SECAmb NHS Foundation Trust Could Go Into Special Measures

Thursday 29th September 2016

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The Care Quality Commission (CQC) has published its report following a planned inspection of South East Coast Ambulance Service NHS Foundation Trust (SECAmb) in May.

The report gives the Trust a ‘good’ rating for its service being caring but highlights a number of areas of concern. The report judges the Trust to be ‘inadequate’ overall and today NHS Improvement is considering placing the Trust into special measures.

SECAmb is committed to improving the quality of its service and would like to reassure the public that it has already been working hard to implement a number of important changes. The Trust also welcomes the additional support placement into special measures would offer.

Acting Chief Executive, Geraint Davies said: “While we are pleased that the dedication and care of our staff is highlighted as good in this report, we are sorry that we have not met the standards expected in a number of other areas.

“Following initial feedback from the CQC we have already been working on and implementing a number of improvements. I would like to reassure everyone we serve that I, along with my senior team, am committed and focused on ensuring these necessary changes continue. We are determined to implement the changes required to restore confidence in our service.”

“I would also like to take this opportunity to point to the enormous amount of excellent work undertaken every day by our staff across our region, often in challenging circumstances, to respond to and treat patients, be it responding to a major road collision or saving the life of a patient in cardiac arrest.  

SECAmb already has a recovery plan in place and has taken action across a number of areas to address concerns including those set out below.

  • Although recruiting and retaining enough staff remains a significant issue for the Trust, 60 new front-line staff have joined the Trust since 1 April – 18 Paramedics and 42 ECSWs, with a further 289 staff (144 paramedics, 84 Emergency Care Support Workers and 61 Associate Practitioners) in the pipeline to join us by April 2017. 53 new Emergency Medical Advisors (999 call-takers) have joined the Trust already, with a further 40 in the pipeline for the remainder of the year. In NHS 111, 62 new Health Advisors (HAs) have started this year and a further 36 HAs are in the pipeline to join over coming months.
  • We have strengthened our systems for the management of medicines and taken action to address the issues identified. We have audited the drug rooms in all stations. In all locations controlled drugs are stored in line with the legal requirements. Non-controlled medicines are stored in lockable cabinets.
  • A detailed action plan focused on recruitment, retention, operational performance, staff engagement and external stakeholder engagement has been developed for NHS 111. As a result performance has steadily improved and in August surpassed performance trajectories, agreed with commissioners, on all measures.
  • The Trust has undertaken a Trust-wide Infection Prevention & Control (IPC) awareness campaign, rolled out extra training and recruited IPC Leads in every operational area. To support this, all operational areas are undertaking regular spot-checks and audits to ensure that improved standards are maintained.
  • The Trust has worked hard to raise awareness of safeguarding processes to all staff, as well as creating a new process for on-going monitoring of safeguarding referrals by operational staff. There are now new formal links in place between safeguarding and complaints to close any gaps between the two processes.

The report also highlights areas where the Trust does well. These include:

  • The CQC reported how caring our staff were and how they behaved with kindness and understanding towards patients, even when faced with difficult situations.
  • 111 call takers treated callers as individuals and treated them in a non-judgmental way
  • The Trust encourages staff to take on additional roles and responsibilities and provided training and support to enhance the paramedic roles. The specialist paramedics’ roles such as the critical care paramedic had expanded and developed.

Geraint Davies added, “I fully recognise that this is a challenging time for the Trust and accept that these are serious concerns which we must address. We understand the seriousness of placement into special measures but would value the additional support that this would offer us. We expect that the move will mean the work we have already started can continue at pace.”

Eastbourne MP Caroline Ansell has commented on the report saying, “This is very disappointing but perhaps not surprising news, and it would now appear the service will be put into special measures by the CQC.

“The problems the service has encountered following its disastrous pilot scheme has led to widespread concern and a lack of confidence in the service’s management team so I welcome the CQC stepping in.

“I have also been told that, although the CQC has serious concerns, the report does recognise the good work by frontline staff and that should be mentioned and welcomed by residents and patients.

“I will be hosting the next parliamentary meeting with SECAmb management in the next few weeks at Westminster where MPs will be eager to find out what is going to be done to improve the service.

“People in Sussex are rightly concerned about what has happened and what will happen, and I know I will be wanting detailed answers on how the service intends to improve.”

Commenting on behalf of all the six South Healthwatch’s, Nicky Scott of Healthwatch Kent said, “Naturally we are extremely disappointed to hear today’s announcement. Our ambulance trust has hit the headlines on several occasions in recent months and not for positive reasons. It is now imperative that the Trust works with patients and local Healthwatch’s to make immediate improvements and that the public are reassured.

People reading this can help in two ways. Firstly, please share your experience of the ambulance service with us and secondly volunteer with Healthwatch and help to improve services.”

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