East of England Ambulance Service Trust

The East of England Ambulance Service provides both emergency medical response services and non-emergency transport services to the Counties of Norfolk, Cambridge, Suffolk, Essex Hertfordshire and Bedfordshire.

This case study covers the non-emergency services for the provision of patient transport to and from hospitals, clinics and other medical facilities and the application of ISO9001 Quality Management. It was a prime requirement for purchasing that the non- emergency services were certificated to ISO9001.


The aim was to introduce controls and produce the quality manual in the ISO9001:2008 format and progress an application to ISO9001:2008. The objective was to implement a quality management system where conformance to specified requirements is to be assured by the organisation during production and delivery.


Chris Eden of Quality Matters Limited obtained sufficient information from the the N.E.S Associate Director and members of the service to produce a quality manual and procedures to meet the requirements of an ISO 9001 assessment. The manual was then fine tuned and an application was made to an accredited certification body to carry out the formal assessment.

The project took over 70 Man days and was subdivided into seven phases:

Phase one – Investigation

  1. Review of the structure of the service;
  2. Review existing procedures;
  3. Review existing documentation;
  4. Review working practices.

Phase two – Preparation

All practises were examined for compliance with BS EN ISO 9001 and, in conjunction with the concerns report from the investigation phase, corrective actions were developed and agreed.

This important phase also involved:

  • training all the staff in quality awareness to involve everyone in the process;
  • gaining full commitment to the project from Senior Managememnt;
  • preparing the Service quality policy statement and displaying it.
  • arranging external training for staff who will carry out internal quality auditing

Phase three – Documentation

The quality manual was written to fit the ISO9001:2008 model. In addition, any working procedures, which did not exist, were written and tested for compliance with the standard. The production of specialised control forms took place.

Phase four – Implementation

When all the preparatory work was done and writing ceased, the quality manual was issued.

The procedures contained in the manual were implemented and a period of settlement was allowed. There were a number of areas which required fine tuning and there were some re-alignment of certain procedures.

It was important that all discrepancies were noted and corrective actions taken, where necessary, to ensure the integrity of the system is maintained.

Phase Five – Audit

This phase involved a detailed check against the specification to ensure that all the procedures were being followed and that there was continuing compliance with the Standard. (The first audit was led by the consultant but conducted by the Service’s own trained staff).

Discrepancies were documented, corrective actions agreed and implemented. After this audit the whole quality system complied with the requirements of BS EN ISO 9001:2008

Phase Six – Formal Assessment

This phase was carried out by one of the UKAS accredited Certification Bodies.

Phase seven – BS EN ISO 9001 award

The project was successful and The East of England Ambulance Service Trust was awarded a Certificate of Compliance To ISO9001:2008


This phase of the project was successfully concluded. The increase in productivity and efficiency together with a much reduced level of patient complaints is attributed to the application of ISO9001.

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