Patient care delayed after ‘failures’ at South East Coast Ambulance Service

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An ambulance trust has been criticised for a ‘poorly managed’ project, which increased the time patients waited for ambulances.

The health sector regulator Monitor has taken action at South East Coast Ambulance Service (SECAmb), which ran a project that increased how long some patients were waiting for ambulances, without giving ‘sufficient consideration to the impact on patient safety or fully informing the trust board’.

The project was run between December 2014 and February 2015 and was launched during the busy winter period.

A spokesman for monitor said: “The trust changed how it handled some NHS 111 calls which were transferred to the 999 emergency system to give itself additional time to deal with more urgent calls.

“The project applied this extra time to calls which were placed in the second most serious category. These are for issues which may be life threatening but less time-critical.”

Paul Streat, regional director at Monitor, said: “Over the winter, there were significant demands on the NHS and it is understandable that trusts want to explore better ways of delivering the best possible care. But this project was poorly managed from the start, done without the proper authorisation and without enough thought given to how it might affect patients.

“We have asked the trust to review the action it took to make sure there was no harm to patients, and look again at the way decisions are taken to prevent something like this happening again.”

Under national standards, ambulance trusts must deal with 75 per cent of these calls within eight minutes.

But under the project, the trust gave itself up to ten extra minutes to re-assess what type of advice or treatment patients needed, and whether an ambulance was really required.

A spokesman for monitor said: “There was a clear failure of management processes, and it also appears that the trust’s Board was not fully aware of these changes.

“As a result, Monitor has concerns about how the trust is being run and how decisions are being taken. It has reasonable grounds to suspect that the trust is in breach of its licence to provide NHS services.”

The regulator is working with the trust to identify what needs to be done to review the impact this project could have had on patients.

The trust will also commission a review into the way it handled this project and more widely into the way it makes decisions.

Monitor has also added a condition to the trust’s licence so that, if sufficient progress isn’t made, further action could be taken. This includes changing the leadership team at the trust, if necessary.

South East Coast Ambulance Service NHS Foundation Trust (SECAmb) said it has welcomed Monitor’s engagement with the Trust regarding the handling of certain NHS 111 calls in our emergency 999 control centres.

Chief Executive, Paul Sutton said: “The process was undertaken to ensure that the right response was provided to patients and that we were able to respond promptly to the most seriously ill patients.”

“However we recognise that it was not well implemented and we did not use our own corporate governance processes correctly. These are serious findings.

“We have already begun to take steps to address Monitor’s concerns and as part of this process, independent reviews will assess how decisions are made within the Trust, governance processes and our approach to patient safety.

“As a trust, we remain extremely proud of the high quality and compassionate clinical services that SECAmb provides to our patients.”

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