Echo HQ

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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.

We looked for evidence that there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of patient who used services and wider communities. We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred and sustainable, and to reduce inequalities.

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

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.

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 clear strategic direction supported by its first healthcare services strategy 2026-2029 which outlined the organisations commitment to innovation, sustainability, workforce development and continuous improvement. Leaders described the strategy as a key milestone in the organisation development which provided a structured plan for how services would evolve to meet changing healthcare needs.

The strategy set out a vison for delivering safe, compassionate, professional and patient focused care supported by ambitions to improve outcomes, reduce inequalities, strengthen workforce capability and enhance operational resilience.

The strategy aligned closely with the organisation’s core values that were clearly defined, visible across the service and understood and reflected in staff behaviour. These values included being responsive, caring, patient focused, respectful, professional, reliable and committed to teamwork.

Staff felt respected, supported and valued. Staff reported the leadership culture to be inclusive and spoke about feeling valued and respected. Relationships between staff were positive, with strong teamwork and collaboration.

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.

Leaders were experienced, knowledgeable and demonstrated the skills and abilities to run the service. They understood and managed the priorities and issues that the service faced and were committed to delivering safe, high-quality care.

Leaders were visible and approachable and actively involved in the governance processes.

Staff felt the leaders supported them to develop their skills and take on more senior roles.

During the assessment leaders staff files were reviewed and found to be fully complaint with fit and proper persons requirements (FPPR). Documentation was complete, up to date and demonstrated pre-employment checks, identity checks, references acquired and DBS clearance had been completed.

Recruitment processes were followed for new staff and were recruited safely with mandatory checks completed prior to employment. Induction processes were robust, supported by high satisfaction scores from training and starter surveys.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff and leaders acted with openness, honesty and transparency. Staff were encouraged to raise any concern relating to safety, quality, behaviors or operational issues.

Staff described having clear routes to raise concerns about their work or how the service operated. The service had an established Freedom to speak up (FTSU), challenge culture and whistleblowing policy and a named Freedom to Speak Up Guardian (FTSUG) and who staff could contact directly.

In the last 12 months there had been no formal FTSUG referrals raised and staff told us that they felt able to speak with management team directly to raise concerns and had confidence they would be listened to and feedback acted upon. Staff provided examples of where they had provided feedback that had been actioned in relation to the vehicle make ready process.

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.

Leaders actively promoted fairness, inclusion and respect. Policies were accessible, staff were aware of their rights and leaders encourage open communication about individual needs. Equality, diversity and inclusion were actively promoted throughout the organisation's culture, leadership approach and workforce engagement processes.

The service promoted an inclusive, fair and supportive working environment underpinned by its Equality at Work Policy and Code of Practice. The policy was developed in line with national legislation including the Equality Act 2010 and reflected the commitment to protect staff across all nine protected characteristics.

Staff were able to request variation to their working patterns to meet personal need. These may include caring responsibilities, disability or long-term ill-health condition, pregnancy or other personal circumstances.

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 had clear responsibilities, roles and systems of accountability that supported safe and sustainable care. Leaders used structured governance process to monitor risk, performance and quality.

Formal clinical governance meetings were held monthly and followed a standard agenda covering incidents, safeguarding, complaints and compliments, audits, national guidance, policy compliance, business continuity and service delivery. Minutes from January to March 2026 demonstrated clear discussions, action tracking and named responsibility. Meetings were chaired by the managing director ensuring senior oversight and leadership accountability.

The service had a comprehensive risk register. Risks were clearly identified, rated by impact and probability and assigned a priority score. Each risk included detailed mitigation, named owners and a status indicator, ensuring accountability and active management.

The service took a proactive approach to Emergency Preparedness, Resilience and Response. The policy was part of the response to increase the resilience of the organisation so that it is able to respond to major incidents and business disruption, regardless of source, whilst continuing to deliver the services that hospitals and the community rely upon.

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.

The provider worked well with system partners and demonstrated a commitment to contributing effectively to the wider healthcare system. Leaders engaged effectively with NHS and non-NHS partners to support safe, coordinated care across the region.

The organisations healthcare services strategy 2026-2029 demonstrated a strong commitment to partnership working and community engagement. The strategy outlined how the provider worked collaboratively with public sector bodies, private clients, healthcare partners and international agencies.

The service had demonstrated a strong commitment to wider social responsibility through its humanitarian work. In 2025 the organisation supported humanitarian efforts in conflict affected regions by donating an ambulance, medical equipment and welfare supplies to support vulnerable communities. This included contributions to a children’s rehabilitation centre providing care, shelter and support to children who had been injured, displaced or orphaned by conflict.

As part of the assessment, we sought feedback from the NHS ambulance trust. Partners consistently described the provider as professional, responsive and patient focused. They reported positive communication, good collaboration and no outstanding concerns or unresolved incidents.

The service engaged with children and young people through structured educational visits to schools, scouts and youth organisations. These visits provided opportunities for children to explore emergency vehicles, learn about the equipment, understand the role of emergency services and ask questions in a safe, supportive environment. Activities included blue light demonstrations and sirens, tour of the vehicle and learning how emergency services help keep the public safe.

The service focused on continuous learning, innovation and improvement across the organisation and local system. 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 demonstrated innovation through practical operational improvements. They had designed and hand manufactured enhanced intravenous (IV) and intramuscular (IM) grab bags to improve speed of access and efficiency during time.

critical emergencies. These bags were developed using frontline clinicians feedback and supported faster life saving interventions.

Leaders introduced different coloured medicine pouches to ensure staff selected the correct equipment for each contract, reducing risk and improving compliance. A holder for an emergency alarm pendant was designed and implemented to support staff personal safety during high-risk situations. These changes demonstrated the providers’ ability to respond to emerging risks and develop innovation solutions that improved safety and quality.

Continuous improvement was supported through investment in workforce development, accredited education programs, apprenticeships and emergency response blue light training. Staff were encouraged to develop their skills and contribute to service improvement initiatives.

The organisation contributed to wider sector learning through its partnership with a university, supporting student placements and delivering specialist teaching sessions. This included major incident and multi agency training delivered to third year paramedic students in 2026. Leaders were directly involved in shaping the future of Paramedic science curriculum (2028) to ensure it remained relevant to modern prehospital care.

The organisation was invited to exhibit a new generation frontline emergency ambulance incorporating increased onboard storage, integrated side ramp access, dedicated automatic cardiopulmonary resuscitation (CPR) device storage and improved digital -technology charging capability. These developments supported productivity, efficiency and enhanced patient experience.