Date published: 15 February 2024

NHS England has today published a report following the review of culture across England’s NHS ambulance services.

The report reinforced its commitment to create and nurture an environment where everyone can feel safe, included, listened to, and able to develop themselves within the ambulance sector.

The 22-page report can be accessed via the NHS England website and includes six key recommendations to improve the culture in ambulance trusts:

1. Balance operational performance with people performance at all levels.

2. Focus on leadership and management culture and develop the ambulance workforce.

3. Improve the operational environment, line management and undergraduate training.

4. Translate the EDI Improvement Plan into a bespoke plan for the sector.

5. Target bullying and harassment, including sexual harassment and enable freedom to speak up.

6. Prioritise, support and develop Human Resources and Organisational Development functions.

NHS England, Integrated Care Systems and ambulance trusts including the Association of Ambulance Chief Executives, will work together to deliver the recommendations. 

The Association of Ambulance Chief Executives (AACE) has provided statements in response to the review including the following from Anna Parry, Managing Director of AACE, who said:

“This timely review focuses on many areas that are already a priority for the sector. We know that there is much still to be done to ensure that NHS ambulance services offer a safe, inclusive, well-led working environment for all their people where inappropriate behaviour will not be tolerated and concerns will be responded to appropriately and compassionately.

“We are committed to moving away from outdated and inappropriate attitudes and behaviours to improve the working lives and experiences of everybody working or volunteering in our ambulance services, regardless of their background, gender, race, disability or sexual orientation. And we ask everybody – our people, volunteers and all those who engage with the ambulance service – to work with us to ensure that the NHS ambulance service is a safe, supportive and inclusive place for everyone.

“This is why we very much welcome today’s important publication which has been produced by a review team with a positive desire to fully understand all of the cultural aspects of the NHS ambulance sector - as well as the context within which it operates in the broader health and social care arena.”

Richard Henderson, Chief Executive at East Midlands Ambulance Service said:

"At EMAS we’ve still got work to do to develop and improve our culture. However, it is my view that we can take assurance that we are not starting from scratch. Through our own internal engagement, and thanks to the colleagues and volunteers who share concerns, feedback and ideas via our internal channels, the NHS Staff Survey and Freedom to Speak Up, we have identified within our new People Strategy, seven priority areas to help us improve staff experiences.  

"A tremendous amount of work is already underway at EMAS to improve and develop our culture. Together with my executive and senior management colleagues, I am committed to deliver the recommendations contained in the review, and we will work with NHS England, integrated care boards, the College of Paramedics, higher education institutions, trade unions and other organisations, to ensure a collaborative response.

"I am encouraged that wide-ranging programmes of work are already well advanced within the ambulance sector, focussed on leadership and management, workforce pressures and wellbeing, equality, diversity and inclusion, bullying and harassment including sexual harassment.

"Additionally, our own Director of Human Resources and Organisational Development, Kerry Gulliver, is Chair for specific national workstreams, and a new leadership development course has recently launched at EMAS for all managers and leaders to complete.

"Whilst recognising there is more to do, you can take assurance that we are listening at EMAS, and acknowledging when we get things wrong and learning from staff experiences. We are playing our part and leading the way to ensure progress is made.

"Today’s review, alongside our own EMAS values, created by staff and Trade Union representatives to underpin everything we do, provides further impetus to continue to build upon this vital work and create meaningful and lasting change for the benefit of our people and our patients."