During an assessment under our new approach
Date of Assessment: 01 December – 02 December 2025.
Health Hero – Fox Talbot House is an urgent integrated care organisation which delivers: Clinical Assessment Service (in which healthcare professionals determine the most appropriate pathway to meet people’s needs following NHS 111 referral); Care Coordination (a multidisciplinary team designed to support paramedic crews and manage people who have been assigned typically urgent but not immediately life-threatening ambulance dispositions); Urgent Care Out of Hours pre-booked appointments and the High-Intensity User Service (to reduce avoidable emergency department attendances and emergency service use in partnership with the Wiltshire Centre for Independent Living) across Bath and North East Somerset (BaNES), Swindon and Wiltshire (BSW), 24 hours a day, 365 days a year. Services are carried out remotely and telephone-based services coordinated from Fox Talbot House, the urgent care out-of-hours service also provides face-to-face patient care. This includes home visits and appointments at treatment centres operated as tenants of established healthcare facilities such as local community hospitals, acute hospitals, and primary care centres delivered from Chippenham, Keynsham, Swindon and Salisbury. Health Hero – Fox Talbot House also provide an NHS 111 service, delivered through a formal subcontract arrangement with another provider. (NHS 111 is a telephone-based service where people are assessed, given advice and directed to a local service that most appropriately meets their needs). We did not inspect the NHS 111 service as part of this assessment.
The service covers a population of approximately 1,000,000 people across the counties of Wiltshire, Bath and North East Somerset and Swindon. Deprivation across the area overall is lower than the national average and it has slightly lower numbers of people from different cultural backgrounds. This assessment considered the demographics of the people using the service, the context the service was working within and how this impacted service delivery. Where relevant, further commentary is provided in the quality statements section of this report.
Systems and pathways were exceptionally well-designed to ensure safe transitions and continuity of care. Staff worked collaboratively across services, using integrated technology and real-time monitoring to anticipate and manage risks effectively. This approach meant people received seamless, safe care even during periods of high demand. Environments were safe and well maintained, with comprehensive risk assessments and rapid escalation processes for any issues identified. Lone worker systems and vehicle tracking provided additional assurance for home-visiting staff. The service had a strong learning culture and people could raise concerns. Leaders investigated incidents thoroughly with demonstratable actions taken to improve the safety of services. Staffing levels were safe and supported by effective recruitment and training processes. Leaders made sure staff received training and regular appraisals to maintain high-quality care. People were actively involved in managing risks, with staff taking time to explain care decisions and safety measures. Risk assessments were holistic and personalised, and staff supported people to make informed choices about their care. The service had effective safeguarding procedures in place to protect people from abuse and suitable arrangements to investigate incidents including outcomes shared with staff to mitigate risk and minimise reoccurrence. People received co-ordinated and joined up care, particularly when transitioning between services.
The service continued to deliver care that is exceptional and consistently exceeds national integrated urgent care standards. People received safe, effective, and well-coordinated care that reflected their individual needs and preferences. Staff demonstrated a strong commitment to equity and inclusion, ensuring care is accessible and personalised for everyone, including those with protected characteristics.
Care was planned and delivered in line with current legislation and evidence-based guidance. People’s needs were assessed thoroughly, and clinicians worked collaboratively across teams and with external partners to provide seamless care. We saw examples of innovative practice, such as improved streamlining of cases which ensured timely accessible care and the use of digital technology to reduce unnecessary hospital admissions, which improved outcomes and supported independence.
People told us they were treated with dignity, kindness, and respect at all times. Staff consistently demonstrated empathy and compassion, responding promptly to concerns. The service fosters a strong learning culture. Safety events were reported and investigated thoroughly, and lessons learned were embedded into practice. Staff felt empowered to speak up, and leaders acted with openness and integrity. Continuous quality improvement was evident through regular audits, participation in national initiatives, and innovative approaches to care delivery.
There were innovative approaches in providing integrated person-centred pathways of care that involved other service providers, particularly for people with multiple and complex needs. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood their options.
Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. There was a strong focus on workforce wellbeing, equality, and diversity, ensuring staff were supported to deliver person-centred care. Partnerships with local health and social care organisations were robust, enabling coordinated care and reducing health inequalities.