Alliance-Pioneer Ambulance Ltd Also known as APG

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 means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. We checked that care, support, and treatment were tailored to meet people’s needs, ensuring individuals were at the centre of their care. We also looked for evidence that leaders promoted a culture of continuous improvement, where reviewing outcomes and applying best practice were part of everyday work.

This is the first inspection for this newly registered service. This key question has been rated good. This means people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

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.

Description: We maximise the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

The evidence showed a good standard. 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 service carried out risk assessments prior to each patient journey, actively involving the patient throughout the process. For contracted work, patient information was provided directly by the commissioner.

There was a company policy for dynamic risk assessments, and staff were trained to carry them out to help ensure patient transfers were completed safely. Staff were trained to take and record clinical observations for high-dependency transfers, and they understood how to request additional support when required. We observed staff selecting the appropriate equipment to transfer a patient to the ambulance, based on their clinical condition.

The service had a vehicle and transport policy to ensure the safe transportation of all patients, with individual needs appropriately considered. The service often received positive feedback from patients. In addition, we reviewed several positive comments from people using the service, which indicated staff routinely assessed, understood, and responded to individuals’ needs.

Description: We plan and deliver people’s care and treatment with them, including what is important and matters to them and in line with legislation and current evidence-based good practice and standards.

The evidence showed a good standard. 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.

People received care, treatment and support that was evidence-based and in line with good practice standards. Leaders accessed the latest clinical updates from the Joint Royal Colleges Ambulance Liaison Committee (JRCALC), which develops and publishes evidence‑based clinical guidelines for paramedics. Staff had access to JRCALC guidance on handheld devices and told us they were kept informed of any changes to policies and procedures arising from JRCALC updates. The service undertook audits of clinical records to provide assurance that clinical care was being delivered in line with best practice.

The service had a policy outlining how to manage end-of-life patients who deteriorated during transport, developed in line with guidance from a UK cancer charity. This ensured staff understood their responsibilities, operated within the scope of their training, and appropriately documented any incidents.

People’s nutrition and hydration needs were met. A service user told us they were offered suitable food and drink, along with sufficient toilet breaks.

Description: We work effectively across teams and services to support people, making sure they only need to tell their story once by sharing their assessment of needs when they move between different services.

The evidence showed a good standard. 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 had access to the information they needed to appropriately assess, plan and deliver people’s care, treatment and support. Booking details were recorded and communicated to crews, providing all necessary information, including journey details, any health concerns, and next of kin contacts. Staff told us they could contact a duty manager if they had any concerns, and support was prompt and responsive.

Information was shared effectively between teams and services to ensure continuity of care. We observed that staff transported patients safely to the correct location and provided timely, relevant information to the receiving healthcare professionals.

The service had a policy to guide staff on how to ensure the patient’s safe onward travel in the event of a vehicle breakdown.

Description: We support people to manage their health and wellbeing so they can maximise their independence, choice and control, live healthier lives and where possible, reduce their future needs for care and support.

The evidence showed a good standard. 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.

People were involved in reviewing their health and wellbeing needs where necessary. The booking form included dedicated fields to ensure patients’ individual needs were identified and planned for, including requirements relating to nutrition, hydration, and toileting. For longer journeys, comfort breaks were planned, and appropriate nutrition and hydration were provided.

Description: We routinely monitor people’s care and treatment to continuously improve it and to ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of people themselves.

The evidence showed a good standard. 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.

There were effective approaches to monitor people’s care and treatment and their outcomes.

External contracts included specific key performance indicators and targets, and the service undertook performance monitoring that was reviewed at monthly governance meetings. The service also monitored adverse incidents to identify themes and trends, alongside reviewing patient feedback to support ongoing improvement.

As part of the contract with the NHS ambulance trust, the service recorded Ambulance Quality Indicators (AQIs), which are standardised performance measures used by the NHS to assess the timeliness, safety, and clinical effectiveness of ambulance services. This information was used constructively in discussions with the NHS ambulance service to support service planning and continuous improvement.

Description: We tell people about their rights around consent and respect these when we deliver person-centred care and treatment.

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

Staff understood the importance of ensuring that people fully understood what they were consenting to and the importance of obtaining consent before they delivered care or treatment. Staff received training in the Mental Capacity Act and consent. Records confirmed that all staff were up to date with this training, and we observed consent being obtained prior to transport.

There was a staff policy that clearly outlined the principles of consent and provided guidance on assessing capacity, as well as obtaining consent for children. The policy also detailed procedures for aborting or cancelling journeys, including situations where a patient chose not to travel. Guidance on obtaining consent from children was provided for staff in all vehicles.