The London Ambulance Service requires improvement to be safe despite being rated Good overall, inspectors said.

The Care Quality Commission (CQC) rated LAS as Good for being effective, caring, responsive and well-led, but it was rated Requires Improvement for being safe, following the inspection in September 2019.

Inspectors visited the emergency operations centres as CQC's intelligence said there were possible safety concerns.

Overall there were enough front-line ambulance staff to care for patients and keep them safe and staff had training in the key skills needed for their role, inspectors said.

LAS staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions, according to findings.

Leaders had the right skills, and abilities to run the service and they understood and managed the priorities and issues the service faced.

"They endeavoured to be visible and approachable in the service for patients and staff," the inspection report said.

"The service had an open culture where patients, their families and staff could raise concerns without fear and had these investigated and responded to."

Inspectors found evidence of outstanding practices, but pointed out the areas that must be improved, including correctly storing medicine and securing vehicles.

"As we found at our previous inspection, some essential equipment items were not always available," inspectors cited in their report.

"Some equipment items had passed the expiry date, suggesting that checks were not being completed fully."

Inspectors also noted a lack of consistency in staffing levels and an unreliable rota system and although people could access the service when they needed it, there were regular delays in responding to initial telephone calls made by the public.

Professor Ted Baker, England's chief inspector of hospitals, said: "The London Ambulance Service has again been rated Good overall. "It has to cope with a number of additional pressures working in the capital.

"Frontline staff deserve fulsome praise for the way they cope with terrorist incidents like the recent London Bridge attack.

"The trust also trained staff well, so they had the training in the key skills needed for their roles."