Spark Medical North West

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked for evidence that safety was a priority for everyone, and leaders embedded a culture of openness and collaboration. Leaders had systems for identifying and responding to safety risks.

The service had safety processes for the preparation of vehicles, equipment and for the patient journey between locations. However, we found some out of date consumables and medicines.

Oxygen was managed safely. Patients were safe from neglect, abuse and discrimination.

Not all staff had a recent appraisal and development review and some policies related to another organisation.

This is the first assessment for this service under the new provider. This key question has been rated good. This meant people were safe and protected from avoidable harm.

We have not awarded this service a score for Safe.

Find out about when we will not publish a key question score and what we look at when we assess Safe.

We scored the service as 3. The service had a proactive and positive culture of safety, based on openness and honesty. Staff and leaders listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Learning was shared with staff.

The service managed patient safety incidents well. The service had an incident reporting policy, which outlined incident reporting procedures, levels and timescales of investigation. There was a risk assessment matrix applied to each incident, according to severity. Staff told us how they raised concerns and reported incidents and near misses, which was in line with this policy.

Staff recognised and reported incidents using the internal system, which was via an incident reporting form (IR1). Managers investigated incidents and shared lessons learned with the whole team and the wider service, including external and contracted partner organisations. Wider learning was shared with the service’s contracted NHS ambulance services and acute trust. The registered manager ensured staff’s welfare, offered them downtime and psychological support.

When things went wrong, staff apologised and gave patients honest information and suitable support. Managers ensured actions from patient safety alerts were addressed and progress was monitored.

We saw evidence of incidents having been investigated, and sufficient action taken to reduce the risk of recurrence. We looked at the system for managing incidents which was electronic. Recent examples of incidents included patient falls, injured staff, aggressive patients, and vehicle damage.

There had been 70 reported adverse events in the preceding year, of which 3 were under the new provider.

Incidents were analysed to identify trends or themes and potential links to individual practitioners. Where additional training or support was required to ensure competence, this was arranged.

Staff were able to identify and report risks, secure in the knowledge these would be addressed. For example we saw evidence of staff escalating concerns when patients were aggressive, and police assistance was required. Where there was an immediate risk of harm to patients or others, staff felt confident to intervene to prevent harms occurring.

Staff understood the duty of candour. They were open and transparent and gave patients and families a full explanation if and when things went wrong. Staff received feedback from investigation of incidents. Managers debriefed and supported staff after any serious incident and provided support through lessons learned discussions, meetings, and feedback posters.

The service provided mandatory training in key skills to all staff. Managers monitored mandatory training and alerted staff when they needed to complete updates.

The data showed an overall completion rate of 97.78% on training

The service’s recruitment policy outlined expectations around staff’s statutory and mandatory training. Staff had to complete this within 4 weeks during their induction as part of the core skills training framework (CSTF).

Clinical staff completed training on recognising and responding to patients with for example, patients with mental health needs, learning disabilities and dementia. Staff also completed and refreshed all their care certificate training (CCT) standards every 3 years and were reminded before any expired.

We scored the service as 3. The service worked with patients and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Staff made sure there was continuity of care, including when responsibility for patient care moved between different areas of a service and between providers.

Safety and continuity of care was a priority throughout people’s care pathway. There were systems and processes to ensure the correct patients were collected and transferred between locations.

Spark Medical had utilised an electronic tracking system; however, following the service transition, the supplier was unable to support the new entity, and the service moved to a new combined solution. This provided enhanced visibility and reporting compared to the previous system.

The provider was in the process of rolling out systems to monitor vehicles and equipment so issues could be reported real-time.

The transfer of patients between locations was done so safely. Staff had appropriate driving skills and experience. Staff accompanied patients during the journey and safety equipment was used throughout.

Patient records were held on an Electronic Patient Record (EPR) system, providing staff with access to GP Connect and NHS Ambulance Trust information, enabling a joined up approach to care delivery.

When overall responsibility for the care and treatment of a patient moved to a different service provider, such as transfer to the NHS, there was effective communication, which allowed for seamless transfer.

Care and support were planned and organised with people, together with partners and communities in ways which ensured continuity after transfer to the destination.

We scored the service as 2. The service worked effectively with patients and healthcare partners to uphold individuals’ right to live safely, free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect. However, staff did not consistently receive appropriate training or guidance.

Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. They understood their responsibilities for notification of safeguarding incidents to the contractor of services. The service had well established partner working and contacts around safeguarding with their contractors and local authorities. Safeguarding cases were passed onto the relevant teams of their contracted NHS ambulance trusts. This meant staff did not report to the local authority directly.

Safeguarding policies were in place; however, these did not fully reflect current national guidance for adults and children, particularly in relation to training requirements. In addition, the policy contained an error, as it referred to another agency within its content. This is a breach of good governance regulation.

We saw that most staff had received safeguarding training for both adults and children. However, the data provided was not sufficiently detailed, as it was not broken down to demonstrate safeguarding training compliance at each required level. As a result, we were not assured that the appropriate staff, in the correct roles, had been trained to the required levels. This is breach of good governance.

