The Care Quality Commission
  • Ambulance service

Archived: East of England Ambulance Service NHS Trust HQ

1020 Cambourne Business Park, Cambourne, Cambridge, Cambridgeshire, CB23 6EB 0845 601 3733

Provided and run by:
East of England Ambulance Service NHS Trust

Important: This service was previously registered at a different address - see old profile

All Inspections

Other CQC inspections of services

Community & mental health inspection reports for East of England Ambulance Service NHS Trust HQ can be found at East of England Ambulance Service NHS Trust. Each report covers findings for one service across multiple locations
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10, 11, 12, 20 December 2013

During a routine inspection

During our inspection we spoke with 15 people who had been transported to hospital by ambulance crews. Overall people told us the care and treatment they had received from ambulance crews had been very good. People told us that the ambulances had arrived quickly and that staff had treated them respectfully throughout their journey to hospital. One person stated, 'I had to wait less than 10 minutes for the ambulance and when they arrived they carried out all sorts of blood pressure and ECG checks. The service was excellent'. People also commented on the quality of the call handler with whom they spoke. One stated, 'The call handler stayed on the phone right until the ambulance arrived. She was very reassuring as I was in quite a state'. Another person had written to us prior to our inspection to tell us, 'I have had to call out an ambulance on four occasions this year, all at night time. All came within an acceptable time and the phone support I got while I was waiting was excellent'. However since our last inspection we had continued to receive a number of complaints from people concerned at the length of time they had waited for an ambulance to take them to hospital.

We spoke to a number of hospital staff in each of the three A&E departments we visited. They told us that relationships with ambulance crews were good and they commented positively on the quality of ambulance staff's verbal and written handover information about patients. One hospital staff member reported that ambulance staff often helped A&E staff when it was busy, by taking patients' vital signs or assisting them with patient transfers. The matron in charge of one A&E department told us that ambulance staff's decisions to bring people into hospital were almost always correct.

We spoke with senior fire offices in four counties about the trust's performance. They told us that they worked well with the trust in resilience planning and the quality of ambulance crews was excellent. However they stated that their crews often had to wait excessive times for an ambulance to arrive which, on occasion, caused them delays in being able to cut people out of cars following road traffic accidents. One of the fire officers stated, 'Quite simply they just don't seem to have the necessary resources to meet the demand'.

Since our last inspection we found that the trust had made significant improvements in a number of areas. Staff sickness absence rates had reduced and the number of staff who had received a performance development review had increased considerably. Complaints relating to ambulance delays had decreased, as had the number of serious incidents experienced by the trust. High spending on private ambulance services had reduced and there had been improved engagement with local stakeholders such as MPs and Health and Overview Scrutiny Committees. The trust had consistently met performance targets in relation to its less urgent calls and there was evidence to show that long waits (over 25 minutes) for back up vehicles to transport people to hospital in life threatening instances were decreasing in some areas.

However, the trust had not seen the improvement needed in some areas such as its ambulance response times to life threatening 999 calls. There continued to be large variations in response time performance across different regions of the trust and there remained problems with getting people who had suffered a stroke to a specialist centre within 60 minutes. Ambulance delays at hospitals, although improving in some areas, still did not meet the required level of performance and the trust had incurred fines from its commissioners as a result.

There had been very significant changes to board membership since January 2013. At the time of our visit, recruitment to the non-executive team had only recently been completed and there was only one substantive executive director in post, with all the others working on an acting or interim basis. Staff told us that the number of interim directors unsettled them and one manager reported, 'I'm just a bit nervous that everything will change again with a new Chief Exec'.

Members of the board we spoke with showed a more realistic understanding of the challenges the trust faced since our last inspection which included the need to recruit more staff; to increase front line resources; to reduce staff sickness, to strengthen leadership and to engage better with staff. The trust had drawn up a detailed action plan which clearly set out how it would meet these challenges and was able to demonstrate that it had already made good progress in implementing some of the changes required. However, the Chair of the board told us that full transformation of the service would take some considerable time and require additional financial resourcing in order to achieve response time targets both locally and regionally.

