THE boss of a scandal-hit ambulance trust is taking a leave of absence after pushing through a controversial project which led to delayed response times.

A report published into the unauthorised experiment carried out by South East Coast Ambulance Service (Secamb) said chief executive Paul Sutton used his powers of persuasion to push through the scheme.

Despite being approached by concerned staff he instructed it should go ahead.

Mr Sutton is taking a leave of absence from his £160,000 a year post after the damning report, carried out by consultants Deloitte, found fundamental failings over the scheme.

Secamb chairman Tony Thorne has resigned and NHS regulator Monitor has appointed Sir Peter Dixon as interim chairman.

Mr Sutton is on leave until Secamb determines “the appropriate actions to take.”

Deloitte’s report said the pilot was “high risk” and did not have approval from board members, the NHS 111 helpline or commissioners.

There was also a strong suggestion of an "intentional effort by members of the executive team" to present the scheme in a positive light despite its governance failings and risks.

Up to 20,000 patients had ambulances delayed during the pilot, which ran between December 2014 and January 2015.

Executives ran the project - without approval - to delay sending ambulances until advisers had time to assess some calls coming through the 111 telephone system.

National rules say 75 per cent of Category A Red 2 calls should have an emergency response at the scene within eight minutes.

These calls are for conditions regarded as serious, such as strokes or fits.

Under the scheme, the ambulance trust gave itself up to 10 extra minutes to reassess what type of advice or treatment patients needed, and whether an ambulance was really necessary.

But patients were kept in the dark about the project, as were 111 call handlers and the trust's board.

The report said Mr Sutton made the ultimate decision to proceed with the pilot and played a critical leadership role throughout.

It was Mr Sutton who drove forward the idea of Red 2 calls being put through the pilot despite objections raised by senior managers.

The report said: "The CEO's directive and persuasive management style, coupled with an impending restructure of the executive team, meant the level of challenge over the pilot within the organisation was inhibited."

Investigators also said that managing the trust's ambulance response times - as set by national NHS targets - was a driver for the project and that figures submitted by the trust to Monitor showed it had hit its target even though it had not.

Monitor regional director Claudia Griffith said: “The way these projects were managed and the associated decision-making processes were flawed from the outset and we expect the trust to use the findings of the report to make sure no decisions are taken in this way again.”

BACKGROUND OF MAN WHO ENJOYS A REPUTATION FOR THINKING AHEAD

PAUL Sutton has enjoyed a reputation as being forward-thinking and innovative when it comes to making improvements.

He is a qualified paramedic who swiftly rose through the ranks from care assistant when he joined the ambulance service in 1990 to technician and paramedic, distribution manager and director of operations before reaching chief executive level.

He has continued to occasionally cover shifts so he can keep his skills up. 

Mr Sutton was appointed the £160,000 a year role of chief executive of South East Coast Ambulance Service in 2006 after helping oversee the merger of trusts in Sussex, Kent and Surrey.

Before this he was interim chief executive of Sussex Ambulance Service from 2004 and before then was director of operations for East Anglian Ambulance Service, which he joined in 2000. He had spent 10 years with Staffordshire Ambulance since joining as a care assistant in 1990.

Mr Sutton has consistently insisted the decision to bring in the pilot was purely for care and safety issues.

He told members of the West Sussex health and adult social care select committee last year the service was under a huge amount of pressure when the pilot was introduced. 

He has acknowledged the way the project was set up could have been handled better and haspublicly apologised for that.

The main causes of the pressure were long delays for ambulances and crews in hospital accident and emergency departments.

There were fewer paramedics available to answer for other emergency calls.

INCREASED CALL VOLUMES LED TO PRESSURE WITHIN EMERGENCY SYSTEM

What did the project do?

Some calls referred to the 999 service by the NHS 111 non-emergency line were delayed by up to 10 minutes while they were reassessed. These included Red 2 calls, which cover conditions such as strokes or fits which are serious, but less critical than when people are non-responsive.

Why was it set up?
There was considerable pressure on the urgent and emergency care system in the south-east during late 2014 due to a range of factors including winter pressures, hospital handover delays, Ebola preparedness requirements and increased call volume from NHS 111 to 999. There was also a perception held by many Secamb staff that a significant number of calls categorised by NHS 111 as Red 2 were incorrectly classified.

Why was it controversial?
Because national guidelines that say all Category A Red calls should be responded to within eight minutes and the pilot was in breach of this. The trust had also not given full details about the scheme to all who needed to know, including its own board, commissioners and NHS 111 operators.

How many patients were affected?
An eight-day-old baby and a patient suffering an obvious stroke were among up to 20,000 patients whose ambulances were delayed as part of the trust’s experiment.

Are there other reports to come?
Two more reports will follow later this year. One will be looking at the impact the scheme had on patients and the other will be taking a wider review of how the trust makes its decisions in all areas.

What has the trust done so far in response to the scandal?
It has welcomed and accepted the findings of the review in full. It recognises that the governance surrounding the pilot was inadequate, and has already started to make serious changes to the way matters of governance are managed and dealt with to make sure lessons are learnt and a lapse in governance of this sort does not happen again. A joint recovery plan is being agreed with the trust’s commissioners and monitor.

Who is in charge of the trust now?
Monitor has appointed Sir Peter Dixon to work as the acting chairman and deputy chief executive Geraint Davies, will be standing in for Mr Sutton while he is on leave.