Care Quality Commission

Health and social care regulator Care Quality Commission (CQC) carried out a week long inspection of North West Ambulance Service (NWAS) NHS Trust in May 2016.

This was the first CQC inspection of NWAS to be rated and the Trust was pleased to receive a rating of ‘good’ in relation to care but was disappointed to receive an overall rating of ‘requires improvement’. Ratings were also provided for each of NWAS’ core functions and found that the Trust’s NHS 111, patient transport services and emergency operations centres were ‘good’, however, the emergency and urgent care service ‘requires improvement’.

The inspection

A week long assessment of the quality of the services provided by the Trust took place in May 2016. The team included two CQC Inspection Managers, 11 CQC inspectors, an analyst, inspector planner, two assistant inspectors and a variety of specialists.

Prior to the announced inspection, CQC reviewed a range of information that it held and asked other organisations to share what they knew about the Trust.  Interviews also took place with staff and patients. CQC also observed how people were cared for, talked to carers and/or family members, and reviewed patients’ records of personal care and treatment.

On inspecting NWAS and the services it provides, CQC asked; is it safe, effective, caring, responsive to people’s needs and well-led? 

Key findings

Ratings were also provided for each of NWAS’ core functions and found that the Trust’s NHS 111, patient transport services and emergency operations centres were ‘good’, however, the emergency and urgent care service ‘requires improvement’.

Service Ratings

In terms of quality, the ratings for care, responsiveness and effectiveness were ‘good’, whilst other areas of quality that were inspected were rated as ‘requires improvement’

Quality ratings:

CQC Quality Rating

Unfortunately, this means that the Trust has received an overall rating of ‘requires improvement’ which is disappointing.

Outstanding practice was noted in other areas, including the delivery of the Trust’s Hazardous Area Response Teams, the implementation of community care pathways and use of new technology to map public defibrillator locations and sharing that information with control centres so they could be used to help patients in the community.

Many positive comments were provided by patients and relatives to CQC about the care and dedication of NWAS staff, who the report said were “exceptionally caring in their approach and went above and beyond their duty to provide compassionate, supportive care.”

NWAS’ response

The Trust accepts CQC’s report and welcomes its observations that NWAS puts safety and quality as its top priority.  The Board of Directors is pleased the Trust has been rated ‘good’ for caring and that its NHS 111 and patient transport services received ‘good’ ratings too, for being safe, caring and effective.

NWAS is proud of its compassionate, supportive and caring staff who frequently go the extra mile to help the people of the North West and the Trust is glad the CQC recognised that it operate a culture of support and continuous improvement and development.

NWAS accepts the comments in the report relating to improvements required for procedures, guidelines and training, however the inspection took place almost ten months ago and the majority of the points highlighted have already been addressed. For the remainder, we are working to a robust action plan which is being monitored by the Executive team. These relate to the Trust’s duty of candour and safeguarding of adults procedures and policies, together with the need to increase the recording and learning from incidents.

Significant developments have already been made in areas such as the recruitment of paramedics - a national issue not unique to NWAS. The Trust has improved in house training for existing EMTs to become Paramedics with a clear progression plan – 49 started the diploma programme with a further 77 on a clear progression route. An intensive recruitment drive has also resulted in the employment of 51 paramedics from Poland and Finland.

Patients and the quality of their care are at the centre of everything NWAS does. The organisation is listening and responsive and will make the required improvements as it strives to become the best ambulance service in the country.

Read the full inspection report.