Medisec Ambulance Service Limited

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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 we rated this key question as good. At this assessment the rating has remained. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Staff carried out assessments that considered each patient’s physical, emotional, and personal care needs. Patients were supported to understand their care and treatment so they could make informed decisions and give valid consent.

We saw that patients and their communities achieved good outcomes because staff assessed their needs thoroughly. Care, treatment, and support reflected individual requirements, including any protected equality characteristics, ensuring patients remained at the centre of decision-making.

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.

Description: We maximise the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

We scored the service a 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Risk assessments were carried out before each patient journey by the external contractor. During the initial referral process, staff assessed each patient’s eligibility for the service and considered any additional needs that patients or their relatives had. This included language, cultural, and accessibility requirements. We looked at 6 journey plans, and they were personalised and holistic.

Staff received clear information patient journeys at the beginning of each shift, this included the patients they would be transporting, destination, and the reason for the journey being made. We saw that at shift changes and handovers, staff shared essential details to ensure that patients remained safe and that care was continuous.

Staff demonstrated the appropriate skills to communicate effectively and assess individual needs. They took account of cultural, religious, and social factors when planning journeys, ensuring that transport arrangements promoted dignity, equality, and inclusion in accordance with the Equality Act 2010. For example, one staff member highlighted that they had received training in British Sign Language (BSL) and Makaton, enabling them to communicate with patients with specific communication needs. Patients allocated to staff with the right skills to meet their needs, ensuring safe, person-centred, and continuous care.

Description: We plan and deliver people’s care and treatment with them, including what is important and matters to them and in line with legislation and current evidence-based good practice and standards.

We scored the service a 2. The evidence showed some shortfalls. The service did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Staff consistently followed up to date policies to plan and deliver safe, high-quality care. The policies we reviewed contained review dates and references to current national guidance. However, we found no evidence of a structured system for routinely communicating to staff when policies were updated. Staff told us that they usually received updates through 1 to 1 discussion with managers or informal conversations with colleagues. We reviewed records of one to ones which confirmed this took place,

The service commissioned an external organisation to support the development of policies and procedures. According to staff, these were then reviewed by the managing director to ensure alignment with the needs of the service. However, we found that not all policies aligned with the service.

There were clear and appropriate clinical protocols to support the safe transport of a range of patient groups. This included protocols for children of all ages, bariatric patients, and patients with mental health needs. Staff were aware of these policies and knew how to apply them in practice, ensuring equitable and safe care across patient groups.

On longer journeys, staff ensured that patients had access to food and drinks where appropriate and documented this in line with NICE Quality Standards on Nutrition and Hydration. Staff surveys and feedback confirmed that this consideration was consistently embedded into daily practice, supporting both patient dignity and comfort during transport.

Description: We work effectively across teams and services to support people, making sure they only need to tell their story once by sharing their assessment of needs when they move between different services.

We scored the service a 3. The service usually worked well across teams and services to support patient. Staff made sure patient only needed to tell their story once by sharing their assessment of needs when patient moved between different services.

Staff worked collaboratively as a team to provide safe and effective care for patients. They supported each other to deliver a high-quality service, ensuring punctual shift starts and carefully planning patient collection routes to maximise efficiency.

There was clear and well documented coordination between referrers (such as hospitals, care homes, and prisons) and the service. Both written and verbal handovers were consistently detailed and followed. The service operated an out-of-hours system, with a call centre managed by an external organisation. This call centre took responsibility for handling calls between 10pm and 8am during the week, and 24/7 cover over weekends.

The call centre received referrals from contractors and members of the public who required the service. These were passed promptly to the duty manager or on-call staff member via email and text message. Staff were then able to review and accept jobs, gathering additional information from the original referrer when needed. Managers confirmed that requests were usually matched to vehicles from the nearest available NHS trust, ensuring timely response and efficiency.

