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Regulation and Inspection of Independent Ambulance Services: Care Quality Commission Update

Ellen Armistead, Deputy Chief Inspector of Hospitals and Lead for Ambulance Services at the Care Quality Commission today updated delegates at the Independent Ambulance Association National Conference on the development of regulation and inspection in this sector.

Ellen stated that the the first pilot inspections of the Independent Ambulance Sector will begin under Wave 1 in October 2015, with evaluation and revision of methodology in December 2015 and then a revised approach in January 2016, with shadow ratings in Wave 2 and the publication of the handbook in April 2016.

Ellen said that as a Commission they need to understand exactly what the sector is delivering, where the higher risk areas are and where the examples of outstanding practice are that should be celebrated. The Wave 1 sites will be a mix of larger organisations, high risk independent providers, low risk providers and people thare arent currently on the CQC radar as well. Ellen urged services that if they feel something isnt right not to wait for CQC to tell you that but to do something about it now for the sake of service users.

There was discussion as to whether the model was unfair to smaller organisations however Ellen stated that there is not a greater burden on a smaller rather than larger organisation, in the larger organisations it is sometimes more difficult to stay in touch with frontline staff and ensure the correct controls and balances are in place. Ellen stated that organisations will receive notice of inspection which for Wave 1 is expected to be around 20 weeks.

There was discussion over roles, particularly the unregistered titles of technician, emergency care support workers and assistants. It is not the CQC role to set standards for these roles, however they will want the organisation to ensure the staff are appropriately skilled and competence in the roles they deliver.

A further area the CQC will look at is risk registers and the board assurance framework - and ensuring these are live documents that represent the risks and issues on the ground and in the frontline.

Ellen confirmed that individuals from the sector will be involved in the inspection teams along with experts by experience.

On enforcement actions Ellen said that there was no doubt that we will see an increase in enforcement action if services are not up to the level they should be, and also that any rating in the Wave 1 period would stand beyond the pilot period. That it will be important to share the learning and compare with NHS services to hold a mirror up to the sector.

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Download: Ellen Armistead Presentation

19 May 2015

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