The London Ambulance Service has been placed into special measures following a damning report by the Care Quality Commission.

Poor response times, staff shortages, inadequate equipment and "a culture of harassment and bullying" were among the problems highlighted by the health watchdog, which inspected the NHS trust that runs the emergency service in the summer.

In a report published today, the CQC rated the trust "inadequate" overall and raised "significant concerns" about its performance.

High among the watchdog's concerns were consistently poor ambulance response times, with the service repeatedly failing to hit Government targets.

Prof. Sir Mike Richards, chief inspector of hospitals, said: "This is a very serious problem, which the trust clearly isn’t able to address alone, and which needs action to put right."

Dr Fionna Moore, chief executive of LAS, said she was "sorry we have fallen short of some of the standards CQC and Londoners expect of us".

RELATED: Lives at risk as critically ill patients left waiting by London Ambulance Service

RELATED: London Ambulance has 'embedded culture of bullying and harassment', independent report finds

Fifty-four inspectors visited 16 ambulance stations, emergency operation centres and other bases across the capital over three weeks in June.

They found that once patients were reached by paramedics they received a good standard of care from LAS and were treated with "compassion, dignity and respect".

But inspectors raised a long list of concerns, including:

  • a "culture of harassment and bullying" and a perception that "discrimination" was not dealt with
  • staff working long hours, with high levels of stress and fatigue reported by a large number of "demoralised" frontline staff
  • deteriorating response times since March 2014 and a consistent failure to meet the national benchmark of 75 per cent of patients with life-threatening conditions receiving treatment within eight minutes
  • a high number of frontline vacancies, with too few appropriately trained paramedics on ambulance crews to ensure patients were consistently safe and received good care
  • staff did not always have access to the necessary equipment
  • senior managers and board members "lacked understanding of the challenges staff experienced"
  • some staff felt they did not receive enough supervision, with newly qualified paramedics working without the guidance of senior colleagues
  • major incident procedures, which are supposed to be reviewed annually, had not been amended for three years and many staff were unaware of them

The criticisms come four months after the delayed publication of a report that identified an culture of bullying "embedded" into LAS.

The report, written by a specialist consultancy hired to investigate a rise of staff complaints, said verbal and physical abuse, ostracisation, sexual harassment, misuse of power and cyber-bullying had been experienced by workers.

It named former chief executive Ann Radmore, who quit her £350,000 role in January, as one of several senior managers seen as tolerating a bullying culture.

Prof. Sir Mike Richards said: "While we do have significant concerns about the performance of the ambulance service, I want to provide Londoners with some reassurance.

"Firstly, that once care arrives, it is of a good standard - and dedicated and caring call handlers, drivers, paramedics and other frontline staff are working hard to ensure this. 

"And secondly, that urgent steps are being taken - and improvements have already been made - to ensure that everyone who relies on this service receives excellent, timely care and that London has the ambulance service it deserves."

He added: "The leadership of LAS has told us that they have already taken action to address the issues we have raised, and we will be monitoring the service closely to ensure this continues.

"But support from external partners including the NHS Trust Development Authority and NHS England will also be crucial to achieving the improvements needed. This is why I’m making a recommendation of special measures, triggering a process which gives LAS access to a package of additional resources and support."

LAS is the first ambulance service to be placed in special measures, which are implemented by the NHS Trust Development Authority on the recommendation of the CQC.

The watchdog has made 11 key recommendations to the trust, including recruitment of paramedics and a detailed action plan to tackle bullying.

Dr Moore said: "While we are pleased that our caring and compassionate staff have been recognised in this report, we are sorry we have fallen short of some of the standards CQC and Londoners expect of us.

"As the newly appointed chief executive, I am, along with my leadership team, completely focussed 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."

The Croydon Guardian reported in September how a third of all critically ill patients in the borough were being left waiting too long for paramedics following 999 calls.

In January Monica Lewis, 54, of Addiscombe, died while waiting more than 90 minutes for an ambulance to collect her from her home.