Acute Ambulance and Medical Services reveal to John Maslen how a safety-first focus benefits patients and vehicles.
When your job is to save lives, it makes sense that the care and concern shown to patients should extend to transport.
Acute Ambulance and Medical Services (AAMS) is a private ambulance service which provides transport services, including bluelight support, to a range of NHS trusts in addition to supporting public events from festivals to concerts.
When Kieren Gibson, managing director, started the Milton Keynes-based business 11 years ago, he admits he knew nothing about fleet management.
After a varied career as a technology specialist, he joined the ambulance service as an operations manager, before deciding to become more ‘hands on’ by qualifying as an emergency medical technician and then forming AAMS.
He has been learning on the job ever since as the fleet has slowly expanded to 18 vehicles.
He says: “At times it has been like banging my head against a brick wall. I had no experience and I had to learn a lot on the job.”
As the fleet started from small beginnings, Gibson has treated vehicles as his own and this culture has also helped in the development of training programmes that encourage drivers to empathise with vehicles as well as patients.
The company has to apply high standards of driver training to ensure that patients are kept safe during transport, with every member of the team that carries out bluelight transfers having a Certificate in National Emergency Response Driving (Ambulance), or equivalent.
Gibson applies some unusual techniques to get employees to think like patients.
He says: “During training, we put drivers in the back of the ambulance when it is being driven around, so they can understand why they need to drive considerately.
“When they have been in the back of an ambulance, it helps them think about the mechanics of the vehicle and how their driving can be made better for the patient.
“I say to them it’s like having a pint of water on the passenger seat that you don’t want to spill, so you drive accordingly.”
Much of the work carried out by AAMS is patient transport, which is reflected in the make-up of the fleet.
In addition to a Renault Kangoo adapted for wheelchairs, the fleet operates eight patient transport vehicles, based on Renault Masters and Peugeot Boxers.
It has a Nissan Navara, a Land Rover Discovery, a Land Rover Defender 130, a Ford Galaxy and four fully-kitted frontline ambulances, based on the Renault Master and Vauxhall Movano, together with two ‘box-style’ Mercedes-Benz Sprinter chassis cabs. There is also a 7.5-tonne DAF support truck on the fleet.
Taking care of patients is paramount, but it is also vital to protect assets as the vehicles and the equipment they carry can be very expensive compared to a traditional van fleet.
A fully-kitted patient transport vehicle starts at around £35,000 and frontline ambulances range from £60,000 to £150,000, with some life-saving equipment costing up to £25,000.
Last year, AAMS invested in an awning for its support truck to create a reception, triage and welfare area.
With around eight crews on the road each day moving more than 200 patients, the fleet is extremely busy, but technology helps maintain close contact with vehicles when they are away from the depot.
Vehicles are fitted with TomTom Live telematics systems, which can be used to send details of new jobs direct to the ambulance crew.
It can also be used to monitor driving style and use the results to offer help and support to drivers.
If there is an incident, then drivers receive a debriefing and assessment, which could be followed up with further driver training if issues are identified.
During emergency transport, the system records when bluelights and sirens are in use, which is essential when it comes to dealing with paperwork.
Gibson says: “If we get a notice of intended prosecution for speeding, then we are able to check against the record from the telematics and then respond to get the fine cancelled.”
But it is not just technology that makes a difference.
The fleet has introduced patient feedback forms so that crews can get direct responses on their performance.
Gibson says: “The introduction of feedback forms was a major change and crews were a little uncertain about the idea.
“However, once it was up and running, they were really encouraged by the praise they were receiving. The comments have been so positive that it has helped crews’ morale because patients are so keen to recognise their hard work. They actually encourage patients to do it now.”
This provides a constant focus on the individual, despite the fleet travelling around 500,000 miles a year and transporting thousands of patients.
The combination of high tech and personal care has meant the fleet has maintained a strong safety record during more than a decade in service.
Gibson adds: “We have only had two accidents in 11 years, one of which was a non-fault incident, which is quite a good record when you look back on it. You just focus on the day-to-day and don’t realise the result until you look back.”
