HEI Inspection Report: Scottish Ambulance Service

The Healthcare Environment Inspectorate (HEI) today (Monday) published its report relating to an unannounced inspection visit of the Scottish Ambulance Service on 12-14 June 2012.

Scottish Ambulance Service

HEI has been set up to help reduce healthcare associated infection risk to patients through a rigorous inspection framework. The HEI inspection team examined the Scottish Ambulance Service’s self-assessment information and then inspected ambulances at various accident and emergency (A&E) departments to validate this information to assess how clean they were and if they were meeting national standards.

The findings from the visit are set out below, and cover eight requirements that the Scottish Ambulance Service is fully expected to address, plus two recommendations for improvement.

The full HEI inspection report and an improvement action plan developed by the Scottish Ambulance Service to address the identified issues are available to view at

www.healthcareimprovementscotland.org/HEI.aspx

Speaking of the report, Susan Brimelow, HEI Chief Inspector, said “We observed staff complying with hand hygiene practice after they had been in contact with patients and there was good provision of alcohol hand rubs. However, overall we found that infection control is not fully embedded into all aspects of the Scottish Ambulance Service. In particular we found poor communication between the infection control team and staff, and there was inconsistent completion of documentation relating to the cleaning of vehicles. We expect the Scottish Ambulance Service to address these issues as a matter of priority.”                                                         

Requirements

The Scottish Ambulance Service must:

1. Ensure that all staff groups adhere to standard infection control precautions to ensure the risk of infection to patients and staff is minimised. This was previously identified as a requirement in the June 2011 inspection report for the Scottish Ambulance Service.
2. Liaise with ambulance control and health and social care providers to ensure that there is robust risk assessment and communication about patients’ infection status. This will ensure additional precautions can be taken as required when in contact with a patient. This was previously identified as a requirement in the June 2011 inspection report for the Scottish Ambulance Service.
3. Ensure that all staff are aware of and implement the policy for station and vehicle cleaning. This should reflect the frequency stated within the NHSScotland National Cleaning Services Specification (2009). This will ensure that all vehicles are clean and maintained ready to use at all times. This was previously identified as a requirement in the June 2011 inspection report for the Scottish Ambulance Service.
4. Ensure that documentation relating to vehicle cleaning is consistently completed.
5. Ensure that they effectively communicate and implement the policy, with regards to the provision and use of mops, to staff and other NHS partners. This was previously identified as a recommendation in the June 2011 inspection report for the Scottish Ambulance Service.
6. Review existing internal and external communication methods to ensure that there is effective communication on matters relating to healthcare associated infection.
7. Ensure that sufficient resources are in place to support education provision.
8. Ensure that all staff have a specific objective for healthcare associated infection within their personal development plan, and that they understand what this is and how it will be achieved. This was previously identified as a requirement in the June 2011 inspection report for the Scottish Ambulance Service.

Recommendations

The Scottish Ambulance Service should:

1. Consider how it works with other NHS boards to use existing compliance monitoring data to identify areas for improvement and provide feedback to staff.
2. Consider how to strengthen awareness of the role of the infection control advisor and other members of the infection control team. The infection control team should also consider working directly with ambulance staff at sites.