UK Emergency Medical Transport Ambulance Service Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This is the first assessment for this service. The key question has been rated good. This meant people were safe and were not at risk of avoidable harm.

We found there were appropriate safety systems and processes to safeguard patients. We looked for evidence that safety was a priority for everyone, and leaders embedded a culture of openness and collaboration. Leaders had systems for identifying and responding to safety risks. The service had safety processes for the preparation of vehicles, equipment and for the patient journey between locations. Oxygen was managed safely. Patients were safe from neglect, abuse and discrimination. Patients gave informed consent prior to any physical support required of staff. Where they were unable to consent, those close to them were involved in decisions made in their best interests.

We have not awarded this service a score for Safe.

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

The service had a proactive and positive culture of safety, based on openness and honesty. Staff and leaders listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Learning was shared with staff.

The service managed patient safety incidents well. The service had an incident reporting policy, which outlined incident reporting procedures, levels and timescales of investigation. There was a risk assessment matrix applied to each incident, according to severity.

Staff recognised and reported incidents using the internal system, which was paper based. Managers investigated incidents and shared lessons learnt with the whole team and the wider service, including external and contracted partner organisations.

Staff understood the duty of candour. There had been no requirement for duty of candour since their CQC registration in February 2026.

The service’s recruitment policy outlined expectations around staff’s statutory and mandatory training.

Clinical staff completed training on recognising and responding to patient needs. For example, patients with mental health needs, learning disabilities and dementia.

The service worked with patients and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Staff made sure there was continuity of care, including when responsibility for patient care moved between different areas of a service and between providers.

Safety and continuity of care was a priority throughout people’s care pathway. Patients were assessed prior to arranging their transport needs. There was a clear criterion for accepting patients as suitable for the available vehicles and resources. The criteria set out exclusions and limitations for secure mental health transfers. This reduced the risk of transporting patients safely. We saw an example where a request to transfer a patient with a number of staff was identified as needing additional support in psychiatric intensive care unit rather than transfer.

There were systems and processes to ensure the correct patients were collected and transferred between locations.

Ambulance drivers were monitored through a road safety app. Drivers were reviewed, and performance reports were overseen by the supervisor who assessed driving performance quarterly. There were no concerns with driving performance at the time of the assessment.

The transfer of patients between locations was done safely. Staff had appropriate driving skills and experience. Suitably skilled staff accompanied patients during the journey and safety equipment was used throughout.

Relevant transport information were shared with authorised crew members through secure, password protected company mobile phones. This included a copy of the transport booking form, patient risk assessment and if required the risk assessment from the requesting service.

When overall responsibility for the care and treatment of a patient moved to a different service provider, such as transfer to the NHS, there was effective communication, which allowed for seamless transfer.

Care and support was planned and organised with people, together with partners and communities in ways which ensured continuity after transfer to the destination.

The service worked with patients and healthcare partners where required, to understand how best to keep people safe, what it meant for individuals and the best way to achieve that. Staff concentrated on protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately.

Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. They understood their responsibilities for notification of safeguarding incidents to the contractor of services. The service had well established partner working and contacts around safeguarding with their contractors and local authorities.

Staff received level 3 adult and children's safeguarding training. Data showed 100% of staff had completed safeguarding training. There were current safeguarding policies, and these reflected the national guidance for adults and children.

Staff knew how to make a safeguarding referral and who to inform if they had concerns. Safeguarding advice was available to support staff. Staff knew how to contact them. The registered manager was the safeguarding lead and had been trained to level 4.

Staff could give examples of how to protect patients from harassment and discrimination, including those with protected characteristics under the Equality Act 2010.

The service worked with patients to understand and manage risks by thinking holistically. Staff provided care to meet patient’s needs which was safe, supportive and enabled patient to do the things that mattered to them.

The service used transfer report forms (TRFs), which were initially completed by the registered manager over the phone or sent via email to understand the requirements of the patient. They gained as much information as possible to risk assess patients and ensure the patient transfer was safe to carry out.

The service worked with patients to understand and manage risks. Patients' needs were met in ways which were safe and supportive and enabled them to do the things that mattered to them. This included for example, who travelled with them.

Staff we spoke with said they could access advice and support from senior leaders in a prompt manner.

Staff could accommodate bariatric patients using their heaviy weighted stretcher or wheelchair. The heavy weighted stretcher was used to ensure dignity, secure and comfortable transport while minimising the risk of injury to ambulance staff. They could assign an extra crew member, or a second crew to these jobs if needed.

Staff completed basic life support and resuscitation for adults and paediatric patients' modules as part of their statutory and mandatory training (SMT).

Drivers used a road safety app during shifts to ensure full vehicle compliance. They used an employee time tracking app for clocking in and out of shifts.

Staff followed the service’s health and safety policy which outlined the risk assessment process, including for manual handling.

The service was aware of all potential risks in the care environment and controlled them well. Leaders worked with staff and external stakeholders to make sure equipment, facilities and technology supported the delivery of safe care.

The design, maintenance and use of facilities, premises and equipment kept people safe. Staff were trained to use equipment and to manage different types of waste safely.

