The Care Quality Commission
  • Ambulance service

Pro Medicus

Overall: Requires improvement read more about inspection ratings

Unit 21, Thrales End Farm, Thrales End Lane, Harpenden, Hertfordshire, AL5 3NS (01582) 969313

Provided and run by:
Promedicus Limited

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

We issued 2 warning notices to Promedicus Ltd on 2 February 2024 for failing to meet the regulations relating to good governance and safe care and treatment at Pro Medicus.

All Inspections

During an assessment of Emergency and urgent care

Pro Medicus is a private ambulance service based in Harpenden, Hertfordshire. It was formed 20 years ago and has 13 vehicles designed for emergencies, patient transport and medical event journeys. The company has a contract with the local NHS ambulance trust to respond to 999 calls. It also has an arrangement with a local hospital trust to provide patient transport services. We carried out this assessment because we received information giving us concerns about the safety and quality of the services provided. We carried out a short-notice announced site visit on 11 January 2024. We also carried out an unannounced follow-up site visit on 22 January 2024. We rated the service as requires improvement because: The service did not always use effective systems and processes to store medicines. The service did not control infection risk well. There were not always effective arrangements to monitor the safety and upkeep of the equipment within vehicles. The service did not manage patient safety incidents well. Leaders did not always demonstrate the skills and abilities to run the service. Leaders did not operate effective processes for governance, information management and the management of risk, issues and performance. Policies were generic and did not reflect up-to-date national guidance. However: Staff had robust recruitment processes, with up-to-date mandatory training and additional training to work with the patient group. During our assessment, we found concerns which resulted in a breach of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings.

During an assessment of Patient transport services

Pro Medicus is a private ambulance service based in Harpenden, Hertfordshire. It was formed 20 years ago and has 13 vehicles designed for emergencies, patient transport and medical event journeys. The company has a contract with the local NHS ambulance trust to respond to 999 calls. It also has an arrangement with a local hospital trust to provide patient transport services. We carried out this assessment because we received information giving us concerns about the safety and quality of the services provided. We carried out a short-notice announced site visit on 11 January 2024. We also carried out an unannounced follow-up site visit on 22 January 2024. We rated the service as requires improvement because: Medical gases were not always being stored in line with best practice. The service did not control infection risk well. Vehicles and equipment were not always well-maintained and there were not always effective arrangements to monitor the safety and upkeep of the equipment and vehicles. The service did not manage patient safety incidents well. Leaders did not always demonstrate the skills and abilities to run the service. Leaders did not operate effective processes for governance, information management and the management of risk, issues and performance. Policies were generic and did not reflect up-to-date national guidance. However: Staff had robust recruitment processes, with up-to-date mandatory training and additional training to work with the patient group. During our assessment, we found concerns which resulted in a breach of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings.

During an assessment of the hospital overall

Pro Medicus is a private ambulance service based in Harpenden, Hertfordshire. It was formed 20 years ago and has a total of 13 vehicles, 8 of which are ambulances designed for emergencies, patient transport and medical event journeys. The company has an ad-hoc contract with the local NHS ambulance trust to respond to 999 calls. It also has an arrangement with a local hospital trust to provide patient transport services. We carried out this assessment because we received information giving us concerns about the safety and quality of the services provided. We carried out a short-notice announced site visit on 11 January 2024. We also carried out an unannounced follow-up site visit on 22 January 2024. We rated the service as requires improvement because: The service did not always use effective systems and processes to store medicines. The service did not control infection risk well. Vehicles and equipment were not always well-maintained and there were not always effective arrangements to monitor the safety and upkeep of the equipment and vehicles. The service did not manage patient safety incidents well. Leaders did not always demonstrate the skills and abilities to run the service. Leaders did not operate effective processes for governance, information management and the management of risk, issues and performance. Policies were generic and did not reflect up-to-date national guidance. However: Staff had robust recruitment processes, with up-to-date mandatory training and additional training to work with the patient group. During our assessment, we found concerns which resulted in a breach of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings.

13 September 2022

During a routine inspection

We rated the service as requires improvement because:

  • The service did not control infection risks well. There was a lack of reporting of safety incidents. Lessons learned from incidents were not shared with staff. Safety information was not always reliable and some equipment was worn or damaged. Medicines were not stored correctly.
  • Leaders did not always understand or manage the priorities and issues the service faced. Governance processes and risk management processes were not effective.

However:

  • The service mostly had enough staff to care for patients and keep them safe. Staff had training in key skills and understood how to protect patients from abuse. They assessed risks to patients, acted on them and kept good care records.
  • Staff provided good care and treatment. The service mostly met agreed response times. Staff worked well together for the benefit of patients and supported them to make decisions about their care.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
  • The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. Most people could access the service when they needed it and did not have to wait too long for treatment.
  • Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients and the community to plan and manage services.

5 December 2017

During a routine inspection

Pro Medicus Limited is an independent ambulance service. The service provides patient transport for private patients or healthcare providers within Hertfordshire and surrounding area. We inspected this service using our comprehensive inspection methodology. We carried out an announced inspection on 5 December 2017.

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? Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we do not rate

We regulate independent ambulance services but we do not currently have a legal duty to rate them. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

We found the following areas of good practice:

  • The service had processes and systems in place to keep patients and staff safe from avoidable harm. This included a process for reporting incidents and effective cleaning regimes.

  • Medicines were stored appropriately and securely with only necessary staff being able to access them.

  • Systems were in place to monitor the administration and disposal of medicines.

  • Staff files were up-to-date and contained necessary documentation to ensure they were suitable for their role. A policy was in place regarding pre-employment checks and was being followed.

  • Patient records had detailed risk assessments and were legible. Identifiable information was stored securely.

  • Records were securely stored in locked cupboards.

  • There was evidence of an induction process for new staff.

  • Effective safeguarding adults and children procedures were in place and were understood by staff.

  • There was a fire safety risk assessment for the premises and a policy that gave guidance for all staff in terms of managing fire safety on vehicles.

However, we also found the following issues that the service provider needs to improve:

  • Audits were not consistently undertaken and therefore learning did not take place from review of procedures and practice.

  • The service had no risk register, which meant there was no system in place to demonstrate risks had been identified and actions taken to mitigate risks.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with three requirement notices that affected the patient transport service. Details are at the end of the report.

Heidi Smoult

Deputy Chief Inspector of Hospitals (Central Region)

On behalf of the Chief Inspector of Hospitals.