Helimed house

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that patients and communities had the best possible outcomes because their needs were assessed. We checked that patient’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring patient were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.
At our last assessment we rated this key question outstanding. At this assessment the rating has remained outstanding. This meant patient’s outcomes were consistently good, and patient’s feedback confirmed this

We have not awarded this service a score for Effective.

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

We scored the service a 4. The evidence showed an exceptional standard. The service made sure patient’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

Clinical staff shared key information to keep patients safe when handing over their care to others. They knew what missions they were to undertake. Staff shift changes and handovers included all necessary key information to keep patients and ambulance crew safe.

Ambulance crew told us they monitored vital signs continuously so that they could quickly detect the deteriorating patient using equipment such as 12-lead electrocardiogram (ECG), invasive blood pressure monitoring and end-tidal carbon-monoxide, among others to monitor any changes in condition. These vital signs were uploaded to the electronic patient record and the duty on call consultant was also able to review these live remotely to offer support with rapid decision making to improve patient outcomes.

The service had a range of up-to-date policies and standard operating procedures to ensure ongoing assessment and treatment of patients such as National Early Warning scores and Sepsis. Staff knew how to access electronic versions of policies and procedures on their handheld digital device.

The service launched an innovative project to help determine if a patient had suffered from a bleed in the brain by taking a blood test. This enabled ambulance crew to make a faster diagnose and transfer patient to the most appropriate hospital for their ongoing treatment and care to improve patient outcomes.

We review patient care records which showed ambulance crew assessing, sedating and administering medicines in response to pain levels to make patients more comfortable.

Staff we spoke with told us they had access to various communication tools online such as translation services to enable them to communicate with people effectively. The service used knitted teddies to aid effective communication with children during assessment to be able to deliver targeted treatment on scene.

Staff considered patient needs when planning transport activities. For example, ambulance crew had planned to transport a patient in the air ambulance, but due to change in the patient’s condition crew made the decision upon re-assessment to convey by land as it would be safer.

We scored the service a 4. The evidence showed an exceptional standard. The service planned and delivered patient’s care and treatment with them, including what was important and mattered to them. Staff did this in line with legislation. They worked to develop evidence-based good practice and standards.

Staff followed up-to-date policies to plan and deliver high quality care. All policies we looked at contained a creation and review date, and clear references to current national guidelines. Policies and processes took account of changes to professional guidelines and National Institute of Care and Excellence (NICE) guidelines.

The service was dedicated to working to improving patient outcomes by developing new treatments, equipment and skills through trials, extensive research, evaluation and by using the latest cutting-edge evidence in pre-hospital emergency medicine (PHEM). Areas of research at the time of our assessment included the Brain-First study to diagnose a bleed on the brain and performing resuscitative endovascular balloon occlusion of the aorta (REBOA) to manage cardiac arrest patients to improve outcome compared to traditional cardiac life support measures.

The service audited clinical processes carried out on missions to monitor performance. Service data was monitored through a bespoke live dashboard for oversight. We reviewed the airways dashboard which showed ambulance crews compliance against the NICE guidance for Trauma Quality standard 1 which indicates people with major trauma who cannot maintain their airway and/or ventilation have drug-assisted rapid sequence induction (RSI) of anaesthesia and intubation within 45 minutes of the initial call to the emergency services. Data also reviewed intubation failure times for ambulance crew. In February 2026 there was 100% intubation achieved and there were no current themes identified.

Staff told us that they kept up to date with changes in practice and were encouraged to make suggestions if they felt current processes could be improved. These could then be assessed by the management team and if appropriate, changes would be made. Changes were communicated through team reads, meetings and governance groups. Ambulance crew said they were told about updates at the beginning of each shift to ensure they were aware of any changes in best practice guidance. Staff adherence to these changes were monitored through the review of missions by the senior leaders.

We scored the service a 4. The evidence showed an exceptional standard. The service worked well across teams and services to support patient. Staff shared thorough assessments of patient’s needs when they moved between different services, so a patient only needed to tell their story once.

Staff and volunteers worked cohesively as a team to benefit patients. They supported each other to provide PHEM care, after care, use research to inform on practice to deliver a quality service and improve patient outcomes. The service had policies and practices to ensure good communication between other agencies. There was regular debrief meetings for managers and teams to review incidents and constructively challenge actions and decision making. The service also had effective service level agreements and memoranda of understanding with external agencies to ensure there was a clear plan of decision making and communications. The service always worked well across teams and services to support people, which was vital to providing an effective service. The service attended regular meetings with other emergency response providers to discuss wider operation matters and response to emergency plans.

We reviewed patient care records and after-action reviews which detailed examples of how staff worked collaboratively across teams and services to improve outcomes for the patient and their families. For example, Helimed House staff supported with continuing treatment upon arrival at the local hospital urgent and emergency care department due to rapid deterioration on arrival.

The NHS ambulance trust reported that the staff worked closely in a professional and supportive manner. That this was strongly emphasised from induction and have had no concerns relating to staff crossing professional boundaries. They reported that Helimed House ambulance crew gained feedback from the paramedics to ensure that they are working collaboratively to ensure coordinated team-based care is delivered on every mission.

The service actively fostered integrated working by delivering joint training and co‑designing pathways with system partners, ensuring consistently aligned practice and improved outcomes for patients. Staff told us that they liaised with local hospitals and trauma centres to enable the most efficient transfer of patients to the appropriate place. We saw evidence in after action reviews of pre-alert calls when leaving the scene and on landing at the hospital to ensure that receiving teams were prepared for handover. This meant that it avoided delay in handing over care and Helimed House ambulance crew were ready for re-deployment if needed. We spoke to external system partners who described the working relationship with Helimed House staff as “A true partnership”.

