The Care Quality Commission (CQC) has rated West Midlands Ambulance Service University NHS Foundation Trust good overall following an inspection in August and October.
West Midlands Ambulance Service University NHS Foundation Trust provides an emergency ambulance service to a population of around 5.6 million people from 15 operational hubs across Shropshire, Staffordshire, Herefordshire, Worcestershire, and Warwickshire.
The inspection looked at two core services: the urgent and emergency care service and the emergency operations centre (EOC) service, as well as how well-led the trust was overall. It was carried out as part of CQC’s continual checks on the safety and quality of healthcare services.
Following this inspection:
- Urgent and emergency care service - The overall rating has changed from outstanding to good, as have the ratings for being responsive and well-led. Effective has dropped from outstanding to requires improvement. It has again been rated good for being safe, and caring was again rated outstanding
- Emergency operations centre (EOC) service - The overall rating has improved from good to outstanding, as has the rating for being effective. Well-led has again been re-rated as outstanding. It has again been rated good for being safe, caring and responsive.
As well as the trust’s overall rating changing from outstanding to good, as have the ratings for being effective, responsive and well-led. It has again been rated good for being safe. It has been re-rated outstanding for being caring.
Charlotte Rudge, CQC deputy director of operations in the midlands, said:
“When we inspected West Midlands Ambulance Service University NHS Foundation Trust, we found leaders had the skills, knowledge and experience to run services well. However, external challenges across the healthcare system meant that ambulances were queuing for hours at accident and emergency departments due to handover delays at hospitals, which impacted on people’s care and wellbeing.
“This resulted in longer response times for people calling an ambulance, it also had a negative effect on staff, who were doing their best to provide safe care and treatment to people.
“We found the trust was working hard to improve its culture, so people using the service, their families and staff could raise concerns without fear. The trust had improved staff wellbeing and freedom to speak up guardian services. However, during the inspection, some staff told us they still felt unable to speak up and be listened to. The trust must continue to address this issue, as we know services which don’t have an open culture, has a negative impact on people’s care.
“In the trust’s two emergency operations centres, the service was the best in the country for answering 999 calls. Also, it was reassuring to hear that when we were listening into emergency operations centre calls, staff understood the emotional impact the situation had on people’s wellbeing and on those close to them, particularly when the service was experiencing delays. They were well trained and responded in a professional way to help people receive the care they needed.
“We will continue to monitor the trust, including through future inspections, to ensure the necessary improvements are made so people are safe and can continue to receive a good standard of care.”
Inspectors found:
- Leaders had the skills and abilities to run the service and were visible and approachable
- The trust worked closely with partner organisations, such as other emergency services, the integrated care boards, local authorities, and the NHS, to help improve services for people and the community
- Staff understood how to recognise and protect people from abuse and the service worked well with other agencies to do so
- The trust was treating around 18 per cent of people with clinical teams over the phone. This was around 5 per cent higher than the England average
- In frontline services, the trust’s retention strategy meant the service was fully staffed and there was no use of agency or bank staff
- The service usually managed safety incidents well. Staff recognised and reported incidents and near misses and reported them appropriately. When things went wrong, staff apologised and gave people honest information and suitable support
- Staff supported and involved people using the service, families and carers to understand their condition and make decisions about their care and treatment.
However:
- There were areas of governance in the trust which did not demonstrate learning when things went wrong.