29.02.16
‘Secret protocol’ meant SECAmb ignored urgent 111 calls
NHS 111 helpline calls were not properly responded to at South East Coast Ambulance Trust (SECAmb) after the trust’s chief executive secretly ordered emergency calls to be downgraded, according to a leaked report.
The Daily Telegraph, which has seen the Monitor report into failings at the trust, said that the trust ordered a pilot scheme in 2014 where non-urgent ‘green’ calls were placed in automatic 10 minute queues to prioritise ambulance responses to ‘red’ calls.
But the report says that trust chief executive Paul Sutton secretly introduced a protocol to apply the queue to ‘red’ calls as well to allow the trust to meet performance targets.
A number of senior managers told the inquiry that they tried to protest the order, with one quoted as saying "an improper level of pressure was applied to certain individuals" who opposed it.
The protocol is thought to have led to 11 deaths in the trust’s target area of Sussex, Kent, Surrey and North East Hampshire, including a 60-year-old man who waited 35 minutes for an ambulance despite suffering a cardiac arrest.
Neither patients or 111 handlers knew about the protocol, and local commissioning groups only knew after they were alerted by a whistleblower.
The report concludes: “Our overall conclusion from this review is that there were a number of fundamental failings in governance at the trust which resulted in the implementation of a high risk and sensitive project without adequate clinical assessment or appraisal by the board, commissioners or the 111 service.
"The CEO made the ultimate decision to proceed with the pilot and played a critical leadership role throughout.”
The report is the latest in a series of criticisms of 111 helplines around the country, after Professor Neena Modi, president of the Royal College of Paediatrics and Child Health said that it was “uncertain” whether the service was capable of diagnosing child patients.
In September 2014 one-year-old William Mead died of sepsis despite his parents contacting 111 and GPs.
A Monitor spokesperson said: “As part of our ongoing regulatory action, we asked South East Coast Ambulance NHS Foundation Trust to commission a detailed review of the project, including the way decisions were made about it. This review is yet to be published. We will provide an update on our regulatory response in due course.
“We also asked the trust to carry out a separate independent review to identify the impact the project had on patients. This review has begun and is due to complete later this year. The impact on patients cannot be confirmed until it concludes. However, in the work carried out so far no cases of patient harm that were not previously identified have come to light.”
NHE contacted SECamb for comment but they did not respond at the time of publication.
UPDATE 2.30pm
A SECamb spokesperson said: “South East Coast Ambulance Service NHS Foundation Trust has refuted claims made in today’s Daily Telegraph following its article based on a leaked, draft report.
“The article refers to a report undertaken by Deloitte which was not looking at patient impact but at the decision-making and governance around the implementation of the pilot, and what recommendations can be made for SECAmb’s governance processes in light of this.
“As we have stated previously, the separate, independent, clinically-led patient impact review, being carried out as part of the Monitor undertakings, is currently underway and is yet to be concluded.
“Until it does it is inaccurate and completely misleading to attribute or imply any harm or deaths to the pilot.
“We will publish the findings of the patient impact review as soon as it is complete.
“However, in the preliminary work to date, no clear indications of patient harm have been identified. Indeed, the review has identified a number of seriously ill patients who received an improved response due to earlier clinical intervention as a consequence of the pilot.”