Scottish Ambulance service fails in eight separate areas

THE Scottish Ambulance Service has been given a month to ensure its vehicles are properly cleaned, after inspectors uncovered failings in standards of cleanliness.

• Scottish Ambulance Service given one month to improve cleanliness of ambulances after criticism over hygiene

• Report recommends new measures to prevent infection after finding that “infection control is not fully embedded into all aspects of the Scottish Ambulance Service”

After a series of unannounced visits last month, the inspectors have listed a raft of concerns including some crews using filthy mops to clean their

ambulances and staff using out-of-date materials.

A Healthcare Environment Inspectorate (HEI) report also called for the service to introduce new measures to control the spread of infection between patients and crews and to make sure ambulance staff adhere to strict dress codes.

In a report published yesterday, investigators revealed they saw some staff wearing jewellery, watches and nail varnish, which were all previously banned to prevent the spread of infection.

HEI chief inspector Susan Brimelow said “Overall we found 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.”

Ambulance bosses were given a list of eight areas that failed to meet official NHS standards – some of which they were pulled up on in the last inspectors’ report a year ago, but which had yet to be implemented. These included the cleaning of ambulances and better record-keeping. The service was given a month to carry out improvements.

The report found ambulances in Grampian and Lanarkshire health board areas had not been properly deep-cleaned in line with NHS policy.

Staff in Aberdeen did not know it was their responsibility to clean the inside of their vehicles every day, other than surface cleaning between patients, inspectors

revealed.

They heard feedback from crews that “the pressure of work” had a negative impact on their ability to clean ambulance interiors effectively.

Some paramedics also told how they did not always have time to clean their vehicles at the beginning of their shift.

The inspectors also criticised poor recording of when ambulances were cleaned and a lack of knowledge among crews and managers as to who was responsible for updating cleaning logs. This was the second year in a row the service has been criticised for poor recording of cleaning routines.

Four ambulances were found to have substandard or out-of-date “fluid kits” used to safely dispose of patients’ blood and other fluids. One kit in use was dated as due to expire in 2010.

Advocacy groups last night said patients deserved a better service and, at the very least, would expect to travel in a clean vehicle. They demanded to know why ambulance bosses had not carried out routine checks on the cleanliness of vehicles and the use-by dates on equipment.

During the inspections, HEI staff found two hospital Accident and Emergency units – at Borders General in Melrose and Edinburgh Royal Infirmary – provided crews with mops to clean vehicles between call-outs. But inspectors found “dirty mop heads” at both locations.

Senior ambulance bosses told how crews had been banned from using hospital mops “a number of years ago” to prevent cross-infection between buildings and vehicles.

Inspectors spent three days with crews across Scotland and saw staff responding to 999 calls, non-emergency call outs and

patient transport requests.

A spokesman for the Scottish Ambulance Service said: “We recognise that more work needs to be done to improve communications and documentation and we have implemented an action plan that addresses the areas highlighted by the report.

“We are absolutely committed to managing the control of infection across all operations, which encompass about 900 vehicles operating from more than 150 stations across Scotland.”

The service said it had introduced daily safety briefings to improve communication between hospitals and outpatient clinics to ensure they let ambulance crews know of any patient likely to have an infection which could be transmitted to them.

Of the service’s 900 vehicles, half are used as emergency transport and the other half as patient transport.

Scotland Patients Association executive director Dr Jean Turner said: “These findings are very welcome, but what I would like to know is why nothing was done about these issues before now. Why have managers not been keeping checks on issues as important as cleanliness and infection control?

“The problem could be complacency; a few things might have been overlooked in the past and now they just carry on and are not seen as an issue.

“Infection control should be paramount. Even wearing a ring can increase the chances of bacteria manifesting and spreading. Small things like this can make a huge difference when controlling infections.”