ERS Medical Midlands

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the service involved patients and treated them with compassion, kindness, dignity and respect.

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

This meant patients were supported and treated with dignity and respect; and involved as partners in their care.

We looked for evidence that patients were always treated with kindness, empathy and compassion. We checked that patients’ privacy and dignity were respected, that they understood that they and their experience of how they were treated and supported mattered. We also looked for evidence that every effort was made to take patients’ wishes into account and respect their choices, to achieve the best possible outcomes for them.

Patients consistently described positive experiences of frontline staff and told us they were treated with kindness, compassion and respect. Patients told us staff provided reassurance, responded to their individual needs and supported them in a caring and dignified way. Many patients praised crews for their professionalism and willingness to help, particularly when they were anxious, vulnerable or attending important healthcare appointments.

The service considered patients individual needs, preferences and circumstances when planning and delivering care. Staff supported patients to maintain their independence wherever possible and involved patients in decisions about their transport arrangements and care. Patients told us staff respected their abilities and encouraged them to remain as independent as possible while providing support when required.

Staff understood the importance of privacy, dignity and person-centred care. They described adapting their approach to meet individual needs and demonstrated a commitment to treating patients with compassion and respect. Staff also worked to respond to patients’ immediate needs and concerns during transport journeys.

The service supported staff wellbeing through a range of training, support and welfare initiatives. Many staff told us they felt supported by their immediate managers and colleagues and remained committed to providing high-quality care for patients.

Overall, patients were treated with kindness, dignity and respect and were involved as partners in their care.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

We scored the service as 3. The evidence showed a good standard. The service mostly treated patients with kindness, empathy and compassion and respected their privacy and dignity. 

Patients were mostly positive about how staff treated them. Most patients told us staff were kind, caring and respectful. 

Patient feedback highlighted staff professionalism and compassion. Patients described crews as friendly, and attentive to their needs. Many patients said staff went above and beyond to help them feel safe and comfortable during journeys.

We spoke with patients who regularly used the service. One patient described staff as very caring. Another patient said crews were responsive, supportive and communicated well. Another said staff were patient, understanding and provided reassurance throughout their journey.

Several patients praised ambulance crews despite transport delays. One patient described crews as "a credit to the company". Patients frequently told us crews were apologetic when delays occurred.

Patient surveys reflected similar experiences. Patients described staff as kind, professional and thoughtful. Patients said crews helped them feel safe, comfortable and respected throughout their journeys.

Staff understood the importance of maintaining dignity and respect. Staff described ensuring patients were covered appropriately during transfers. Staff maintained privacy where possible. Staff also described building relationships with regular patients. They recognised changes in people's needs, health conditions and personal circumstances.

Patients often distinguished between service delays and crew conduct. Many patients expressed frustration about waiting times. However, they continued to praise frontline staff for their compassion and professionalism.

The service had specific arrangements to support people receiving end-of-life care. Policies recognised the importance of dignity, respect, personal wishes and family involvement. End-of-life transport planning considered patient preferences and clinical risks. Transport planners considered the need for exclusive journeys so the patient did not have to travel with other patients. The service’s policy stated care and transportation should be centred on the person's wishes and aimed to enable people to spend their final days in their preferred place wherever possible.

Some patients raised concerns regarding the conduct of a small number of sub-contracted taxi drivers. Concerns included communication, attitude and support during journeys. One patient made a clear distinction between contracted taxi drivers and ambulance crews. They consistently described ambulance crews as caring, professional and supportive. The Senior Operations Manager told us concerns about contracted taxi providers were reviewed with the relevant companies. Leaders held meetings with contracted taxi providers when required. These meetings reviewed patient feedback and addressed concerns.

We scored the service as 3. The evidence showed a good standard. The service treated patients as individuals and made sure patients’ care, support and treatment met patients’ needs and preferences. They took account of patients’ strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service gathered information about patients' individual needs before journeys. Booking systems recorded mobility needs, communication requirements, infection risks, escort arrangements and other support needs. This information supported staff to plan care and transport appropriately. 

