Criticare UK Ambulance Service

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

At our last assessment this key question was rated Requires Improvement. At this assessment the rating has improved to Good.

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of patient and their communities.

The provider had a clear vision, purpose and set of strategic objectives that supported the delivery of safe and effective patient transport services. Leaders had documented the organisation's vision and strategy and were able to explain how these informed operational decision-making and future service development. Staff told us they were aware of the organisation's vision and strategy.

The provider promoted a positive organisational culture based on openness, accountability and continuous improvement. Staff were supported to contribute to service delivery and improvement, and leaders demonstrated an understanding of the challenges facing the service and the needs of the patient population it served.

The provider had commissioned an external HR consultant to undertake an independent review of staff morale and workplace culture. This provided leaders with valuable insight into staff experiences and helped identify opportunities to further strengthen workforce support and engagement.

The service had leaders who understood the context in which they delivered care and support and embodied the culture and values of their workforce and organisation. Leaders usually had the skills, knowledge, experience and credibility to lead effectively.

The provider had leaders who demonstrated the skills, knowledge and experience required to oversee the safe and effective delivery of patient transport services. Leaders understood the nature of the service they provided, the needs of the patients who used it, and the operational challenges associated with delivering reliable transport services.

Staff spoke positively about local leadership and told us leaders were approachable, visible and supportive. Leaders promoted an open culture where staff felt able to raise concerns, share feedback and contribute to service improvement. Evidence from the external HR review commissioned by the provider demonstrated how leaders listened to staff and took action to support workforce wellbeing and engagement.

Leaders demonstrated a commitment to the organisation's values and were focused on delivering person-centred services. They maintained oversight of quality, safety and performance through regular governance processes and used information from incidents, complaints, audits and staff feedback to inform decision-making.

The service fostered a generally positive culture where patients felt they could speak up and their voice would be heard.

The provider fostered a positive and open culture where staff felt able to speak up, share concerns and provide feedback. Leaders encouraged open communication and demonstrated a willingness to listen to staff views and use feedback to support service improvement.

The provider had arrangements to promote staff wellbeing and engagement, recognising the importance of creating an environment where people felt valued and supported.

Staff had access to several routes through which they could raise concerns, provide feedback or discuss workplace issues. Leaders used information gathered through staff engagement activities, wellbeing initiatives and routine communication to understand workforce challenges and respond effectively.

The service valued diversity in their workforce. Staff work towards an inclusive and fair culture by improving equality and equity for everyone.

The provider valued diversity within its workforce and promoted an inclusive culture in which staff were treated fairly and with respect. Leaders recognised the importance of equality, diversity and inclusion in supporting staff wellbeing, engagement and the delivery of person-centred services.

Policies and procedures were available to support fair employment practices and ensure staff were protected from discrimination, harassment and inappropriate behaviour. Staff had access to equality, diversity and inclusion training as part of the provider's mandatory training programme, helping them understand their responsibilities and the needs of the diverse communities they served.

Leaders sought to understand staff experiences and identify opportunities for improvement through workforce engagement and wellbeing initiatives. Evidence reviewed demonstrated the provider had taken steps to gather independent feedback on staff morale and workplace culture, enabling leaders to better understand workforce needs and promote a supportive and inclusive working environment.

The service had clear responsibilities, roles, systems of accountability and good governance. Staff used these to manage and deliver good quality, sustainable care and support. Staff act on information about risk, performance and outcomes, and shared this with others when appropriate.

The provider had clear governance arrangements, defined leadership responsibilities and effective systems of accountability to support the safe and sustainable delivery of patient transport services. Governance processes were proportionate to the size and nature of the service and enabled leaders to maintain oversight of quality, safety, workforce and operational performance.

The provider maintained a comprehensive risk register that reflected the key risks associated with the service. Risks were effectively risk-rated and supported by detailed mitigating actions and progress updates. Leaders told us historic risks remained on the register even after closure to provide an audit trail and organisational learning. The risks identified were consistent with the nature of the business and demonstrated an ongoing focus on risk management and service resilience.

