THE ambulance trust serving Merseyside, Manchester and Cheshire has been slammed for "continual failures", with the number of serious incidents including abuse towards patients and "sub-optimal" care having soared in recent years.

The North West Ambulance Service (NWAS) has failed to hit crucial targets in recent months, and a damning report has identified "key weaknesses" within the trust.

Also revealed this week were the rising number of "serious incidents" involving the ambulance service – ones that had a "significant effect" on patients.

Figures released by the Reach PLC data unit showed there were 79 of these incidents, including abuse or alleged abuse, confidential information leaked, and "sub-optimal" care during 2017/18.

That's three times as many as 2015/16.

Separate reports released by Wirral's NHS Clinical Commissioning Group (CCG) into the service’s failures said the issues causing recent underperformance were recruitment, sickness levels, retention and training of call handlers and clinicians.

It was discussed at the CCG board meeting this week, and said despite various improvement plans being tried, none so far have been "effective".

Alan Whittle, lay member for audit and governance of Wirral CCG, told this week's board meeting: "It's quite a serious situation. We were given no assurance as to any sense of medium-term improvement in terms of response times.

"Although it's a system-wide problem I am anxious about the sustainability of the organisation given current performance and continual failure to implement improvement plans that are effective.”

As part of a NHS 111 Service Performance review, the report added that all four performance standards for the North West 111 service – calls abandoned, calls answered in 60 seconds, call back in 10 minutes and warm transfers – were missed in both May and June.

It added that a performance improvement plan had been put in place, and a range of measures used to ensure the service is sustainable will be reviewed, including addressing issues surrounding absence management, call handling times and the impact of training for new staff.

The report to the CCG said it could offer "no assurance" that the 111 service performance will improve in the near future.

It said "key weaknesses in workforce management" had been identified, as well as "unstable leadership", adding: "This led to committee members expressing concerns over the sustainability of services."

Responding to the statements, a spokeswoman for the service said: "As mentioned in the report, the trust has recently worked with Commissioners to produce a performance improvement plan for 111 and this is already proving to be successful with call pick up times improving.

"As part of the plan, the trust is focusing heavily on a targeted recruitment drive, improving the technology within our call centres and collaboration with other 111 providers to identify efficiencies and better ways of working in partnership.

"Both NWAS and Commissioners are confident that these actions will see significant improvements."

It comes as data showing the number of serious incidents – defined as one in which the consequences to a patient or the "potential for learning" are so significant as to warrant a comprehensive response – is revealed.

The 79 serious incidents was an increase from the 43 in 2016/17, and nearly three times greater than the 24 recorded in 2015/16.

One of the cases involved "abuse or alleged abuse of an adult patient by a third party" while under the care of the ambulance service, although the report did not provide further details of the case.

Four more involved confidential information being leaked, or an information governance breach.

A further 31 involved delays in treatment, while 37 related to patients receiving "sub-optimal" care.

Two more incidents were classed as serious because of "adverse media coverage" or public concern about the ambulance service or the NHS more generally.

There were an additional four individual serious incidents that took place, one of which was classed as a "medication incident".

The data was from a Freedom of Information request made to the NWAS, and a spokesperson said: "Keeping our patients safe is extremely important to us and as such, we take any reports of serious incidents very seriously.

"All serious incidents are thoroughly investigated in order to identify areas for improvement and implement any changes that need to be made so that the risk of reoccurrence is reduced and the quality of patient care is improved."

An NHS Improvement spokesperson said: "Patient safety is a priority for the NHS, so we expect ambulance services to do everything they can to prevent serious incidents from occurring.

"We have introduced the Ambulance Response Programme to improve clinical outcomes for patients, particularly those with life threatening illness and injury.

"This programme enables ambulance services to prioritise the sickest patients, so they receive the fastest response whilst maintaining a clear focus on the needs of all patients dialling 999."