MAJOR failings including staffing shortfalls and safety slip-ups have led the ambulance service that serves Bolton to receive the worst rating from a watchdog.

North West Ambulance Service NHS Foundation Trust was told it ‘requires improvement’ in a report by England’s Chief Inspector of Hospitals.

The organisation was graded ‘good’ for its effectiveness, caring and responsiveness but ‘requires improvement’ for its safety and leadership and the trust’s chief executive said the majority of problems highlighted have already been addressed.

Chief Inspector of Hospitals, Professor Sir Mike Richards, said: “Inspectors found a number of improvements were needed. There were concerns surrounding staff training and whether the service had enough staff to meet the needs of the service and patients.

“There were also concerns surrounding how safeguarding issues and incidents were reported and the communication around complaints to the service.“The trust is working against a backdrop of increased pressure on all of its services and, while I am anxious to see the trust continue to monitor and improve staffing levels and share lessons learned from incidents and complaints, I’m confident that the areas of good practice can be maintained and further improvements made.”

Inspectors identified 35 areas where the body — headquartered in Chorley New Road, Heaton — needs to right “poor practice”.

These included an absence of assessments of a person’s mental capacity, the board lacking an overview of serious incidents due to the time it takes the trust to investigate and conclude cases, and patient information being inappropriately provided to volunteer drivers in breach of patient confidentiality.

They pinpointed a lack of specialist equipment and training for staff to safely manage extremely heavy patients, ambulances overdue for deep cleans and log books of anti-infection measures not kept up to date and paramedics crews potentially missing key opportunities to safeguard children or adults from abuse because senior colleagues were not available for consultation

The report said: “The responsiveness of the service was adversely affected by frequent, long handover delays at hospital emergency departments which resulted in a shortage of staff and response vehicles to attend to emergency and urgent calls. Turnaround times for attendance at the emergency departments were monitored and had remained over 25 minutes, on average, since 2013.

“There was a reliance on volunteer services to provide first response to emergency calls when mainstream staff were not available.”

Inspectors said the trust displayed many outstanding features including its Hazardous Area Response Team and the way information sharing allowed its clinicians to know about patients on care plans.

Their report said: “Patients told us the care and treatment they received was good. They felt they had been treated with dignity and respect and were extremely positive about the care and kindness shown by both ambulance and patient transport service staff.”

Trust chief executive Derek Cartwright said: “We accept the comments in the report relating to improvements required for procedures, guidelines and training.“The inspection took place almost 10 months ago and the majority of the points highlighted have already been addressed. The last 12 months have been extremely challenging for the organisation with unprecedented demand for our services, and it is unfortunate that by not reviewing policies and guidelines as often as we should, we are in the position we are now.”