Hospital inspector gives verdict on ambulance service

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AMBULANCE staff in our area have been ranked outstanding in dealing with heart attacks and getting to emergencies within eight minutes.

But a new report on the quality of care offered by South Central Ambulance Service NHS Foundation Trust paints a varied picture of the quality of the services on offer.

England’s chief inspector of hospitals has published his first report on the quality of care provided by South Central Ambulance Service (Scas) today.

Overall, the inspection found the trust provided safe and effective services which were well-led with a clear focus on patient care.

The trust was ranked as the best in the country for dealing with patients who had suffered a cardiac arrest and stopped breathing, who were then resuscitated and taken to hospital. However the trust was told it needs to ensure patients who have a heart attack are given appropriate pain relief and that stroke patients have timely access to hospital

The trust had the highest percentage of patients who were treated at the scene without the need for ambulance transfer to hospital.

But inspectors also noted the trust was affected by the national shortage of paramedics and staff worked long hours and some reported stress and fatigue.

The trust said it was working with staff to manage peaks in demand and improve working hours to improve their work life balance.

Emergency operation centres had a high number of staff vacancies and staffing levels were, at times, not adequate to meet the demand.

Staff worked long hours, sometimes without breaks, to deliver the service.

The service had an escalation plan for when calls exceeded capacity and action was taken to shorten calls if safe to do so or to divert calls to other operation centres.

At the time of the inspection, however, calls were not being answered within target times.

Meanwhile, the patient transport service, which deals with non-urgent transport, was not meeting performance targets and this was having an impact on patients’ care and treatment.

Some patients were experiencing delayed or missed appointments and some were choosing to curtail their treatment rather than risk missing their transport home.

Professor Sir Mike Richards, the chief inspector of hospitals, said: ‘Overall, we found services provided by South Central Ambulance Service NHS Foundation Trust were safe, well-led with a focus on care and quality.

‘Our inspectors came away with many examples where staff demonstrated exceptional care and compassion to patients, especially when working in very difficult and pressured conditions.

‘It is reassuring that the frontline 999 services have been meeting their emergency response times to people with life threatening emergency or urgent conditions.

‘Not everyone who calls an ambulance needs to go to hospital, and we saw that the service was working well with local hospitals to meet their needs and decrease the pressure on these services.

‘However – the less urgent patient transport service does need attention. Patients told us how they had become worried waiting for transport, and had missed appointments for outpatient consultations or other treatment and checks. Call handlers were overwhelmed with calls about service delays.

‘While I can commend the staff for their dedication and effort, particularly for 999 emergency services, I will continue to watch progress with the Patient Transport Services to ensure that there are real improvements.’

The inspection team found several areas of good practice including the work of the trust’s Helicopter Emergency Medical Services team, the outreach work it does with schoolchildren and community organisations and efforts to provide first aid on Friday and Saturday nights in city centres.

Areas of improvement were also named, including necessary improvements to patient transport delays, emergency call-taking delays and the requirement for staff to meet mandatory training targets.

Will Hancock, the chief executive of South Central Ambulance Service, said: ‘We welcome the report findings and the opportunity this has given us to see ourselves as others see us.

‘We are grateful to everyone who contributed to this inspection process and we are keen to use the learning and findings to focus on improving and ensuring our patients receive the best possible care we can provide.

‘I was delighted the CQC remarked on how proud staff were to work for SCAS and how noticeable it was that staff lived the values of the trust in everything they did day to day.’

Inspections took place on two dates in September last year, with a further two unannounced visits later on.

The inspection team included inspectors from the Care Quality Commission, doctors, nurses, paramedics, patient experts and senior manager.

The team visited the trust’s emergency operations centres in Oxfordshire and Hampshire and shadowed ambulance crews and paramedics.

They also visited ambulance stations along with A&E and outpatient departments at hospitals to talk to patients and staff about their experience of the ambulance service.

The inspectors spoke to emergency call handlers, dispatchers, paramedics, ambulance technicians, emergency care assistants, managers and other staff.

As reported in The News, the pressure has been growing on the emergency services in our area to deal with record levels of calls and patients attending the Accident and Emergency department at Queen Alexandra Hospital in Cosham.

· Click here to read the report in full