EMED Sussex

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• 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

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this newly registered service.

This key question has been rated requires improvement: this meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

We found a breach of regulations in relation to good governance.

The provider did not have effective systems of accountability to monitor risk, performance or outcomes. Governance arrangements were not embedded, and leaders did not consistently act on, review or escalate information about quality, safety or data assurance. The risk register was underdeveloped and did not include key risks we would expect, such as patient harm and contract performance risks linked to delays and cancellations.

Leaders did not always demonstrate sufficient capacity or experience to lead a contract transition of this scale. Operational pressures associated with taking on the contract affected leaders’ ability to embed systems, routines and inclusive ways of working.

Freedom to Speak Up arrangements were not well embedded; the service had a corporate Freedom to Speak Up Guardian and corporate whistleblowing policy, but staff were largely unaware of the third‑party reporting route. In addition, leaders did not yet have sufficient oversight of workforce equality and inclusion.

The provider had not collected Workforce Race Equality Standard data or completed equality impact assessments for policies, which limited assurance that staff with protected characteristics were being treated equitably.

Although quality meetings were held, minutes showed limited scrutiny of assurance data, weak monitoring of actions, and no clear evidence that risks were being reviewed or updated. Leaders also lacked clear oversight of subcontracted activity, as performance data was not separated, limiting their ability to identify issues or hold partners to account.

However, leaders had established a shared vision and values, and staff spoke positively about the culture, describing leaders as visible, approachable and supportive, including during the Transfer of Undertakings (Protection of Employment) Regulations (TUPE) process.

Leaders engaged with commissioners and partner organisations, had effective arrangements for collaboration at system level and showed a commitment to learning and innovation.

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 evidence generally showed a good standard. 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 people and their communities.

The organisation had established overarching group objectives and priorities, which leaders planned to communicate to staff annually through a roadshow. The service had only been registered for 4 months at the time of assessment. Local leaders were focused on establishing the service and delivering the requirements of their local contract. They recognised that more time was needed for the culture and strategy to be fully embedded.

Staff that we spoke with felt respected, supported and valued. They described the leadership culture as inclusive and spoke positively about their working relationships with colleagues.

Staff also reported that the Transfer of Undertakings (Protection of Employment) (TUPE) process had been managed better than they had expected.

The evidence showed some shortfalls. Leaders did not always demonstrate the leadership capacity or experience required to lead the transfer of a contract of this scale. Leaders were aware of the challenges, but the scale and pace of mobilisation affected their ability to lead effectively throughout. Leaders told us they faced significant operational demands during mobilisation of the new contract and had not yet embedded the systems or routines needed to actively demonstrate inclusivity, ensure all voices were represented, or translate staff feedback into visible, sustained improvements.

Leaders told us they promoted an inclusive culture and encouraged both transferred staff and newly recruited teams to share ideas and raise concerns without fear of blame. We did not hear or see consistent evidence of this in practice, and opportunities for staff to meaningfully influence decision-making were limited.

However, leaders were described as visible and approachable across the service. They demonstrated a clear understanding of the challenges associated with the mobilisation of the new contract and were open about the work still required to embed consistent standards.

Staff told us leaders were supportive and responsive. We saw examples of managers taking time to check in with teams, listen to concerns, and provide reassurance during periods of service pressure.

The evidence showed a good standard of care. People generally felt they could speak up and that their voice would be heard.

The service ensured that staff felt able to speak up or confident that their concerns would be heard. The provider had fostered a positive culture in which people felt safe to raise concerns.

The service had a corporate Freedom to Speak Up Guardian (FTSUG) and corporate whistleblowing policy. The provider used a third-party company that staff could contact confidentially to raise concerns. The service referenced this option in policies, the staff induction booklet, and on posters with 24/7 contact details. However, none of the staff we spoke with were aware that this service existed.

Leaders told us they had established terms of reference for a staff forum, which they planned to hold monthly. Leaders said this was intended to provide a structured and accessible opportunity for staff to raise concerns, share ideas and influence decision‑making in a supportive environment, which they believed would help staff feel more confident to speak up.

The evidence showed some shortfalls. The service did not always value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who work for them.

The provider did not collect Workforce Race Equality Standard (WRES) data. Without this information, the organisation lacked insight into the experiences and outcomes of staff from majority ethnic backgrounds. This limited the provider’s ability to identify inequalities, monitor workforce diversity, or take targeted action to reduce disparities. The absence of WRES data also reduced assurance that the provider was meeting its responsibilities to promote an inclusive culture and actively address race-related concerns within the workforce.

The provider had not completed equality impact assessments (EIAs) for its policies or procedures, which meant the service could not be assured that its processes did not unintentionally disadvantage vulnerable people or those with protected characteristics.

However, the service had an equality, diversity and inclusion (EDI) statement that outlined its commitment to fair treatment of staff, representing the wider community, and preventing unlawful discrimination.

The provider submitted a gender pay gap report in 2025, providing some oversight of gender‑related workforce equality.

The evidence showed significant shortfalls. The service did not have effective systems of accountability or good governance. They did not act on information about risk, performance, and outcomes, or share this securely with others when appropriate.

Governance systems did not provide adequate oversight of performance, risk or data quality. Arrangements lacked the clarity required to give leaders assurance that journeys were being delivered safely and were responsive to patient needs.

The service had a risk register, and the operational team had responsibility for its maintenance and review. The risk register included descriptions of risks, their potential impact, and action plans to manage and reduce risks. The service graded risks in terms of original and target risk. The risk register contained only 4 risks, which focused on operational matters and did not include risks that we would expect to see monitored. For example, patient harm and contract performance risks arising from delayed drop-offs and pick-ups.

The service commenced monthly governance and performance review meetings in October 2025. They were led by the CQC registered manager and staff reviewed incidents, complaints and risks. We reviewed meeting minutes from October and November 2025 and found consistent shortfalls in governance processes.

Leaders lacked clear oversight of quality and safety across the whole transport service. The provider did not separate performance data for journeys completed by subcontracted services and did not provide a standard operating procedure for patients’ suitability to travel by taxi. This limited leaders’ ability to monitor performance accurately, identify areas of concern, and hold sub‑contractors to account.

The evidence showed a good standard. The service understood their duty to collaborate and work in partnership. They share information and learning with partners and collaborate for improvement.

Leaders engaged with a range of external stakeholders, including commissioners, Healthwatch and Age UK. Managers reported a positive working relationship with the Integrated Care Board (ICB) and held regular, open discussions to understand risks to contract delivery. The service met with the ICB monthly to review key performance indicators, with actions captured in a shared action log. Managers also presented performance data to each acute NHS hospital trust monthly. The service recorded all stakeholder concerns and complaints and analysed emerging themes to support improvement.

The evidence showed some shortfalls. The service did not always focus on continuous learning, innovation and improvement across the organisation and local system.

The provider was exploring ways to drive improvement across the organisation and the wider system, The service was developing a range of initiatives to improve accessibility and better meet individual needs, including a pilot programme for dementia-friendly transport. Leaders told us work had begun on a reminiscence app for to support crews when transporting people living with dementia, as well as quieter and less distressing vehicle adaptations. The service was also developing enhanced dementia care learning tools.

Leaders described plans to place bleed kits on all vehicles contains items to support rapid, potentially lifesaving first aid for severe bleeding before emergency services arrive. Leaders also told us about plans to develop a new training package to support patients with autism, attention deficit hyperactive disorder (ADHD), and sensory needs.

However, these initiatives remained at a formative stage, reflecting that the service had been operating for only 5 months at the time of our assessment.