The London Ambulance Service (LAS) is ‘inadequate’, responds too slowly to incidents and has “a culture of harassment and bullying”, a report has found.

The NHS trust should be put into special measures – giving additional resources and support to quickly make improvements – following the Care Quality Commission report, chief inspector of hospitals professor Sir Mike Richards has said.

Although a team of inspectors found the trust’s services are caring, they need to be safer, more effective, more responsive and better led.

Problems with LAS, which is the largest ambulance service in the country, include frontline understaffing, high levels of stress and tiredness among workers, and “a perception of discrimination which had not been dealt with”.

Sir Richards said: “I am recommending that London Ambulance Service be placed into special measures because I believe that this is the step necessary to ensure that this vital service - which provides emergency medical services to 8.6 million Londoners - gets the support it needs to improve.

“The Trust has been performing poorly on response times since March 2014.

“This is a very serious problem, which the trust clearly isn’t able to address alone, and which needs action to put right.”

The trust had been the best performing in the country for responding to ‘category A’ calls but has seen a “substantial decline in performance”, failing to meet a target of 75 per cent of calls responded to in eight minutes.

Sir Richards added: “The frontline staff who CQC inspectors talked to and observed in their work were overwhelmingly dedicated, hardworking and compassionate, which is why I have rated this service ‘Good’ for Caring.

“However, these staff were not being properly supported to do their jobs.

“Some reported a culture of harassment and bullying and we found that in many cases there just weren’t enough properly trained staff, or that the proper equipment wasn’t available to them.”

Other issues included newly qualified paramedics saying they were expected to work on the frontline without experienced or senior guidance while they settled in, and major emergency response plans being left unchanged since the London 2012 Olympics – despite requirements to update them annually.

LAS says these protocols have now been updated.

Despite recommending the special measures, the first for an ambulance service, Sir Richards added: “Once care arrives, it is of a good standard - and dedicated and caring call handlers, drivers, paramedics and other frontline staff are working hard to ensure this.

He added: “Urgent steps are being taken - and improvements have already been made - to ensure that everyone who relies on this service receives excellent, timely care and that London has the ambulance service it deserves."

LAS chief executive, Dr Fionna Moore MBE, said: “While we are pleased that our caring and compassionate staff have been recognised in this report, we are sorry we have fallen short of some of the standards CQC and Londoners expect of us.

“As the newly appointed chief executive, I am, along with my leadership team, completely focussed on addressing the challenges highlighted in this report.

“We accept that we need to improve the way we measure and monitor some important standards and processes but we would like to reassure Londoners that we always prioritise our response to our most critically ill and injured patients and, in the event of a major incident, we are ready to respond and CQC recognise this.”