UCS Medical

On this page

• 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

We looked for evidence that patients and communities were at the centre of how care was planned and delivered, including whether their needs were understood and whether they were actively involved in decisions about their care. However, the service did not consistently provide person-centred or inclusive care. Patients were not always involved in decisions about their care, and staff did not consistently understand or use systems to identify and respond to complex needs, including learning disabilities, autism, dementia, and mental health needs.

Feedback and complaints processes were ineffective, and leaders could not demonstrate how patient feedback was recorded, responded to, or used to improve care. In addition, the service did not monitor equity of access, experience, or outcomes, which limited its ability to identify or address health inequalities. Communication with patients about waiting times and changes was inconsistent, and governance arrangements did not provide sufficient assurance that care was consistently responsive or driven by patient involvement.

However, staff were generally responsive when patients’ needs changed during journeys and usually ensured continuity of care for complex transfers.

This was the first assessment of the service, and the responsive domain is rated as requires improvement.

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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

When working with external partners crews told us they had the information they needed to provide personalised care when they met the patient. However, this was not always shared with them in advance.

Staff adapted their approach when patients’ needs changed, such as pausing a journey if someone became distressed. However, not all staff we spoke with understood the systems that were in place to support people with complex healthcare needs, experienced sensory loss, learning disabilities and those living with dementia.

Staff understood that patients aged 16–18 were still children and adjusted their care accordingly.

Mental health awareness and autism training was not provided despite being listed as a requirement in the services Mental health policy.

There were some shortfalls in how the service understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

The service did not always plan and provided care in ways which met the needs of local people, and the communities served. Managers could not demonstrate how they worked with others in the wider system and local organisations to plan care where relevant.

Managers told us when patients did not respond to planned collection times they were contacted to make alternative transport arrangements and check on their wellbeing.

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

The service was not compliant with NHS England’s accessible information standard. Crews did not use communication aids for non-verbal, speech impaired or neuro-diverse patients. The service had plans to introduce access to translation services but in the interim staff were told they could use a translation App on their own devices.

Patients told us that staff did not always keep people updated about timings, delays and changes through phone calls or face‑to‑face conversations.

Information was available on the services website and there was a member of staff with responsibility for keeping all information updated.

The service did not make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They did not involve people in decisions about their care or tell them what had changed as a result.

Patients were not always involved in decisions about their needs related to ambulance service provision. The service had a feedback policy which outlined the complaints process. The registered manager told us that complaints were recorded on the services computer system but was unable to access the data during our assessment. The service had received a complaint a few weeks prior to our visit. However, when we asked for details of the complaints received in the previous 12 months as part of our data request we were told the service had received no complaints in the previous 12 months.

Managers told us learning from complaints and concerns was seen as an opportunity for improvement but could give no examples of how they incorporated learning into daily practice. Staff told us they did not receive feedback or details of complaints and were unsure of the services complaints process. Managers had not completed any audit of patient complaints.

Managers told us patients could provide feedback via the services website. The services website did not provide any information in relation to the complaint process but did allow people to leave feedback.

We did not see any evidence of how complaints were investigated or that and patients received a response in suitable time because managers could not access previous responses during our assessment.

Where the internal complaints process has been exhausted, there were no formal arrangements for the independent review of complaints where the patient was receiving non-NHS funded care.

The service did not always make 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. However, waiting times for collection and delivery to pre-arranged appointments were not monitored for efficiency and timeliness.

Managers and staff worked to make sure patients did not stay longer than expected whilst waiting for collection and return home. However, patients told us that waiting times for collection and delivery could often be quite lengthy with little or communication as to the reason for the delay.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

The service did not monitor patient access and outcomes to identify potential health inequalities. Therefore, the information was not collected to inform service planning and delivery. There were no systems and processes for gathering feedback to enable the collection of information about equity of patient's experiences and outcomes.

We did not see any evidence of adjustments that may be made to support those most likely to experience inequality in experience or outcomes.

People who did not speak English as their first language could access the service, however there was no translation service available to them. Pictorial information to assist engaging with people with additional needs was not available.

People were not supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Patients were not supported to make informed choices about their continuing needs which relied on ambulance transport.

Patients who had care plans and information about their wishes for resuscitation were not encouraged to bring these documents with them when they were transported. Where individuals had medicines they needed to take whilst away from home, they carried these with themselves and were responsible for self-administration.

Staff told us they would make sure that any information provided to patients by the discharging service accompanied the patient and was taken with them once they arrived home.