Heathrow Air Ambulance HQ

Updated 13 October 2023

Heathrow Air Ambulance (HAA) is an independent ambulance provider with a head office in Iver and an ambulance station on the perimeter of Heathrow Airport. Most of their work involves repatriation of Kuwaiti or Qatari nationals for second medical opinions in the UK. HAA carry out this work for all age groups. Additionally, HAA repatriate British nationals who may have suffered an injury or illness abroad. The Care Quality Commission (CQC) does not regulate repatriations made on behalf of patients by their employer, a government department, or an insurance provider.

Repatriations funded privately are regulated by the CQC. This could be transporting patients who arrive in the UK for second opinions, or those who have suffered an injury or illness abroad. It must be noted that HAA have not carried out any regulated activities since February 2020 and, therefore, the inspection team has been unable to gather evidence to assess areas of service delivery such as service user care record keeping. However, reliable evidence has been gathered including on the safety of vehicles, training of staff, and policies and procedures which are used by the provider for delivery of both non-regulated and regulated activities. Due to the above, this inspection has not led to a service rating.

HAA are also tasked with the transport of persons to be deported from the UK by the Home Office. Most are wheelchair patients, and a few are stretcher cases and are deemed unsafe to travel through normal channels and searched in the normal way. The patients are all unwell or have a physical injury or impairment.

The company has an agreement with a separate independent ambulance provider who occasionally help when HAA cannot fulfil all journeys. There is no contract in place for this agreement. The third party is separately registered with the CQC.

HAA have 4 ambulances and 1 car.

HAA do not carry out any other patient transport service or emergency work.

HAA has a registered manager in post. A registered manager shares the legal responsibility for meeting the requirements of the relevant regulations and enactments with the provider.

The CQC previously inspected, but did not rate, this provider in 2017. Following the inspection, the CQC served requirement notices in relation to the following actions the provider must take to improve:

• The provider must ensure there are effective governance arrangements to monitor the quality of the service, including processes for updating policies in line with national guidance and gathering of service risks and mitigating actions.
• The provider must ensure there is a robust process for the reporting, recording and investigating of all incidents.
• The provider must introduce a system for monitoring their compliance to policies and procedures.
• The provider must ensure all staff are up to date with safeguarding children level two training in accordance with national guidance.

Further, the CQC advised the provider of the following actions it should take to improve:

• The provider should ensure all staff are up to date with mandatory training requirements.
• The provider should ensure that all permanent staff receive an appraisal to identify any training or development needs.
• The provider should consider implementing a business contingency plan.
• The provider should ensure that oxygen and Entonox administration guidance is available to all staff.
• The provider should consider offering violence and aggression training for all staff due to the service conveying patients with mental health conditions.

Following the 2017 inspection and report, the manager completed an action plan to ensure the service would meet the regulations of the Health and Social Care Act. The action plan outlined the steps HAA would take to ensure regulations would be met.

During this inspection on 5 January 2023 some of the above issues had not been rectified.

Updated 13 October 2023

• The service had enough staff to care for patients and keep them safe. Staff had training in most key skills, understood how to protect patients from abuse, but did not manage safety well. We did not have full assurance the service controlled infection risk well. Staff assessed risks to patients, acted on them and kept care records when required. The service did not have a robust safety incidents system in place, and we did not have assurance staff learned lessons from them.
• Staff provided good care and assessed patients’ food and drink requirements. The service met agreed response times. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, but did not always make it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for transport.
• Leaders ran services well and had years of experience. They supported staff to develop their skills. However, they did not use reliable information systems. Although the service had a vision, this was not supported by a robust strategy. Staff felt respected, supported, and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities.

Updated 13 October 2023

• The service had enough staff to care for patients and keep them safe. Staff had training in most key skills, understood how to protect patients from abuse, but did not manage safety well. We did not have full assurance the service controlled infection risk well. Staff assessed risks to patients, acted on them and kept care records when required. The service did not have a robust safety incidents system in place, and we did not have assurance staff learned lessons from them.
• Staff provided good care and assessed patients’ food and drink requirements. The service met agreed response times. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of patients.
• The service planned care to meet the needs of local people, took account of patients’ individual needs, but did not always make it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for transport.
• Leaders ran services well and had years of experience. They supported staff to develop their skills. However, they did not use reliable information systems. Although the service had a vision, this was not supported by a robust strategy. Staff felt respected, supported, and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities.