CQC publishes inspection report into London Ambulance Service

27 November 2015

Today (Friday 27 November) the Care Quality Commission (CQC) published its report following a planned inspection of London Ambulance Service in June.

While the report gives the Service a ‘good’ rating for its care of patients, it highlights a number of areas of concern and judges the Service to be ‘inadequate’ overall and the NHS Trust Development Authority is placing the Service into special measures.

Chief Executive, Dr Fionna Moore MBE, said: “While we are pleased that our caring and compassionate staff have been recognised in this report, we are sorry we have fallen short of some of the standards CQC and Londoners expect of us.

“As the newly appointed chief executive, I am, along with my leadership team, completely focussed on addressing the challenges highlighted in this report.

“We accept that we need to improve the way we measure and monitor some important standards and processes but we would like to reassure Londoners that we always prioritise our response to our most critically ill and injured patients and, in the event of a major incident, we are ready to respond and CQC recognise this.”

The Service is aware of many of the issues raised in this report and is already taking action. For example:

  • The report says that when the Service was inspected it did not have enough staff. However, since the inspection we have 167 additional frontline staff responding to incidents in London and over 200 staff are in training and under supervision while our recruitment campaign continues. More staff will help take some of the pressure from our work force, who work incredibly hard in often difficult circumstances.
  • While the Service is not meeting government targets, performance is improving and ambulance crews now reach 77 per cent of the most critically ill and injured patients within ten minutes.
  • The report says that the Service needs to improve staffing and culture. Dr Moore and her executive team recently met 900 people during staff road shows and the discussion and feedback from these sessions will influence programmes of work over the coming months.
  • CQC say that resilience is inadequate; however since the inspection in June, the Service has reviewed its major incident plan and is confident it can respond to a Paris style attack in London. It regularly tests its major incident response with London’s emergency services and NHS partners and recently took part in Exercise Strong Tower with 120 ambulance staff over two days.
  • The reports says that some of the Service’s vehicles are not up to standard but it has recently invested £14m on 104 new ambulances to reduce break downs which result in vehicles being out of service. And the Service is expecting 60 new fast response cars to be delivered by March 2016.
  • CQC was critical of the Service’s medicine management arrangements, however since the inspection in June it has appointed a medicine safety officer and executive lead on the Trust Board.
  • And it gave the trust an inadequate rating for well led, but since the inspection in June the Service has new leadership teams in place that are resolutely determined to tackle the issues raised in this report and create a positive working environment for everyone.

Dr Moore said: “While we haven’t always got it right for our staff or responded quickly enough to the challenges we faced, we are beginning to see the benefits of many of the changes we have introduced. For example, we have more staff joining the service than leaving, our performance is improving and I have personally met 900 ambulance crews, control room and support staff recently during our road shows.”

As well as some areas of concern - the CQC report also highlights what the Service does well: For example:

  • that patients in London receive good clinical care
  • ambulance staff are caring and compassionate
  • Paramedics and nurses in our control room give good advice to frontline staff while the Service’s intelligence conveyance system prevents overload of ambulances at any one hospital.
  • In the event of a major incident the Service has clear systems and plans in place and an alert system for staff who have proved they are always keen to respond – even when not on duty.
  • The Service has effective systems to manage large scale events such as Notting Hill Carnival and the central London New Year’s Eve event.
  • And staff were positive about local leadership and said the management style of the new chief executive would improve the service and staff retention.

Dr Moore said: “We take being put in special measures seriously and value the additional support this will offer us. It will mean the progress we have already made will be accelerated.

“We’re pleased to have the opportunity to work with Defence Medical Services (DMS), which provides medical care to the armed forces. DMS recognises the complex operational challenges the Service faces and have offered their expertise to help us develop an education programme to address some of these issues.

“We will also work with the Trust Development Authority and our other partners to put processes in place to address the concerns raised in this report.”

- Ends -

Notes to editors:

  • London Ambulance Service receives 1.9 million emergency calls a year and responds to 1.1 million incidents in the capital.
  • On 2 December the CQC will present its findings to a local Quality Summit including NHS commissioners, providers, regulators and other public bodies.
  • In October 2015 our category A performance was 65 per cent compared to 57 per cent in the same period last year.
  • For further information about the London Ambulance Service or this news release please contact the communications department on 020 7783 2286.

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Video message from Dr Fionna Moore