Elite EMS Headquarters

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The leadership had a clear 5 year plan to develop the business to meet the needs of the NHS ambulance services that commissioned them. This, however had changed as a result of the purchase, at the behest of commissioners, of another provider. While the activity was expanding, the plan aimed to reduce the number of MRCs so that they could better meet the needs of their commissioners. This involved the closure of some, the improvement of others and more generally the consolidation of activity in large “superhubs” which the provider had recognised as a developing best practice in the industry.

New vehicles had been acquired, and these were spread around the MRCs, not just for equipment resilience but to ensure that all staff had the opportunity to use them. However, this meant that some staff were disappointed that they had “lost” some of their new ambulances and were using older ones that had been brought in from other areas.

When we spoke to staff who had joined the company recently, they were positive about their new employer and compared it favourably to other employers in the sector. Another long-standing employee told us that the company “had a bright future”

While some staff were critical, the majority spoke positively as to the support they received from managers and leaders. We noted that there was some correlation as to whether staff had previously worked for the current or previous providers. Some staff were pleased with the changes and others were not. This was a complex matter involving interpersonal relationships and other factors such as staff having moved employers, changed managers and the people they worked with and that their base might have moved due to the rationalisation of the MRCs.

Team leaders and managers were qualified and experienced for the roles that they carried out.

When we spoke to senior leaders they were aware, and were taking steps to work with staff to address any concerns and taking action if individual performance needed to be addressed. Overall while we recognised some staff’s dissatisfaction we were not concerned as to the quality of the leadership in the organisation.

Staff were generally well supported in respect of the stresses that their work entailed. One member staff said that they did not get enough support following an unpleasant incident while another told us that following a “rotten job” they got Trauma Risk Management (TRiM) and “plenty of support”.

The CEO was supported by a senior leadership team. Below this were area managers, and operation managers such as the fleet manager. They in turn were supported by shift supervisors.

There were good personnel systems in place and staff were given clinical and managerial supervision. All staff worked and were recruited to job descriptions and there was an organisational structure in place where staff were managed through lines of managerial accountability.

There were processes for managers provide support through, “hot debriefs”, Trauma Risk Management (TRiM) and other welfare schemes.

There was a Freedom To Speak Up Guardian (FTSUG) based at the Tamworth headquarters modelled on best practice within the NHS. This FTSUG made themselves available to staff in the south by making visits and working flexibly to be available around shifts.

The telephone number and other contacts for the FTSUG were prominently displayed, and they would visit staff at their MRC on request. In addition to their FTSUG role this member of staff also carried more general staff welfare duties as part of their roles. Several staff told us that they valued this service, and some gave examples as to how they had been supported not just with work issues but in their life outside of work too.

While most staff were positive about the company and their leaders, and we had some very positive testimonials about their managers and colleagues. Some staff expressed dissatisfaction saying managers were strict and others that the company was not as good to work for as before. When pressed however they did not tell us about issues that caused significant concern, and in some cases, they were referring to people and incidents that were historical.

The RM, CEO and Clinical Lead were present at each make ready centre 2/3 times a month and made themselves available for informal chats with staff. Some staff confirmed this, others said they had not met them, and this seemed to be as a result of shift working as staff who were based solely in the MRCs all reported meeting senior staff. The senior leadership confirmed this saying that because staff were only at the MRC for a very short part of their shifts it was difficult to be visible to everyone.

The FTSUG had suitable responsibilities as part of their job description and operated within a framework. This was based on the model promoted by the National Guardian’s Office We noted that their office, at the Tamworth headquarters was setup with a breakout area and encouraged staff to “drop in” for any welfare needs as well as FTSU concerns.

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here were FTSU posters and publicity in all crew rooms that promoted the methods by which the FTSUG could be contacted.

We spoke to many members of staff in private as part of our inspection and no-one raised any concerns about discrimination based on any protected characteristics.

Equality and diversity formed part of staff’s mandatory training and staff could receive support from the FTSUG. We noted that the FTSUG office had suitable resources for this topic.

We discussed the provider’s organisation and governance structures and were shown various documents that demonstrated how the business operated.

We noted that despite the provider, as a result of the ongoing reconfiguration of services in the south, being in a constant state of reorganisation, documents and processes were kept up to date. This included the provider’s adherence to the regulations that required them to keep CQC informed of changes, such as their Statement of Purpose.

The senior team were candid about problems resulting from the takeover as well as changes to working practices. There was understandable dissatisfaction from some staff because of the rationalisation of the MRCs as some staff were working from different bases, with different colleagues and having to travel further to work.

There was a clinical governance structure in place with a clinical governance manager and two clinical governance assistants. A quarterly audit system was in place that covered suitable topics for the nature of the service.

Policies, procedures and work instructions were comprehensive and well written and were clearly used to direct in the day to day running of the business. Changes to procedures were communicated well through meetings, notices and training and if urgent action was needed there were mechanisms to cascade the change through the management structure and staff bulletins.

There was a clear management structure in place with defined roles, responsibilities and job descriptions. We saw that meetings were minuted and where appropriate distributed to staff. A new manager told us that the service was well structured, and that system worked well.

At the last inspection we made a requirement that notifications of deaths and incidents were to be made, even if these had been done by the commissioning NHS ambulance service. Changes to the process were made quickly and the systems for making notifications to the CQC were in place and were robust.

Because of the numerous changes being made to the organisation the provider’s Statement of Purpose (SoP) needed to be frequently updated. Changes to the SoP were being notified and the document was of high quality and beyond that required by the regulations. This, together with the quality of other documents meant that many aspects of the inspection were made easier.

The contracting NHS commissioners fed back through audits and learning from incidents. They were also used to feedback patient satisfaction information in addition to the feedback processes used by the provider.

There were regular contract management and clinical governance meetings with the contracting NHS commissioners. Contract monitoring visits by the commissioners to place and resulted in action plans.

We were shown several recent changes that demonstrated that the provider was an innovative organisation. They were familiar with current and developing best practice in the sector and were developing approaches normally only seen in NHS providers.

They were proactive in the implementation of information technology and most processes were computerised including the management of stock, reporting of incidents and equipment faults and data from these systems was used to support audits

The provider had systems in place to both stimulate and control innovation. Staff were encouraged to put forward ideas, but trials and pilots were managed so as to not introduce risk and to ascertain any benefits.