Serious Incidents

Phil McCrackin made this Freedom of Information request to East of England Ambulance Service NHS Trust

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Dear East of England Ambulance Service NHS Trust,

I would be grateful if you could answer the following under the Freedom of Information Act.

1) How many serious incidents has the trust declared in the past 3 years? Confirm the resolution to each SI, e.g. system changes or staff development.

2) How many HCPC referrals have been made by the Trust regarding paramedic conduct or capability in the past 3 years? Please confirm the action taken, if any, by the HCPC in each case.

3) How many members of staff have the trust dismissed in the past 3 years? Please confirm whether each dismissal was due to a clinical error, poor attendance or bullying/harassment etc.

4) How many members of staff have been suspended from front line duties in the past 3 years? Please confirm whether these relate to clinical, attitudinal or safeguarding concerns.

4) How many incidents reported in the past 3 years involved errors in drug administration e.g. wrong drug, wrong route or wrong dose? Please provide copies of any SI reports relating to drug errors.

5) How many incidents reported in the past 3 years involved errors in the discharge of a defibrillator or pacing unit e.g. inappropriate shock, failure to shock when indicated or incorrect energy selection? Please provide copies of any SI reports relating to errors in defibrillator usage.

5) Please confirm whether the following statements are true or false:
i) EEAST policy is that all patients with potentially cardiac chest pain must not be allowed to walk to the ambulance in any circumstance.
ii) EEAST policy is that any patient under 2 years of age must be taken to A&E as per RCPCH guidance.
iii) EEAST policy is that ambulance clinicians must speak to a clinical advice line or Out of Hours GP prior to administering pre-prescribed end of life medications from a 'just in case' box.

6) Please confirm the number of Student Paramedics recruited prior to 2014 who are still not registered with the HCPC as a Paramedic?

Yours faithfully,

Phil McCrackin

foi (EAST OF ENGLAND AMBULANCE SERVICE NHS TRUST),

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foi (EAST OF ENGLAND AMBULANCE SERVICE NHS TRUST),

Dear Phil,

My apologies for the delay in our responding to you, the Trust is continuing to process your request below and will have our response to you as soon as possible.

Once again, my apologies for this delay and any inconvenience this has caused.

Kind Regards

FoI Officer
East of England Ambulance Service NHS Trust

Please note our new email address: [East of England Ambulance Service NHS Trust request email]
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From: Phil McCrackin [[FOI #344416 email]]
Sent: 08 July 2016 00:43
To: foi (EAST OF ENGLAND AMBULANCE SERVICE NHS TRUST)
Subject: Freedom of Information request - Serious Incidents

Dear East of England Ambulance Service NHS Trust,

I would be grateful if you could answer the following under the Freedom of Information Act.

1) How many serious incidents has the trust declared in the past 3 years? Confirm the resolution to each SI, e.g. system changes or staff development.

2) How many HCPC referrals have been made by the Trust regarding paramedic conduct or capability in the past 3 years? Please confirm the action taken, if any, by the HCPC in each case.

3) How many members of staff have the trust dismissed in the past 3 years? Please confirm whether each dismissal was due to a clinical error, poor attendance or bullying/harassment etc.

4) How many members of staff have been suspended from front line duties in the past 3 years? Please confirm whether these relate to clinical, attitudinal or safeguarding concerns.

4) How many incidents reported in the past 3 years involved errors in drug administration e.g. wrong drug, wrong route or wrong dose? Please provide copies of any SI reports relating to drug errors.

5) How many incidents reported in the past 3 years involved errors in the discharge of a defibrillator or pacing unit e.g. inappropriate shock, failure to shock when indicated or incorrect energy selection? Please provide copies of any SI reports relating to errors in defibrillator usage.

5) Please confirm whether the following statements are true or false:
i) EEAST policy is that all patients with potentially cardiac chest pain must not be allowed to walk to the ambulance in any circumstance.
ii) EEAST policy is that any patient under 2 years of age must be taken to A&E as per RCPCH guidance.
iii) EEAST policy is that ambulance clinicians must speak to a clinical advice line or Out of Hours GP prior to administering pre-prescribed end of life medications from a 'just in case' box.

6) Please confirm the number of Student Paramedics recruited prior to 2014 who are still not registered with the HCPC as a Paramedic?

