Archived: Falck (Bow)

Updated 2 July 2019

Falck (Bow) is an independent ambulance service operated by Falck Ambulance Service Ltd based in Bow, East London. The Bow station opened in 2011. It is the location of the organisation’s national head office and is the national operations centre for all of the provider's registered transport services at weekends. Falck Medical Services Ltd (Bow) operates 24 hours a day, 365 days a year.

Falck Medical Services Ltd (Bow) worked under contract with NHS ambulance trusts across Greater London and South East England to provide emergency and urgent ambulance services and with NHS hospital trusts across Greater London and South East England to provide PTS services. The service did not have contracts with any independent health providers.

Both the emergency and urgent care and PTS teams operated across an extensive and varied geographic area and served a diverse patient demographic.

Updated 2 July 2019

Falck Ambulance Service Ltd provides emergency and urgent care, including the transport of high-dependency patients and patient transport services for non-emergency patients. All services are provided to both adults and children. The service has been registered to provide transport services, triage and medical advice provided remotely since 2011.

Emergency and urgent care covers the assessment, treatment and care of patients at the scene by ambulance crews as well as transport to hospital. It includes high dependency and intensive care transport between hospitals or other care settings. Patient transport services (PTS) are the non-urgent and non-specialist services that transport patients between hospitals, the patients’ home and other places such as care homes.

We inspected this service using our comprehensive inspection methodology and visited the provider’s premises on 23 and 24 April 2019.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

During our inspection we spoke with 25 staff including; registered paramedics, patient transport drivers, administrators and management. We spoke with one patient. During our inspection, we reviewed ten sets of patient records. Before the inspection we reviewed information the public had shared with us through the CQC’s National Customer Service Centre and documents provided by the service.

Throughout the inspection, we took account of how the provider understood and complied with the Mental Capacity Act 2005.

The majority of the work carried out by the service was emergency and urgent care. However, PTS work formed a significant portion of the work. There were 25 emergency and urgent care vehicles in London and 301 patient transport vehicles. We have prepared reports for each service. However, where our findings on emergency and urgent care also apply to patient transport services, for example, management arrangements, we do not repeat the information but cross refer to the emergency and urgent care section of the report.

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

This was the first time we have rated this location. We rated it as Good overall:

• There was a high standard of safety performance. There was a positive and proactive incident reporting culture across the services. Incidents were reported through an electronic application, which allowed for the reporting of incidents whilst staff were on the road, allowing for a timely response where necessary.

• Vehicles were kept visibly clean and tidy. There were efficient systems in place to ensure that vehicles and equipment were kept in good working order.
• There were effective processes in place to safeguard patients from abuse. Staff had a clear understanding of their safeguarding responsibilities.
• Mandatory training rates were very high for both services, with 100% compliance in emergency medical services and 98% in patient transport services.
• The training team devised and delivered training informed by themes identified through incidents, complaints and concerns. In addition, elements of training for frontline staff were shared with the dispatch team, in order to improve their understanding of the issues faced by frontline staff.
• There was an electronic application which helped to ensure crews on the road were kept up to date with national and local guidelines and best practice.
• Staff understood the vision and values of the service. There were clear lines of career progression, and staff told us that they felt supported by the senior leadership team.
• Ambulance staff received training in the care and transportation of patients with specific individual needs, including those living with dementia or learning disabilities.

Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South East), on behalf of the Chief Inspector of Hospitals

Professor Sir Mike Richards

Chief Inspector of Hospitals

Updated 2 July 2019

Where arrangements were the same, we have reported findings in the urgent and emergency service section.

The patient transport services were provided under contract with NHS hospital trusts across Greater London and the South East.

Overall, we rated this service as good. There were appropriate policies and procedures in place to protect patients and staff were committed to patient care. There was a strong incident reporting culture and learning was shared across the provider as a whole.

Updated 2 July 2019

The service worked under contract with NHS ambulance trusts across Greater London and South East England to provide emergency and urgent ambulance services. Crews operated under the policies and procedures of the trust to which they were contracted.

The service had its own governance structure, however, a number of aspects of senior leadership and governance, for example HR were shared across both services.

Overall, we rated this service as good, a patients were kept safe from harm by staff adhering to best practice. There were clear governance structures in place to minimise the risk of harm. Incidents were well reported and learning from incidents was shared across the provider as a whole.