Staff described having positive and healthy working relationships with external organisations they engaged with regularly. This was also confirmed with these services during our assessment

Managers placed a strong emphasis on staff welfare and safety. For example, they encouraged drivers to take adequate rest between shifts to reduce fatigue and ensure safe practice.

Discharge and transfer arrangements took account of each patient’s individual needs, personal circumstances, and ongoing care requirements. Staff ensured that information was appropriately shared between services and care teams to maintain continuity and uphold patient safety.

Description: We support people to manage their health and wellbeing so they can maximise their independence, choice and control, live healthier lives and where possible, reduce their future needs for care and support.

We scored the service a 3. The service generally supported patients to manage their health and wellbeing to maximise their independence, choice and control. The service supported patients to live healthier lives and where possible, reduce their future needs for care and support.

The service actively supported patients to take responsibility for their own health and wellbeing. Staff encouraged individuals to maximise their independence, choice, and control. For example, two staff members from the contracted service highlighted feedback from patient surveys that confirmed patients felt empowered and supported during transport. Patients were encouraged to manage aspects of their own care, such as planning bathroom breaks during long journeys. This ensured that patients remained involved in decisions affecting their dignity and comfort, while allowing the crew to plan safe and appropriate rest stops as required.

Description: We routinely monitor people’s care and treatment to continuously improve it and to ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of people themselves.

We scored the service a 3. The service monitored patient’s care and treatment to continuously improve it. Staff ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of patient themselves.

The service used findings from feedback to make improvements and consistently achieved good outcomes, particularly in ensuring patients arrived at their treatments on time.

Managers had clear systems in place to monitor and improve performance. They reviewed key performance indicators (KPIs) regularly and ensured that targets were consistently met. Wherever possible, managers also used commissioner performance data to track progress and drive improvements.

An external provider reported that the service’s KPIs were strong and shared audit results from April 2025 to July 2025, which confirmed that performance targets such as response times and competition of transfers were being met. External stakeholders confirmed that there had been no issues or complaints, describing the team as “extremely dedicated.”

Performance data from April to June 2025 showed the service responded to 92 jobs, which included 92 patient transfers, including one ward assistance. Seventeen journeys were cancelled during that period, but all cancellations were made by the contractor and not by the service.

KPI achievement remained consistently high. External stakeholders confirmed that staff met expected standards and highlighted the service’s commitment to learning from their audits and feedback.

Description: We tell people about their rights around consent and respect these when we deliver person-centred care and treatment.

We scored the service a 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centered care and treatment.

We saw patients were calm, relaxed, and comfortable throughout their journeys. Staff engaged with patients respectfully and demonstrated awareness of their responsibility to obtain informed consent. They were clear about their duty to respect patients’ wishes, including compliance with DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) protocols, in line with national NHS guidance and professional standards.

Staff completed mandatory training in the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) as part of their training. Office dispatch staff also checked capacity considerations at the point of booking to ensure any concerns were identified early.

Staff consistently gave patients the information, support, and time they needed to make informed decisions about their care. Staff were confident in supporting patients who lacked capacity or were experiencing mental ill health, ensuring that their rights and choices were respected. We observed staff applying these principles in practice. For example, staff sought verbal consent before helping a patient transfer from a chair to a wheelchair and before moving them onto an ambulance. Patients told us they felt involved in decisions about their care.

Where patients made specific requests, such as being cared for by a health professional of the same sex, staff discussed these openly and met them wherever possible. Chaperones were available when requested. Interpreters were also used to support patients in giving informed consent, including British Sign Language.

In cases where patients were transported under the Mental Health Act, records showed that all necessary statutory forms and authorisations were in place. We reviewed 5 patient records and found documentation was accurate and complete.

The service also had a clear policy on the use of restraint, setting out when it could be applied and the techniques staff were trained in, such as de-escalation, minimal force, and breakaway techniques. Training equipped staff to manage challenging situations safely. Staff understood consent when transporting children. The records we reviewed looking at restraint contained all the relevant documentation and were in order.