Staff knew how to make a safeguarding referrals and who to inform if they had concerns. Safeguarding advice was available to support staff. Staff knew how to contact them. The safeguarding lead and had been trained to level 5.

Safeguarding concerns were considered when an incident occurred and a referral or further advice sought, when necessary. There were links to external agencies and staff knew what happened when they raised concerns.

Staff knew how to identify adults and children at risk of, or suffering, significant harm and worked with other agencies to protect them. We saw an examples of how staff protected a patient with protected characteristics under the Equality Act.

We scored the service as 3. The service worked with patients to understand and manage risks by thinking holistically. Staff provided care to meet patient’s needs which was safe, supportive and enabled patient to do the things that mattered to them.

The service used Electronic Patient Records (EPR) , which were initially completed by office staff over the phone to understand the requirements of the patient. They gained as much information as possible to risk assess patients. Staff always included the date and time the booking was made on the EPR and considered medicines under ‘other information’. This information was then passed to the registered manager, who completed the form as ambulance crew.

Staff we spoke with said they could access advice and support from senior leaders in a prompt manner, in cases where unexpected risks were identified. The service currently did not transport any mental health patients. Staff used a dynamic risk assessment for any patients with specialist needs. For example, in the past staff had transported patients with mental health needs, dementia, autism and learning disabilities. They ensured at least one parent, carer or chaperone accompanied the patient during transfer.

Staff could accommodate bariatric patients under the maximum limit of their heavily weighted wheelchair and bariatric ambulance. They could assign an extra crew member, or a second crew to these jobs if needed.

Staff were up to date with the appropriate level of life support training for their role, including Basic Life Support, Immediate Life Support, and Advanced Life Support, as part of their statutory and mandatory training programme.

Staff followed the service’s health and safety policy which outlined the risk assessment process, including for manual handling.

We scored the service as 3. The service detected and controlled potential risks in the care environment. Leaders and staff took steps to make sure equipment, facilities and technology supported the delivery of safe care. Where they were unable to do so, they mitigated the risks.

We inspected 11 ambulance vehicles and found the design, maintenance and use of facilities, premises and equipment kept people safe. Staff were trained to use equipment and to manage different types of waste safely.

Records of equipment maintenance and schedules were available. Vehicles were stored in a safe area and could not be accessed by unauthorised persons. Keys to vehicles were securely stored. Any fleet issues were escalated to relevant local managers for action and/or repair.

Staff carried out daily safety checks of specialist equipment. There was a system for staff to report faulty equipment and vehicles. A formal record was made of action taken to address the fault/s. Any equipment that was required to be removed from service was done so and red tagged; the equipment was placed into a sterile area away from any live equipment.

Leaders maintained oversight of equipment to ensure it was safe and ready to use. Equipment audits were completed and outcomes shared with staff. Equipment audits between March 2026 and May 2026 that vehicles were generally safe, well-equipped, and compliant, with overall compliance typically exceeding 90% across most equipment categories, although some consumables fell as low as 81% (oxygen masks) and 50% (drinking water provision). Most clinical equipment and PPE were consistently present and in date; however, weaknesses were identified in consumables management, including expired items such as oxygen masks and airways, alongside inconsistent stock checking processes.

Fire safety equipment was available on vehicles and had been serviced. Fire exits were clear and free from obstruction in office areas. All fire extinguishers onboard vehicles were securely fastened, checked and well within expiry date.

Oxygen cylinders were stored correctly, upright and in cages with no flammable or electrical equipment nearby. All full and used empty oxygen cylinders were stored safely upright and chained in separate locked cages with hazard signs.

Staff disposed of clinical waste safely, both inside vehicles and outside the storage areas. Waste was segregated and labelled in accordance with the local policy. Hazardous substances were stored safely and information about the products was available to staff.

We scored the service as 2. Staff did not always make sure staff received effective support, supervision and development.

The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and support. Training courses were allocated according to job role or clinical grade. The e-Learning system, notified all staff and managers of the required statutory and mandatory training, including when it was due or approaching expiry. The system automatically removed any staff member from planned shifts when their compliance had expired. Staff were made aware of their shifts in advance and could make requests. Patient pathways and their discharge were not delayed because of a lack of staff.

New staff had a full induction tailored to their role before they started work.

The new provider identified overall compliance with staff appraisal and development reviews was 45.3%, with 39 staff having an in-date review and 47 member of staff identified as requiring a review. Managers had identified this and had a plan in place to offer all staff an appraisal and development review in the forthcoming 6 months.

Managers reviewed the number of staff needed for each shift based on planned activity. Managers could adjust staffing levels daily according to the needs of patients and changes in activities.

As part of the onsite visit, we reviewed the duty rotas, which demonstrated that sufficient cover was in place and that appropriate contingency measures had been established. These included the provision of backup crew to ensure adequate cover in the event of staff sickness or absence.

Managers limited their use of bank staff and requested staff familiar with the service. We saw that Bank staff all go through the same recruitment.

