PARAMEDICS from West Midlands Ambulance Service (WMAS) have been praised for ‘working hard under sustained pressure’ amid rising response times and missed handover targets.
Inspectors from the Care Quality Commission (CQC) delivered the verdict following an inspection of services provided by the West Midlands Ambulance Service University NHS Foundation Trust in November.
Staff treated people with compassion and kindness, respected their privacy and dignity, especially when moving them long distances from an ambulance to the emergency department, according to inspectors.
Infection, prevention and control was good, and staff were ensuring equipment and personal hygiene were of a high standard
Communication and multi-disciplinary team working were good. Staff maintained a focus on patient care and shared information appropriately.
However, inspectors also found some senior leaders were often not available at busy times, and this led to lack of leadership support and some staff feeling disheartened about the prospect of improvement
Alternative pathways, to avoid taking people to hospital, were not always known to staff from outside the area said inspectors.
Communication to staff about processes, like sourcing nutrition for a patient waiting in an ambulance, was not clear to all staff, according to the report.
But the rise in both response times and delays in handing over patients once at hospital were of a concern to inspectors.
Sonia Brooks, CQC deputy director of operations in the Midlands, said “The delays in handing people over at hospitals meant ambulances and crews couldn’t be made available to attend other calls.
“These lengthy delays at hospitals increased risk to people, particularly those who had been lying on trolleys or stretchers in ambulances for long periods of time.
“Although ambulance staff were working hard to meet national targets, these handover delays were a reflection of what’s happening across the healthcare system nationally during these times of sustained pressure.
“However, people praised ambulance crews for their care and compassion, particularly during the lengthy waits at hospital.
“We will continue to monitor the trust closely, through future inspections, to ensure leaders are mitigating the risks of these issues and that people are receiving high quality care.”
IN REPONSE to the findings, West Midlands Ambulance Service said less than half of its patients were taken to Accident and Emergency.
Trust chiefs said ‘Ambulance Decision Areas’ has been set up in hospitals in Birmingham, Shropshire and Worcestershire.
Advanced paramedics and ambulance healthcare assistants take a handover from crews and start the patient’s treatment even before they get to A&E.
This frees up ambulance crews more quickly so that they can respond to patients in the community, according to the trust.
“We are pleased the CQC inspectors recognised the enormous lengths that our staff have gone to, to look after patients while they deal with excessive hospital handover delays,” a WMAS spokesperson said.
“As a Trust, we absolutely recognise the impact these delays have on the health and wellbeing of our staff as they do all they can to cope with these very difficult conditions.
“Sadly, as the report points out, we have seen some patients wait a very long time for ambulances to arrive as a result of the hospital delays with the resultant increased risk to patients both waiting for an ambulance and those left on ambulance stretchers for very long periods.
“The Trust has invested heavily in ensuring there is 24 hour support for staff on all of our hubs as well as improvements in the wellbeing support available such employing three mental wellbeing practitioners, dedicated peer to peer and online support.
“There has been a significant improvement since the turn of the year with delays reduced at hospitals across the region, which has allowed ambulances to get to patients more quickly than we have seen for many months.
“We will continue to work with the hospitals to find new ways of reducing the time that patients are left on ambulances so our crews can respond more quickly to patients in the community and save more lives.”
