ERS Medical North

On this page

• 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 good. At this assessment the rating has remained good. Leaders understood the service they were responsible for and were visible to staff. However, governance and oversight arrangements were not consistently effective, particularly in relation to recruitment checks, incident learning and the maintenance of accurate policies. These were continuing concerns and limited assurance that quality and safety were being effectively monitored.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

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 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 patient and their communities. 

The provider had a clear vision, strategy and implementation plan focused on improving community wellbeing through access to health and care services. Leaders had defined organisational values of collaboration, agility, reliability and empowerment, which aimed to promote teamwork, continuous improvement, accountability and high-quality service delivery. These values formed part of the provider’s approach to achieving its strategic objectives.

Organisational values guided how staff worked and delivered services. Staff were expected to work collaboratively to meet the needs of patients, colleagues, customers, local communities and the wider environment. 

Staff were expected to be reliable and act with integrity, take responsibility for their actions and deliver on their commitments. Staff were supported to be confident and accountable in their roles and provide high-quality, person-centred care and services.

Staff spoke positively about the local culture and said they felt supported and valued by managers with strong teamwork and collaboration. However, organisational changes following the merger resulted in inconsistencies in branding, documentation, and a clear understanding of the vision and strategy, which leaders acknowledged were still being addressed. Staff were focused on the needs of patients receiving care and delivering a high quality of service

Staff were trained in data protection and information governance and shared relevant patient information appropriately during transfers.

Patient safety was a priority for all staff, with a focus on an open and transparent, no blame culture. Staff spoke positively about supporting patients and working with dedicated colleagues. Staff told us they were thanked for their work.  

The service had leaders who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders usually had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty and understood the impact their behaviours and leadership had on patient outcomes and experience. 

Local managers were visible and approachable, and staff said they could raise concerns with them. Regional and senior leaders held regular meetings with managers, although some meetings were not formally recorded. This reduced oversight and assurance that actions and decisions were consistently recorded and followed up. Leaders recognised the need to strengthen governance arrangements.

The registered manager and leaders had the skills and abilities to run the service and understood the priorities and issues the service faced. Staff felt that leaders supported them to develop their skills and take on more senior roles. 

Leaders had taken incidents seriously and knew how to deal with concerns when raised which promoted a positive culture in the service. 

Staff were invited to team meetings and could direct questions or suggestions to the registered manager. Survey results were acted upon, for example, ‘You Said We Did’, showed improvements to vehicles and staff training had been made.  Some staff told us they felt career development opportunities were limited.

The service fostered a generally positive culture where patients felt they could speak up and their voice would be heard. 

Staff and leaders acted with openness, honesty and transparency. Staff were encouraged to raise concerns and offer ideas; the culture allowed staff to be confident their voices were heard. 

The whistleblowing policy enabled staff to raise concerns confidentially, including through an independent service.

Staff told us they were supported when raising concerns, leaders investigated these sensitively and addressed matters raised.

A risk register and management reports contained analysis of concerns over time and associated action plans.  

Patients, their families and carers were provided with information to explain how they could raise a concern and how this would be investigated. Senior staff were encouraged to respond to immediate concerns or complaints with a view to resolution. There were policies to support the complaints process. 

Patients and carers were encouraged to provide feedback through direct contact with the service and through feedback forms. Feedback was reviewed and used to support service improvements

The service valued diversity in their workforce. Staff work towards an inclusive and fair culture by improving equality and equity for everyone. 

Leaders acted to improve negative experiences for staff with protected characteristics. The service had an Equality, Diversity and Inclusion (EDI) policy, and fair recruitment processes, including safer‑recruitment checks and risk‑assessment procedures for applicants with previous convictions. In addition, the service shared an EDI bulletin with staff which highlighted key dates that encouraged understanding, awareness, and action around religion, belief, well-being, and mental 
health.

The workforce included staff from varied backgrounds. Staff told us they were treated fairly and that they could report behaviours or attitudes which were negative.

Leaders acted promptly on poor conduct or inappropriate comments, and staff with disabilities or specific needs were supported through reasonable adjustments. Communication channels encouraged staff to provide feedback on equality and inclusion.

The service had clear responsibilities, roles, systems of accountability and good governance. Leaders used these to manage and deliver good quality, sustainable care, treatment and support. Leaders did not always act on information about risk, performance and outcomes and systems were not embedded across both sites. 

Governance systems monitored quality, risk, incidents, and performance. Risks were recorded, and contracts were reviewed with commissioners. However, governance processes were still in transition following organisational restructuring, and some systems, such as learning from incidents and assurance of recruitment records, were not consistently embedded across all sites. 

Performance data was analysed and compared within the organisation and action plans were developed where improvements were needed.   

Senior management held regular meeting including bi-monthly Patient Safety Committee, which reviewed quality and safety themes.

A communication framework ensured essential information, such as learning from incidents and complaints, was shared. Staff understood arrangements for working with other teams and had access to necessary equipment.

Staff at all levels were clear about their roles and accountabilities. Staff had job descriptions, and these set out expectations and responsibilities. Where senior staff had designated tasks related to audit and monitoring quality of services, they understood what was required of them. Audits were completed included infection prevention and control, environmental, health and safety, information governance and physical security, medicines management, and patient record forms. 

We reviewed several service level and provider policies and found these were not always up to date and readily available to staff. 

Risks were identified and a formal log of these was used to keep oversight and manage mitigations and/or bring to resolution. However, the risk register identified several overdue high and extreme risks, these included operational pressures, workforce challenges, estates and fire safety issues, safeguarding demands, and limited mitigation for some severe risks. The risk meeting highlighted that managers were advised to improve risk closure and evidence standards. This indicates ongoing concerns about the organisation’s ability to reduce risk effectively.

Staff and leaders at the service collaborated with relevant external stakeholders and agencies to improve care and treatment for patients using the service. The service had established relationships with the local NHS ambulance trust and NHS acute trusts.

Feedback mechanisms were in place, for example we saw positive feedback from individuals, including members of the community, who had received care and assistance from the service.

The registered manager met with external stakeholders and regional networks to understand community needs and provider ambitions. Monthly contract reviews and quality improvement group meetings with integrated care boards and local trusts ensured learning from safety themes.

The service focused on continuous learning, innovation and improvement across the organisation and local system. Staff encouraged creative ways of delivering equality of experience, outcome and quality of life for patient. 

The service supported learning through training, supervision, and development opportunities. Staff were committed to learning and improving services. Following the inspection, leaders shared a new organisation-wide learning newsletter Organisation Wide Learning (OWL) implemented in June 2026 to support the sharing of learning across the service. 

Staff and leaders were committed to improving the patient experience, they worked together for example as part of a wider Patient Safety Improvement Plan. The service was developing and testing a clinical risk assessment tool to support decision-making in the control room. The tool used operational data to generate clinical risk ratings and help improve patient safety. The clinical risk tool would also review past performance to help identify trends, promote learning, improve patient safety, and inform resource planning.

Registered managers were supported through development forums, with additional work underway to strengthen induction, peer support and leadership development. Leaders had identified opportunities to improve assurance processes, the use of quality and safety data, strengthen the learning from incidents and inspections, and further develop the capability of quality teams to support service improvement and regulatory compliance.