Head Office

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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

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics. 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 Responsive.

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

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

Patient and referrer feedback was positive about how staff made sure people were at the centre of their care. We heard about a crew who stayed longer than necessary to reassure a person in emotional crisis and another where a crew member purchased a stuffed toy for a young person who was distressed.

Specific feedback comments included that staff had ‘provided excellent support to a young person’ and another that stated staff put a person ‘at ease’ and helped to prevent them getting anxious while waiting. Feedback from a young person included that the crew ‘were very nice to me’. Another person described the staff as ‘fantastic from start to finish’.

The evidence showed a good standard. 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.

Staff and managers fostered good relationships with local services, engaging with providers to ensure that patient transport services met the needs of the individuals they were transporting. This included working with the local authority who completed quality assurance visits as well as local safeguarding teams to ensure care provision for individual patients was appropriate.

Staff understood the diverse health and care needs of people in their care. There were systems in place to receive handovers of care prior to transportation so that continuity was provided.

The evidence showed some shortfalls. The service did not always manage patient information appropriately and had not considered the impact on data protection of a messaging application in use. They did not consistently have information in formats that were tailored to individual needs.

Information governance systems were not sufficient to ensure confidentiality of patient records. For example, we found patient information was included in a mobile messaging application used for coordinating the logistics of jobs. This meant there was a potential risk of patient data leakage and there was a lack of audit trail and organisation oversight. Service leads had not identified these risks themselves to ensure the confidentiality of patient information. They had not carried out a data protection impact assessment of the use of the mobile messaging application.

Staff told us they used internet-based translation services on their own devices if they needed help communicating with patients during journeys. They told us that some patients would be transported with family members and the transport coordinator identified patients with specific communication needs at the point of referral. The service did not provide service information in easy read formats, despite the service being geared towards patients with complex needs. This meant some people may not have received information in a format that met their communication needs.

The evidence showed a good standard. 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 and referrers were given information on how to complain and provide feedback on the service. There was a clear and up to date complaints policy that detailed the processes the service took to address complaints. Staff knew how to handle complaints and passed these on to managers for investigation.

There had been 5 complaints in the 12 months leading up to our assessment. There were not themes or trends identified. We reviewed the records about 2 complaints and found these were comprehensive and included investigations, staff interviews and a review of patient records where appropriate.

We saw that external organisations were involved in complaints where appropriate. This included the local authority designated officer (LADO) when there were complaints against individual staff working with children. We also saw the police were involved in a complaint against staff about the use of restraint and the outcome of the complaint was that the use of restraint was proportionate and lawful.

Staff received feedback on the outcome of investigation of complaints and acted on the findings. This included a review and changes to policies and procedures when necessary, and additional training for staff.

The evidence showed a good standard. The service made sure that people could access the care support they needed when they needed it.

Staff made reasonable adjustments for patients – for example, people with clinical needs were transported with a registered mental health nurse or an escort from the referring hospital. Patients with mobility difficulties could be transported using a stretcher when sitting in a vehicle was not appropriate for their care needs.

The transport coordinator received referrals for patient transport and sourced the appropriate size and skills of the team. This was always a minimum of 2 crew and was regularly increased to 3 or 4 crew to accommodate the unique needs of the patient. This flexible approach ensured that the service could accommodate a wide range of needs.

The service monitored a range of key performance indicators. For example, late pick-ups and cancellations. Data showed that cancellations were mostly cancelled before dispatch. Data showed they were generally due to issues outside of the service’s control such as a clinical decision or lack of escort when an escort was needed from the hospital or referring service.

The evidence showed a good standard. 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 were encouraged to provide feedback and leaders within the service reviewed feedback to ensure reasonable adjustments were made as necessary.

Because of the nature of the service providing secure patient transport services including for patients with protected equality characteristics, the service had a particular focus on meeting the needs of people who may be at risk of inequality. Service leads had ensured that staff had completed training to support a diverse range of people. Training included care for people with mental health issues, learning disability and those experiencing neurodiversity. Staff are also trained in equality, diversity, inclusion (EDI) and human rights, we saw that 100% of staff had completed this training.

Staff we spoke with had a clear understanding of the needs of individual patients and the risks faced about potential inequality. They told us there were clear processes for sharing feedback direct from patients and carers with managers and action was taken to address concerns.