Archived: EMED Surrey Heartlands

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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.

This was the first inspection for this service. This key question has been rated good. 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. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. However, the service did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

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.

We scored the service as 3. The evidence showed a good standard. 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.

The service continuously reviewed people’s needs to ensure they planned the correct type of vehicle and crew. For example, they ensured they knew about people’s up-to-date mobility and communication needs. Some patients needed a familiar person to accompany them, and the service ensured this was planned for.

If there was a patient with complex needs or a journey requiring extra planning time, this would be highlighted individually to the planning team once the booking had been placed.

Crews listened to patients about their preferred ways to mobilise to a vehicle and transfer into the vehicle and supported them. For example, they helped patients walk from their house to the vehicle even if this took longer than transferring them in a wheelchair.

We scored the service as 3. 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.

The service ensured they incorporated patients’ needs when arranging their transport. This included patient preferences, physical and mental health needs, and details on people’s capacity. We reviewed numerous bookings, together with patient and journey notes. Passenger notes included details of how many crew members would be needed for the journey, their medical information and mobility needs, and their communication abilities. The journey notes included information regarding specific requests, such as giving patients 10 minutes notice before arrival, or requests for a quick turnover due to increased pain or anxiety.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information about patients that was collected and shared met data protection legislation requirements. The service had a comprehensive and up-to-date data protection policy, which was based on the General Data Protection Regulation (GDPR). We did not have concerns about the provider’s use of confidential data. The service’s website contained a data protection leaflet, which patients could download. Staff recorded patient notes on an electronic patient record system, which was secure and confidential. Crews accessed patient records on their PDAs.

Staff provided people with information on other transport providers when they did not meet EMED Surrey Heartland’s eligibility criteria. Information given to patients included contact numbers or emails, and details of what other services provided. Staff had access to an information sheet about other services, which contained important details to let people know; for example, how long another service might take to contact the patient, how much in advance patients could book journeys with other providers.

The service’s website was informative and easy to navigate. It contained contact details, FAQs, team information, and a variety of leaflets to download. Every leaflet had been produced with an easy read version (easy read is a method of presenting information in a way that is easy for people to understand, particularly those with learning disabilities). These included pictures and large writing.

We scored the service as 2. The evidence showed some shortfalls. The service did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

Patients did not always know how to give feedback about their experiences of care and support including how to raise any concerns or issues. We spoke with patients who regularly experienced transport delays. They told us they had never been informed how to make a complaint and would not know how to go about doing so. However, each vehicle displayed a sticker with details on how to raise complaints or to provide feedback. This could be done via a Quick Response (QR) code or telephone. The service’s website contained a complaints leaflet, which patients could download. It also had a feedback section, and the service encouraged patients to leave positive or negative feedback.

Complaints were not always responded to within the desired time frame. In the 6 months prior to our on-site assessment, EMED Surrey Heartlands received 128 complaints. On average it took 57 days to respond to each complaint. Managers told us there had been a gap in the service in terms of a patient experience manager between February to June 2025, which may have accounted for the delays.

The patient experience team dealt with any patient feedback and analysed this for themes.

There was an established process for the management of complaints and concerns. This included an initial basic investigation prior to the complaint forwarded to the relevant operational teams. An acknowledgement letter was also sent to the complainant which stated the final response would be received within 25 working days. Patients received an update if the final response was delayed. Once the investigation was concluded, the patient experience team formulated the response to the patient.

At the time of the on-site assessment, the service had 41 open complaints, the oldest being from February 2025. We reviewed 3 complaints. There was a clear audit trail, which listed dates and staff involved in the investigation. The investigation varied in their detail; however, it was evident the service investigated patient complaints and acted upon them.

The service integrated complaints to identify themes and trends. The company’s quality management system logged each complaint under a theme and identified any contributory factors. The system allowed staff to run reports and drill down into this data, to identify themes and trends for further analysis. The patient experience team met weekly to discuss themes and actions.

The provider had a national communications and engagement lead who supported quality assurance processes. They played a pivotal role in listening to patient’s feedback and collecting themes and actions. For example, they currently explored introducing soft-closing ambulance doors due to feedback from patients with dementia and their carers. This group of patients could become startled when doors closed with a loud noise.

The service gathered patient feedback, part of which we reviewed for the months of February, April, and May 2025. Most of the positive feedback related to the kindness and helpfulness of staff. Negative feedback mainly related to delays in being picked up from home or from hospital, poor planning, and uncomfortable journeys.

