Archived: St John Ambulance East of England Region Also known as East of England Region

Updated 15 February 2018

St John Ambulance East of England Region is operated by St. John Ambulance. The service opened in 2012. It is an independent ambulance service based in Chelmsford, Essex. The service primarily serves the communities of Essex, Suffolk, Norfolk, and Cambridgeshire.

The service has had a registered manager in post since 2012.

Updated 15 February 2018

St John Ambulance East of England Region is operated by St. John Ambulance. The service provides patient transport services.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 31 October 2017, along with an unannounced visit to an organised event supported by the service on 3 November 2017.

St John Ambulance East of England Region is part of St John Ambulance, a national first aid charity. St John Ambulance provides a number of services including first aid at organised events for example firework displays and professional football matches, emergency and non-emergency PTS, and first aid training. St John Ambulance East of England Region uses a blend of employees and volunteer staff. The objective of the organisation nationally is the relief of sickness and the protection and preservation of public health.

St John Ambulance East of England Region provides ambulance services across a number of counties in the East of England Region, through a contract with a local NHS ambulance trust. The service also provides an Acute Neonatal Transfer Service (ANTS), commissioned through a local hospital trust. St John Ambulance East of England Region provides first aid at organised events in the local area. Events are not within our scope of regulation and we do not inspect events. However, at some events, the provider transfers patients from an event for further medical treatment. Patient transport falls into our scope of regulation and thus require inspection.

During our inspection, we visited three ambulance stations (Chelmsford, Ipswich, and Cambridge) as well as the ANTS at a local NHS hospital. We also attended one organised event where St John Ambulance East of England Region staff provided cover.

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.

The main service provided by this service was Patient Transport Services (PTS).

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 of good practice:

• Vehicles and ambulance stations were visibly clean and tidy, with evidence of regular deep cleaning of vehicles.
• Servicing routines, Ministry of Transport (MoT) and insurance for ambulances were all up to date.
• Staff knew how to report incidents. The provider had a system in place to report incidents, and made changes because of incident reviews.
• Staff demonstrated a good understanding of their responsibilities around safeguarding.
• Staff carried out structured patient assessments and clinical observations, appropriate for their level of competence.
• Staff followed evidence-based care and treatment and nationally recognised best practice guidance. All staff had access to the Joint Royal College Ambulance Liaison Committee (JRCALC) guidelines 2016.
• The majority of staff within the organisation had received a recent appraisal.
• All staff received training on the Mental Capacity Act and the Deprivation of Liberty Safeguards as part of their induction. During our inspection staff asked patients for consent before starting treatment.
• St John Ambulance had recently launched the national continuing professional development (CPD) portfolio to ensure staff had up to date skills and knowledge to carry out their roles effectively.
• We observed good multidisciplinary working between ambulance staff and other NHS staff when treating patients. We noted good co-ordinated care and transfer arrangements when handing the care over to NHS staff.
• Staff showed compassion, kindness, empathy and treated patients with dignity and respect throughout their treatment or care
• Staff had access to translation services for patients who may not speak English as their first language.
• The provider had a national vision, strategy, and values, which most staff were aware of and shared.
• The provider had a publicly accessible website, which contained information for the public including details of services offered and how to make a complaint.

However, we also found the following issues that the service provider needs to improve:

• Staff did not complete safeguarding training to required levels.
• Audits and reviews of patient journeys did not take place for one of the NHS services.

Following this inspection, we told the provider that they should take some actions even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Heidi Smoult

Deputy Chief Inspector of Hospitals, on behalf of the Chief Inspector of Hospitals

Updated 15 February 2018

We have only inspected and reported on patient transport services (PTS) provided at St John Ambulance East of England Region. Urgent and emergency care services were a very small ad-hoc proportion of the activity of this provider therefore we have not reported on it as a separate core service.

We have not rated this service, as we currently do not have the legal duty to rate independent ambulance services. However, we found:

• Staff knew how to report incidents, the provider shared learning from these incidents with staff.
• Vehicles we inspected were visibly clean and serviced appropriately; equipment was serviced and appropriate for patient use.
• Staff assessed patient needs appropriately and care planning took into account individual needs and choices wherever possible.
• Staff supported patients in caring and respectful ways at all times and involved them in their care.
• Staff valued local leaders and felt part of a team working towards putting the patient first.

However,

• Staff did not complete safeguarding training to satisfactory levels.
• The service did not audit or review patient journeys for one of the NHS trusts to whom they provided services.