The ambulance service still requires improvement, although patient care has been rated as 'outstanding'.

The East of England Ambulance Service NHS Trust (EEAS) has once again received a 'requires improvement' overall rating following an inspection of its services in April and May this year.

A Care Quality Commission (CQC) inspector raised concerns about the "significant turnover" within the senior leadership team at the trust. The chairman and chief executive positions are currently held by bosses in interim positions.

Meanwhile, the inspection found there were continued breaches in regulation such as with the safe management of medicines. The trust has been told it must act immediately.

The trust, which covers six eastern regions including Hertfordshire and Essex, was given the lowest rating of 'inadequate' for leadership of its services. It was rated ‘requires improvement’ in the same category in July last year.

It was also rated ‘requires improvement’ for the safety and effectiveness of its services.

However, the trust has shown progress for the responsiveness of its services. Last year, it was rated ‘requires improvement’. Now, it is rated ‘good’.

Despite staff numbers remaining low, staff were once again praised for their care as the trust received an 'outstanding' rating in that category.

CQC's chief inspector of hospitals, Professor Ted Baker, said: "The services still did not have enough staff to care for patients and keep them safe despite a focus on recruitment and retention.

"People continued to wait too long for services and response times, although improved, were worse than the England average.

"Despite this, we found that staff were overwhelmingly caring and dedicated to providing the best care they could. Despite factors such as high service demands and frequent callers, staff strived to always provide care that was compassionate, respectful, supportive, never time-rushed and met patients’ needs."

Prof Baker added: "But there were still a number of areas for concern where improvements were needed. We were particularly concerned that there had been significant turnover within the senior leadership team over the last 12 months.

"There continued to be a mixed culture at the trust. Not all staff felt that concerns were listened to and recently implemented strategies and initiatives, developed to improve performance, governance and staff welfare, were yet to be embedded."

The trust has been given a list of improvements to make as a result of the inspection. These include improving response times in emergency and urgent care, and patient transport services; ensuring processes are in place for appraisals, and improving staff numbers and retention.

The board at the trust has said it is focussing on recruiting a permanent chairman and chief executive (CEO) and acknowledged the improvements which the CQC has asked to be made.

Dorothy Hosein, interim CEO, said: "I am delighted to see that this report rightly pays tribute to the outstanding care that our staff and volunteers deliver to patients on a daily basis. I am pleased that the inspectors noted the positive changes underway.

"Over the coming months my commitment is to ensure that our patients and staff really feel the impact of these improvements.”

The full report can be read at https://www.cqc.org.uk/provider/RYC