Archived: Essex Ambulance Service Limited

Updated 1 February 2024

Essex Ambulance Service Limited is operated by Essex Ambulance Service Limited (EAS). The service registered with the Care Quality Commission (CQC) in February 2020, as an independent ambulance service based in Essex. EAS supplies paramedics, emergency technicians, first responders, and first aiders to provide first aid cover and conveyancing at organised sporting and public events. It provides ad-hoc frontline urgent and emergency care services at weekends on behalf of a local NHS trust and transports patients from hospital to home or other care services. The service also transports patients from home to outpatient appointments.

The service is registered to provide the following regulated activity:

• Transport services, triage and medical advice provided remotely

• Treatment of disease, disorder, or injury

The registered manager for this service had been registered with the CQC since February 2020. The service had 3 managers, including the registered manager, and employed 29 other members of staff on zero hours contracts.

The fleet consisted of 15 vehicles and the service carried out 3,063 patient transport journeys and 361 urgent and emergency care between 30 March 2022 and 29 March 2023. This is the first time the CQC have inspected and rated the service.

The main service provided by EAS was patient transport services. Where our findings on emergency urgent care – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the patient transport service.

Updated 1 February 2024

We rated Patient Transport Services and Emergency and Urgent Care as inadequate.

Following our inspection, we issued a notice of decision under Section 31 of the Health and Social Care Act 2008, to impose conditions on the registration in respect of the regulated activity Treatment of disease, disorder, or injury. We took this urgent action as we believed a person would or may be exposed to the risk of harm if we did not do so.

We told the provider they must take some actions to manage the regulated activity in a way which complied with their conditions of registration.

We will reinspect the service to check that improvements have been made. We will produce another report of that inspection and include an update of our actions.

For details of the individual services, see the service sections of this report.

This is the first time we have rated this service. We rated it as inadequate because:
• The service did not have effective medicines management or legal mechanisms in place for medicines and medical gases management.
• The service did not manage staff effectively to ensure they were trained and managed. The service did not manage safety and safeguarding incidents well and did not learn lessons from them. The service did not manage infection control risk and clinical waste well.
• The service did not have effective and robust governance systems and processes. The service did not monitor the quality of the service. The service did not have an effective risk management process in place. The service did not monitor and improve the quality and safety of services provided.

However:
• Vehicles were visibly clean and well maintained.
• Staff worked together for the benefit of patients.
• Staff felt supported and valued.

Updated 1 February 2024

This is the first time we have rated this service. We rated it as inadequate because:

• The service did not have effective medicines management or legal mechanisms in place for medicines and medical gases management.
• The service did not manage staff effectively to ensure they were trained and managed. The service did not manage safety and safeguarding incidents well and did not learn lessons from them. The service did not manage infection control risk and clinical waste well.
• The service did not have effective and robust governance systems and processes. The service did not monitor the quality of the service. The service did not have an effective risk management process in place. The service did not monitor and improve the quality and safety of services provided.

However:

• Vehicles were visibly clean and well maintained.
• Staff worked together for the benefit of patients.
• Staff felt supported and valued.

Urgent and emergency care is a small proportion of the service activity. The main service was patient transport services. Where arrangements were the same, we have reported findings in the patient transport services section.

We rated this service as inadequate because it was not safe, effective, responsive, and well-led. There was insufficient evidence to rate caring.

Updated 1 February 2024

This is the first time we have rated the service. We rated it as inadequate because:

• There was no training for medicines management for all staff.
• Patient records were not clear and accurate.

Additional concerns identified during this inspection are described under the patient transport service section of this report.

We rated this service as inadequate because it was not safe, responsive, and well-led. There was insufficient evidence to rate caring. We rated effective as requires improvement.