Event Medical Services

Event Medical Services is operated by Event Medical Services Limited. The service provides event medical cover both locally and nationally, for example, for sporting and music events. This can include transporting patients from events to hospitals.

We inspected this service using our comprehensive inspection methodology. We carried out a short-notice announced inspection of urgent and emergency care, on 13 and 14 August 2019.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Event Medical Services provides services to patients taking part in or attending a sport or cultural event. These types of arrangements are exempt by law from CQC regulation. Therefore, at Event Medical Services the services provided to patients taking part in or attending a sport or cultural event were not inspected. Event Medical Services can also transport patients from events to hospitals. Arrangements to provide these services were inspected.

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.

This service was last inspected on 10 April 2019 using our responsive focussed inspection methodology which related to information of concern.

This was our first rating of this service. We rated it as Requires improvement overall.

We rated safe, effective and well-led as ‘requires improvement’ and responsive as ’good’. We did not rate the caring or responsive domains at this inspection. This was because we did not observe any patient, relative or carer interaction during inspection and there was limited data about service performance.

We found the following areas where the service provider needed to improve:

• We were concerned with the prescription, storage and monitoring of medicines. The provider did not have systems in place to ensure safe prescribing, monitoring and audit of medicines in line with their medicines policy.
• We were not assured the service had robust arrangements in place to ensure all staff were fit and proper for their role, with the right skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment.
  • Managers did not always check new staff were fit and proper for their role before starting employment. Record-keeping systems were not operated effectively.
  • Managers did not check all staff met mandatory training requirements to ensure a safe service was delivered. The service did not provide specific mandatory training for staff employed to work at events. There was no central system for oversight of events staff qualifications and registrations.
  • Managers did not follow up to check suitability and training of staff who were sub-contracted from other services. Assurance was sought, but not followed up.
  • There was no formal process to review performance of existing events staff.
  • There was no effective system of clinical audit to check staff and managers’ practice followed company policies and learning and improvement was identified. For example, in relation to patient records, outcomes, medicines management, safeguarding and vehicle cleanliness.
• Facilities for equipment storage were not well organised. Health and safety signage in the garage area was missing in some areas. Monitoring of vehicle cleaning and access to hand gel could be improved.
• New systems and processes introduced to address concerns identified at the previous responsive inspection were not yet fully operational and some actions were not yet complete, following the previous CQC comprehensive inspection.

We also identified the following areas of good practice:

• An electronic system had been introduced to record staff HR information and a review of gaps in information had begun.
• A more structured approach had been taken to management meetings which were now formally recorded.
• An online feedback form was available on the company website for patients to use.
• The ambulance vehicles we inspected were clean and well maintained.

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 issued the provider with four requirement notices relating to emergency and urgent care, Regulation 19 Fit and Proper Persons, Regulation 18 Staffing, Regulation 17 Governance, Regulation 12 Safe Care and treatment, for the purposes of a regulated activity of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Details are at the end of the report.

Ann Ford

Deputy Chief Inspector of Hospitals (North), on behalf of the Chief Inspector of Hospitals

Event Medical Services is operated by Event Medical Services Limited. The service provides emergency and urgent care at events, including for sporting and music events. Event Medical Services can also transport patients from events to hospitals.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC which relate to particular types of service and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Event Medical Services provides services to patients taking part in or attending a sport or cultural event. These types of arrangements are exempt by law from CQC regulation. Therefore, at Event Medical Services the services provided to patients taking part in or attending a sport or cultural event were not inspected.

Event Medical Services can also transport patients from events to hospitals. Arrangements to provide these services were inspected. We inspected this service using our comprehensive inspection methodology. We carried out a focused, unannounced inspection on 10 April 2019, following specific concerns identified.

Due to this being a focused inspection, we did not inspect all five domains (safe, effective, caring, responsive and well led) and we did not rate the service. We inspected the safe, effective and well-led domains, specifically key lines of enquiry relating to: mandatory training; safeguarding; cleanliness, infection control and hygiene; staffing; medicines; competent staff; culture within the service; governance; and management of risk, issues and performance.

We inspected the service’s headquarters, including the garage, storage areas and two ambulances. We reviewed staff files, training records, rotas, and company policies and procedures. We spoke with two of the company directors.

We found the following areas where the service provider needed to improve:

• The service did not have robust arrangements in place to ensure staff were fit and proper for their role, with the right skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment. Appropriate records were not kept and there was no process in place for managers to review performance of events staff.

• We were not fully assured the service had staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and to provide the right care and treatment. The service did not provide specific mandatory training for staff employed to work at events and managers did not always check all staff met mandatory training requirements to deliver a safe service.

• We were not assured that the safeguarding arrangements in place were effective or that safeguarding concerns were appropriately reported and referred.

• We were not assured the service systematically improved service quality and safeguarded high standards of care. We found the service had failed to comply with its own policies and some policies and records were insufficient.

• We were not assured that risks to the service, patients and staff, were properly identified, monitored and mitigated.

However we also found the following areas of good practice:

• The ambulance vehicles we inspected were clean and well maintained. The service controlled infection risk and had an infection prevention and control policy in place.

• The service had a medicines policy which it followed when giving, recording and storing medicines.

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 one requirement notice relating to emergency and urgent care, Regulation 19 Fit and Proper Persons, for the purposes of a regulated activity of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Details are at the end of the report.

Ann Ford

Interim Deputy Chief Inspector of Hospitals (North), on behalf of the Chief Inspector of Hospitals