CQC Inspection Report

Staff praised, but improvements required in some areas

Health watchdog, the Care Quality Commission, has told NEAS that improvements are needed to ensure patients receive services that meet national standards of safety and quality. 

A formal warning has been issued to the ambulance trust because disclosure and barring service checks (formerly criminal records bureau checks) had not been completed for all frontline staff. 

CQC inspectors have also told the trust that action is required to address shortfalls against the national standards relating to medicines management, supporting workers and monitoring the quality of service provision.   

Julie Walton, CQC Head of Hospital Inspections for the North East, said: "The issues we identified are a real concern and we have told the trust where further improvements must be made to ensure patients receive the service they are entitled to expect.   

"We will return to check that the necessary changes have been made and that they can be sustained for the future." 

The report follows an unannounced inspection of the trust's services in February 2014 when inspectors visited four ambulance stations and a contact centre. They also spent time at three hospital sites and at one of the trust's training centres, where they spoke to a number of patients and trust staff. 

The CQC examined six standards in total and their report found that NEAS was meeting two of those standards. As a result, they praised NEAS staff for their professionalism and respect of patients' privacy, dignity and independence. Patients, their carers' and hospital staff all spoke positively about NEAS when asked by the CQC inspectors. 

Simon Featherstone, NEAS chief executive, said: "The findings in this report are disappointing, but I am pleased that our staff have been recognised by the CQC inspectors for the wonderful and caring job they do for our patients.   

"The CQC has agreed with my view that this organisation has been 'running hot' for some considerable time now, in that we are extremely busy and under increasing demands to achieve performance and quality targets within our financial budgets. 

"We recognise that some of the issues highlighted in the inspectors' report require investment in frontline leadership, which is why we have taken the decision to plan a £1.7m deficit in our budget this year - the first in the Trust's history - to invest in recruiting team leaders to support the front line." 

All existing staff in the service have now had a DBS check within the last three years in line with national guidance. A three-year rolling programme will continue to monitor DBS disclosures for all staff that come into contact with patients.   

A total of 57 employees had information disclosed on their DBS certificates - mainly for minor offences with the oldest dating back more than 38 years. A risk assessment has been carried out for 54 of these staff and they have all returned to their frontline jobs. Of the remaining three staff, two are currently off work for an unrelated issues and the other is on alternative duties until their risk assessment is complete. 

The CQC report also found that NEAS were above the national average for responding to emergency calls. Their inspection found that 97.4% of emergencies received an ambulance within 19 minutes. This was in excess of the national standard of 95%.   

NEAS responses to potentially life-threatening calls within eight minutes were the highest in the country in 2013-14. 79.2% received a response in faster than eight minutes compared to the national standard of 75%. In the CQC report, one patient told inspectors: "They arrived when I was still on the phone. You couldn't get much quicker than that." 

CQC inspectors spoke with 13 patients in three A&E departments who had been transported to hospital by emergency ambulances and also talked with their relatives. These patients said that they were happy with the time that the ambulance took to arrive and all were extremely complimentary about the care and treatment they had received.   

Inspectors will return, unannounced, to check that the necessary improvements have been made. 

Malcolm Parker, GMB branch secretary, said: "It is extremely concerning that the CQC have issued NEAS with a formal warning in respect of process failures relating to the Disclosure & Barring Service.   

"We are keen to work with the Foundation Trust to identify and improve areas of concern. We welcome the praise for the frontline staff who have consistently achieved targets, although this has been to their detriment with missed meal breaks and consistently late finishes.   

"It is clear that significant resources are necessary to improve the situation and the initial proposals are welcomed, but do not in our opinion address all the issues which exist within the Trust." 

Unison spokesman Joel Byers said: "Unison finds it extremely disappointing that the Trust finds itself in this position which potentially could have placed patients and staff at risk. It was welcoming to see the CQC praising Contact and Emergency Care staff who find themselves doing a difficult job with little or no support. 

A copy of the report can be found here

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