Criticare UK 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

At our last assessment this key question was rated Good. At this assessment the rating has remained Good.

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 usually made sure patient’s care was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider had effective processes to assess and respond to patients' needs before and during transport. During the booking process, call handlers used an electronic booking system that prompted them to ask key questions relating to patients' mobility, medical conditions and transport requirements. The electronic booking system included mandatory fields that ensured key information was captured before staff could complete and submit a record. For example, prompts to gather additional information where specific risks or needs were identified, helping to ensure effective transport arrangements were made.

Staff were supported by a Dynamic Risk Assessment Policy, which provided clear guidance on assessing and responding to changing circumstances during the patient journey. This enabled crews to identify and manage situations where a patient's actual needs differed from the information recorded on the booking form. Staff were empowered to make decisions to maintain patient safety and escalate concerns where necessary.

The provider's approach ensured relevant information was gathered at the point of booking and staff remained responsive to patients' individual needs throughout transport.

The service and staff planned and delivered patient’s care in line with legislation and current evidence-based good practice and standards.

The provider planned and delivered care in line with current legislation, national guidance and recognised best practice. Systems ensured clinical and operational policies remained up to date and reflected changes in national standards. Staff delivering EUC activity worked within these frameworks and had access to current guidance when delivering care.

The provider demonstrated a structured approach to reviewing and updating policies, procedures and standard operating procedures (SOPs). Oversight was provided through governance processes that included regular policy reviews, scheduled update cycles and horizon scanning to identify changes in legislation, guidance and best practice. The provider also had arrangements to undertake prompt reviews where urgent updates to national guidance were issued.

Staff had access to current policies and procedures and were expected to work in accordance with them. Discussions with leaders and the evidence reviewed showed changes in guidance were communicated effectively and incorporated into practice where required.

The service usually worked well across teams and services to support patients.

Staff worked effectively with NHS trusts, healthcare professionals and receiving services to coordinate urgent and high-dependency transfers. Information was shared appropriately to support continuity of care and effective patient handover.

The provider usually worked well with other teams and services to support patients throughout their transport journey. Staff communicated effectively with healthcare providers, commissioners and receiving services to ensure relevant information was shared and patients experienced coordinated care.

Processes ensured information gathered during the booking process and subsequent assessments accompanied the patient throughout their journey. This helped reduce the need for patients to repeat their circumstances, needs and preferences multiple times and supported continuity of care between services.

Staff understood the importance of effective handovers and sharing accurate information when transporting patients between locations and services. Where changes in a patient's condition or identified needs arose during transport, staff were able to communicate these to relevant healthcare professionals and receiving teams.

The service generally supported patients to manage their health and wellbeing to maximise their independence, choice and control.

The provider generally supported patients to manage their health and wellbeing during transport and took action where concerns were identified. Crews were aware of patients' individual needs and care requirements and used information from booking records and care plans to support safe and person-centred transport.

The provider demonstrated that staff took opportunities to identify potential risks to patients' health, wellbeing and safety. Where concerns were identified, staff could raise safeguarding referrals or communicate relevant information to healthcare professionals and other agencies to ensure patients received support.

The service monitored patient’s care during their journey. Staff ensured outcomes were positive and consistent, and they met the expectations of patient themselves.

The provider monitored the quality and effectiveness of its service to help ensure positive outcomes for patients and support continuous improvement. A range of internal and external key performance indicators (KPIs) were routinely reviewed through the provider's governance processes. This allowed leaders to assess performance, identify trends and take action where improvements were required. For example, timeliness of collection and drop-off times for patient journeys were monitored. A further example showed 100% compliance with time of arrival on scene, a key metric for two specific contracts held by the provider.

The provider maintained performance data relevant to the size and nature of the patient transport service, and this demonstrated that KPIs and operational metrics were regularly monitored. This provided meaningful oversight of service delivery, patient experience and contractual performance requirements.

There were systems to monitor and manage agreed response and collection times. The provider worked with commissioners and service users to establish transport requirements in advance and used these arrangements to support timely service delivery. Evidence reviewed demonstrated performance against agreed timescales was monitored and concerns or complaints relating to transport timings were investigated appropriately. We saw an example where staff, including call handlers and operational crews, had followed provider procedures and managed a booking in line with organisational policy.

Leaders used performance information, complaints, incidents and operational feedback to inform service improvements and maintain oversight of outcomes.

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

The provider supported patients to make informed decisions about their care and respected their rights when delivering EUC services. Staff understood the importance of obtaining consent and demonstrated an awareness of the principles of capacity, choice and person-centred care.

Staff understood their responsibilities relating to consent and capacity and involved patients in decisions about their care wherever possible. Staff were supported by organisational policies and guidance to ensure decisions were made in accordance with relevant legislation.