Heart Medical HQ

Updated 24 February 2020

Heart Medical HQ is operated by Heart Medical Limited. The service opened in 2016. It is an independent ambulance service in Ossett, West Yorkshire. The service primarily serves the communities of North East and North-West England.

We first visited this provider in March 2019, due to several concerns raised with CQC about the cleanliness of vehicles and the culture within the service. Following this inspection, we carried out urgent enforcement action and served a notice under Section 31 of the Health and Social Care Act 2008 to suspend the registration of the service provider in respect of the regulated activities: Transport services, triage and medical advice provided remotely and treatment of disease, disorder or injury. We took this action because we believed that a person would or could have been exposed to the risk of harm if we did not take that action. Following the action, the service was not allowed to carry out any regulated activity until they had improved.

We undertook two further visits to the location, in May and June 2019. At the May 2019 inspection, we did not receive assurance that services had improved sufficiently, and the provider agreed to voluntarily suspend regulated activity. At the June 2019 inspection we received adequate assurance and the provider was able to provide regulated activities again.

The provider submitted an action in relation to the five requirement notices following the June 2019 inspection. The providers response to the requirement notices is included in this report.

The service has had a registered manager in post since July 2016.

Updated 24 February 2020

Heart Medical HQ is operated by Heart Medical Limited. The service is registered to provide a patient transport service and urgent and emergency care.

The service provided medical and first aid support at events and worked on behalf of insurance companies in relation to medical repatriations. Both these services are not activities regulated by CQC and were not inspected, however, the transfer of urgent and emergency care patients to hospital from events is regulated and this element was inspected.

At the time of the inspection Heart Medical HQ was not commissioned or contracted to provide patient transport services for any commissioners, NHS or private health providers. Patient transport services were provided on an as required basis for a local NHS hospital trust. The provider was also registered with an external company which was a digital market place where independent ambulance companies could bid for patient transport work.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced part of the inspection on 10 December 2019.

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.

We rated this service as Requires improvement overall because;

• The provider did not use patient record forms for patient transport patients.

• Staff did not complete and update risk assessments for each patient, removing or minimising risks because they were totally reliant upon the risk assessment carried out by the provider requesting the patient transport.

• Staff did not keep detailed records of patients’ care and treatment as they used patient booking forms which contained patient details supplied by the provider requesting the patient transport.

• The provider did not carry out any hand hygiene audits of staff.

• The provider did not have an audit process for reviewing patient record forms for patients transferred from an event to hospital.

• The providers safeguarding policy did not have any reference to the current 2018 intercollegiate guidance.

• The provider did not have a patient eligibility criteria policy, so we could not evidence if staff had the correct level of training to deal with the level of acuity of the patient transported.

• There were limited opportunities for staff to learn from the performance of the service or the standards of care provided because the service did not have key performance indicators or used patient record forms.

• It was not clear at which meeting the information from the risk register was discussed at or for how long the risks had been active.

• The risk register was not a standard agenda item on the provider’s monthly quality report.

• There was no evidence the business continuity had been tested either in response to an incident or by way of an exercise.

However, we did find the following good practice;

• All staff were up to date with statutory, mandatory and safeguarding training.

• There was evidence of regular vehicle deep cleans and infection prevention control audits.

• The provider adhered to the national patient safety (2016) colour coding systems.

• Medical gases were stored in accordance with health and safety executive legislation 1998.

• We saw evidence staff who had worked for the company for over a year had an annual appraisal and those who had not were booked to receive one in January 2020.

• We saw evidence of disclosure and barring service checks for staff and when DBS re-checks would be done.

• The provider published a quarterly quality report which was shared with staff which covered incidents, records, infection prevention control and any other business.

Following this inspection, we told the provider that it should make seven improvements and must make four other improvements to help the service improve. The provider was issued with one requirement notice. Details are at the end of the report.

Ann Ford

Deputy Chief Inspector of Hospitals (area of responsibility), on behalf of the Chief Inspector of Hospitals

Updated 24 February 2020

Patient transport services (PTS) was the main regulated activity carried out by the provider. At the time of this inspection patient transport services were provided on an as required basis for a local NHS hospital trust. The provider was also registered with an external company which is a digital market place where independent ambulance companies could bid for work.

In the reporting period April 2019 to November 2019 there were 88 patient transport journeys undertaken, five of which were informal patients with mental ill health.

All the patient transports were adults. There were no patients aged under 18 years transported in the reporting period.

Updated 24 February 2020

The transfer of urgent and emergency care patients to hospital were all from events.

In the reporting period April 2019 to November 2019 there were four emergency and urgent care patient journeys undertaken.

All the patient transports were adults. There were no patients aged under 18 years transported in the reporting period.