QE Facilities Patient Transport

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

We have a shared vision, strategy and culture that is based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding and meeting the needs of people and our communities.

We scored the service as 3. The evidence showed a good standard. The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The service had a corporate strategy (2025-2030) in place which covered patient transport services. The vision for the was ‘…to continually improve and refine the way we work and grow our business, so that we can continue to be an organisation …we’re all passionate about being a part of.’

To achieve the strategy the service had developed the following vision and strategic goals:

• Champion our people – Make QEF an inclusive and engaging place to work;
• Quality focused – support outstanding care in all that we do; and
• Fit for the future – grow our business in a collaborative and sustainable way.

For each strategic goal the service had identified how the particular goal wouldill be achieved and what wouldill be different as a result. For example, ‘to champion our people’ the service was committed ‘…to create and use a behavioural framework in conjunction with our people’, ‘…improve communications and increase visibility of our leaders and ‘…design a dedicated leadership programme focused on equipping current and aspiring leaders to set a compassionate and positive cultural tone for their teams.’

The vision and objectives had been discussed and shared with staff through individual meetings, team briefs and notice board displays. Staff were able to demonstrate they were aware of its contents and objectives, and that they understood how this contributed to the delivery of a high quality service.

We have inclusive leaders at all levels who understand the context in which we deliver care, treatment and support and embody the culture and values of their workforce and organisation. They have the skills, knowledge, experience and credibility to lead effectively and do so with integrity, openness and honesty.

We scored the service as 3. The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

We met with the registered manager, chief executive, director of logistics, and front-line managers during our inspection of the service. They explained how the service operated, teams were managed, and how outcomes were measured.

The senior management team had the skills, knowledge and experience to undertake their roles and had a good understanding of the service. We were told by front-line staff the registered manager, operations managers and team leaders were visible and approachable for staff and patients.

This was confirmed through the group 2024 Staff Survey (reported January 2025) responses. Overall results showed staff viewed the service and group as compassionate and inclusive, always learning, working flexibly, and engaged positively. Staff also felt recognised and rewarded, they had a voice that counts and worked as a team. We saw that morale within the group was rated at 62%, based on work pressures (Health and Safety Executive index) and stressors.

Senior managers recognised there had been fewer respondents in the survey for a number of reasons, for example the impact of senior leadership changes, but did identify areas for increased focus, that is recognition, staff engagement and feedback through effective communication.

We create a positive culture where people feel that they can speak up and that their voice will be heard.

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The host trust had a ‘Freedom to Speak Up’ policy in place to ensure the provision of ‘…high quality health care in all aspects of its services to patients, visitors, local community and employees’. Staff were encouraged to raise day to day, general or lower risk concerns with their manager in the first instance.

The service had adopted the policy and recognised individuals may have concerns about what is happening at work. Managers accepted individual’s concerns may need to be raised with the host trust’s freedom to speak up guardian and encouraged the freedom to speak up. Staff were aware of the policy and the guardian.

The policy encouraged staff to raise concerns through conversations with supervisors and line managers where possible, enabling issues to be resolved quickly. The service aimed to provide a culture, where raising issues appropriately is normal everyday practice. Options identified to raise issues included contacting the full-time freedom to speak up guardian, as well as independent health regulators.

The policy emphasised victimisation of colleagues reporting a concern will be treated as a serious disciplinary offence, and that discouraging staff from raising a concern was not acceptable. Separately staff were encouraged to raise issues affecting them personally through the service grievance policy and procedure to address their concerns.

We value diversity in our workforce. We work towards an inclusive and fair culture by improving equality and equity for people who work for us.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

The host trust had an ‘Equality, Diversity, Inclusion and Human Rights Policy’ in place and the service had adopted this to apply to staff. The policy was in the process of being reviewed at the time of inspection.

We saw the host trust and the service were committed to ‘…providing a working environment, which is free from unlawful discrimination on any grounds. This includes age, gender, sexual orientation, gender reassignment, marriage and civil partnership, pregnancy and maternity, paternity, adoption, fostering, disability, health status, mental health need, race, ethnicity, language, religion, civic duties, political, trade union or other opinion or belief, social origin, domestic circumstances or offending background’ and ‘…cases of discrimination will be dealt with fairly, confidentially and in accordance with the appropriate … policies.’

