Delay in hospital handover cited as cause of CQC downgrading of ambulance service

Delay in hospital handover cited as cause of CQC downgrading of ambulance service (Image: Newsquest)

Delays in handovers meant patients were forced to wait outside hospitals for ambulances, contributing to West Midlands Ambulance Service losing its excellent rating with the CQC.

The Care Quality Commission today (Friday 23 February) published its report on the post-inspection findings in August and October 2023, giving the trust an overall rating of Good.

Inspectors looked into how well the trust’s emergency operations center (EOC), its frontline emergency operations and the trust as a whole was being directed as part of the CQC’s regular inspections of safety and health services.

The overall rating for the emergency operations center improved from ‘good’ to ‘outstanding’, but the overall rating for emergency medical services decreased from ‘outstanding’ to ‘good’, indicating that the service was effective. The rating for whether there is or not has plummeted from “excellent” to “requires improvement.”

Charlotte Rudge, CQC Midland Deputy Director of Operations, said: “We found that our leaders had the skills, knowledge and experience to run the service successfully.

“However, external challenges across the health system meant that handover delays at hospitals meant ambulances were queuing for hours in accident and emergency departments, impacting on people’s care and health.

“This has resulted in longer response times for people calling ambulances and has had a negative impact on staff who were doing their best to provide people with safe care and treatment.

“We found that this trust is working hard to improve its culture so that people who use services, their families and staff can raise concerns without fear. Improvements have been made and people are now able to speak freely about guardianship services. However, during inspections, some staff said they still felt like they could not speak up or be heard. They do not have an open culture. We know that services have a negative impact on people’s care, so trusts must continue to address this issue.”

The trust’s two emergency operations centers said the service was “the best in the country for responding to 999 calls” and inspectors said: “Staff are concerned that the situation is causing serious harm to people’s health and the mental health of those close to them.” I understand that this is having a negative impact, and I feel relieved, especially in an emergency.” Service was experiencing delays. ”

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Inspectors found the trust was treating around 18% of its clinical team by telephone, which was 5% higher than the England average. We also found that the service generally manages safety incidents well, with staff recognizing and reporting incidents and near misses appropriately. And when issues arose, staff apologized and provided people with honest information and appropriate support.

However, inspectors also identified areas of governance where the trust had not demonstrated learning when problems arose. In addition to the decline in overall ratings, ratings for Effective, Responsive and Appropriate Instruction were downgraded from “outstanding” to “good”, while Trust was re-rated as “good” for being safe. It has been re-rated as “excellent” for being acclaimed and considerate.

Anthony Marsh, chief executive of the trust, said: “The overall rating has dropped from ‘outstanding’ to ‘good’, which is disappointing given the hard work our staff work every day. I am pleased that inspectors continue to believe that the area of ​​compassion remains outstanding.

“Furthermore, inspectors currently rate our emergency operations center as excellent, the only one in the nation. As noted in the report, we have the best call response capabilities in the nation. , treats more patients over the phone than any other trust.

“However, the biggest change noted by inspectors was in our effectiveness, which has fallen from outstanding to requiring improvement.” We have made it very clear that these delays have resulted in our crews being stuck outside the hospital for hours, unable to serve patients in the region. It has also been pointed out that it has a significant negative impact on health.

“There is much to be proud of, given that this test took place during perhaps the most difficult period in the NHS’s history.”

He said the report recognized the work that had been done to ensure staff felt they had a voice and that colleagues treated each other with respect, adding: “CQC has confirmed that our “While we are pleased to note progress, we absolutely acknowledge that there is more work to be done,” he added. If it’s not done. “

The CQC said it would continue to monitor the trust, including through further inspections, to ensure improvements were made.