Archived: Gloucester Event Medics

Updated 8 December 2017

Gloucester Event Medics starting trading in 2004. It is an independent ambulance service providing medical cover at public events, such as sporting events. The service primarily serves the community in Gloucestershire but also supports events in Worcestershire, Herefordshire, Wiltshire, Oxfordshire and Somerset. The registered manager is Steven Price, who is one of two directors of the company. The company is registered at the home address of the second director. However, due to a change in domestic circumstances, records had recently been moved to the home address of the registered manager. The service was last inspected in September 2013 and all of the quality and safety standards inspected were met at that time.

The service provides the following regulated activity:

Transport services, triage and medical advice provided remotely

We inspected the service on 1 October 2017. This was an announced visit.

Updated 8 December 2017

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 1 October 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.

Gloucester Event Medics primarily provides medical cover at public events, such as sporting events. This is outside the scope of regulation. However, the service may occasionally convey patients from an event site to the local hospital’s emergency department for treatment. This activity is within the scope of our regulation.

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 that the service provider need to improve:

• The service had reported no adverse incidents since it began trading in 2004. We were concerned that this may indicate a culture in which staff were not encouraged to report incidents or did not understand what constituted an incident. There were no incident report forms made available on ambulances and the incident reporting procedure did not state where these could be found.

• Arrangements for managing medicines were not sufficiently robust so as to provide assurance of safe practice. In particular, we were concerned about the lack of safeguards in relation to the management of controlled drugs.The registered manager showed a lack of understanding of the legislation surrounding the possession and supply of medicines and was not familiar with the company’s policy in this regard. The service did not hold a Home Office licence for the possession and supply of controlled drugs to healthcare professionals employed by the service.

• There were no systems in place to seek assurance or evidence from paramedics or their NHS employers that they were up to date with their mandatory training.

• Employment records were incomplete. There was an assumption that paramedics were suitably skilled because they were employed by the NHS. No DBS checks had been carried out and references had not been obtained in respect of their character or suitability for the role. The provider could not be assured on an ongoing basis that staff remained suitable to work with vulnerable people.

• There was insufficient assurance that staff had the skills, knowledge and experience to deliver effective care and treatment.There was an assumption that registered paramedics maintained their clinical skills during their NHS employment; no checks were made to ensure that they remained competent and up-to-date in their clinical practice.

• There were no clinical pathways, protocols or local guidelines available for staff.

• There was no formal supervision of clinical practice or audit of patient record forms to ensure that care, treatment and clinical outcomes were appropriate.

• The complaints procedure was not publicised either on the service’s website or on ambulances.

• Policies and procedures did not always accurately reflect working practices and appeared, in some cases, to be plagiarised from other services. Some policies contained inaccurate or out of date information.

• Governance processes described in the provider’s Operations Procedures were not operating as described. There were no effective quality assurance systems in place to monitor quality and safety.

• Recruitment procedures were not operated effectively or in accordance with the Human Resources Policy. This meant the provider was not assured of the suitability, skills, competence and experience of staff for the work they were required to perform.

We found the following areas of good practice:

• Vehicles and equipment we inspected were fit for purpose and mostly well maintained and visibly clean.

• Risks to patients were assessed and their safety monitored and maintained.

• Regular monthly training sessions took place for first aiders. These allowed volunteers to update and extend their skills and participate in reflective practice. However, no records were kept of these events.

• Staff assessed pain and had access to appropriate pain relief.

• All of the staff working for Gloucester Event Medics gave up their own time to support events. They displayed a genuine desire to help people in need.

• Feedback from patients was not routinely captured but a number of comments had been received via social media, which were positive.

• Volunteers were able to provide examples of care where they had ‘gone the extra mile’ when providing care’.

• While there were no specific tools available to assist staff to support vulnerable groups or patients with complex needs, staff demonstrated empathy and patience. They spoke thoughtfully about being accessible to people of all ages and backgrounds, and told us they adapted their style of communication to the individual needs of those requiring the service.

• Directors of the service were highly visible and frequently worked alongside staff. They were respected by staff, who described them as “highly professional” and “supportive”.

• The service had developed a mission statement and a set of values. Whilst staff were not familiar with the precise wording of these, they passionately articulated values which were important to them and which mirrored the organisation’s values; caring, team work and striving for excellence.

• The company’s directors were committed individuals who showed a genuine desire to continually improve their service and who saw our inspection as a positive learning experience.

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 four requirement notices that affected emergency and urgent care. Details are at the end of the report.

Amanda Stanford

Deputy Chief Inspector of Hospitals (south)