FIFTY seven people were given jobs as frontline ambulance staff despite having unknown criminal convictions - after trust chiefs failed to carry out background checks for four years.

The North East Ambulance Service (NEAS) has been issued with a formal warning after a health watchdog found no checks had been carried out on the background and suitability of prospective staff since 2009.

When checks were finally made by NEAS, it emerged 57 staff working as 999 ambulance crews or in the patient transport services had undeclared past convictions.

The Care Quality Commission issued the warning after an inspection in February revealed NEAS - which covers County Durham, Darlington, Tyne & Wear, Northumberland, Hartlepool, Middlesbrough, Stockton and Redcar and Cleveland - failed to meet four out of six national standards.

"The issues we identified are a real concern and we have told the trust where further improvements must be made to ensure patients receive the service they are entitled to expect," said Julie Walton, CQC head of North-East hospital inspections.

It requires improvements in the four areas - recruitment procedures, medicines management, supporting workers and monitoring service quality.

NEAS said the convictions highlighted among staff were mainly for minor offences, the oldest dating back 38 years.

Following a risk assessment 54 of the staff have been allowed to return to their frontline jobs.

Of the remaining three, two are currently off work for unrelated issues while the other is on alternative duties until their risk assessment is complete.

As well as discovering that Disclosure and Barring Service (DBS) checks (previously known as Criminal Records Bureau checks) were not completed on all staff, the CQC found some medicines were not always kept safely or securely in ambulance stations.

Staff also told inspectors they had difficulty in receiving meaningful supervision due to work pressures.

Although systems were in place to monitor and improve performance, inspectors found shortfalls in human resource governance, complaint management and medication audits.

The CQC team visited four ambulance stations and an emergency control centre. They also spent time at three hospital sites and at one of the trust's training centres, where they spoke to patients and staff.

Inspectors saw that patients "experienced positive interactions" with ambulance staff and that care and treatment "was delivered to a high standard."

Simon Featherstone, NEAS chief executive, said: "The findings in this report are disappointing, but I am pleased that our staff have been recognised by the CQC inspectors for the wonderful and caring job they do for our patients"

He said NEAS had been "extremely busy" and was under increasing pressure to hit performance targets within budget.

To improve standards Mr Featherstone said the trust was planning a £1.7m deficit in this year's budget so it could invest in increased support for frontline staff.

All existing staff have now had a DBS check within the last three years, in line with national guidance, he added.

Malcolm Parker, GMB branch secretary, said the CQC warning was "extremely concerning" and added extra funding would not address "all of the issues which exist".

NEAS responses to potentially life-threatening calls within eight minutes were the highest in the country in 2013-14 - with 79.2 per cent receiving a response in faster than eight minutes compared to the national standard of 75 per cent.

The inspection also found that 97.4 per of emergencies received an ambulance within 19 minutes - above the national target of 95 per cent.

The trust has given CQC an action plan and promised that all background checks will be finished by the end of April this year. Inspectors will return to check that the necessary changes have been made.