We inspected 4 ambulance vehicles and found they were suitable for the purposes they were used for. Vehicles used for the transport of patients who were detained under the Mental Health Act (MHA) were appropriate and safe.

Vehicles were equipped for the type of services provided, this included safety seatbelt straps. Records of equipment maintenance and schedules were available. Vehicles were stored in a safe area and could not be accessed by unauthorised persons. Keys to vehicles were securely stored.

Staff carried out daily safety checks of specialist equipment. There was a system for staff to report faulty equipment and vehicles. A formal record was made of action taken to address the fault/s.

Leaders maintained oversight of equipment to ensure it was safe and ready to use. Equipment audits were completed and outcomes shared with staff. Staff told us they had enough equipment to carry out their work safely and to support the treatment and care needs of patients.

Fire safety equipment was available on vehicles and had been serviced. Fire exits were clear and free from obstruction in office areas. Oxygen cylinders were stored correctly, upright and in cages with no flammable or electrical equipment nearby. All fire extinguishers onboard vehicles were securely fastened, checked and well within expiry date.

All full and used empty oxygen cylinders were stored safely upright and chained in separate locked cages with hazard signs.

Staff disposed of clinical waste safely, both inside vehicles and outside the storage areas. Waste was segregated and labelled in accordance with the local policy.

Hazardous substances were stored safely and information about the products was available to staff.

The registered manager worked with an ambulance manufacturing company to design the ambulance to support a safe and comfortable secure transfer for patients that included low lighting and tinted windows.

Restraint methods were risk assessed for each secure transfer. Most secure transfers were completed using the vehicles purpose designed secure patient compartment, without the need for staff applied physical restraint. The service did not use spithoods. Handcuffs had been used on one occasion following an individual dynamic risk assessment, by appropriately trained staff, as a last resort for the minimum time necessary.

The service made sure there were adequate numbers of qualified, skilled and experienced staff, who received effective support, supervision and development. Staff worked together well to provide safe care, which met patient’s individual needs.

The service had enough staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and support. Staff were made aware of their shifts in advance and could make requests for annual leave and specific shifts. They were able to take breaks during their shift.

We reviewed 3 staff recruitment records which contained the full information to demonstrate compliance with staff recruitment requirements. New staff and temporary bank workers had a full induction tailored to their role before they started work. Managers supported staff to develop through constructive recorded, annual appraisals and 6 months reviews.

Managers reviewed the number of staff needed for each shift based on planned activity. Managers could adjust staffing levels daily according to the needs of patients and changes in activities.

Managers limited their use of bank staff and requested staff familiar with the service. Staff spoken to said they felt the service was safe.

The service supported the learning and development needs of staff and made sure staff received any specialist training for their role. Managers identified any training needs their staff had and gave them the time and opportunity to develop their skills and knowledge. For example, prevention and management of violence and aggression (PMVA) training. This included control and restraint using handcuffs when necessary. Staff had initial training and annual refresher training.

The service provided mandatory training in key skills to all staff. Managers monitored mandatory training and alerted staff when they needed to complete updates. There was an electronic online system for training which included conflict resolution, epilepsy awareness, medical oxygen, mental health awareness, privacy and dignity.

Staff completed an ambulance driver competency test and included a reflective learning log.

The service assessed and managed the risk of infection. Staff detected and controlled the risk of it spreading by following policies. Infection prevention and control data was collected and reviewed.

The service managed infection risks well. Staff used equipment and controlled measures to protect patients, themselves, and others from infection. They kept equipment and the premises visibly clean.

There was access to a local infection prevention and control policy (IPC) and supporting guidance was accessible to staff. Staff received training on IPC.

There was a programme of infection and prevention and control audits including for example, cleaning the vehicles. The service performed well in local IPC audits. In the most recent audits, the scores showed compliance with infection prevention and control measures in all clinical areas.

Staff understood the process for managing spillage of body fluids and the use of the spillage kits.

Staff supported infection prevention and control measures by following the uniform policy.

Staff cleaned the interior of vehicles and equipment before and after each transfer. This was documented on pre and post transfer checklists

The service made sure that medicines and treatments were safe and met patient’s needs, capacities and preferences. Staff involved patients in planning, including when changes happened.

The service had clear policies and standard operating procedures outlining the responsibilities for administering medicines. The service had not transferred any medicines with a patient since their CQC registration February 2026. We were told if medicines were moved with the patient they would be transported in accordance with the services medicines policy. Medicines were stored securely, documented and handed directly to the receiving ward or service.

Oxygen was used onboard vehicles when required. Cylinders were stored safely. All staff were appropriately trained and had completed medical gas administration training as part of their First Response Emergency Care Level 3 (FREC3) course qualification.

The service had an oxygen policy which staff told us they followed when administering emergency oxygen. The service’s latest medicines management policy incorporated oxygen for use, as per the Health and Safety Executive ‘Oxygen use in the workplace’ guidance and included information about hazards of using oxygen, causes of oxygen fires and explosions, correct or optimal storage, and non-compatible materials.