CQC reports on positives for NHS 111 Service provided by Ambulance Service

The North West Ambulance Service NHS Trust (NWAS) welcomes the findings from the Care Quality Commission (CQC) report, published today, on NHS 111 telephone service inspections. The CQC is the body that regulates all health and social care services nationwide.

The inspection, which was one of the first of its kind nationally, was undertaken as part of a pilot to help the development of the CQC’s approach to inspecting NHS 111 services throughout England and Scotland.

As part of the visit, the team assessed a number of areas, to gain a valuable and detailed insight into NWAS NHS 111.  To form the basis of the inspection, five questions were asked around the overall quality and safety of the service being provided. These questions were:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

Due to the inspection being part of a pilot, the CQC hasn’t given the service a quality rating, however, there were many detailed positives, which were reported during the inspection. The report states that they found ‘NWAS NHS 111 provided a well-led, safe, effective, responsive and caring service to a diverse population spread across North West England’.

Bob Williams, NWAS Chief Executive commented on the inspection findings: “I would like to thank and praise all NWAS NHS 111 frontline staff and managers for their hard work and continued commitment to the Service and to the Trust, the findings from this inspection has many excellent and positive outcomes for all at NWAS and supports all the hard work and improvements made during NWAS’ time as the stability partner.”

Bob added: “As we now move forward to fully mobilise and provide the NHS 111 service across the region from October, along with our Delivery Partners FCMS and Urgent Care 24 (UC24), I believe the overall positive findings and commendable staff attributes highlighted within the CQC’s Quality Report, will stand us in good stead to continue to develop and innovate the service over the course of the next five years. It provides a valuable foundation for us as we plan to deliver a resilient NHS 111 service which is responsive to the needs of the population, offering excellence in patient care and support.”

The report goes on to state the key findings are:

• NWAS NHS 111 has systems, processes and practices in place to mitigate safety risks.
• The Service works closely with the 33 Clinical Commissioning Groups (CCGs) in the North West, who commission the service.
• The Service is appropriately monitored against the national performance standards, data collection tools are in place to provide intelligence about the level of service being provided and action plans are implemented where variation in performance was identified.
• Staff are trained and monitored to ensure they use the NHS Pathways safely and effectively supported to report issues and concerns.
• Patients are supported through the telephone clinical triage system, their consent and decisions are respected and complaints and feedback are acted upon.
• There is visible leadership, with an emphasis on continuous improvement and development of the service in accordance with the Trust’s five-year business plan.

As well as many positives reported on the service, the CQC team identified an area in which attention should be given to ensure further improvement. This was around the analysis of the feedback, complaints and compliments that the service receives. Since the visit in March, however, NWAS NHS 111 has implemented clearer clinical and quality governance and monitoring arrangements.

Professor Steve Field, Chief Inspector of General Practice, said: "NHS 111 is an important part of the urgent care system; ensuring people have quick and easy access to health care advice and information when appropriate. We expect these services to demonstrate that they prioritise people with the most urgent needs at times of high demand, and to ensure that care and advice is delivered safely and effectively, and they are referred to the right service as quickly as possible when necessary. The way that NHS urgent and emergency care is delivered in England is changing, but people will always be entitled to services that provide safe, effective, compassionate and high quality care."

This inspection came at an important time for NWAS NHS 111, whilst continuing with providing the contract this inspection has found many positives in which can be taken forward to make even more improvements with the patients at the heart of all the decisions the Service makes. This report has determined how safe, effective and well-led the NWAS NHS 111 service is and has also set a precedent and a level of understanding for the CQC for NHS 111 inspections nationally.