Archived: Derbyshire, Leicestershire & Rutland Air Ambulance

Updated 14 March 2018

Derbyshire, Leicestershire, and Rutland Air Ambulance is operated by The Air Ambulance Service (TAAS). The service opened in 2003 with the Warwickshire and Northampton Air Ambulance Service and the Derbyshire, Leicestershire, and Rutland (DLR) Air Ambulance service was launched in 2008, based at East Midlands Airport, and offers a helicopter emergency medical service (HEMS). Together with the Warwickshire and Northamptonshire Air Ambulance, and the Children’s Air Ambulance, the service provides a rapid response to trauma and medical emergencies over an area of 3,850 square miles in central England. They cover road networks including the M1, M6, M69 and M42. With an average response of 13 minutes, between them they attend on average six missions a day. The service has been registered with the Care Quality Commission since 2011.

The service has had a registered manager in post since December 2015.

Updated 14 March 2018

Derbyshire, Leicestershire, and Rutland Air Ambulance is operated by The Air Ambulance Service (TAAS), a registered charity, which also operates the Warwickshire and Northamptonshire Air Ambulance and the Children’s Air Ambulance. It provides a helicopter emergency medical service and a doctor/critical care paramedic service.

The service operates under a service level agreement with the local NHS ambulance trust, which activates the service based on emergency 999 calls.

We inspected this service using our comprehensive inspection methodology. We carried out the inspection on 15 and 16 January 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.

The main service provided by this service was emergency and urgent care.

Services we do not rate

We regulate independent ambulance services but we do not currently have a legal duty to rate them. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

We found the following areas of good practice:

• Clinical staff were knowledgeable about incident reporting and there were robust processes to report, investigate and learn from incidents, and strong track record on safety
• The service was doctor lead and highly skilled. It had a high level of paramedic critical care expertise, supported by an effective personal development system, a range of clinical skills development opportunities and specialist clinical standard operating procedures
• Aircraft and rapid response vehicles were visibly clean and tidy, and there were systems in place to ensure that equipment was suitable and maintained on a timely basis
• Clinical staff could access specialist advice when they were on a mission from a designated team of specialists
• There were sufficient staff, and arrangements for short notice cover if needed
• The service cooperated with and supported other emergency services, and communicated well with other health providers
• Clinical staff audited their work in line with best practice
• Staff understood the relevant consent and decision making requirements of legislation and guidance, including the Mental Capacity Act 2005 (MCA)
• Staff were professional, caring and compassionate, and involved relatives in patient care. Care was tailored to the individual patient
• The service analysed unmet need to develop new services together with the NHS ambulance provider. They also worked with them to improve helicopter and rapid response vehicle dispatch arrangements
• There had been no complaints in the last 12 months. Historical complaint investigations were thorough.
• Leaders were respected and had the skills, knowledge, experience, and integrity they needed.
• Strategic planning processes were effective and staff were engaged in service planning
• There was an open and learning culture and an ethos of continuous improvement.

However, we also found the following issues that the service provider needs to improve:

• The safeguarding adults’ policy referenced out of date guidance. This was raised with the registered manager during the inspection who took immediate action to update the policy.
• Aircraft pilots had not had safeguarding training.
• The compliance with some mandatory training was low.

Following this inspection, we told the provider that it should make other improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Heidi Smoult

Deputy Chief Inspector of Hospitals (Central Region), on behalf of the Chief Inspector of Hospitals

Updated 14 March 2018

The service was well led with experienced and capable leaders who drove improvements in the service with a focus on the best possible care in emergency situations for patients in need. The leaders promoted a positive staff culture and encouraged staff development to deliver the best possible care and treatment for all patients. Effective systems were in place to ensure patients received safe and high quality care and treatment at all times.