The service supported the learning and development needs of staff and made sure staff received any specialist training for their role. Managers identified any training needs their staff had and gave them the time and opportunity to develop their skills and knowledge. At the time of assessment, Spark UK Medical was able to undertake mental health transfers, with policies in place to support the safe delivery of care and transport. However, it was identified that further development was required before fully operating within this sector.

The service collaborated with the NHS Ambulance Service and its third-party team to generate system access PINs for staff. Prior to allocation, staff were assessed and confirmed as eligible to work in patient transport services, frontline roles, or both.

The provider ensured that each staff member held a valid enhanced background check, along with the required clinical qualifications and certifications. This information was submitted to support system records, ensuring that staff details and competencies were accurately documented.

Once all compliance checks were successfully completed, NHS access PINs were issued, enabling staff to use the ambulance service systems.

The NHS organisation conducted regular annual inspections to review personnel records and ensure ongoing compliance. When staff left the provider, the external team was notified promptly, and system access was revoked accordingly.

The company invested in (Prevention and Management of Violence and Aggression) PMVA training for a staff member in 2024; however, this training had not been utilised. Due to the risk of skill and knowledge degradation, a decision was made to complete refresher training and updates prior to undertaking any secure mental health work. Spark UK Medical confirmed that appropriate training, support, and supervision would be in place before progressing further in this area.

Spark UK Medical confirmed that there had been no instances of handcuff use or the use of celled vehicles.

Managers made sure staff attended team meetings or had access to the information shared when they could not attend.

We scored the service as 2. Evidence identified some shortfalls. While the service assessed and managed infection risks, effective systems had not commenced to audit and monitor infection control.

There were systems in place to manage infection prevention and control risks. Staff used equipment and controlled measures to protect patients, themselves, and others from infection. They kept equipment and the premises visibly clean. However, the audits of infection prevention and control had not been fully implemented to ensure ongoing compliance.

A local Infection Prevention and Control (IPC) policy, along with supporting guidance, was available and accessible to staff. However, the policy contained the incorrect company name throughout the document following recent organisational changes. This is a breach of good governance.

Staff received training on IPC. There was guidance to support staff to respond to infection prevention and control risks such as transmittable infections.

Staff were following infection control principles including compliant handwashing and the use of personal protective equipment (PPE) as outlined in the services PPE standard operating procedure.

Staff understood the process for managing spillages of bodily fluids.

Staff supported infection prevention and control measures by following the uniform policy.

Staff cleaned the interior of vehicles and equipment routinely. A record of cleaning was retained within the vehicles.

Following the recent change of provider, a new audit plan has been proposed; however, it had not yet been fully implemented, and audit compliance outcomes were therefore not available for review at the time of assessment. This is a breach of good governance.

We scored the service as 2. The evidence showed some shortfalls. The service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

The service had a Medicines Management Policy in place which contained multiple references to an alternative company name and additional document omissions. The inclusion of an incorrect organisational identity and omissions within a formal policy document presented risks to the governance, accountability, and the delivery of safe practice. This was a breach of good governance.

Despite the policy referring to a different provider, parts of it were relevant. The Medicine Management Policy outlined the responsibilities for administering medicines. It explained which practitioners were authorised to administer medicines in accordance with Schedules 17 and 19 of the Human Medicines Regulations. Paramedics used their own supplies of schedule 2 controlled drugs. The provider had procedures to make sure these were fit for purpose.

Staff carried out regular checks of medicines to ensure they were available when required, fit for use, and within their expiry dates. However, during the assessment, we identified several out-of-date consumables on the vehicles inspected, as well as sharps bins that were labelled with disposal dates from 2025. This was a breach of safe care and treatment.

Medicines were stored securely and in accordance with local standard operating procedures. However, there was no system in place to monitor ambient room temperatures in areas where medicines were stored. We also identified out-of-date Schedule 4 Controlled Drugs. This was a breach of safe care and treatment.

Medicines held on vehicles were routinely checked and documented to ensure stock levels were accurate and all items were accounted for.

Patient Group Directions (PGDs) were in place, and staff compliance stood at 85%, with eight staff members still requiring sign-off to demonstrate authorisation and competency.

The service had an oxygen policy which staff told us they followed when administering emergency oxygen. The service’s latest medicines management policy incorporated oxygen for use, as per the Health and Safety Executive ‘Oxygen use in the workplace guidance and included information about hazards of using oxygen, causes of oxygen fires and explosions, correct or optimal storage, and non-compatible materials. The policy described the registered manager’s responsibility to report any adverse reactions to the patient’s own medications to the Medicines and Healthcare products Regulatory Agency (MHRA).

Oxygen was used on board vehicles, with cylinders stored securely in accordance with safety requirements. Healthcare personnel were permitted to administer oxygen where appropriate training had been completed. Administration to patients was carried out in line with a prescription issued by an authorised healthcare professional, or in accordance with the AACE Clinical Practice Guidelines, Spark UK Medical Protocol.