CONTROL staff at the former Wiltshire Ambulance Service NHS Trust doctored emergency response times over a 15-month period to meet national targets, according to a report by the Audit Commission.

The damning report comes a day after it was revealed ambulance workers in the Swindon area had the lowest morale in the country.

The audit, released yesterday, found that between April 1 2005 and July 17 2006 the response times for 594 category A - life threatening - calls were changed manually from the target of eight minutes to below eight minutes.

And the response times for 89 category B - serious - calls were altered from more than 19 minutes to under 19 minutes.

The report said that Wiltshire Ambulance Service was the third worst performing trust in the country for 2005/06, but had been the worst in the country over the previous two years.

The trust, which handles all of Swindon's 999 ambulance calls, has since merged with Gloucester and Avon Ambulance Trusts to become part of the Great Western Ambulance Trust.

The audit identified a number of problems including a large number of manual amendments to the time of emergency calls and the time when ambulances arrived at their destination.

The report also found that a number of call categories had been changed.

It said: "Although these changes are acceptable if ambulance crews don't use the automated systems correctly, the number of manual amendments in 2005/06 is a cause for concern (1,241 to response times and 684 to dispatch codes).

"A review of recent practice shows that, between April and June 2006, staff were still regularly making manual amendments, although the number had dropped slightly.

"Most of the changes improved Great Western Ambulance Trust's performance."

The Audit Commission also reported failings at board level to address the situation and that senior managers had done little to stop the response times being routinely manipulated.

The report found that the culture in the trust's control room was to achieve targets at all costs' because the trust's image and the managers' reputation rested on achieving these.

It also uncovered an operational instruction issued to all staff in April 2005, which clearly defined manual amendments as being permitted.

Procedural problems were also found in the control room.

Richard Lott, the appointed auditor and engagement lead, said: "The key performance indicator for ambulance trusts is how quickly the ambulance arrives at a situation.

"It is crucially important that the public has confidence in the integrity of the data used to produce this indicator.

"The newly-merged Great Western Ambulance Service NHS Trust, set up in April 2006, has responded positively to our findings. I am pleased that the new trust and the Department of Health have already taken action to prevent alterations taking place again."

The Great Western Ambulance Service Trust chief executive, Tim Lynch, said: "The report dates back to 2005/06 and we would like to stress that we have since taken a number of steps to ensure current recording is more robust and reliable.

"We're pleased that the Audit Commission has recognised that we have responded well to the recommendations and that the board is actively monitoring processes to manage data quality.

"Appropriate controls have now been put in place to ensure the accuracy of response time data, along with additional management support.

"We are continuing to develop our trust-wide IT systems, moving away from the three separate systems used by the former ambulance trusts to one unified model. This will also improve our ability to record, monitor and predict demand levels, helping us to manage resources more efficiently for our patients.

"We are shortly to discuss further plans for improvement across the trust with staff, health overview and scrutiny committees and patient and public involvement forums, which represent local people's interests.

"The public can be reassured that we have decided to introduce regular audit of all those systems as standard practice."