Yours faithfully,

Phil McCrackin

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foi (EAST OF ENGLAND AMBULANCE SERVICE NHS TRUST),

7 Attachments

Dear Phil,

Further to your email on 8th July 2016, please find the Trust’s response below. Your request has been allocated the following reference: 6818, please quote this reference in any future correspondence with the Trust. My apologies for the late response for this request

1) How many serious incidents has the trust declared in the past 3 years? Confirm the resolution to each SI, e.g. system changes or staff development.
2015/16 = 83
2014/15 = 92
2013/14 = 54
The Trust does not record individual action type. To find all of the action types for the SIs above would involve a manual review of each record which would require more than the 18 hours to complete the FOI request and would exceed the appropriate limit as defined by the Freedom of Information Act. As such we are unable to answer your request under s.12 of the Act.

2) How many HCPC referrals have been made by the Trust regarding paramedic conduct or capability in the past 3 years? Please confirm the action taken, if any, by the HCPC in each case.
Dates looked at:
16 July 2013 – 15 July 2016
Referrals made by Trust = 20
Sell referrals = 20
Referrals via 3rd Party = 5
Total = 45
No Action Taken = 20
Suspension = 4
Struck Off = 3
Ongoing = 18

3) How many members of staff have the trust dismissed in the past 3 years? Please confirm whether each dismissal was due to a clinical error, poor attendance or bullying/harassment etc.
There were a total of 12 dismissals of clinical staff for this period, for dignity at work reasons. There were no clinical or safeguarding reason dismissals.

4) How many members of staff have been suspended from front line duties in the past 3 years? Please confirm whether these relate to clinical, attitudinal or safeguarding concerns.
12 suspensions of front line staff, 7 behavioural, 1 clinical and 4 for other reasons

5) How many incidents reported in the past 3 years involved errors in drug administration e.g. wrong drug, wrong route or wrong dose? Please provide copies of any SI reports relating to drug errors.
SIs relating to the wrong drug, wrong route, wrong dose = 4, SI reports attached : Report 1, Report 2, Report 3, Report 4
Adverse Incidents = 19

6) How many incidents reported in the past 3 years involved errors in the discharge of a defibrillator or pacing unit e.g. inappropriate shock, failure to shock when indicated or incorrect energy selection? Please provide copies of any SI reports relating to errors in defibrillator usage.
SIs related to defibrillator failure = 3, SI reports: Report 5, Report 6, Report 7
Adverse Incidents = 0, all reported as SIs.

7) Please confirm whether the following statements are true or false:
i) EEAST policy is that all patients with potentially cardiac chest pain must not be allowed to walk to the ambulance in any circumstance.
No formal policy but EEAST train to consider the impact of exertion on the patient through dynamic risk assessments.
ii) EEAST policy is that any patient under 2 years of age must be taken to A&E as per RCPCH guidance.
This is not the Trust’s Policy to automatically convey. It asks the clinician to assess against physiological parameters and NICE guidance on feverish children. If leaving on scene, safety netting and 2 sets of observations 20 minutes apart need to be completed.
iii) EEAST policy is that ambulance clinicians must speak to a clinical advice line or Out of Hours GP prior to administering pre-prescribed end of life medications from a 'just in case' box.
Not prior to administration for senior and specialist paramedics unless they need to discuss the administration. It would be expected that appropriate discharge of care and liaison of care would occur. It should be remembered that we are involved at what could be deemed a crisis but we need to move back to planned care.

8) Please confirm the number of Student Paramedics recruited prior to 2014 who are still not registered with the HCPC as a Paramedic?
We have 9 students remaining from the previous student paramedic recruitment that are being withdrawn from the programme for not achieving/completing by the University.

I am obliged to advise you that if you are dissatisfied with the Trust’s response to your request you have a right to complain to the Trust and should set out your concerns to the Freedom of Information Officer, EEAST, Hospital Approach, Broomfield, Chelmsford, Essex, CM1 7WS or by email to [East of England Ambulance Service NHS Trust request email]. If you remain dissatisfied following this, you have a right under Section 50 of the FOIA to seek a determination from the Information Commissioner on whether the Act has been properly applied by the Trust. For more information, please see www.ico.gov.uk.

Please do not hesitate to contact me should you require any further information.

Kind regards

FoI Officer
East of England Ambulance Service NHS Trust

Please note our new email address: [East of England Ambulance Service NHS Trust request email]

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