Special measures ambulance service plagued by IT problems

South East Coast Ambulance Service Foundation Trust has some of the worst performance figures in the sector was rated inadequate last month.

Information obtained by HSJ shows the trust’s computer aided despatch system has so many problems that staff are sometimes reverting to manual methods to bypass it.

The issues include:

• The mapping systems in ambulances failing, leaving crew members to locate addresses through Google Maps on their mobile phones. In some cases crews “simply cannot find the location or even a nearby road”.
• Ambulance dispatchers trying to send ambulances to emergencies but finding they are not where expected as previous instructions had not been received.
• Staff in control rooms having to give instructions over the radio because on board systems have failed.
• Staff being unable to give the location of defibrillators and the codes to open them to callers when someone has had a cardiac arrest. Trust board papers suggest at least one patient died when a staff member had not been trained in how to obtain this information manually.

Board papers said there was a full outage of the dispatch system on 12 July and “partial outages occur approximately weekly”. “There was continued risk around the stability of the [computer aided dispatch system],” the papers said.

Internal documents from May show the CAD system sometimes closes down while being used, and said this was an issue that “cannot currently be fixed”. Other high priority issues included dispatchers unable to dispatch vehicles and towns not showing up on the system when addresses are selected – meaning vehicles cannot be sent.

Many of the problems relate to the CAD system. The trust’s IT strategy in 2014 showed it was the only user of this type of system in Europe and it was “running on software which is no longer supported and it is essential for the trust to establish an upgrade path”. Since then there have been numerous small upgrades. However, the trust’s latest board papers show there is still concern about how the system will be supported, with the ultimate plan to have a new system.

The Care Quality Commission said in September the trust should take action to ensure the system was properly maintained, and said it had not been appropriately updated. Its gazetteer – an index to help locate addresses – had not been updated for 18 months, despite NHS England recommendations that updating should take place every six weeks. The trust underestimated this risk and had not responded to a safety alert, it added.

A trust spokesman said: “We are aware of the significant issues we face with our CAD system, as outlined previously in our board papers and elsewhere.

“We are committed to improving the performance of our CAD and recognise the frustration and stress that these issues have on staff. This issue will be discussed by our board next week and we will inform all of our stakeholders of the outcome as soon as possible.”