Outdoor Medical Solutions 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

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant the service was consistently managed and well-led. There was a clear vision for the service, and leaders fostered a culture that promoted high‑quality, person‑centred care. Clear and effective governance, management and accountability arrangements were in place. Staff told us there was an open and supportive culture, with leaders who were visible and approachable. Staff understood the service’s vision and values, and we saw evidence of ongoing innovation within the organisation.

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.

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.

Leaders explained a clear strategy, focussing on a desire to continue to meet the needs of the community and provide good quality care over expansion of the business.

Staff said there was an open and supportive culture, where feedback was shared and achievements recognised. This was achieved by sharing positive feedback and recognising achievements of staff.

The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The Managing Director was experienced in the ambulance sector and was supported by a Compliance and Office Manager, a Paramedic Team Leader, and a Medical and Clinical Governance Director.

Staff told us that leaders were visible, approachable and supportive, and described the service as a lovely place to work.

We scored the service as 2. The evidence showed some shortfalls.

The service did not have access to a Freedom to Speak Up Guardian, which is a professional who supports staff in raising concerns and speaking up about any issues they encounter. This is required by all providers holding a contract to deliver services for the NHS, or receiving NHS funding for services it provides, as set out in the NHS Standard Contract.

However, the provider had an up‑to‑date policy to support staff with whistleblowing and freedom to speak up concerns. There was also a clear process that enabled staff to raise concerns confidentially with the management team or externally when appropriate.

Leaders explained that a staff survey had been used in the past but was no longer undertaken. Despite this, staff told us that the leadership team was approachable and promoted open communication. They felt confident raising concerns and were assured that any issues they reported would be addressed.

The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

The Equality and Diversity policy outlined the service’s responsibilities to promote equality, fairness and respect for all, in line with the requirements of the Equality Act 2010. The recruitment policy also demonstrated the organisation’s commitment to ensuring equality of opportunity in employment. Staff had received training in Equality, Diversity and Human Rights.

Staff told us they felt they were treated equally by the leadership team. The service adopted a flexible approach to working patterns, with shifts arranged around individual staff availability.

The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

There were clear lines of accountability. A recruitment policy set out the process for appointing staff, and a disciplinary policy ensured that any concerns about conduct were managed appropriately.

Although regular team meetings were not held due to the challenges of coordinating staff shifts, communication with staff was maintained through verbal updates and a messaging service, which staff told us worked effectively.

Regular communication also took place with the hospital for intra‑hospital transport work. This included weekly check‑ins and monthly meetings with the Hospital Transport Team, as well as monthly data reviews with the Hospital Flow and Site Management Team.

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

The service used a risk register to identify current risks to the service along with the controls used to mitigate them. Risks were formally rated, reviewed regularly, and monitored by leaders to ensure appropriate action was taken.

When working with third-party providers, the service completed due diligence checks to ensure operational standards were met. Ongoing oversight included monthly catchups and annual due diligence visits to maintain assurance over the quality and safety of the third-party service.

The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

There was regular communication between the service and the hospital, allowing both parties to raise concerns, share updates and review performance.

We were told that supporting the local community was an important part of the service’s identity. They took an active role in community initiatives, including donating defibrillators and first aid kits, sponsoring first aid training at the local lido, and providing out‑of‑date consumables to local scout and cub groups for first aid practice.

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.

There was a strong culture of learning and continuous improvement across the service. Leaders and staff were proud of the enhancements made to the fleet over the past 12 months, including the purchase of two nearly new vehicles and three brand‑new vehicles designed specifically to meet the needs of the service. These updates not only improved efficiency and environmental performance but also had a positive impact on staff morale. Additional investment had been made in equipment, such as stretchers and staff personal digital assistants (PDAs). These are rugged smart devices used to access records and communicate with the hospital.

The service had also invested in a new electronic management system to improve stock control, including the management of consumables. Staff told us this had significantly improved efficiency and reduced waste. Plans were in place to introduce personal logins for all staff and subcontractors, enabling them to upload information such as incidents, complaints and compliments, view all policies and procedures, and record their continuous professional development (CPD).