After careful consideration, we have concluded that the trust is taking reasonable steps to address the breaches in regulations and therefore it would not be appropriate to take further enforcement action at this point. However as the impact for people waiting to be transported to hospital remains as a moderate concern, we have escalated our concerns to the Trust Development Authority who have the responsibility to support the trust in taking the necessary action to improve its service. We will continue to closely monitor the trust, inspecting it as required and working with NHS England to review its progress.

30, 31 January and 5 February 2013

During a routine inspection

During our inspection we spoke with 23 people who used both the trust's emergency and patient transport services at the three hospitals we visited. People who used the trust's emergency service told us that the ambulance had arrived quickly and they had not waited a long time for assistance. They reported that staff had undertaken a thorough assessment of their medical needs; had monitored their welfare throughout the journey to hospital and explained to them clearly what they were doing. People expressed a high level of satisfaction with the service and we received many positive comments about the ambulance staff's attitude and capability. One person described the service as, 'Brilliant' and that they would give them, 'Three stars'. People told us they had been treated respectfully by staff and one person was particularly appreciative that staff had helped them put on appropriate clothing and shoes before leaving for hospital. Another family member told us that staff had moved her elderly relative downstairs, 'Expertly' and hadn't bumped them once. However one person's carer told us that ambulance staff had not applied the brakes on a trolley correctly when removing it from the ambulance, despite a large notice in the ambulance instructing them to do this.

15 March 2012

During an inspection in response to concerns

We spoke with a total of 16 people who used the service at the four accident and emergency (A&E) departments that we visited. Most people spoke highly of the service they had received from the ambulance service and told us that they had been transported to hospital quickly.

People told us that the call handlers (the trust's staff who answered their emergency phone call) explained to them where the ambulance was and how long it would take to reach them. One person told us, 'The call handler was really good, she talked me through very clearly how to take my friend's pulse and timed the 30 seconds for me to count. She was so calm and that helped me stop panicking'. Another person, who had taken a self-administered overdose stated, 'I was nervous about calling them I thought they'd be judgemental, but they were really nice'.

The majority of people told us they were well looked after and that ambulance staff were friendly, reassuring and asked them about their pain levels. One person told us, 'The crew treated me well and with respect, they were very good and I was kept comfy and warm'. Another person reported, 'They went out their way to help me and I couldn't fault them'. One relative told us that the ambulance crew dealt with her mother very well, describing them as 'business-like'. However she stated that at no point did crew explain what they were doing to her mother.

A friend of someone who had accompanied them to hospital told us that, whilst her friend was being treated by a female crew member, the male crew member always knocked on the vehicle door first and waited to be told to enter before he came in. However, another person told us he had got very cold lying on the pavement for 40 minutes at Cambridge train station waiting for a back up ambulance to arrive from Huntingdon that could take him to Addenbrookes hospital.

We spoke with 17 people who use the trust's patient transport services and received mixed views from them about the quality of the service they were provided with. People told us they mostly arrived for their hospital appointments on time and that ambulance crews were attentive and courteous. One person told us that the drivers were very good and, as a lone female, made her feel, 'Safe and confident.' Several people told us that the wait for transport to be taken home following their hospital appointment could be very long. One person told us she had waited up to 5 hours on more than one occasion.

We spoke to a number of hospital staff in each of the four A&E departments we visited. Most talked positively about their working relationships with ambulance staff and rated their professional skills highly. One member of nursing staff told us that, 'Ambulance staff are excellent at knowing when people are really sick' and that, 'Crews on the ground are brilliant'.

However an A&E sister told us that the majority of patient care records given to her by ambulance crews, 'Could be better' and that sometimes important information about people had not been recorded in them. However she described verbal handovers given by ambulance crew as, 'Really good'.

We spoke with 12 care home managers and most reported they received a good quality service both from the trust's emergency and patient transport services. They told us that initial emergency help arrived quickly but that they sometimes had to wait a long time for a back up vehicle to transport their residents to hospital. One manager told us that residents could be left on the floor with fractured bones for up to three hours on occasions, sometimes resulting in tissue damage to vulnerable areas. In terms of patient transport services, most home managers reported high levels of satisfaction. However common concerns that were identified centred around them only being able to book transport a week in advance; crews' poor understanding about how to communicate effectively with people with dementia and sometimes crews' perceived, 'Stroppy' attitude if residents were not immediately ready to go when they arrived.