A report published today by the CQC has warned of significant variation in the safety and quality of private ambulance services.
The healthcare watchdog said that despite seeing evidence of good practice among some individual services, its inspections had identified concerns about how safely and effectively providers are caring for patients.
Many services, it said, lacked clear understanding of governance issues and had weak recruitment processes in place. Checks to ensure that staff had appropriate references and DBS certificates, as well as appropriate driving licence categories, were not always enforced consistently.
In addition, CQC inspectors found that many providers offered no or very limited staff training, particularly in relation to emergency driver response training. Standards of medicines management was also ‘extremely variable’. And while some services had robust policies to support the safe administration of medication, others showed a lack of understanding, especially around controlled drugs and the need for their safe administration and secure storage.
Independent ambulance providers mainly offer specialist patient transport services and non-emergency responses. However, an increasing number also provide 999 emergency responses to support NHS ambulance trusts routinely or during times of peak demand.
‘Providers have a responsibility to ensure that people within their care receive appropriate treatment, that the vehicles used to transport patients are fitted with the right equipment, that staff are appropriately trained and supported to carry out their roles, risks and incidents are reported and addressed, and that medicines are stored securely. This was not the case in many of the services we inspected,’ said the CQC’s deputy chief inspector of hospitals and lead for ambulance services Ellen Armistead.
The regulator’s national report, which presents an analysis of findings from its comprehensive inspection program of independent ambulance services, also raised concern about those services which remain outside the remit of CQC regulation. It said the current lack of oversight for some services, such as medical cover provided at temporary events, was putting the public at risk. It called on the Department of Health and Social Care to review the regulatory gap and commissioners to ensure they make safety and quality a priority.
‘Those who deliver and commission care must learn from the services that are getting it right so that people are protected from risk and can have confidence in the quality of care they receive from independent ambulance services across the country,’ added Armistead.
The CQC said it will be strengthening its assessment of how NHS hospital trusts that sub-contract ambulance services from independent providers ensure they have continued oversight of performance and quality.