To maintain this record, the company is keen to ensure vehicles remain fit for the road at all times, with services every 10,000 miles or 10 weeks and ongoing checks using the Fleet Check vehicle management platform.
The procedures and processes that Gibson has put in place have led to the AAMS fleet being accredited to the Van Excellence standard from the Freight Transport Association (FTA).
Gibson says the support of organisations such as the FTA, in addition to other fleet operators and suppliers, has been important in developing best practice on the fleet.
This includes maintaining a close watch on operating costs as the fleet expands and is updated.
When the business started, Gibson bought used vehicles from specialist retailers, but he has just invested in leased vehicles for the first time, with a five-year, 200,000 miles contract with Dawson Group.
The business has also had to develop to minimise downtime with two major initiatives.
The first has been to invest in an in-house garage, complete with two five-tonne lifts, so that ambulances can be serviced in-house.
Gibson says: “Our previous supplier was very good, but no matter how flexible they were, we would always be just another customer and sometimes we would just have to join the queue, which is not good in this industry sector.
“Having our own garage means vehicles always get priority and issues can be sorted out straight away.”
The expanding fleet means that Gibson is now much less involved in driving day-to-day, as operational requirements take priority.
To assist with the increasing size of the operation, he has also appointed a fleet manager, Mark Boobier, who oversaw the development of the in-house garage operation (see panel opposite).
Gibson says: “Mark is responsible for keeping the fleet maintained and on the road – no mean feat with 18 vehicles currently on fleet.
“Having a fleet manager is important as the fleet grows. You need a dedicated focus to ensure vehicles are safe and operating efficiently at all times.”
With the business turning over more than £1.1 million a year, Gibson is expecting future growth, which will bring additional fleet challenges, including staff turnover.
He says: “We have some staff who want to drive emergency ambulances and want to dip their toe in the water with patient transport.
“It is a different mindset from when I was driving my own vehicles and now I let other people drive them. You do get more issues appearing, but you have to put your trust in people and make sure they are properly trained.
“I say to them, imagine that one day you will be transporting a member of your own family and think how you would like them to feel.
“It is also about taking care of vehicles, including security, so we make sure they are always locked and paperwork taken out.”
In addition, the fleet’s fuel cards, which are used to manage its £120,000 a year fuel spend, are all PIN protected.
Gibson adds: “If there is minor damage, then it is dealt with in-house, but drivers do a walk-around each day and have to report anything.
“We do more training in-house now along with external providers. If there is minor damage, then we can now repair that in-house.”
Fleet manager’s role ‘still vital’
The addition of a fleet manager to the AAMS fleet shows the role still plays a vital part in modern businesses, says AAMS boss Kieren Gibson.
Employing Mark Boobier to run the fleet has freed up other team members to focus more on their core roles and ensured there continues to be a focus on best practice.
Gibson says: “Fleet managers are vital in modern business in order to minimise vehicle downtime, prepare, maintain and safety inspect the whole fleet.
“Our fleet manager liaises with motor factors, to ensure the timely delivery of parts and spares, manages the Fleet Check platform, the telematics system, the Van Excellence programme and prepares event vehicles for all our weekend activities.
“He also risk assesses every new vehicle that comes onto the fleet and manages the tax, MOT, service and insurance schedules. It leaves the operations team more time to be effective in their roles.”
AAMS shares expertise with new services
The expertise developed in building the AAMS fleet has led to the roll-out of added value services targeting other public sector fleets.
AAMS recently announced that, in association with CTG International, it is promoting a National Emergency Response Driver Training for Ambulances course.
The first course ran last year and is aimed at anyone in need of a driving qualification to undertake bluelight work for an NHS trust.
The organisation is also now providing services to other fleet operators as a new business called Ambulance Automotive & Mechanical Services.
Boss Kieren Gibson said: “Since 2014, ours has grown to be a more independent business and, with the latest technology and equipment, our mechanics can diagnose, faults, service, repair and get MOTs for all makes and models of cars and light commercial vehicles.”