Pivotal role and customised CQC inspections on the way, IAA conference told “Ambulances central to radical changes in urgent care”

Thursday, 03 April, 2014



The audience of 80 delegates at the second IAA second annual conference in London on 2 April were given 3 clear messages by the influential platform of speakers from the NHS and regulatory bodies:

  • There will be a pivotal role for the independent ambulance sector in the new-look urgent care services;
  • Opportunities will exist for partnerships because the NHS ambulance providers will need help;
  • The new CQC inspection regime being introduced next year will be more robust and customised specifically for ambulance services.

Professor Jonathan Benger, National Clinical Director for Urgent Care, NHS England, who is a member of the Keogh Review, said that the new system will see an increased provision of care over the phone, at scene and in the community, with transport to A&E the exception rather than the rule. This will require an increase in community provision, free flow of information, joined up work with social care, enhanced clinical support and workforce development.

A range of new opportunities will exist for independent ambulance services in the new system, ranging from the support of new models of care to urgent transportation to transfer and retrieval for the most seriously ill and injured patients.

He added: “There is an appetite for change within Government and all those engaged in the review. Ambulance services are central to the changes which will be radical and there will be a pivotal role for the independent ambulance sector”.

Mark Docherty, Lead Commissioner, London Ambulance Service, said that CCG’s were in the driving seat of the changes but there were massive challenges ahead.

He acknowledged that NHS ambulance providers on their own would be unlikely to be able to solve all the urge changes.

“They will need help and the independent providers should take the opportunity to step forward….partnerships are likely and relationships are key.”

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Mark Pawsey, Conservative MP for Rugby, one of the few politician to have visited an independent ambulance service, said it was clear the sector had a bright future and was poised to contribute to a modern ambulance service but he gave delegates 3 pieces of advice:

  1. Demonstrate the add-on value you bring to the nation’s healthcare service;
  2. Deliver a good service at a fair price to overcome any suspicion that you are not as good nor as professional as the public sector;
  3. Urge your members to invite their local MPs to visit their companies to get first-hand what for most will be an understanding of a private ambulance service and the role it plays in the local community.

Sir Mike Richards, the CQC Inspector of Hospitals, outlined for the first time how the new inspection regime will be customised for ambulance providers, based on 5 questions:

Is the service safe?

  • Clean?
  • Safe equipment?
  • Well maintained fleet?
  • Safe medicines management?
  • Safeguarding?
  • Learning from incidents?
  • Staff training in safe practices?
  • Clinicians maintaining essential skills?

Is the service effective?

  • Appropriate assessment?
  • Correct diagnosis?
  • Evidence-based care pathways?
  • Audits of services, treatment and destination?
  • National comparisons of quality standards (where feasible)?

Is the service caring?

  • Are patients treated with dignity, respect and compassion?
  • Are families and friends treated with dignity, respect and compassion
  • How is feedback from patients and carers gathered

Is the service responsive to patients’ needs?

  • Timely responses
  • Appropriate information sharing
  • Management of specific groups of patients (e.g. vulnerable; patients with dementia; patients with mental health problems)
  • Gathering and responding to complaints

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Is the service well led?

  • Vision and strategy?
  • Culture?
  • Governance arrangements?
  • Leadership?
  • Learning from good practice
  • Integration with other providers


He told delegates: “We want to work with the independent sector to produce a robust, fair and effective approach to inspections and ratings for ambulance services.”

Dr Anthony Marsh, Chair, The Association of Ambulance Chief Executives and Chief Executive of West Midlands Ambulance Service NHS Foundation Trust addressed the issue of improving patient experience. He said that the review provided the opportunity to prepare staff for change in three specific areas – the introduction of a national standard for clinical training based on quality, innovation and improvement, embracing the new CQC inspection regime and more focus on technology, covering data tracking, mobile data terminals, patient care records, modern equipment and vehicles.

Other speakers at the conference included Dr Rekha Elaswarapu, Senior Policy Adviser and Research Manager, The Patients Association, Professor Ric Marshall, Director of Pricing for NHS England, currently attached to Monitor, Andrew Foster, Chief Executive Officer, Wrightington, Wigan and Leigh NHS Foundation Trust, and Dr Andrew Carson, GP & Medical Director, West Midlands Ambulance Services, NHS Foundation Trust.

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