East Midlands Ambulance Service improving, but still work to be done

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Improvements have been made at East Midlands Ambulance Service (EMAS), but there is still work to be done, health watchdog the Care Quality Commission (CQC) has said.

The CQC has today (Tuesday) published a report on EMAS following an inspection carried out in February.

The inspection looked at:

• The safety and effectiveness of Emergency and Urgent Care Services - rated requires improvement. This is progress on the inadequate rating in May 2016

• The safety and effectiveness of the Emergency Operations Centre - rated requires improvement

• Safety, effectiveness and well-led at provider level - rated requires improvement

Richard Henderson, EMAS Chief Executive, said: “During its inspection the Care Quality Commission found that patients were overwhelmingly positive about our caring and compassionate staff across all levels and specialities of our service.

“Despite sustained challenges, the CQC recognised that we have made significant improvements since the November 2015 CQC inspection and I am pleased that the CQC has identified no new areas of concern, whilst identifying several areas of outstanding practice at EMAS.

“EMAS was not commissioned to meet the national performance targets during 2016/17 and therefore was not resourced to do so, however during the year we got to more people faster than ever before - 1,264 more Red 1 (the most life threatening) patients received a response within eight minutes compared to the previous year, and a further 9,950 more Red 2 patients within eight minutes.

“I am sorry that some patients experienced unacceptable waits. During the year we have invested in new ambulance vehicles and our electronic patient record system, recruited more staff to our frontline, and improved the clinical outcomes for many of our patients.”

In July 2016, the trust was issued with a warning notice by the CQC which required them to make significant improvements to the quality of health care provided.

Key findings from February’s inspection included:

• The trust had made significant improvements as required by the July 2016 warning notice. However, the CQC remained concerned about response times

• Response times for Red 1, Red 2 and A 19 calls were consistently below the national target and patients were not receiving care in a timely manner.

• There were variable standards of incident investigation, limited recommendations, lack of learning at an organisational level and a lack of evidence that recommendations had been actioned.

• The trust had taken appropriate actions which had been successful in increasing the number of front line staff.

• Standards of cleanliness had improved.

• The majority of equipment and vehicle checks were appropriately completed.

• There was an increased number of operational vehicles available to deliver emergency and urgent care services.

Outstanding areas of practice identified by the CQC at their February 2017 inspection include:

•Caring, professional staff delivering compassionate, patient focused care despite challenges due to continued demand.

•Joint working arrangements with other NHS and blue-light organisations improving accessibility of patient services, particularly those located in remote areas and for patients who require mental health care.

•A Sepsis pilot in North and North East Lincolnshire is providing prompt lifesaving treatment.

•A highly effective recruitment campaign which has received a national award for equality and diversity in recruitment.

And areas for improvement include:

•Meet national and locally contracted response time targets for Red 1 and Red 2 categorised calls, and improve call taking response times.

•Continue to work with other providers and commissioners to reduce handover delays and improve timeliness of resource allocation in Emergency Operations Centre.

•Continued provision of sufficient clinical mentors for newly qualified staff.

•Ensure staff receive, read and understand information when there are updates to trust policies, procedures or clinical practice.

•Improve staff awareness of the legal duty of candour.

•All staff access and attend mandatory training with particular focus on compliance rates for equality and diversity and risk management training.

•Ensure all staff know how to report incidents and learning is shared and accessible.

EMAS Chairman Pauline Tagg added: “We know what needs to be done at EMAS and we continue to progress our improvement plans. Strains on the health and social care system directly impact on our ability to address all the concerns highlighted by the CQC; whilst not within our control to fix them, we continue to play our part.

“The CQC Quality Summit on June 20 gives us an opportunity together with regulators, commissioners and hospitals to identify further actions to improve care for our patients and staff. This includes what can be done in response to an independent strategic demand, capacity and price review that looked at the level of demand we have experienced, and the staff, vehicles and finance needed to be able to respond.”

Responding to the Care Quality Commission’s report into the East Midlands Ambulance service (EMAS) following its February and March 2017 inspections, regional Chief Operating Officer at NHS Improvement, Mark Cubbon, said: “We are pleased to see the significant improvements the trust has made since 2015 reflected in the CQC’s report, particularly in terms of patient safety.

“While the trust clearly has some way to go, staff can be proud of their achievements in delivering professional and compassionate care.

“We will continue to work closely with the trust to ensure that the areas for improvement identified in the CQC report are addressed at pace.”