Ambulance boss showed 'exceptionally poor decision making'

Paul Sutton has now formally resigned as chief executive at South East Coast Ambulance Service (Secamb) following a highly controversial and secretive pilot project aimed to meet response time targets.

Patients Association chief executive Katherine Murphy said: "The public rightly expects that those in senior leadership positions show integrity and honesty at all times, and are held accountable for their actions.

"The conduct of the leaders at Secamb falls far short of the standards that the public expects from those appointed into such key roles.

"This scheme was dangerous and the secretive decision to implement it demonstrates exceptionally poor decision-making. It is right that the leaders of Secamb are held responsible for their actions."

Geoffrey Bowden, who sits on the board of Brighton and Hove Healthwatch, said the resignation came as "no surprise", adding: "His departure was inevitable following the resignation of his chairman earlier this year."

It has also emerged that Secamb has been struggling to meet national response targets over the last year.

The trust was recently inspected by the Care Quality Commission and the results are expected to be unfavourable.

Mr Bowden said the trust had already given a self-declaration its service was 'inadequate' even before the inspection report is published.

He said: "At the heart of the problems that beset Secamb has been an inability to meet national targets set by the Department of Health.

"A review will determine whether these failures are isolated or systemic."

The trust is continuing to experience delays and pressures.

This is partly caused by long periods of time spent at hospital accident and emergency departments as crews wait to hand patients over.

This means fewer crews are on the road to respond to emergencies and patients are being put at risk.

Mr Sutton left Secamb after taking a mutually agreed leave of absence when a damning report was released into a pilot project run by the trust which slowed ambulance response times.

Up to 20,000 patients were affected by the project, which ran during the winter of 2014 and 2015.

Executives ran the pilot to delay sending ambulances until advisers had time to assess some calls coming through the 111 telephone system.

However the move breached national guidelines and patients, commissioners, NHS 111 call handlers and the trust board had not been told about it.

There was also concern about the potential risk to patients and a possible link between the delays and some patient deaths.

The trust has previously said there was no direct link but a second report into the impact the trial had on patients will be published this summer.

A spokesman for Unison said: "Nobody was particularly surprised by this. It is now time to get a new substantive chief executive in post as soon as possible and move on "

Healthwatch is interested in hearing from patients who have been affected by ambulance delays.

Visit healthwatchbrightonandhove.co.uk.

WHERE DID IT ALL GO WRONG FOR THE GOLDEN BOY?

SO how did it all go so spectacularly wrong?

Paul Sutton was the golden boy, a popular and highly respected chief executive at South East Coast Ambulance (Secamb) Service with a real passion for the job.

Starting out as a paramedic, he had a rapid rise up through the ranks.

But despite this Mr Sutton was happy to get his hands dirty and pitch in when needed – regularly going out and working as a paramedic on shifts while still managing the top position at a major trust.

He also had a reputation as being forward-thinking and innovative when trying to make improvements.

Mr Sutton directed his passion in other areas, publicly supporting the Argus' Save a Life campaign to get more life-saving defibrillators into the community and urging his staff to spread the word.

He worked with former East Sussex High Sheriff Juliet Smith, regularly going to presentations to urge organisations to get the machines.

Mrs Smith said: “He was very passionate about what the campaign was trying to do and very determined and genuine about it. You always got that feeling about how important it was to him

“He was so clearly highly well regarded and liked by his staff as well. You could see that all the time.”

But his hands-on management and close involvement in making decisions may be something he comes to regret.

It emerged this week Mr Sutton had formally resigned from Secamb after 10 years in the job, leaving under a cloud as the trust still reels from the major scandal.

The beginning of the end began with Mr Sutton's decision to push through a controversial pilot project in winter 2014/15 which delayed 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, such as strokes or fits, should have an emergency response at the scene within eight minutes.

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

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

A damning report published by Deloitte in March led to Mr Sutton going on “mutually agreed leave” while Trust chairman Tony Thorne resigned.

The report said the ultimate decision to proceed was Mr Sutton’s and he played a "critical leadership role throughout".

It said Mr Sutton was also approached separately by staff who had concerns about Red 2 calls being included in the plan - but these "were not adequately addressed" and he instructed it should go ahead.

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

Mr Sutton has always insisted the pilot was not about meeting targets but about patient care.

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

However investigators said managing the trust's ambulance response times - as set by national NHS targets - was a driver for the project.

But there is little doubt that ambulance services had been under exceptional pressure at the time - partly caused by long waits to hand over patients at hospital accident and emergency departments.

The scheme, which affected up to 20,000 patients, was devised as a way of alleviating this, but the project was halted after continuing concerns were raised by staff.

As news of the pilot became public knowledge, there was widespread anger about how it had been handled.

Mr Sutton found himself coming under intense pressure as concerns were raised about possible links between the delays and patient deaths.

A report on the impact the project had on patients is due to be published this summer, although the trust has insisted there were no direct link.

However the damage it is clear that whatever the intentions, an error of judgement was made and the buck stops with Mr Sutton.

Staff have supported Mr Sutton since his resignation, posting several comments online, calling him an “inspiring leader” and a forefront of innovation in the UK ambulance service.

One said: “He would never put patients' lives in danger, but has had to work with impossible targets exacerbated by failures by hospitals to clear ambulances quickly to take on new tasks."

However there are also others who feel let down by Mr Sutton and the decision he took.

His mistakes in setting up the project, not following proper governance and not telling people what was happening needed to be highlighted and exposed.

Mr Sutton is now moving on to pursue other interests but his decision to introduce the pilot will have a devastating impact on what had been a very successful career.