Ambulance Trust criticised for safety failures

Managers at Staffordshire Ambulance Service NHS Trust took risks with the safety of patients, staff and volunteers, according to an investigation published by the Healthcare Commission. The investigation, covering the period April 2004 to June 2007, highlighted problems at the former Trust including the poor management of controlled drugs, “community first responders” (emergency ambulance volunteers) and an out-of-hours GP service.

The Commission pointed out that the Trust was a good performer in terms of response times for emergency calls. It was considered to be innovative in its introduction of new equipment and services and had good relationships with patients and the public. But the investigation found that these achievements were undermined by a culture and approach that did not prioritise safety and that put patients at risk.

The Commission stressed that West Midlands Ambulance Service NHS Trust (WMAS), which took over Staffordshire Ambulance Service NHS Trust in October 2007, has already made progress on addressing these issues.

Key findings included the fact that staff and volunteers were supplied with controlled drugs that they were not legally supposed to possess, such as the sedatives diazepam and midazolam. This practice was a potential risk to patients and volunteers, and has now been stopped.

Medicines in the Trust’s stations regularly went missing or were unaccounted for due to poor recording and monitoring. In addition, patients were sometimes given larger packs of controlled drugs than they needed and told to dispose of the excess themselves.

Furthermore, community first responders were allowed to drive at speed using blue lights and sirens without the necessary advanced driving training; doctors employed in the out-ofhours GP service were not always GPs, or were not approved by the relevant primary care Trusts; and delays in transferring patients from ambulances to A&E were not well managed.

On some occasions the Trust would threaten to put tents up in the car park of the hospital to receive the patients. A realistic solution for patients needs to be developed by the Trust and the hospitals working together.

Some ambulance staff told the Commission that previously they were threatened with disciplinary action over the issue of delays in A&E, over which they had no control. Staff were hard working and resourceful and did not always receive the necessary support from the Trust.

The Commission is calling on all ambulance Trusts to read the report and take note of the recommendations.


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