Medisec Ambulance Service Limited

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

We found that staff generally understood the needs of the patients and people they cared for. We focused on whether patients and local communities were truly at the heart of how care was planned and delivered. We considered how well the service supported access to care that reflected patients' circumstances and respected equality characteristics.

While we saw positive examples, there were some gaps in how the service recognised the diverse health and care needs of patients and local communities.

We have not awarded this service a score for Responsive.

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

Description: We make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs.

We scored the service a 3. The service made usually sure patients were at the centre of their care and treatment choices and they decided, in partnership with patients, how to respond to any relevant changes in patient’s needs.

Staff took steps to ensure patients had equal access to the service. When booking patient transfers, office staff asked about additional needs such as disability, sensory loss, or infection risks. This information was recorded on the system, which also flagged any required personal protective equipment (PPE). The transport team received all relevant details in advance, helping them prepare and understand what to expect.

The service had an inclusion criterion, and staff consistently followed it. This policy was underpinned by legal frameworks such as the Equality Act 2010 and NHS England’s Accessible Information Standard, ensuring that services were inclusive and responsive to diverse needs.

The service did not have specific systems to support patients with more complex healthcare needs, such as those with sensory loss. However, staff did explain that these patients were usually accompanied by a carer or chaperone, which reduced the need for additional internal arrangements. As a result, this was not included within the contractor’s formal contract.

Staff recognised that some patients aged 16 to 18 may require additional support due to them being potentially vulnerable young adults. Records showed that when accepting jobs, the service factored this into their planning. Staff confirmed they had not experienced issues with this process and the NHS contractor ensured and confirmed these cases were managed appropriately.

Managers also ensured staff, patients, families, and carers could access interpreting and signing support where required. For example, one operations manager who spoke the same language as a regular patient always accompanied them on journeys to ensure effective communication, despite this not being part of his main operational duties.

Description: We understand the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.

We scored the service a 3. The evidence showed a good standard. The service understood the diverse health and care needs of patients and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service planned and delivered care in ways that reflected the needs of local people and the communities it served. The managing director worked collaboratively with other organisations, including local charities, to design services that responded to community priorities. For example, managers met with voluntary groups to discuss specific patient needs in the area and to explore where additional support could be offered.

During our observations, we noted an example where the service could not respond to a request from the emergency department because all available crews were already committed to other transfers. In this case, there was no established process for referring patients to alternative transport providers when the service was at full capacity. Managers confirmed that this was not part of their contractual responsibility, and that pathways for escalation or referral to other services were not routinely in place.

While staff demonstrated a clear commitment to patient care, developing clearer pathways for onward referral would strengthen resilience and improve patient access during periods of high demand.

Description: We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

We scored the service a 2. The evidence showed some shortfalls. The service did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service did not ensure that key information was publicly available. At the time of assessment, the website did not include up to date details about the service. We discussed this with the managing director and confirmed that it was an external agency responsible for maintaining and updating this content.

The service did not fully meet NHS England’s Accessible Information Standard, which requires services to provide information and communication support in formats that patients with disabilities or sensory/communication needs ca understand and use. Although staff received appropriate training to reflect, we found no evidence that staff had access to, or used, communication aids for patients with non-verbal needs, speech impairments, or neurodiverse conditions. This could affect a significant portion of the patient group. While there was no documented evidence of this practice, staff confirmed that they cared for patients with such needs. In these cases, staff explained that when they accepted a booking in these cases, they expected the original referrer to have already decided, such as ensuring the patient travelled with a carer or family member. They confirmed this support was not part of their contractual responsibilities.

Staff engaged with patients and their carers in an open and supportive manner. They provided available information clearly and responded to questions honestly. Staff made use of other accessible methods of communication wherever possible. For example, they arranged interpretation and translation services and made reasonable adjustments when a patient’s protected characteristics required it.

Description: We make it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. We involve them in decisions about their care and tell them what’s changed as a result.

We scored the service a 3. The evidence showed a good standard. The service generally made it easy for patients to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved patients in decisions about their care and told them what had changed as a result.

Staff told us that patients understood how to give feedback about their care and support, including how to raise concerns or complaints. Feedback could be given in different ways, such as using a staff member’s tablet or phone while in the vehicle. Staff made the process straightforward, helping patients share their experiences, ideas, or concerns about their treatment and support.

The NHS trust, which subcontracted the service, kept responsibility for managing complaints, carrying out investigations, and identifying lessons learned. The trust met with the provider each month to discuss issues, and we reviewed the meeting minutes, which were appropriate and detailed. When complaints were raised, the ambulance service was informed and involved in the investigation process. External stakeholders confirmed this system and gave examples but also noted that the service itself had not received any complaints in the past 12 months. The service confirmed this.

Description: We make sure that everyone can access the care, support and treatment they need when they need it.

We scored the service a 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Patients were able to access the service when they needed it and received timely support. Collection and drop-off times for pre-arranged appointments were monitored to ensure journeys ran efficiently and patients arrived promptly.

Managers took steps to make sure patients received care within agreed timeframes. They worked to keep cancellations to a minimum, and when appointments were cancelled at short notice, staff acted quickly to rearrange journeys at a time convenient for the patient.

Staff and managers also ensured patients were not left waiting unnecessarily for transport back home after treatment. This process was regularly audited by the contractor, with results showing consistently positive outcomes. Staff carefully planned transport, paying particular attention to patients with more complex mental health or social care needs.

The service organised resources effectively so vehicles and crews were available where and when required. Managers communicated with external contractors to confirm availability, and any unexpected delays were promptly escalated to the contractor or senior duty staff to minimise disruption for patients.

Description: We actively seek out and listen to information about people who are most likely to experience inequality in experience or outcomes. We tailor the care, support and treatment in response to this.

We scored the service a 2. The evidence showed some shortfalls. Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

People who did not speak English as their first language could access the service. Staff had access to interpretation services by telephone. There was a range of pictorial information to assist staff in engaging with people who had additional needs.