Archived: EMC Medical Services - Blewbury

Updated 5 May 2020

EMC Medical Services Blewbury is operated by EMC Medical Services Limited. The service opened in May 2011. It is an independent ambulance service in Blewbury, Oxfordshire. The service primarily serves the communities of Oxfordshire. The service provides planned patient transport services for adults over the age of 18 years, private organisations, privately funded patients and for some NHS acute trusts and NHS ambulance trusts.

EMC Medical Services Blewbury also provided medical cover on event sites. In England, the law makes event organisers responsible for ensuring safety is maintained at events. This meant event medical cover comes under the remit of the Health and Safety Executive. Therefore, we do not regulate services providing medical cover at events. However, the transport of patients from an event to hospital is a regulated activity.

We visited the service on 2 March 2020 and gave the provider 24 hours’ notice. This was the first inspection for the urgent and emergency care service. We completed a comprehensive inspection for both the urgent and emergency care and patient transport services.

The main service provided was patient transport services. Where our findings on patient transport services – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the patient transport service report.

We previously carried out a comprehensive inspection of EMC Medical Services Blewbury patient transport service in November 2018. Following that inspection, we issued the provider with a requirement notice:

• The registered person must ensure there is a system to assess, monitor and improve the quality and safety of the service provided and assess monitor and mitigate any risks.

Following this inspection, the above requirement notice had not been met and the service, while some information was gathered, did not have a comprehensive system to assess, monitor and improve the quality and safety of the service provided.

The service is registered to provide the following regulated activities:

• transport services, triage and medical advice provided remotely

• treatment of disease, disorder and injury

• diagnostic and screening procedures

The governance and management arrangements were the same across the emergency and urgent care and patient transport service.

At the time of inspection, the provider had been without a registered manager from October 2019 but there was an application in process. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage a service. Like registered providers, they are ‘registered persons. Registered persons have a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated regulations about how a service is managed.

Updated 5 May 2020

EMC Medical Services Blewbury is operated by EMC Medical Services Limited. The service predominantly provides patient transport services on an when required basis for local authorities, private patients and NHS trusts. EMC Medical Services Blewbury also provides event cover. However, we do not currently regulate event medical cover. A small proportion of the service’s activity was the transfer of patients from events sites to hospital. This activity is regulated by us.  We inspected this service using our comprehensive inspection methodology. We carried out the announced (24 hours’ notice) part of the inspection on 2 March 2020.

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 was patient transport services. Where our findings on patient transport services – for example, management arrangements – also apply to other services, we do not repeat the information but cross-refer to the patient transport service level.

We rated it as Requires improvement overall.

• There were limited governance systems to improve service quality and maintain high standards of care.

• The provider did not have an effective system in place to identify, limit and control clinical and non-clinical risks. The managers were able to identify several risks. However, there was limited evidence to demonstrate the managers identified all service risks including some we identified during our inspection.

• The recruitment records did not provide assurance that all staff had the required employment checks completed before they commenced work.

• Most staff understood how to protect patients from abuse. However, the managers were unsure of who the safeguarding lead was.

• Although medicines were stored securely, the patient group direction did not include pharmacist sign off and medicine storage temperatures were not monitored.

However:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The provider controlled infection risk well. Staff assessed risks to patients and acted on them.

• Managers made sure staff were competent for their roles.

• The service planned care to meet the needs of local people, took account of patients’ individual needs, and made it easy for people to give feedback. People could access the service when they needed it.

• Staff were focused on the needs of patients receiving care. The provider engaged well with patients and the community to plan and manage services and all staff were committed to improving services continually.

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 both patient transport and emergency and urgent care services. Details are at the end of the report.

Nigel Acheson

Deputy Chief Inspector of Hospitals (London and South) on behalf of the Chief Inspector of Hospitals

Updated 5 May 2020

EMC Medical Services Blewbury provided patient transport services for a local NHS hospital and a local NHS ambulance trust. They also provided privately funded transfers.

We rated this service as requires improvement overall because it required improvement in  safe and well led and was good in effective, caring, and responsive.

Updated 5 May 2020

Urgent and emergency services were a small proportion of activity. The main service was patient transport services. Where arrangements were the same, we have reported findings in the patient transport services section.

EMC Medical Services Blewbury is an independent ambulance service who transferred patients off event sites when required. The service primarily serves the community of Oxfordshire.

The service had no formal contractual or service level agreements but worked with both NHS ambulances and NHS Trusts.

We rated this service as requires improvement overall because it required improvement in safe and well led and was good in responsive. We did not have enough evidence to rate effective and caring.