CIPHER Medical

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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
• Planning for the future

This means we looked for evidence that the service met people’s needs.

At our last assessment we did not rate the service. At this assessment the rating is Good

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 had access to special patient notes (SPNs), care plans and end of life documentation to ensure care aligned with people’s wishes and existing treatment plans.

When appropriate, ambulance crews would acknowledge and respect the patient’s choice regarding their care, including the right to refuse treatment.

Crews prioritised the patient’s physical comfort and safety throughout the process, for example keeping a patient warm if they were being cared for outside.

When appropriate, crews involved the patient's family and friends in the decision-making process, providing emotional support and information.

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.

Crews worked effectively with emergency departments, urgent treatment centres (UTC), mental health teams and community services to ensure people received the right care at the right time.

Staff shared relevant clinical information during handovers to support safe and seamless transitions of care.

Crews considered alternative pathways to hospitals where safe, including referrals to General Practitioners (GPs), community-based services and palliative care teams.

We observed crews working jointly when attending emergency calls to co-ordinate safe and appropriate care. Staff communicated effectively with partner agencies, shared relevant information and agreed a joint plan to support the patient`s immediate needs.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service complied with NHS England’s accessible information standard.

The service ensured people with communication needs could access appropriate information and support. Staff had access to a full range of interpreter and communication services through the NHS ambulance trust including spoken-language telephone interpreters, British Sign Language (BSL), video relay services and the Relay UK emergency text service for both emergency and non-emergency calls, and staff were trained how to use them. During ambulance visits, crews could use the on-demand telephone interpretation or connect patients to a remote BSL interpreter using a service iPad. This meant patients with communication difficulties were able to understand their care and make informed decisions.

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.

Patients were involved in decisions about their needs related to ambulance service provision. Leaders told us patients knew how to give feedback about their experiences of care and support, including how to raise any concerns or issues and could do so in a range of accessible ways. We saw there were QR codes in the vehicles, which patients could use if they wished to feedback.

The service and staff made it easy for people to share feedback and ideas or raise complaints about their care, treatment and support.

The NHS ambulance trust, which the Independent Ambulance Service was subcontracted by retained responsibility for complaints and their investigation. Where such a complaint arose the NHS ambulance trust was made aware of the matter and were involved in investigating and identifying learning from this.

The service had a clear complaints and compliments policy which set out how people could raise concerns, the stages of the process and expected timescales for a response. The policy also signposted people to the Parliamentary and Health Service Ombudsman (PHSO) and the Independent Complaints Advocacy Service (ICAS) if they were unhappy with the outcome.

Data showed the service received 21 complaints between January 2025 to December 2025. All complaints had been managed in line with the policy, with actions identified and responses provided in a timely and appropriate way. Leaders used learning from complaints to improve practice, and staff were able to describe changes that had been made as a result.

We saw evidence of learning from complaints displayed on staff boards in the staff room, including information relating to complaints involving seizures. This helped ensure staff were aware of themes and actions taken and supported ongoing improvement in practice.

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

The service was available 24 hours a day all year round and saw people regardless of residency status.

Equity in access to emergency care meant that all individuals, irrespective of their socioeconomic status, ethnicity, disability, location, or any other characteristic, had the same opportunity to access timely and appropriate emergency healthcare services. This involved addressing barriers to access and ensuring fair treatment for all patients.

Ambulance vehicles were equipped with ramps, powered stretchers and securement systems to accommodate patients in wheelchairs and on stretchers. The service used specialist equipment such as high weight-bearing stretchers to ensure that bariatric patients could be safely and comfortably accommodated. This commitment to inclusive care helped ensure that all individuals, regardless of their physical needs, could access the service with dignity and safety.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People using the service experienced fair and consistent care regardless of their background, communication needs or personal circumstances. Staff followed the NHS ambulance trust clinical pathways and protocols, which helped ensure people with similar needs received comparable assessments and treatment.

Staff were trained in equality, diversity, inclusion and human rights.

We did not look at Planning for the future during this assessment. There is no previous rating for the Responsive key question so we cannot yet publish a score for this area.