The service collected patient feedback and used it to drive improvement. Managers told us they changed the model of the service to be more able to meet people’s needs and expectations; for example, patients had expressed the wish to know who is picking them up, and to have regular drivers. The ‘call aheads’ helped the service to let patients know who they would travel with. We did not have assurance the service currently managed to ensure patients had regular drivers.

The customer care team dealt with stakeholder complaints and had received training in dealing with complaints. Managers or HALOs investigated stakeholder complaints and gathered trends and themes to pass to the quality and governance team.

We scored the service as 2. The evidence showed some shortfalls. The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

Patients were not always supported to access their care in a timely way because of the impact of the timeliness of their journey. Although for dialysis patients this had been an improving picture some patients were still dropped off late, and some patients waited a long time for their return journey. A review of data relating to the timing of dropping patients off for dialysis and picking patients up after their treatment over a period of 6 months, demonstrated an improving picture. In December 2024, 31 per cent of renal patients (523 out of 1678) were dropped off late at the hospital for their appointments. 11.5 percent of those (60 out of 523) were dropped off an hour or more later than the scheduled dialysis appointments and 1.3 per cent over 3 hours later than the scheduled dialysis appointments. In May 2025, 12.5 per cent of renal patients (179 out of 1433) were dropped off late at the hospital. 2.7 per cent of those (5 out of 179) were dropped an hour or more later than the scheduled dialysis appointments and 1 per cent (2 out of 179) over 3 hours later than the scheduled dialysis appointments.

In terms of renal patients being picked up from the hospital to go back home, in December 2024, 7.8 per cent of patients (113 out of 1445) were picked up more than one hour after their appointment, with 12.3 per cent of those (14 out of 113) not being collected until 3 hours after their appointment. In May 2025, 5 per cent of patients (53 out of 1104) were picked up more than one hour after their appointment, with 2 per cent of those (1 out of 53) not being collected until 3 hours after their appointment.

Waiting times for non-renal patients in hospital outpatient departments appeared to be deteriorating between December 2024 and May 2025. In December 2024 a quarter of patients (450 out of 1799) had to wait over an hour to be taken back home, with 11 per cent of those (48 out of 450) having to wait more than 3 hours. In May 2025, 38 per cent (714 out of 1902) of patients waited more than 1 hour to be taken back home, with 13 per cent of those (94 out of 714) waiting longer than 3 hours.

We saw presentation slides EMED Surrey Heartlands had produced to share with the ICB. Data with regards to patient delays and waiting times showed consistent failure to meet expectations between January to May 2025.

We reviewed data for the cancellation of journeys over a period of 6 months (December 2024 to June 2025) and saw 24947 journeys were cancelled for a variety of reasons. Most cancellations appeared to be outside of the service’s control. The top 3 causes listed included the hospital or patient cancelling an appointment, and the patient making their own way without letting the provider know. The 3 categories made up 33 per cent of journeys.

We reviewed data looking at aborted journeys over a period of 6 months, which equalled 4550 journeys. The majority of those, 60 per cent (2770 out of 4550), appeared to be outside of the service’s control. The top 3 reasons for journey aborts were that patients had made their own way, patients were not ready, or patients were not at the pick-up location.

The service ensured the booking process was straightforward. Patients called one central telephone number and had 3 options: making a booking; making an enquiry about an already existing booking; speaking with the control team. The Surrey Heartlands booking line was manned by call handlers from 8am to 6pm.

The service provided training for NHS trust staff on how to use the system to make transport bookings. Their website had a dedicated information section for healthcare professionals.

EMED Surrey Heartlands had a dedicated planner who oversaw the bookings for the 2 Surrey sites. The planner met with the local control room and someone from the engagement team twice a day to discuss resources and other relevant information. The planner largely worked on their own but could access support when required.

The service had a call response time target, which was that 90 per cent of calls had to be answered within 120 seconds. Managers told us the service did not always meet this target, which was part of the discussion with the ICB. However, data we reviewed as part of the assessment showed the target was achieved in 5 of the last 6 months, with the score consistently 90 per cent or higher.

We scored the service as 3. 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.

The provider had not undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

The provider ensured they planned the most appropriate vehicle, crew and equipment for people, depending on the individual needs identified at the time of booking. We reviewed data regarding reasons for aborted journeys and saw a small number of incorrect booking details led to journeys being aborted. It was unclear when the booking error had occurred.

The service had an equality, diversity and inclusion (EDI) statement which stated their commitment to treating all staff members the same, to being representative of all sections of society, and to eliminating unlawful discrimination. All staff received training on EDI as part of their induction.