Transforming ambulance services in the south east

Since I became CEO of South East Coast Ambulance Trust in 2023, transformation has characterised our approach. That single word encompasses large-scale changes across every aspect of the trust’s activities: its performance, its culture, its infrastructure and its forward vision.

The starting point for SECAmb’s transformation was the CQC’s 2022 report. This gave the trust an overall rating of ‘requires improvement’ and described leadership as ‘inadequate’.

What's more, the CQC’s findings included some serious concerns about the culture within the trust. This stated that ‘bullying and harassment and inappropriate sexualised behaviour, were not addressed and became normalised behaviours’ – echoing the conclusions of an independent report commissioned by the trust itself back in 2017.

On the ground, SECAmb’s performance fell behind many of its peers. In 2022, the organisation languished in the bottom quartile of the National Outcomes Framework (NOF) for ambulance trusts.

Steep learning curve

Coming into this role from outside of the ambulance sector was always going to be a steep learning curve, and was never going to be easy. Nonetheless, thanks to the efforts of colleagues from right across the organisation, SECAmb is now well on the way to a transformed future.

I’m very grateful to all of the staff who have supported me and my team, endorsing our approach and seeing the value of doing the hard work necessary to turn the trust around – even in the teeth of entrenched opposition from others.

"...all parts of the NHS can benefit from pulling in expertise, leadership and ideas from parts of the system."

Change is often frightening but nevertheless necessary. As per NHS England’s cultural review of ambulance trusts, all parts of the NHS can benefit from pulling in expertise, leadership and ideas from parts of the system. This is beginning to pay off for SECAmb, as our initial staff survey results have started showing some positive signs of a changed culture. 

This has fed through into our frontline operations as well. The latest data put us in NOF segment 2, with above-average performance against many of our key targets. Our mean CAT-2 response time so far in 2025/26 has both beaten the sector’s month-on-month average and also fallen below the 30-minute ‘recovery standard’ set down by NHS England.

Transforming how we work has led to these improvements. Making the most of our two new EOC centres has boosted our productivity and flexibility for our crews - as per the aims of the Carter Review - and call handlers alike.

This has enabled us to upgrade our technical infrastructure and for our 111 and 999 teams to come together. Co-location has built a transformed, united workforce that can train and learn as one whilst also offering improved clinical support for day-to-day decision-making.

Future improvements

I’m proud of the transformation journey SECAmb has undergone. What excites me even more, however, is the scope for future change and improvement in the years to come. 

To ensure compatibility and generate savings, SECAmb is now undertaking joint procurement of vehicles, digital systems and AI with four other trusts. This will also offer us a promising opportunity to share best practice, feeding into further improvements on the front line.

Embracing new technologies will continue to be a key part of how SECAmb transforms. By linking in with primary care, we could build a shared telephony model following the blueprint set out by London Ambulance Service. Linking consultants in our hubs to paramedics on scene via video calls, too, would allow us to bolster decision-making and thereby increase the number of people who can get the treatment they need faster without having to go to hospital.

"Going beyond conveyance and becoming system navigators, the ambulance sector can become the NHS’s system navigators."

This reflects how SECAmb’s role can transform as well, in line with the concept of a neighbourhood health service. Going beyond conveyance and becoming system navigators, the ambulance sector can become the NHS’s system navigators – assessing and directing patients to the help they need. We’re actively exploring how this can become a reality with our partners in Surrey and Sussex.

A transformed role for the ambulance sector would mean trusts could go beyond the relentless focus on CAT-2 performance and financial balance as our two chief metrics for performance and take a leading role in neighbourhood health. This is where we can make a real difference to some of the key areas in which Britain lags behind other nations, such as out-of-hospital cardiac arrest survival rates.

That willingness to innovate is also why SECAmb is coming together with South Central Ambulance Service (SCAS) in the sector’s first ever joint leadership model. Whilst it means I’ll be bidding SECAmb farewell with a heavy heart, the opportunities this change offers will allow transformation to continue and to deepen across both trusts.

In our most recent trust strategy, I set out an ambitious vision for SECAmb’s future:

‘…to collaborate closely with health and social care providers across the south east, ensuring the delivery of high-quality patient care and creating an environment where our people enjoy working at SECAmb.’

Transforming the trust has not been straightforward - either for me, my team, or our amazing staff on the ground. Yet, even where we’ve had to invest our time, money and spirit in making change happen, it’s been worth it. SECAmb is now a transformed trust with a transformed vision for its future –  I’ll always look back upon both with pride and gratitude. 

Simon Weldon is the outgoing chief executive of South East Coast Ambulance Trust. You can follow SECAmb on Instagram, Facebook and LinkedIn