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Inspection carried out on 25th to 26th July 2017

During an inspection to make sure that the improvements required had been made

Q Despatch is operated by Q Despatch (West) Limited. The organisation provides non-emergency patient transport services in London and nationally from its 24-hour London control centre on behalf of hospitals and healthcare organisations.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 25 and 26 July 2017.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

The service provided by this provider was non-emergency patient transport services.

We regulate independent ambulance services but we do not currently have a legal duty to rate them. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

We found the following areas of good practice:

  • An established incident-reporting procedure was in place and there was evidence of learning from this. However, there was no formal process in place for disseminating outcome learning to staff and drivers.
  • Recruitment processes and compliance with statutory equipment maintenance ensured passengers were carried safely. Healthcare organisations checked this through regular audits.
  • The service was benchmarked against legislative guidance and national best practice standards. All contracts were carried out in accordance with the Official Journal of the European Union requirements.
  • A 24-hour control centre team provided continual monitoring of demands on the service and provided an immediate response in case of driver delays. In the 12 months prior to our inspection, no patients had missed an appointment due to transport delays.
  • All staff and drivers were up to date with mandatory training, including dementia awareness.
  • Patients and healthcare organisations spoke positively about their experiences with the provider and we observed staff speak to patients with kindness and dignity during our control centre observation.
  • Staff and drivers provided an individualised service to patients and we found evidence of continual service planning to meet patient needs.
  • The general manager resolved complaints with an investigation and appropriate action.
  • The working culture of the organisation was demonstrably positive and staff and drivers felt respected by the senior team.
  • Governance structures were in place at a senior level and there was evidence of continual oversight from and multidisciplinary working with partner organisations.
  • The organisation had an ethos of development, adaptability and innovation and demonstrated how it strived to achieve them.

However, we also found the following issues that the service provider needs to improve:

  • There was room for improvement in the overall organisational approach to safeguarding. This included better training and oversight. The safeguarding lead did not have any formal safeguarding training. It was not clear that staff had a good understanding of safeguarding principles and processes. Following our inspection, the provider informed us that the safeguarding lead had started the process of safeguarding training, and that they had implemented further safeguarding modules into the driver training programme.
  • The depth and content of safeguarding training was not always sufficient to ensure staff and drivers could demonstrate appropriate levels of knowledge.
  • There was no centralised system in place to track and monitor trends for incidents, complaints and risks. Following our inspection the provider commented that they would implement a centralised system, as these had previously been recorded on an account basis, linked to specific contracts.

Following this inspection, we told the provider that it should make improvements, even though a regulation had not been breached, to help the service improve.

Amanda Stanford

Deputy Chief Inspector of Hospitals, on behalf of the Chief Inspector of Hospitals

Inspection carried out on 7, 12 December 2012

During a routine inspection

We visited the provider�s office on the 7th December and inspected records relating to the service and the drivers. We spoke with the provider�s general manager and head of sales and marketing. On the 13th December, we visited a dialysis clinic frequently attended by people using the service. We spoke with six people who use the service, four drivers and two of the clinic staff. We spent some time observing the service being provided to people and inspected the vehicles used to transport them. We also telephoned four people, some of whom were transported long distances, to discuss their experience of the service.

Most people we spoke with were very satisfied. One said they had been using the service for two years and were �very happy� with it. Another person, who had been using the service for three years, said it was �first class.�

The service is almost entirely provided using unmarked cars, with some wheelchair-accessible vehicles allowing wheelchair-users to be easily and safely carried. Where specialist ambulances are required to transport people with higher needs, the provider has arrangements in place to sub-contract the work to two companies, Abacus Ambulance Service and Starcross Trading Ltd, t/a Bears, both of which are registered with the CQC.

Inspection carried out on 24 January 2012

During a routine inspection

On this occasion we did not speak to people about the service.

We did review patient feedback questionnaires. Patients reported that they liked the transport staff and found staff to be professional. They had confidence in the staff and felt their transport and logistical plans and choices were clearly explained to them.