January 2015

The crew member was not a paramedic but an Emergency Care Assistant employed by an Independent Private Ambulance Service (IPAS) contracted to response to lower priority calls for the East of England Ambulance Service. IPAS crews are only used from the Trust’s accredited independent ambulance providers, who must be registered with the Care Quality Commission, with no conditions to practice. Each company is accredited and re-accredited every six months to ensure continual assurance to the standards required. Any issues around crew practise is reported on the Trust’s internal incident reporting system and investigated in the same way as with the Trust’s staff. The investigation manager interviewed the attending crew. The doctor did not leave any information or a letter to explain what the Doctor had found and the suggested treatment. The crew wanted to speak to the GP to ensure continued care on route and on arrival at hospital. The crew would not have been able to question the Doctor’s request for ambulance transport.

Crews are provided with information prior to arrival with the patient if this is provided at the time of the call. When the call was made the ambulance service were not notified of the patient’s dementia. When the crew were interviewed and asked about their reasoning for making a vulnerable persons referral for the patient, they felt that she may be vulnerable due to the way the carer was behaving with them. Crews are always expected to make referrals to protect patients if there is any doubt in their mind. If it is found that there is no case to answer to, then at least the patient’s welfare has been safeguarded. We will always support crews in making these referrals.

Upon review, it is clear that there was a breakdown of communication and clash of personalities between the crew and the carer. The crew have apologised if they have caused any upset by this incident but felt that they had the patient’s best interests at heart throughout their attendance.