The Aftercare team offered specialist emotional and practical support to patients and their families following the aftermath of a medical emergency attended by the service. Patient and family feedback is highly supportive and described as “fantastic” and “comforting as I needed to know what had happened”.

Managers had fully considered staff welfare. For example, we saw evidence of a cold debrief carried out jointly with the NHS ambulance service following a baby death that ambulance crew had attended. Senior leaders acknowledge the impact missions had on staff and facilities were centred around supporting their physical and emotional well-being. For example, staff had access to an onsite gym, rest area, sleep area to stay after their shift if they were unable to travel home.

Due to the context and nature of the service, there is no opportunity for staff to support patients to live healthier lives. The service focused on supporting people to live healthier lives supporting emotional and psychological health after their need for care. The evidence of reactive aftercare was of an exceptional standard.

The aftercare provided at Helimed House was for everyone not just their own staff. Debriefs were held with all external agencies that were involved in a mission such as police, fire and rescue and NHS ambulance services.
The Aftercare service was made up of specialist clinicians, providing vital emotional and practical support to those recovering from traumatic incidents and even members of the public who may have witnessed a traumatic event. It helped patients adjust to life after critical illness or injury, guided families through the shock of what had happened and offered compassion. The staff we spoke to told us that support was tailored to everyone’s needs and for however long they needed the support.

Feedback received from patients and their families included “They helped me so much and really took the edge off. They gave me lots of tools and help to contact more people that could help me and gave me advice about how to deal with situations.” One family member described how following the loss of their son the service was pivotal in their mental health and survival following the tragedy.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service collected patient feedback through the Aftercare team to make changes to methods of care or communication to enhance patient experience. Patient and families were highly complementary about the prompt and effective treatment they received from the service at the time of the incident and following it.

Senior leaders monitored the effectiveness of care and treatment through live dashboards, outcome data and reviewing benchmarking to compare with other similar services; such as cardiac arrest outcomes, paediatric outcomes and regional review of trauma outcomes.

The service had set key performance indicators (KPI), in line with national guidance, which they measured performance against. When compliance fell below the required target they took action to address it. For example, we saw that in 2025 quarter 1 the compliance for antibiotic administration in open fractures was 86% against a target of 90%. Leaders told us that they shared the performance data at the clinical governance day with clinicians, emailed a reminder of the standard operating procedure to remind all staff of the KPI. Improvements were noted in the following quarter, with staff achieving 91% compliance.

The service used the findings to make improvements and achieved good outcomes related to getting patients treatment on time. For example, Post- prehospital emergency anaesthesia (PHEA) hypotension is strongly associated with increased mortality, particularly in trauma patients. A concern was identified regarding the rate of post-PHEA hypotension. As a result the service produced evidence-based clinical recommendations to support improvements, updated the PHEA standard operating procedure (SOP) to strengthen expectations and shared these with the clinical workforce, developed a collaborative research proposal to assess the impact of plasma transfusion on post-intubation hypotension and initiated a project to evaluate and monitor the improvement of patient outcomes.

The service had systems to monitor and improve outcomes. However, leaders recognised they did not have access to commissioners’ performance data to monitor and improve patient outcomes. They worked closely with the local major trauma centre to ensure routine sharing of patient outcomes. The service had started to use the quarterly outcome data to ensure accurate recording of patient outcomes. This meant that the service had more data to inform their practice and drive improvement for outcomes of those they treated.

The service monitored and reacted to avoidable incidents of harm. Learning from investigations was shared with the aim of making improvements, for example, the service modified their policy on the use of heated blankets in patients that were unconscious following a thermal burn to prevent future harm.

Health inequalities are avoidable differences in health outcomes between groups or populations, such as age, health conditions and gender. These impact on physical and mental wellbeing and life chances of individuals and groups most affected. By looking at data, services can provide evidence-based interventions, highlight which communities suffer from worse health outcomes and understand specific barriers faced by under-represented groups. At the time of our assessment, senior leaders told us that they did not review their patient outcome to identify health inequalities for the people they served. However, there was a plan to review this data going forward.

We scored the service a 3. The evidence showed a good standard. The service carefully explained to patient what their rights around consent were, made sure they fully understood them and always fully respected these when delivering person-centred care and treatment.

Staff understood how and when to assess whether a patient had the capacity to make decisions about their care. The service did not have a specific consent policy; however all staff were expected to adhere to their professional body policies on consent. Consent and capacity assessment formed part of the service’s mandatory training policy and adherence to this was monitored through audit of patient care records. We reviewed care record audit data which showed consent was documented in 94% of notes reviewed.

Staff completed mental capacity act (MCA) and deprivation of liberty safeguards (DoLS) training modules as part of their care certificate completion. Data showed 100% compliance for both modules. The service also required staff to complete consent training, compliance was above 95% for doctors and paramedic staff.

Staff took all practicable steps to give people the appropriate information, support and time to make an informed decision in a way they could understand. Where it was not possible for staff to get valid consent from a patient, the service acted in accordance with legal requirements.

Staff undertook training for patients with cognitive impairment such as dementia so that they understood how to act when a patient did not have capacity to make their own decisions. Data reviewed showed 100% compliance.
Staff had access to interpreters to support patients to give informed consent. We saw evidence of this being used where a patient’s first language was not English. Ambulance crew used language line to support the clinical assessment and gain consent for an intimate examination.