Ambulance Headquarters, Bernicia House

Updated 1 February 2023

North East Ambulance Service (NEAS) became a foundation trust in November 2011 and are one of ten ambulance services in England. They serve a population of 2.71 million people and employ 2,500 staff including volunteers. NEAS serves the counties of Durham, Northumberland, and Tyne & Wear, along with the boroughs of Darlington, Hartlepool, Middlesbrough, Redcar & Cleveland and Stockton-On-Tees.

The 111 service is based in NEAS’s Emergency Operations Centre (EOC). NHS 111 services began in 2013/14, and NEAS has held the contact to provide the service in this North East since then. They operate 24 hours per day, 365 days a year.

The NEAS’s 111 service operates from three call centres which we visited during the inspection;

• Bernicia House, Newburn, Newcastle upon Tyne, NE15 8NY
• Russell House, Hebburn, Tyne and Wear, NE31 2JZ
• Winter House, Unit 7, Wynyard Business Park, Billingham, TS22 5FG

This inspection report refers to the NHS 111 service, however, some of the information contained in this report refers to either the whole of the ambulance service, or the EOC which is a mix of staff who work across both on 111, 999 calls and clinical staff.

There is also a clinical advisory service (CAS) within the EOC. The CAS supports both 999 and 111 calls and workflow, and it delivers two out-of-hours contracts in the South of Tyne area. Currently, additional CAS support for some 111 calls is provided by a third-party supplier.

Winter House at Billingham is relatively new and has only been functional since May 2022. There are a very small number of 111 staff working there. The trust is currently recruiting and increasing the numbers of staff who work there to strengthen their establishment.

The service had the following whole-time equivalent staff working in the EOC at 31 August 2022, unless otherwise stated;

• Two service managers
• One clinical service manager
• Five section managers
• Five clinical section managers
• 21 team leaders
• 18.7 Senior health advisors
• 272 Health advisors of which 156 could deal with 111 calls, 92 were dual trained and 24 handled 999 calls only, (split in EOC is 33% 999 and 67% 111)
• 63 clinical advisors – (111 call handling only)
• One EOC training manager
• Five operations centre trainers
• Three workforce scheduling and planning analysts
• Four intraday analysts

Updated 1 February 2023

This service is rated as Requires improvement overall. (Previous inspections carried out in September 2018 and March 2016 both rated the service as Good overall)

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Requires improvement

Are services well-led? – Requires improvement

We carried out an announced comprehensive inspection at North East Ambulance Service NHS Foundation Trust NHS 111 Service on 13 and 14 September 2022 as part of our inspection programme. The inspection was undertaken as part of a joint inspection in partnership with the CQC hospitals inspection team.

We have rated this service as requires improvement overall

We rated the service as requires improvement for providing safe, effective, responsive and well led services because:

• There were inconsistent approaches to the process for raising a safeguarding referral which put patients at risk.
• The service did not have enough staff in post to facilitate the provision of care and treatment at the right times.
• Gaps in systems and processes had been identified by the provider, but not addressed, and had been on the service risk register for some time.
• There was not a clear system for the co-ordination of significant events and incidents.
• The service was not meeting national targets, these related to call handling and the number referred to a clinical advisor. However, plans were in place and some progress had been made to address this.
• We were concerned about how the competency of senior health advisors was assessed.
• People could not always access care and treatment at a time when they needed it. Some of the systems and policies in place did not support good governance and management.
• The processes for managing risks, issues and performance could be improved.

We rated the service as good for providing a caring service because:

• The NHS friends and family test survey results were mostly positive.
• Staff involved treated patients with compassion, kindness, dignity and respect.

The areas where the provider must make improvements as they are in breach of regulations are:

• Ensure patients are protected from abuse and improper treatment.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services