Archived: E-Zec Medical Transport - Staffordshire

Updated 24 October 2018

E-Zec Medical Transport - Staffordshire is operated by E-Zec Medical Transport Services Ltd. The service has been operating in North Staffordshire since August 2016 and South Staffordshire since October 2016. Two new contracts have been recently awarded; and commenced in June 2018 across both North and South Staffordshire. These are high dependency contracts which involves the transfer of critical and non-critical transfers of patients from one hospital to another; and the Community Health Care contract which transports patients who are being treated for mental health conditions on either a voluntary or involuntary basis.

The service subcontracted staff from two local independent ambulance services, and subcontracted taxi drivers and their vehicles from two local taxi firms to cover shortfalls and to meet the needs of the contract.

The service primarily serves the communities of Staffordshire. In order to be eligible to use the service, patients must be registered with a GP within Staffordshire. Patients must also meet certain criteria which means their medical condition and mobility means the patient requires patient transport services.

Carers and or escorts from the sending locations (such as a care home staff member) may also be accommodated on the journey with the patient, should the patient require this due to a physical or mental health condition; or have some other vulnerability.

The service can transport patients of any age; however, those patients under 16 years old must be accompanied by a responsible adult. In circumstances where a responsible adult was not available; for example an urgent high dependency transfer from one location to another; either a member of the hospital staff or a member of the road crew would act as a responsible adult as per the service’s policy on transporting children.

As well as local journeys, the service offers repatriation from other areas of the UK, assuming the patient meets the criteria set by the service.

We inspected the service on the 24 and 25 July 2018. The inspection was announced and we used our comprehensive inspection methodology for independent ambulance providers. We looked at the core service of patient transport services (PTS).

Updated 24 October 2018

E-Zec Medical Transport - Staffordshire is operated by E-Zec Medical Transport Services Ltd. The service provides routine and high-dependency patient transport services.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 24 and 25 July 2018.

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.

At the time of this inspection; we regulated this service but did not rate it. This is because we issued a provider information request to gain data prior to the inspection before 2 July 2018. Inspections where provider information requests are sent to independent ambulance services after 2 July 2018 will be rated.

We found the following issues that the service provider needs to improve:

• Vehicles checked were found to be unclean; patient areas were dusty; with spilt liquids on seats and stretchers. We saw unsecured clinical waste on vehicles and a dirty, stained patient blanket behind a folded chair. Vehicle cleanliness was not audited by local managers.

• Medicines stored on the bases were not temperature controlled or monitored. The service medicine management policy did not specify this requirement.

• Mandatory training levels were below 50%. The service did not have a structured plan with set actions to achieve compliance.

• Incidents were not always reported in line with the provider’s incident reporting policy.

• The service was underperforming in seven out of nine key performance indicators as of April 2018.

• Supervision and appraisal rates were poor; and the quality of appraisals was substandard.

• Staff morale was poor in areas; the culture of the service was one of fear to speak up. Staff team meetings were rare; and generally not formally recorded or structured.

• We found there was no overall service improvement plan. Learning from any feedback was not embedded and used to improve the service. Where ideas were generated; there were no formal action plans or objectives. Following the inspection; the provider gave us action plans for improving specific areas of business including renal patient key performance indicators.

• The risk register was outdated and missing key risks.

We found the following areas of good practice:

• Staff presented as passionate about their role in supporting patients; and were caring and respectful.

• Paramedic specific competencies were monitored and in date.

• Supervision and development of staff was being undertaken within the bookings team.

• The service sought to accept every booking made.

• Staff were aware of their safeguarding requirements; and had the means and knowledge to report concerns. Concerns were dealt with appropriately.

• Feedback from staff indicated that the new local managers structure was already making positive changes with regards to staff engagement.

• During the inspection we observed effective teamwork and communication between staff.

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. Details are at the end of the report.

Victoria Watkins