Archived: SSG UK Specialist Ambulance Service - North

Updated 16 August 2019

SSG UK Specialist Ambulance Service North is operated by SSG UK Specialist Ambulance Service Ltd (SSG) . The service commenced operating in July 2017. It is an independent ambulance service. The northern base is in Cramlington Northumberland.

In August 2013, the current SSG UK Specialist Ambulance Service North Regional Manager was asked to run the UK Specialist Ambulance Service Ltd North Division (UKSAS), with a view to building the company up in the North of England.

Initially this was done by providing a service for the transport of patients sectioned under the Mental Health Act. At this early stage the business operated from the Regional Manager`s home until such time that the volume of work warranted obtaining a business premises. This was achieved by November 2014, the company moving to the current premises in Cramlington.

The company continued to build up the business obtaining contracts with several clinical commissioning groups (CCGs). In July 2017, Servicios Socio-sanitarios Generales (Spain) purchased UK Specialist Ambulance Service Ltd SSG, creating the new company, SSG UK Specialist Ambulance Service Ltd.

SSG UKSAS nationally is a provider of urgent and emergency care, patient transport services and secure transportation services to numerous NHS Trusts around the country. SSG UKSAS had three main sites:

• Corporate HQ Rainham, Essex, serving two NHS ambulance service Trusts.

• SSG UKSAS South Fareham, Hampshire, serving one NHS ambulance service trust.

• SSG UKSAS North, Cramlington, Northumberland, serving CCG`s and Mental Health Trusts across the north.

The service has had a Registered Manager in post since 3 August 2017.The provider is registered to provide the following regulated activities at SSG UKSAS North;

• Transport services, triage and medical advice provided remotely

• Treatment of disease, disorder or injury

The service also provides a patient repatriation service for insurance and air ambulance companies which fall outside the remit of CQC regulated activity and were not inspected. There were two PTS and two urgent and emergency care ambulances based at Cramlington.

Updated 16 August 2019

SSG UK Specialist Ambulance Service North is operated by SSG UK Specialist Ambulance Service Ltd (SSG) . The service provides a patient transport service for patients with mental ill health.

We inspected this service using our comprehensive inspection methodology. We made an unannounced visit to the service on 30 April 2019.

The service had been previously inspected in April 2018 but not rated.

Following that inspection, we told the provider that it must take three actions to comply with the regulations and that it should make six other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice that affected Patient Transport.

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 patient transport.

We rated it as  requires improvement overall.

We found the following issues that the service provider needs to improve:

• During the previous inspection the provider was given six should do actions to improve the service. During this inspection we found four of the six should do actions had not been completed.

• The provider did not have their own procedure for identifying high risk/infectious patients.

• During the inspection we found limited evidence the provider carried out effective audits to measure the quality and effectiveness of the service delivered. This was because the number of observations or gathering of audit information was so low; they were not a representative sample of the number of staff employed or the number of patient transports undertaken.

• The provider did not actively seek feedback about the quality of care and overall service provided.

• There was no evidence that dynamic risk assessments in relation to patients were recorded.

• There was not a system to record or measure the levels of staff adherence to local policies and procedures.

• There were very limited supervisory operational observations of staff carried out to identify either good or poor practice.

• During this inspection there was no evidence the PTS vehicles we inspected carried any information or leaflets which would explain to a patient, relative or carer how to make a complaint.

• During the inspection we did not see evidence of an effective system to actively seek feedback from patients, those lawfully acting on their behalf, their carers and others such as staff or other relevant bodies.

However, we found the following areas of good practice:

• During this inspection we saw evidence the provider had acted to deal with the three must do actions, two of the six should do actions and the requirement notice issued following the previous inspection.

• There was evidence of a formal system for reporting and responding to incidents.

• There were high levels of staff statutory and mandatory training.

• The station and working environment were visibly clean, safe and fit for purpose.

• There was evidence during this inspection that the five employed staff had a current appraisal.

• Staff observed during inspection displaying a caring, empathetic and supportive attitude.

• Staff were observed working well with hospital staff to calm a patient who was refusing to be transported.

• Patient transport journeys were planned to take account of patient risk.

• There was a shift system to manage access and flow covering 24 hours per day.

• There was evidence of a provider mission statement, values and strategic priorities for 2019.

• There was evidence of recent 1:1 staff employment consultation in relation to increasing the number employed staff in the company.

Following this inspection, we told the provider that it must take six actions to comply with the regulations and that it should make 12 other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with three requirement notices that affected Patient Transport Services. Details are at the end of the report.

Ann Ford Deputy Chief Inspector of Hospitals (North), on behalf of the Chief Inspector of Hospitals

Updated 16 August 2019

Patient transport services for patients with mental ill health was the regulated activity carried out. No other categories of patients were transported.

In the reporting period April 2018 to March 2019 there were 4,014 patient transport journeys undertaken, of these 80 were children aged under 18 years.

Safe was rated as requires improvement because there were no general waste bins or clinical waste bins on either vehicle inspected, not all incident forms had been reviewed by a manager and no personal protective equipment (PPE) audits had been carried out.

Effective was rated as requires improvement because there was a lack of audit activity and some of the improvement actions resulting from the previous inspection had not been completed. The provider did not have a system to record or measure the levels of staff adherence to local policies and procedures. There were very limited supervisory operational observations of staff carried out to identify the levels of competence of staff or good or poor practice.

Caring was rated as good because staff we observed displayed a caring, empathetic and supportive attitude toward the patient they were transporting.

Responsive was rated as requires improvement because following the previous inspection the provider had been given some actions to improve the service during this inspection some of the actions had not been completed. There were no communication aids for staff to use with patients when English was not their first language in the vehicles we inspected. The PTS vehicles we inspected did not carry any information or leaflets which would explain to a patient, relative or carer how to make a complaint.

Well Led was rated as requires improvement because there was not an effective system to actively seek feedback from patients, those lawfully acting on their behalf, their carers and others such as staff or other relevant bodies and there was limited evidence the provider carried out audits to improve the service.