14 March 2018
Warwickshire & Northamptonshire Air Ambulance Service is operated by The Air Ambulance Service. The service is a charity and opened in 2003. It is an independent ambulance service based in Coventry and the service primarily serves the communities of Warwickshire and Northamptonshire. It also provides support for transporting children across England and Wales.
The Warwickshire & Northamptonshire Air Ambulance is a critical care Helicopter Emergency Medical Service based at Coventry Airport. Warwickshire & Northamptonshire Air Ambulance began operations in October 2003 providing critical care services to both main local NHS ambulance foundation trusts and mutual aid to neighbouring NHS ambulance service NHS trusts. It operates from 7am to 2am.
The service also operates a critical care rapid response vehicle out of hours (and when the aircraft are off-line) currently between the hours of 4pm to 2am.
In 2012, the Children's Air Ambulance launched its service operating from the same operational base as the Warwickshire & Northamptonshire Air Ambulance at Coventry Airport. The Children's Air Ambulance is the first and only national service dedicated to transferring neonatal and paediatric patients and clinical teams (when patients are too sick to fly) from local district hospitals to specialist care/treatment centres across the United Kingdom. Different to the helicopter emergency medical services, clinical teams for the Children’s Air Ambulance are provided by dedicated NHS specialist transport teams. The children’s air ambulance operated from 9am to 7pm.
The service has had a registered manager in post since 2011. The current registered manager has been in post since 2014. We carried out an announced inspection on 15 and 16 January 2018. We spoke with 12 members of staff, including the Chief Executive, Director of Operations, Director of Human Resources, pilots, doctors and critical care paramedics.
14 March 2018
Warwickshire & Northamptonshire Air Ambulance Service is operated by The Air Ambulance Service. The service provides emergency and urgent care and a patient transport service.
We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 15 and 16 January 2018.
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?
Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.
The main service provided by this service was emergency and urgent care. Patient transport services were a small proportion of activity. Where arrangements were the same, we have reported findings in the emergency and urgent care section.
Services we do not rate
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:
- There was an effective system and policy in place to report and respond appropriately to incidents. Learning was shared.
- There were effective systems and processes in place to protect people from the spread of infection, to ensure safe storage and administration of medicines and to safeguard patients from the risk of abuse.
- The maintenance and use of equipment kept patients safe from avoidable harm during treatment and transfer in the aircraft or vehicle.
- Patients’ individual care records were written and managed appropriately. Appropriate protocols were in place to assess and respond to patient risk. Staff had access to relevant information when needed.
- Staffing levels and skill mix were planned and reviewed to ensure that people received safe care and treatment at all times.
- The service planned for any anticipated risk and these were outlined in the business continuity policy. Staff understood their roles in a major incident.
- The care and treatment of patients was based on nationally recognised guidance. The service monitored compliance against its own key performance indicators (KPIs) to continue to drive improvements in patient outcomes.
- Staff had the skills, knowledge, and experience to deliver effective care and treatment.
- Care was delivered in a coordinated way with all other services involved. Effective and positive multi-disciplinary working was clearly evident.
- Staff understood the relevant consent and decision-making requirements of legislation and guidance, including the Mental Capacity Act 2005 (MCA).
- Care was provided in a sensitive and dignified way, wherever possible. Feedback received was very positive. Staff kept patients and families well informed regarding the treatment taking place on the scene and the plan ahead, including which hospital they would be transferred to.
- The service effectively planned and delivered services based on patient needs and were planned to take into account the different needs of the type of incidents and patients they responded to.
- Patients had access to timely care and critical care treatment.
- Effective procedures were in place to respond and learn from complaints.
- Leaders had the skills, knowledge, experience, and integrity they needed to ensure the service met patient needs.
- The service had a clear vision and strategy, underpinned by holistic values that were embraced by all staff at every level.
- Governance and risk management systems were effective in maintaining a clear oversight of the safety and high quality of services delivered.
- The service had an open and learning culture, fully focused on safe and high quality patient care.
- Staff and public engagement was positive and designed to seek feedback to continue to improve the service.
However, we also found the following issues that the service provider needs to improve:
- The safeguarding adults’ policy referenced out of date guidance. This was raised with the registered manager during the inspection who took immediate action to update the policy.
- Aircraft pilots had not had safeguarding training.
Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. Please refer to the end of the report.
Deputy Chief Inspector of Hospitals (Central Region), on behalf of the Chief Inspector of Hospitals
14 March 2018
The service was well led with experienced and capable leaders who drove improvements in the service with a focus on the best possible care in emergency situations for patients in need. The leaders promoted a positive staff culture and encouraged staff development to deliver the best possible care and treatment for all patients. Effective systems were in place to ensure patients received safe and high quality care and treatment at all times.