A £50,000 review into the region's ambulance service found staff were unhappy but praised leaders.

The report into East of England Ambulance Trust (EEAST) was put together by Deloitte, and found the leadership was 'cohesive' and 'professional'.

The consultants found 'the trust board has all the necessary foundations in place to become a high performing board and well governed trust'.

But more focus was needed and changes needed to be made quicker.

And 'there is an imperative to fundamentally rethink the current approach to staff communications and engagement to address the high levels of disaffection we have observed amongst staff across the trust'.

The review was ordered to see whether the trust's leadership was good enough to deliver 'high quality, sustainable care'.

But it was found 'staff have described an 'us and them' culture between staff and senior leadership; the communication of decisions and initiatives does not always reach all parts of the organisation; regional teams have expressed feeling isolated from the wider organisation; and staff have reported a sense of being voiceless and disempowered'.

However, it was felt the trust was going in the right direction and recognised cultural change takes many years.

And it was recognised that EEAST had a 'robust approach to the reporting of incidents'.

The trust came under a lot of pressure over the winter period and it was suggested at the time that leadership had not prepared adequately.

But the review 'found evidence of a heavy focus on planning, forecasting and delivery' although executive 'visibility and availability' could be improved during long periods of sustained pressure.

The comprehensive review included interviews, focus groups and surveys along with desk research and meeting observation. It involved internal and external stakeholders from across the organisation and across the region. Almost 1,000 staff participated in the engagement process.

Chairman Sarah Boulton said: 'This has been an extremely worthwhile exercise, and the report and its findings will inform our future strategies and plans to provide an excellent service.

'We are pleased that the independent report confirms that the leadership and governance at EEAST is well placed to meet the challenges facing the trust.

'We acknowledge that there are substantial challenges to be addressed and that the board needs to clearly focus on these challenges. Particularly we want to address as a matter of urgency the dissatisfaction among staff highlighted in the report.'