Overworked paramedics covering the county say they do not feel respected by bosses with morale low and sickness rates high across the service.

South East Coast Ambulance NHS Foundation Trust (Secamb) has been rated down from good to requires improvement following a Care Quality Commission inspection.

The troubling inspection by the health watchdog found that staff working extra hours and getting increasingly sick said they "do not feel respected, valued or supported".

CQC carried out two inspections in August to look at Secamb's urgent and emergency care and resilience teams, as well as check the trust’s progress in meeting the requirements from a well-led inspection in February.

At the February inspection, CQC downgraded the well-led category from good to inadequate and suspended other ratings until this inspection had been completed.

Areas including how safe, effective and responsive the trust are have been rated as requires improvement, but caring remained with a good rating.

Some of the report's main findings included urgent and emergency service being under pressure due to staff sickness and Covid-related absences.

Data showed from February and July 2022, the overall sickness rate for staff working in urgent and emergency care was just over 10%, equal to losing more than 43,000 working hours.

Many staff were also working beyond their hours and not always getting breaks on time in what were already long shifts.

The report revealed that from February to July this year, 86% of ambulance crew took their break from their own dispatch location and 41% of crew actually took their break in their allotted break time.

In the same time period, just over 1% of staff did not have a break at all in their shift.

In the previous six months 10% of staff finished their shift an hour after their shift finished.

It also found, as flagged in a wider national CQC report published last week, the South East, along with other areas, has a health and social care system that is "gridlocked".

Inspectors recognised that Secamb is unable to solve all of its issues alone and encouraged the trust to work with the wider health system to find resolutions.

Deanna Westwood, CQC’s network director, listed a few of the issues faced by Secamb, including how a few members of staff did not feel valued, respected, or supported.

She said: "During our inspection of South East Coast Ambulance NHS Foundation Trust, our inspectors found that staff on the front line were doing their utmost to provide safe and effective care to people across Kent, Surrey and Sussex.

"However, additional pressures on the service, which included an increase in staff sickness and increased delays in handovers from partner organisations, meant that the quality of care we saw being delivered had declined. It was for this reason that we have changed their overall rating from good to requires improvement

“Leaders were very aware of our concerns in relation to the trust's performance and have showed a real sense of urgency in prioritising the issues which had been identified, which is encouraging.

“As flagged in CQC’s report published last week, State of Care, the South East like many other areas, has a health and social care system that is gridlocked. The trust can’t solve all of their issues, such as handover delays alone, and I encourage the whole system to work together to find a resolution.

“We did have other more specific concerns that we have told leaders about. For example, they need to have better oversight on how often restraint was used and if it was done safely. Although staff knew what incidents to report and how to report them, they weren’t always reporting when somebody had been restrained.

'Leaders were very aware of our concerns in relation to the trust's performance and have showed a real sense of urgency in prioritising the issues'

“We also spoke with staff within the resilience team, who were frustrated and didn’t feel respected, valued or supported. There was low morale within the service and staff told us they didn’t feel appreciated by management at a senior level.

“We continue to monitor the service closely and will be returning to check on the progress of improvements that the trust has been told to make.”

Secamb interim chief executive, Siobhan Melia, said the trust has taken the concerns around culture and leadership "very seriously" and "are committed to making further improvements".

She said: "I am really pleased that the excellent care provided by our staff has once again been recognised and rated as ‘good’ by the CQC, despite the huge pressures they face every day. I am very proud of the high-quality care and compassion provided by our staff.

"We have already taken concerns around our culture and leadership extremely seriously and we are committed to making further improvements to ensure we improve our response to patients and the working lives of our staff.

"I know that there is much to do to get the trust to where it needs to be and we are working closely with staff as well as partners both regionally and nationally to make the necessary improvements highlighted in the report."

Secamb has outlined an improvement plan focussing on four main areas: quality improvement, responsive care, sustainability, and people and culture.

Work includes improving learning from incidents as well as further recruitment and greater retention of staff.

It also involves growing the trust’s voice within the wider NHS system to support improved patient pathways, reduce hospital handover delays and develop new partnerships.