTS) provided resilience to support the emergency and urgent care service, both operationally and within the Emergency operations centre. The trust was in the process of implementing a project to integrate PTS with emergency care to create an integrated care and transport service. This meant additional capacity would be created to support the transportation of urgent care patients.
The trust took into account local events which increased demands on the service. Information provided by the trust highlighted that staffing demands for local events were planned in advance and staffing rotas were adjusted as required.
There was a lack of clarity in the line management and governance arrangements for the community first responders they told us that there had been many changes recently, which had left them unclear about who managed them.

We saw several areas of outstanding practice including:

The trust had enrolled in the Mind blue light mental health programme and had encouraged staff to take on training to support colleagues with their mental health.
The trust provided national support for a motorcycle application; this was a mobile phone application, that used smart phone technology to identify if a motorcyclist had had an accident, and sent location data to the NEAS EOC, allowing staff to contact the nearest appropriate ambulance service to arrange an emergency response. The trust had been recognised at a national level for this.
The resilience service developed strong working relationships with the Sports Ground Safety Authority (SGSA) following innovative approaches to improving medical safety standards at stadia events such as premier league football matches and music concerts.
The advanced paramedic programme was an area of work that would benefit patient care and improve treatment pathways for patients.
The trust research and development team were involved in a number of trials which were underway at the time of the inspection. These included for example trailing a device that regulated intrathoracic pressure during resuscitation and the PASTA trial which was a multi-centre randomised controlled trial to determine whether a Paramedic Acute Stroke Treatment Assessment (PASTA) pathway could speed up access to stroke patients.
The Trust had pioneered a Flight Deck methodology for the North East. This was a capacity management system intended to support improved whole system awareness of capacity, quicker and safer diverting of patients to appropriate receiving care locations, and enhanced whole system learning.
The trust had been nominated for a national innovation award for the development and use of the electronic communication system.

However, there were also areas of poor practice where the trust needs to make improvements.

Importantly, the trust must:

The trust must review and ensure there are appropriate arrangements in place to provide dispatch in the event that Bernicia House was unavailable to operate as a dispatch centre.
The trust must ensure at all times there are sufficient numbers of suitably skilled, qualified and experienced staff.
The trust must ensure all staff have completed mandatory and role specific training relevant to their role.
The trust must ensure all staff receive an appraisal and are supported with their professional development. This must include support to maintain the skills and knowledge required for their job role.
The trust must continue to address the complaint and incident backlog and ensure systems and processes are put in place to prevent a re-occurrence.
The trust must ensure that clinical records are stored securely.

In addition the trust should:

The trust should ensure all relevant staff have received appropriate major incident training.
The trust should ensure staff within the emergency operations centres are involved in the development of the strategy and vision of the service.
The trust should ensure staff are supported and encouraged to report incidents and feedback is provided to staff on the outcomes of the incident investigation.
The trust should review the training requirements for operational staff for vulnerable groups such as patients living with dementia and patients experiencing mental health concerns.
The trust should ensure there is a robust system in PTS to monitor the daily cleanliness of vehicles and ensure deep cleans are carried out to planned levels.

North East Ambulance Service NHS Foundation Trust

All Inspections

25 April 2023, 26 April 2023, 03 May 2023, 04 May 2023

During an inspection of Emergency and urgent care

25 April 2023, 26 April 2023, 03 May 2023, 04 May 2023

During a routine inspection

How we carried out the inspection

26th - 28th July 2022 and 13th to 15th September 2022

During a routine inspection

26th - 28th July 2022 and 13th to 15th September 2022

During an inspection of Emergency operations centre (EOC)

26th - 28th July 2022 and 13th to 15th September 2022

During an inspection of Emergency and urgent care

03 Jun 2019

During an inspection looking at part of the service

03 Jun 2019

During an inspection of Emergency operations centre (EOC)

18 September to 18 October 2018

During a routine inspection

18 September to 18 October 2018

During an inspection of Emergency operations centre (EOC)

18-22 April, 4 May 2016

During a routine inspection

Professor Sir Mike Richards

18-22 April, 4 May 2016

During a routine inspection

Professor Sir Mike Richards

Chief Inspector of Hospitals