UK Ambulance trusts’ Safeguarding Guidance are a serious potential future hazard

  • 16% of ambulance trusts (two out of 12) reported safeguarding incidents in last three years
  • Three trusts unable to audit their guidance to central standards
  • Three trusts rely on 3-yearly cycles for training in regards to safeguarding
  • Five trusts rely on 3-yearly cycles for updating their guidance

4th October, London, UK – Panlogic, the UK’s leading digital engineering consultancy specialising in the public sector, has today announced the findings of a freedom of information (FOI) request into the 12 ambulance services that operate across England, Scotland and Wales. The research has uncovered two substantial records of safeguarding issues along with a culture lacking in training and ongoing learning for operational guidance.

Reported Incidents leading to dismissal

The East of England Ambulance Service NHS Trust and the South Western Ambulance Service NHS Foundation Trust identified the most serious concern with (respectively) 27 and 44 reported incidents of safeguarding guidance not being followed in the last three calendar years. Furthermore, the East of England Ambulance Service NHS Trust reported that 11 members of staff had been warned due to these incidents and two had been dismissed.

The East of England Ambulance Service NHS Trust has over 4,000 staff and 130 sites under its control, while the South Western Ambulance Service NHS Foundation Trust has the same amount of permanent staff and 105 sites.

The fact that the other trusts which reported back showed zero safeguarding incidents indicates a potential issue with these two trusts in the way that they apply safeguarding guidance.

Accessibility

In regards to accessibility, the North West Ambulance Service NHS Trust stated that its guidance could only be accessed as an inflexible PDF, and the South East Coast Ambulance Service NHS Foundation Trust could only allow guidance to be accessed from a mobile device if it was a trust-issued tablet. The usage of both approved devices and PDFs has a serious impact on the accessibility of operational guidance in emergency situations.
Interestingly, when viewed in conjunction with the safeguarding incidents that were reported, the South Western Ambulance Service NHS Foundation Trust was one of only two trusts to not allow both online and offline access of safeguarding guidance (along with the North Eastern), meaning that those operating in the field may be limited when trying to access guidance.

William Makower, CEO, Panlogic, explains: “Just as vital as the contents of any guidance is the accessibility of it to staff; it can be the most up-to-date and detailed guidance possible, but unless it can be put in the hands of staff in critical situations it is worthless. There is a good proportion of trusts that can deliver this kind of guidance service which is pleasing to see, but there is still a large proportion of the trusts that need to ensure their operatives can access, understand and audit the guidance that they need.”

Auditing, updates and length

The FOI questions from Panlogic also covered the vital ability for trusts to audit their safeguarding guidance against central standards, with the East of England Ambulance Service NHS Trust as one of three trusts, along with the London Ambulance Service NHS Trust and West Midlands Trust, to not have staff able to dynamically audit their guidance accordingly. This could lead to disparate trusts using incorrect guidance as they cannot audit this to a clear, central standard.
Five of the trusts also had tri-annual cycles when asked how often their safeguarding standards are updated (North East, West Midlands, South Central, Yorkshire and Wales respective trusts) – a clear sign that the culture of ongoing learning is not present in a large proportion of the trusts.

The length of guidance is also something that clearly needs addressing from the results of the FOI. Several trusts reported upwards of a hundred pages of safeguarding guidance too – a very large amount of information to be read and remembered for just one area of patient care for ambulance trusts.

William Makower continues: “The updating and auditing of guidance is simply vital. If there is a major incident that changes the way ambulance staff respond to a specific type of call-out, the results show that a high proportion of these trusts won’t be able to tell their staff about this for years at a time – this showcases an acceptance of not learning on a regular basis. If this continues, then other trusts may start reporting safeguarding incidents if they continue with this lack of framework.”

Training

Further questions from Panlogic showed that several of the trusts had issues with exceptionally long training times. The South Central Ambulance Service NHS Foundation Trust, Yorkshire Ambulance Service NHS Trust and the aforementioned South Western Ambulance Service NHS Foundation Trust had three-yearly cycles for safeguarding training, with all other trusts annually training staff in the area. The South Western Trust also have an hour-long update during their annual development day, but the cycles for training on such a crucial area are still extremely long – and the lack of regular training could well have affected the incident numbers for South Western.

Makower concludes: “This research has focused on the NHS Trusts that are responsible for ambulance services, but there is an increasing number of Independent Ambulance Services which are also operating across the UK. Held to the same standard as NHS services by CQC, there needs to be a parallel emphasis from them on good guidance practices, including auditing, training and updating of content.”
“We know that regular training and learning is vital for all on-the-ground operatives, but guidance, especially for the emergency services, is an incredibly important resource that can often be put on the back burner by under-pressure and under-resourced trusts. Throughout this research we are seeing pockets of best practice, but it’s certainly not widespread. However, there is work being done within the emergency services to tackle the way they handle operational guidance, such as UK Fire and Rescue and its National Operational Guidance programme. Our experience with UK fire and rescue is that the best learning and training is continuous and is fed via learnings from operations.”

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