Medicmart Ambulance Service

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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.
This was the first assessment of this service at this location.
This key question has been rated good. This meant that people’s needs were met through good organisation and delivery.

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 behaviour clearly reflected a commitment to prioritising the needs of the people they were treating. They gave people information that supported them in their choices around their own treatment and care which reflected their physical, mental, emotional and social needs.

The people that we observed with staff were all able to verbally communicate and had capacity. Staff were able to demonstrate the steps they would take to gain capacity from someone who was not verbally communicative, using other forms of communication like visual prompts, written communication or using family and carers to assist them. They could also demonstrate the circumstances when they may need to make a best of interest decision for someone who did not have capacity.

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.

The service has access to various care pathways, including A&E, General practitioner (GP) services and more specialised areas including stroke units, cardiac care centres and trauma centres. The care that patients needed was coordinated and responsive to meet their needs. Staff aimed to achieve the best possible outcome for patients and their families. Continuity of care was observed between the staff and other healthcare professionals within the hospital and community environments. This was observed when staff received an handover of care from a community first responder of a patient with chest pain. Staff continued to care and treat patients until arrival at hospital where they gave a concise, clear and thorough handover of patient care to the hospital staff.

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

Staff were aware that some people had different ways of communication and needed support. The service had a communication aid that included pictures and diagrams. Staff also had access to a language line for translation and interpretation for patients whose first language was not English. Staff also used other forms of communicating with patients for example writing information down for people who were hearing impaired. All information was given in a way that was suitable for the person involved and/ their families or carers. All emergency and urgent care staff had completed training in dementia, autism and learning disabilities and were aware of support these people may need whilst they delivered care and treatment.

All staff had completed training with General Data Protection Regulation (GDPR) and information governance. Staff knew the importance of keeping patient information confidential, with appropriate information sharing when it was needed. Patient care records were kept confidential and stored electronically.

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.

The service had a complaints policy which detailed the process of investigating complaints; however, it was not clear what arrangements were in place should internal complaint investigations be exhausted and how complaints would be independently reviewed. The service had not received any complaints regarding their emergency and urgent care work over the last year. The NHS ambulance trust confirmed that they had not had any complaints received against the service.

Staff knew how to inform patients how to complain or give feedback about their care. This could be by phone call or email to the service. Managers told us it was also considering setting up a feedback quick response (QR) code system. People told us if they felt the need to complain they would do so.

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

This service provided contracted emergency support to an NHS ambulance trust; therefore, the service received their calls to treat and care for people from the NHS trust call centre. This enabled people to have equal access to the care, treatment and support that this service provided when they needed it. The contracted NHS ambulance trust monitored Ambulance Quality Indicators (AQI) and other Key Performance Indicators such as response times and patient outcomes to treatment and care. The ambulance trust told us there were no concerns regarding the service’s performance and they were compliant within all indicators.

Staff had access to tools and guidance to aid them with care assessment to enable them to signpost and refer people to the right care pathway. They also had access to equipment to support people with mobility problems.

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.

Staff had received equality, diversity and human rights training. We observed staff demonstrate tailored care to the people using the service and listened to and acted on the information that they were given. We observed staff asked the people if there was any specific individual support that they needed to provide, for example cultural or religious needs, the person in this instance did not disclose anything.

People who did not speak English as their first language could access the service as staff had access to interpretation services and a language line. Pictorial aids helped staff to engage with people who had other additional communications needs.

People were 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.

All staff received training in end-of-life care, Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) and Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) documentation. The deteriorating patient policy also detailed what staff should do in the event of a person with this documentation dying whilst with ambulance crew. The staff we observed did not have the opportunity or need to engage in future care planning discussions with patients they treated. Staff also had access to the end-of-life protocols of the NHS ambulance trust that they supported via their electronic device.