HEALTH inspectors have raised serious concerns about dirty, unhygienic ambulances and potentially dangerous lifesaving equipment within Yorkshire Ambulance Service.

England's Chief Inspector of Hospitals has told YAS that it must improve some services following an inspection by the Care Quality Commission.

Inspectors found that services were caring but work was needed to improve safety and effectiveness.

It reported that the ambulance service was not meeting national targets for responding to life-threatening conditions within eight minutes, although it was above average in reaching less serious incidents within 19 minutes.

Inspectors found that the service, like many others, had major difficulties recruiting paramedics.

Infection control procedures were not always followed by staff, according to the CQC.

A large number of ambulances were dirty - inside and out - and procedures for disposing of clinical waste gave cause for concern.

Inspectors were particularly concerned at the lack of checks on equipment by the Hazardous Area Response Team.

A large amount of lifesaving equipment had passed its expiry date.

Inspectors also found out-of-date medical supplies in some ambulances and at ambulance stations.

People using the patient transport service told inspectors they had difficulty in getting through to the control centre to book or cancel appointments.

Ambulance service staff told inspectors that they felt that senior managers "were remote and simply issued commands."

"Staff reported that they could not remember a stable leadership team since 2006."

The report identified three main areas for improvement:

l YAS must ensure all ambulances and equipment are appropriately cleaned.

l It must ensure that equipment and medical supplies are checked and are fit for use.

l It must ensure all staff are up to date with mandatory training.

Ellen Armistead, deputy chief inspector of hospitals, said: "It is clear that within the trust there is an ambition to develop a culture of clinical and professional excellence.

"There has been a history of change at executive level and the trust would benefit from a period of stable management to see this vision through.

"Staff we met told us that they were proud to do their job but were under intense pressure. Although the inspectors found many examples of good practice, we have also identified areas of concern, including the failure to adopt good hygiene and infection control standards.

"The issue had been known to the trust for some time and as such is disappointing the trust has not effectively addressed the problem."

Inspectors highlighted areas of outstanding practice, including support for 1,055 community first responders.

YAS chief executive Rod Barnes said: "The report recognises the challenges we and services nationally face in recruiting and training sufficient staff numbers to meet rising levels of demand and the pressures this places on existing staff and response times."

He said concerns about "equipment and consumables" in the Hazardous Area Response Team were addressed during the inspection.

"The inspection took place nine months ago at the busiest time of year for us and at a time of unprecedented high demand."

He said monitoring for daily cleaning had been tightened up, along with increased focus on mandatory training.

There was now "greater stability" at senior management level and improved staff engagement.

Mr Barnes added: "We accept though, that the report raises a number of issues that we need to tackle. Most of these were issues that we were aware of as a Trust and were already acting to address before the inspection. We have continued to make progress in all areas over recent months and have a clear plan of action to maintain this improvement."