Medisec Ambulance Service Limited

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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

At our last assessment we rated this key question requires improvement. At this assessment we looked at 3 quality statements and the rating has changed to good.

This assessment focused on 3 quality statements across well-led: shared direction and culture, governance, management and sustainability and learning, improvement and innovation.

At our last assessment the service was in breach of Regulation 17. At this assessment, the service had met compliance with this regulation.

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.

We scored the service as 3. The evidence 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 service demonstrated a clearly defined mission and vision that was well understood across the organisation. The services mission focused on delivering a safe and effective service centred on patient care. The vision emphasised sustainable business growth, the use of technology to tailor services, and ensuring staff work cohesively as one team. This shared direction was communicated through induction, ongoing training, and visible leadership.

Staff reflected this understanding, confirming that organisational updates were communicated regularly and that management engagement had improved since the previous assessment. They were able to clearly describe current priorities relating to service quality, patient safety, and organisational improvement.

There was clear evidence that communication mechanisms had improved since the previous assessment. Staff reported receiving updates through management communications and operational briefings. Staff also demonstrated awareness of recent policy reviews and governance improvements undertaken by the organisation.

Staff understood the services strategy and how their role helped to deliver it. Leaders had introduced education spot checks with staff to check their understanding of relevant policies, procedures and business strategies. For example, findings from these checks were fed back into staff one to one meetings which leaders used to address any gaps in understanding directly with individual team members.

Leaders used staff survey results to identify educational gaps within the team. Leaders told us they used this information in one-to-one meetings to support staff to grow and develop in their roles.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We scored the service as 2. The evidence showed some shortfalls. The service did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Governance processes existed and staff understood their roles, but risk management and oversight remained inconsistent.

The service maintained an electronic risk register covering Disclosure and Barring Services (DBS) processes, control room issues, complaints, and staff mental health. Staff told us they could feed information into senior leaders to be considered for the risk register. Each risk had a score, mitigating actions, an owner and a review date.

However, oversight of the risk register needed further development. At the previous assessment, concerns were raised regarding the risk register. While improvements have been made sense then, further development is still required. For example, the risk register was not reviewed during monthly governance meetings or any formal meeting structure, and review dates for high-risk items were overdue with no documented evidence of actions taken or discussion. Risk owners told us risks were discussed informally in team meetings, but this was not consistently recorded.

The service held monthly management meetings at Southampton site headquarters to discuss staffing, progression, feedback, business management, new and existing contracts, supervision, appraisals, and actions from directors. Records from these meetings were logged on the system, forming part of the governance record. Minutes showed a set agenda was followed and previous actions reviewed. However, minutes were brief, lacked a standardised layout for tracking actions and the standard agenda did not include a review of risks and incidents. Leaders explained that discussions were held informally every day and not documented, as the office was small and consistently staffed every morning.

The service also held monthly external stakeholder meetings, and minutes confirmed that they addressed complaints, outstanding actions, and audit findings.

The service monitored quality and safety through clinical audits, and records showed these were completed in line with the audit schedule.

Key policies were accessible, up to date and showed evidence of senior oversight to ensure accuracy, consistency and alignment with national standards.

Leaders had taken action to strengthen governance following the previous assessment. Policies, including safeguarding and Infection control and Prevention policy had been reviewed and updated in October 2025 to align with national guidance.

Infection Prevention Control (IPC) governance had improved since the last assessment. The service had introduced a colour coded cleaning system in line with national guidance, with equipment and signage clearly designated by area of use

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We scored the service as 3. The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

Senior staff demonstrated a strong understanding of quality improvement methods, having received training in this area. The office manager was still utilising “Team Talk” sessions with staff to strengthen collaborative working and encourage open discussion across teams.

Staff and leaders consistently showed commitment to improving the patient experience. When needs appeared, they worked collaboratively to find practical solutions. For example, a staff member had introduced sensory equipment for people with additional needs in transport, having identified a gap.

The service had made improvements to its electronic systems, tailoring them to be more bespoke to the service. For example, staff had work mobiles with quick easy to find buttons giving immediate access to incident reporting forms, safeguarding referral forms, equipment manuals and guidance, vehicle and equipment fault reporting forms, medical training vehicles and patient survey. Staff told us this made it easy to report concerns, access information and escalate issues in real time.

Leaders and staff had a good understanding of incident reporting, with 100% compliance of staff having read the services Incident Policy. The service had only one incident since the previous assessment, which was recorded under welfare checks and no safeguarding incidents in the past year. Although accident and incident reporting was not part of mandatory training, leaders told us they held staff knowledge testing through scenario-based tasks and supervision on rides.