Yorkshire Ambulance Service has been told that it must improve the quality of some of its services following an inspection by the Care Quality Commission.
A team of inspectors found that the trust delivered services that were caring, but needed to improve safety, effectiveness and responsiveness.
The service has been rated as requires improvement as it did not meet national target emergency response times for responding to life threatening conditions.
The trust has also had major difficulties in recruiting staff impacting on its ability to be responsive or enable staff the time to attend training.
The inspection found that infection control practices were not always followed by staff and a large number of ambulances were dirty on the outside and the general cleanliness of the inside of ambulances and procedures for disposal of clinical waste gave cause was considered worrying.
A large amount of lifesaving equipment had passed its expiry date but checks undertaken by the trust had not detected this and out of date stock of medical supplies were also found.
Patients told inspectors that they had difficulty in getting through to the control centre to book or cancel appointments.