Archived: E-zec Medical - Norfolk

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

Leaders and staff generally shared a vision and culture centred on listening, learning, and trust. Leaders were visible, knowledgeable, and supportive, and staff were encouraged to provide feedback. Staff understood their roles and responsibilities, and leaders worked closely with the local community to deliver the best possible care while remaining open to new ideas.

We looked for evidence of an inclusive and positive culture focused on continuous learning and improvement, aimed at meeting the needs of service users and the wider community. We also checked that leaders proactively supported staff and worked with partners to deliver safe, integrated, person-centred, and sustainable care while reducing inequalities.

At the time of this assessment, the location was in the processes of being decommissioned as another provider had secured the commissioned service. Processes were in place to transition staff to the new provider, and during this period, staff were being supported by local management teams. The service continued to provide regulated activity until the contract ended in October 2024.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff did not always see how the service's vision and values were reflected in their day-to-day roles. Some staff felt that leaders did not consistently encourage them to share improvement ideas or contribute to changes within the service. Leaders explained that the merging of patient transport companies multiple times over the past five years had affected the location's processes and structures. They acknowledged that these changes had taken time to implement effectively.

Following the provider’s merger with anotherpatient transport company, staff faced confusion due to a lack of unified policies and processes. There was no clear shared direction or cohesive workplace culture, particularly in areas such as the management of acute medical conditions. Some policies were still based on the old provider’s systems and hadn’t been updated, which only added to the uncertainty. This lack of clarity left staff uncertain about expectations and procedures. Additionally, at the time of the assessment, the Great Yarmouth location was being decommissioned after the service’s contract was not renewed by commissioners.

Staff told us they felt able to seek support and advice from local managers and found leaders to be approachable, responding promptly to resolve issues. Local leaders stated that they were available out of hours to provide both emotional and operational support to staff.

Leaders conducted yearly appraisals for all staff, and at the time of assessment, compliance was fully met. The provider had also appointed staff engagement champions who participated in staff forums with senior leaders to discuss concerns and provide responses. These forum discussions were shared with staff, who were encouraged to contribute to the topics being discussed.

However, there was no associated action log with clear timeframes for implementing improvements, making it difficult to track progress and accountability.

Staff were aware of the Freedom to Speak Up provision within the service. However, most felt comfortable approaching their local management team with any concerns or issues. Leaders explained that the service operated a centralised Freedom to Speak Up provision for both staff and volunteers. Additionally, a dedicated Speak Up staff champion was in place and actively supported colleagues.

The service used an external provider to facilitate its Freedom to Speak Up provision for staff and volunteers. This provision was communicated to staff through their induction, regular emails, and posters displayed throughout the location.

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.

Staff felt anxious about the loss of the service contract with the commissioners and were concerned about transferring to the new company. They were uncertain about how this change would impact patient care and service delivery. Leaders stated that during the transition process, staff were being supported by both management and trade union representatives.

Policies and processes were confusing for staff to follow. Due to multiple mergers of transport companies over the past five years, policies and procedures did not always reflect the current provider. It was unclear which policies were to be followed and which were under review.

Leaders held meetings to discuss operational effectiveness and service governance. However, these meetings lacked an action log, clear timeframes for improvements, and defined leadership accountability.

Leaders told us they held regular meetings with local stakeholders to review the service and gather feedback from patient groups. These sessions were used to analyse feedback on care, identify any concerns, and work collaboratively with stakeholders to find solutions.

The service also participated in a community engagement event at a local primary school, where staff attended with an ambulance and delivered a learning session. This initiative received positive feedback from attendees.

Commissioners told us they closely monitored the provider using key performance indicators and held regular meetings with leaders to discuss any service issues. However, they noted that at times, leaders were not always responsive to suggestions and required additional guidance and support to implement necessary improvements.

The provider held regular meetings with stakeholders and commissioners to discuss service delivery. Commissioners recorded these meetings and maintained associated action logs. There was a clear process in place for the provider to escalate concerns to commissioners, and leaders maintained regular contact with them.

Staff did not always feel that senior leaders listened to or acted on their feedback. Due to local changes in patient transport contracts, there were several months during which suggestions and improvements were not addressed, as the remaining length of the contract impacted the prioritisation of these actions.

Learning and improvement suggestions were shared with staff, but it was unclear how these improvements were implemented in real time. There was a lack of clear timeframes and leadership accountability for actions. However, local leaders had taken action based on staff feedback and produced a "slips, trips, and falls" leaflet, which provided staff with advice on safety within people’s homes and signposted them to additional support.