Response Ambulance Service

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes

This is the first assessment for this service. This key question has been rated good. This meant patient’s needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

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

The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff knew how to ensure patients had equal access to their service.  When staff received booking information for patient transfers, they were provided with information about reasonable adjustments such as disability or sensory loss as part of their additional needs. 

Crews had all the necessary information and knew what to expect because information was shared with them. 

The service had a numerous policies to support them to provide person centred care, such as Patient Communication, Accessible Information and Translation Procedure. This referenced legal frameworks such as the Equality Act 2010 and NHS England's Accessible Information Standard. 

The service had systems to support patients with complex healthcare needs, sensory loss, mental health, learning disabilities and dementia. Staff were able to access support through their leaders and the local NHS provider.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service planned and provided care in ways which met the needs of local people, and the communities served. They worked with others in the wider system and local organisations to plan care where relevant. The service worked closely with the control room of the local NHS provider who contracted the service to ensure continuity of care was maintained across services and patients received coordinated support throughout their journey.

RAS ensured it had enough ambulances and staff to support all journeys ensuring care was joined-up, flexible and supported choice and continuity. Staff worked flexibly to meet patient need. 

Staff regularly transported the same patients, enabling them to develop a good understanding of each patient's diverse needs and individual requirements.

The service did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service did not meet all of the accessible information standards which is a requirement for all services who provide care to NHS patients. The service did not provide patient information in alternative formats such as braille, audio formats or have access to visual aids to assist with communication. Staff could access interpretation services and individual communication needs were recorded for each patient. 

Following our on-site visit the service told us a visual communication aid was added to each ambulance.

The service had recently produced a Patient Communication, Accessible Information and Translation Procedure to provide ensure all patients communication needs were met. 

The policy stated monitoring would be thorough audit, but as the policy was relatively new this had not taken place as yet. 

Information governance systems ensured all patients information was held confidentially with effective security systems in place. 

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

The service had a complaints, concerns and feedback policy and procedure in place. 

The policy clearly described the steps staff should take when receiving a complaint. It stated staff were to be supported to offer an apology, where appropriate, at the time a complaint was raised, acknowledging the patient's experience and demonstrating a responsive and person-centred approach to concerns. Staff were requested to record all complaints on the electronic safety system, and leaders would monitor responses against key performance indicators to ensure complaints were managed effectively and within required timescales.

Staff had all received training in complaints and concerns.

There had been no complaints to the service in the last 12 months. 

The service reviewed patient feedback via a web based search engine review site. 11 reviews over the past 12 month had all provided 5 stars to the service. 

However, staff did not provide patients with information in the ambulance about how to complain. When we brought this to the leaders attention, they immedicably produced posters for all ambulances explaining how patients could provide both negative and positive feedback about the service they had received.

The service made sure that people could access the care, support and treatment they needed when they needed it.

People could access the service when  they needed to and received the right care promptly. Waiting times for collection and delivery to pre-arranged appointments were monitored for efficiency and timeliness.

Managers made sure patients could access services when needed and received treatment within agreed timeframes and professional guidelines.  

Managers and staff worked to make sure patients did not stay longer than expected whilst waiting for collection and return home. Staff planned patients’ transport arrangements carefully, particularly for those with complex mental health and social care needs.

The service made sure resources were where they need to be at the time required and informed external contractors of the availability of private vehicles. Unforeseen delays were communicated to the NHS trust from which it sub-contracts by the registered manager or senior duty person.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes.

The service monitored private patient access and outcomes to identify potential health inequalities. This information was used to inform service planning a delivery. 

Staff received training in equality, diversity and human rights as part of their induction and at mandatory updates staff received training in ‘Working in a person centred way.’

The service ensured patients who accessed the service whose first language was not English, could access interpretation services.