We reviewed three sets of governance meeting minutes which showed regular attendance by the service directors and senior leadership team. There was evidence of structured discussion relating to clinical matters, workforce issues, audit activity, risk management and service governance. Leaders used these forums to monitor performance, review issues and agree actions where necessary.

Staff engagement formed part of the provider's governance framework. Minutes from staff meetings demonstrated open, honest and transparent discussions between leaders and staff. Topics included staff morale, the findings from the external HR review, conflicts of interest, service developments and operational processes. This provided evidence that leaders sought staff views and were willing to discuss areas for improvement openly.

The provider also maintained an audit programme that supported the monitoring and review of key aspects of service delivery. Audit activity provided assurance regarding compliance, performance and quality and formed part of the wider governance and improvement framework.

Workforce assurance arrangements included enhanced DBS checking, routine driving licence monitoring and ongoing supervision by clinical team leaders. Some historic recruitment documentation was not consistently retained within personnel files, for example application forms and interview notes. However, evidence demonstrated key workforce assurance processes were operating in practice.

Inspection findings relating to vehicle condition also provided leaders with opportunities to further strengthen asset management and defect-tracking arrangements.

The provider also maintained an audit programme that supported the monitoring and review of key aspects of service delivery. Audit activity provided assurance regarding compliance, performance and quality and formed part of the wider governance and improvement framework. The provider had governance arrangements to oversee compliance with medical gas management procedures and maintain patient safety.

IPC compliance was monitored through routine operational oversight and governance processes. Where required, learning and reminders were shared with staff to maintain standards and support continuous improvement.

Business continuity and operational resilience were supported through established policies and procedures. We reviewed the provider's Risk Aversion and Business Continuity Policy, which outlined arrangements for managing disruption, maintaining essential services and responding to operational risks. These processes provided assurance leaders had considered potential challenges and had plans to minimise the impact on patients and service delivery.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for patient. Staff share information and learning with partners and collaborate for improvement.

The provider understood the importance of working collaboratively with other organisations to ensure patients received coordinated and seamless care throughout their transport journey. Staff worked effectively with healthcare providers, commissioners and receiving services to share relevant information and support the safe transfer of patients between care settings.

Evidence reviewed demonstrated the provider regularly liaised with external stakeholders when planning and undertaking more complex patient transfers. Leaders and staff described effective communication with partner organisations. This ensured patient needs were understood, risks were managed effectively and transport arrangements supported continuity of care. This was consistent with discussions held during the inspection and demonstrated a practical approach to partnership working.

The provider also shared relevant information with partners where appropriate to support patient care and operational effectiveness. Staff understood the importance of effective communication and collaboration when transporting patients between services.

Due to the size and nature of the patient transport service, there were limited opportunities or requirements for wider community engagement. However, the provider maintained an awareness of the needs of the population it served and adapted transport arrangements to meet patients' individual circumstances where required.

The service focused on learning, innovation and improvement across the organisation and local system. Staff encouraged creative ways of delivering equality of experience and outcome for patient.

The provider demonstrated a positive culture of learning and improvement. Leaders and staff were committed to improving the quality and safety of the patient transport service and used a range of mechanisms to share learning, monitor performance and implement changes where required.

Evidence reviewed showed clinical leads regularly shared updates, revised guidance and learning resources with staff through a secure internal messaging platform. This enabled staff to remain informed of current best practice, emerging issues and relevant changes in guidance. The system encouraged ongoing learning and supported consistent communication across the workforce.

The provider made effective use of data to identify areas for improvement and monitor the impact of actions taken. For example, audit findings identified lower levels of compliance with patient observations documentation. In response, leaders shared learning with staff and implemented changes to operational processes. Subsequent re-audit activity demonstrated improved compliance, providing evidence that learning had been embedded into practice and resulted in measurable improvement.

Patient feedback also formed part of the provider's improvement approach. We reviewed several examples of positive patient feedback which highlighted the professionalism and caring approach of staff. In addition, the provider maintained a tracker of identified concerns and improvement actions, which clearly documented issues, proposed solutions, responsible individuals and progress updates. This demonstrated a proactive approach to identifying opportunities for improvement and monitoring actions through to completion.