Medicmart Ambulance Service

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• 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.

This was the first assessment of this service at this location.

The key question has been rated as good, this means that outcomes were consistently good, and people’s feedback confirmed this.

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.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We observed staff listening to patients they were treating, considering not only what they needed but what they wanted, making the whole care experience patient centred. People were provided with support and information to enable them to make informed choices and decisions around their own care and treatment. Physical and communication needs were taken into consideration. Full capacity assessments were completed. Staff adapted their communication style appropriately and respectful discussions were had; a good rapport was built with the patient, and they reported feeling cared for and supported. Clear care and treatment plans were put into place; shared decision making was observed with the patient. People that were conveyed into hospital were reviewed and reassessed as needed throughout the journey, using the appropriate monitoring equipment.

People we spoke with felt confident that their needs had been assessed and had been fully understood by staff. People told us that they had received care and treatment that was appropriate to them.

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. They worked to develop evidence-based good practice and standards.

People received care, treatment and support that was evidence based and in line with good practice standards. This was confirmed through our observations during our assessment; staff used their skills and knowledge to assess the patients’ needs to determine what treatments may be required to benefit the patient.

Staff had access to other pathways of care and treatment as an alternative to A&E or if they were treating a patient who was experiencing symptoms requiring more specialised care. Staff also had access to a clinical advice line and a “call before convey” line which would enable them to discuss with another clinicians the patient’s condition and treatment plan to aid with shared clinical decision making. This was in keeping with the contracted NHS ambulance trust and national guidelines. The NHS ambulance trust told us that this service was compliant with National Ambulance Service Quality indicators (AQIs) and care bundles. AQIs look at various aspects of a service to provide a view of the quality of care and efficiency of a service from call and response times to the clinical outcomes of treatments received by patients.

The provider had systems to ensure that staff were up to date with evidence based on good practice and required standards. Joint Royal Colleges Ambulance Liaison Committee (JRCALC) guidelines could be accessed from the staff’s digital devices.

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 policies, guidelines and other assessment tools to enable them to appropriately plan, assess and deliver safe care and treatment to support people. We observed staff working well together as an ambulance crew, with other healthcare professionals and NHS colleagues. Patients were listened to; information and treatment plans were written down and documented. We observed comprehensive patient handovers providing smooth transition and continuity of care as the patient was transferred between different services.

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, reduce their future needs for care and support.

Staff demonstrated that they were able to give people help and support to have choice and control around their own lives and to remain independent within their own homes. Staff had access to other services for example GP services if A&E was not appropriate when a patient’s complaint could be related to lifestyle choices, engaging in conversations around health and wellbeing.

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.

Staff we observed used the equipment available to them to monitor patients, recognising that any changes in observations may indicate a change in a patient’s condition. This allowed them, together with patients, to make informed and considered treatment choices and monitor outcomes of treatment. Staff had access to national sepsis guidance tools and National Early Warning Score 2 (NEWS2), to allow them to quickly assess patients and identify those at risk of deteriorating. Patients told us that they felt that the staff fulfilled their expectations of treatment and care.

National Ambulance Quality Indicators and Care Quality Indicators of this service were audited by the NHS ambulance trust with which it is contracted. The trust reported no concerns regarding the service in relation to these areas. These together with key performance indicators (KPIs) were discussed at weekly and monthly engagement meetings with the service.

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

Staff understood the importance of obtaining consent before delivering care and treatment, ensuring that patients fully understood what they were consenting to. All emergency and urgent care staff had received training in the Mental Capacity Act (MCA) and the Mental Health Act (MHA). Staff we observed had a good understanding of the MCA and how to apply it.

Staff ensured that patients received information around care and treatment in a way that they understood. People were supported to make informed decisions. Both capacity and consent were documented on patient care records with treatment plans put into place to meet the needs and expectations of the patients.