Response Ambulance Service

On this page

• 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

This is the first assessment for this service. This key question has been rated good. 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.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The local NHS provider who contracted the service provided all of the personal information required to understand the needs of the patients. Staff accessed this via their PDA’s. This information included the patients heath and care needs and their communication needs. Staff undertook dynamic risk assessments when meeting patients and whilst undertaking the journey to ensure their needs had not changed. 

RAS used this information to ensure they were able to meet the needs of the patients and if they could not, they would inform the local NHS provider who contracted the service that they were unable to transport the patient. Staff used this information to ensure patients were comfortable and to help prepare patients for their ambulance journeys.

We observed staff amending how they communicated with patients to reflect their needs. Staff were able to provide examples of how they had communication with patients with complex communication needs. 

The service assessed private patients using  the same process used for NHS patients, ensuring it met their needs effectively.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current 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. There were systems to communicate changes in guidance through meetings and management newsletters. Staff said they received information via meetings. 

All journeys we observed were prompt with no delays.  Patients told us they were contacted by the provider if there was a delay in the expected ambulance arrival.

Polices and processes were based around legal and regularity frameworks such as Health and Social Care Act 2008 (Regulated Activities) Regulations 2014,  Health and Safety at Work etc. Act 1974, Equality Act 2010, and NICE guideline CG50 recognising and responding to deterioration. 

Staff undertook monthly vehicle audits which were available on the PDA’s with results being electronically sent immediately to the leaders computer for action.  

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff worked together as a team to benefit patients. They supported each other to provide good care and deliver a quality service, ensuring for example, they started their shifts on time and planned the route of patient collection to maximise efficiency. 

We observed good working relationships with external organisations when travelling with the service to drop and pick patients up as part of our on-site inspection.  

Staff understood the importance of effective handovers and sharing accurate information when transporting patients between locations and services. Staff were able to give examples of how they provided effective handovers, including any relevant information from the journey itself. We observed 5 patients pick up and drop offs which were all good with all relevant information provided. 

Leaders reviewed daily rotas to ensure more experienced staff worked alongside less experienced colleagues, providing support, building confidence, and facilitating the development of necessary skills.

Leaders used a real time electronic dashboard to view the ambulances out on the road.  Staff were able to communicate any issues whilst out on the patient journeys to ensure immediate support from Leaders. 

Staff told us they regularly met with leaders and felt there was good engagement with them and with the staff they see from the local NHS provider who contracted the service, hospitals and care homes. 

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

The service supported patients to manage their health and wellbeing during transport and provided support if concerns were identified. Staff were aware of patients' individual needs and care requirements and used information from booking records to support safe and person-centred transport.

Staff monitored patients during journeys and, if required, escalated any concerns.

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.

Leaders monitored key performance indicators, including journey times, drop off times and pick up times. For example, out of 6,652 journeys over 6 months, 91.5% were no longer than 90 minutes. This information was a requirement of the contract with the local NHS provider who contracted the service. RAS also used this information within the service, sharing it with staff as part of team meetings. 

Leaders told us they did not benchmark themselves against other private ambulance services but rather look at how they can provide a better service on a day to day basis.

Staff used technology to support patients and journeys effectively. This provided up to the minute data for leaders and assisted with high quality monitoring of outcomes to help improve the service. Data was shared with staff and partners.  

The provider received regular feedback on their performance and outcomes from the local NHS provider and there were no outstanding actions required.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.                                                

The service had a Consent, Mental Capacity, Best Interests and Patient Choice Policy and Procedure in place which describe the principles of consent for staff to follow, including at every point consent must be obtained. 

Staff received induction and mandatory training in mental capacity and consent. Staff told us how they changed their communication styles based on patient’s complex need, for example those living with dementia, so they could communicate effectively. 

The local NHS provider who contracted the service informed the service about patients capacity as part of the assessment. Staff would dynamically assess this at each journey in case circumstances had changed. If staff noticed a change in capacity this was reported as a safety event and a new risk assessment was undertaken. 

We observed staff taking all practical steps to enable patients to make their own decisions.  We observed staff asking and receiving patient’s permission prior to any intervention. All staff were compassionate, reassuring and explained what they were doing right throughout the journey. 

We viewed examples of journeys which had not gone ahead owing to patients refusing to consent to the journey when the staff arrived to transport them.