Derbyshire’s ambulance service safety is inadequate says health watchdog

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The chief of Derbyshire’s troubled ambulance service has apologised after again failing to meet three out of five standards set by a health watchdog.

Inspectors from the Care Quality Commission (CQC) rated East Midlands Ambulance Service (EMAS) as ‘inadequate’ for safety and ‘requires improvement’ for effective and well led measures following a week long inspection in November.

Following the release of the report today, Acting Chief Executive Richard Henderson said “We are sorry and disappointed that we have not met the required standards for these measures.”

The CQC report gives EMAS a ‘good rating’ for two of the five measures - caring and responsive - and highlighted several areas of outstanding practice and services.

Mr Henderson said: “The report recognises that we have been working really hard to improve response times to emergency calls.

“However there are concerns that ultimately relate to our lack of resource (staff and vehicles ) made worse by the numbers often kept waiting at hospitals and lack of capacity to do things as quickly and as well as we need to.

“As a result we have been rated as ‘inadequate’ for safety.

“The report makes it clear that this relates to insufficient numbers of staff and vehicles - not to the quality of care provide by our staff.

“We are rated ‘requires improvement’ for the effective and well led measures .

“We are sorry and disappointed that we have not met the required standard for these measures.

“EMAS is an emergency ambulance service and people in East Midlands can be assured that we always prioritise our response to our most critically ill and injured patients.”

At CQC inspection found:

All staff were passionate about and committed to providing high quality, safe care for patients.

There was an unrelenting demand for emergency services combined with a lack of staff and resources to meet the need.

There were insufficient staff and a lack of appropriate skill mix to meet the needs of patients in a timely manner.

Despite hard work to recruit, the service found it a challenge to retain staff.

Frontline leaders did not have the capacity to fulfil their managerial responsibilities.

Many staff were not receiving appraisals and statutory and mandatory training rates were not achieved.

There was a clear statement of vision and values driven by quality and safety and the Trust board functioned effectively.

Without exception, the Chief Executive was held in high regard by staff for her visible open approach.

Richard Henderson added: “We are taking the CQC findings seriously and value the additional support that we will be getting from other NHS organisations.

With their input we will be able to progress areas that we cannot fix quickly or that are not within our immediate control, for example the delays we experience at hospitals when they are notable to accept a clinical handover from or ambulance crews.

He said EMAS had agreed as part of their Accident and Emergency 999 Contract awarded for 2016/17 to carry out an independent strategic demand, capacity and price review.

This would look in detail at the level of demand experienced and the level of staff and vehicles needed along with finance, to be able to respond.

He said: “Together with the clinical commissioning groups that pay us to provide a service, we have agreed to implement the outcome of the review and ensure we are able to meet demand.

The trust has recruited more than 300 new frontline staff since April 2015 and will invest in an additional 68 ambulance vehicles this year.

He added: “Another big challenge we face is retaining our staff and recruiting qualified colleagues to improve our skill mix.

He said there were staff reporting low morale, adding:

“The CQC acknowledge that is no surprise with the unrelenting pressure combined with lack of resources to meet demand.

“There is a national shortage of paramedics and a better work life balance and pay rates for paramedics in other areas of the NHS makes it very difficult for us to retain colleagues.”