The policy underpinned the service’ ambition to create a working environment which,

• nurtures dignity and mutual respect encouraging staff to achieve their full potential;
• attracts, develops and retain a diverse workforce;
• increases awareness and implementation of anti-discriminatory practice amongst all staff;
• ensures that no employee or potential employee experiences less favourable treatment as a result of personal attributes or circumstance on grounds that cannot be shown to be justifiable; and
• highlights that any form of unlawful direct and indirect discrimination, victimisation or harassment in employment practice and service delivery is unacceptable.

Opportunities within the service such as career development, training, learning and education were available for all staff to apply.

We have clear responsibilities, roles, systems of accountability and good governance to manage and deliver good quality, sustainable care, treatment and support. We act on the best information about risk, performance and outcomes, and we share this securely with others when appropriate.

We scored the service as 3. The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

The service was managed by a nominated individual and a registered manager. Regular meetings such as the performance committee, quality committee and risk group were held and attended by senior managers from QE Facilities. These meetings had standing agenda and for example the risk group discussed the risk dashboard, internal audit (overview, recommendations and forward plan), and audit outcomes. This group identified items for escalation to the quality committee, such as organisational risks, risk management, financial performance, and forward planning.

The service specification outlined the scope of the services to be provided to the host trust and ensured regular monthly contract meetings were held to ensure the proper arrangements are in place to support the patient discharge service to the host trust.

We saw a departmental risk register which recorded risks within the areas of people, fleet, service and finance. The register was logical in its approach giving a risk description, impact description, recurrence, the levels of impact, probability and priority. Importantly strategies for control and mitigation were identified. An example of this was when a vehicle was ‘off road’ (VOR), the process led to mitigation through commercial breakdown cover, vehicle rotation, the use of other vehicles and a longer term aim to procure new vehicles.

Service level agreements were in place with the host trust for the transport of patients from ‘hospital to home’ and the provision of ‘people and organisational development services’ from the host trust. There was a business continuity plan, risk management policy and also a group recruitment policy in place applicable to the service; full recruitment checks were completed before employment. The service completed a schedule of audits on a monthly basis, such as patient records, safeguarding, infection control and vehicle inspections.

We understand our duty to collaborate and work in partnership, so our services work seamlessly for people. We share information and learning with partners and collaborate for improvement.

We scored the service as 3. The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

Although the service provided patient transport services to the host trust only, relationships had been developed with the local NHS ambulance trust and local NHS acute trusts where patients were transported from the host trust.

Within the local hospital relationships had been developed with the discharge lounge and individual wards.

We focus on continuous learning, innovation and improvement across our organisation and the local system. We encourage creative ways of delivering equality of experience, outcome and quality of life for people. We actively contribute to safe, effective practice and research.

We scored the service as 3. The evidence showed a good standard. The service focused on continuous learning, innovation and improvement. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

The service actively reviewed opportunities to improve safety, efficiency, and quality of care. An example given was the implementation of systems to enhance vehicle tracking, bringing benefits to patients and the service. These enabled:

• enhanced safety monitoring through capturing alerts for speeding, harsh braking, and collisions. This was used to identify unsafe driving behaviours and address them through targeted coaching and refresher training, promoting a culture of safety;
• full visibility of vehicles through real-time tracking ensured staff and managers were always able to locate vehicles, improving oversight and responsiveness in the event of delays or incidents;
• accurate journey documentation: Arrival and departure times were automatically recorded, supporting reliable reporting, audit trails, and service transparency;
• environmental and cost benefits through monitoring fuel usage and driving patterns helped reduce fuel consumption, vehicle wear, and overall running costs;
• data driven learning provided detailed reports and analytics, which were used to identify trends, drive continuous improvement, and develop best practice guidance for staff; and
• improved patient experience by proactively managing delays, informing patients accurately, and providing reassurance that journeys are being conducted safely and efficiently.