Staff used information from referrals, bookings to allocate suitable vehicles, equipment and staffing based on their assessed needs. This helped ensure transport reflected each person's circumstances and support requirements. 

The service recognised that patients' needs could change over time. Staff updated transport requirements when new information became available. Leaders told us staff worked with healthcare professionals to ensure transport arrangements were appropriate. 

Leaders told us patients could travel with their main carer where additional support was required. This included circumstances where family members or other carers provided important support during journeys. This helped ensure patients received appropriate assistance and continuity of care during transport.

We scored the service as 3. The evidence showed a good standard. The service promoted patients’ independence, so patients knew their rights and had choice and control over their own care, treatment and wellbeing.

The service promoted people's independence and supported them to maintain control over their transport arrangements. Patients were encouraged to remain as independent as possible where it was safe to do so. Staff adapted their support to reflect individual abilities and changing needs.

The service supported patients to access healthcare appointments and treatment. Many patients told us they relied on the service to attend essential appointments. Some patients said they would be unable to access treatment without the support provided. 

Staff told us patients received explanations when transport requests did not meet eligibility criteria. Staff explained decisions and signposted patients to alternative support where appropriate. This included information about the NHS healthcare travel costs scheme (HTCS).

Patients told us crews provided  support during journeys. Patients who used wheelchairs said staff assisted them when required. Patients also told us staff respected their abilities and supported them to do as much as possible for themselves. 

We scored the service as 3. The evidence showed a good standard. The service listened to and understood patients’ needs, views and wishes. Staff responded to patients’ needs in the moment and acted to minimise any discomfort, concern or distress.

The service responded to people's immediate needs and took action to reduce distress and inconvenience where possible. Staff listened to patients and adapted support when circumstances changed.

Staff told us they contacted patients when vehicles were delayed and provided updates about revised collection times. Staff told us they also contacted healthcare providers when delays occurred which could affect appointments or treatment. However, some patients told us this did not always happen, and they sometimes had to contact the service for updates on delayed transport. Leaders recognised communication during delays was not always consistent. They told us this remained an area for improvement and was being addressed through service improvement work and complaint learning. 

Staff described reprioritising journeys where clinical needs changed. They told us transport arrangements could be reviewed throughout the day to respond to urgent patient needs and service pressures. Alternative transport options, including taxis, were considered where appropriate to reduce delays and support access to treatment. 

Patient feedback included examples of staff responding quickly to unexpected situations. One patient told us their appointment had been cancelled whilst they were on their way. Staff immediately contacted the control centre and arranged transport home. 

Staff told us they responded immediately if a patient's condition deteriorated during transport. They said crews would assess the situation and contact emergency services where necessary. Staff told us they would call 999 if a patient required urgent medical assistance.

Staff escalated safeguarding concerns immediately. Staff said concerns were reported through established safeguarding processes without delay.

Patients told us staff were attentive to their needs during journeys. Patients said crews checked on their wellbeing, provided reassurance and offered support when required. One patient said crews helped them feel safe despite anxiety about attending hospital. Several patients described staff as responsive and willing to help.

We scored the service as 3. The evidence showed a good standard. The service promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centered care. However, not all staff felt recognised or valued.

Staff felt supported in their roles and generally spoke positively about the support available to them. Newer staff received guidance from mentors, team leaders and experienced colleagues, helping them build confidence during their probation period. Staff had access to induction, training, supervision and appraisal to support their ongoing development and wellbeing.

The service monitored staff performance through appraisals and regular reviews. Appraisal records showed staff had opportunities to discuss performance, development needs, career aspirations and training requirements. Managers recognised positive performance, professionalism and contributions to patient care.

Staff achievements were recognised through local recognition schemes. These included employee of the month awards and wider organisational recognition programmes. Long service awards acknowledged staff who had completed significant periods of service. Local noticeboards highlighted positive achievements and contributions. Organisational communications were also used to celebrate staff success.

Staff had access to a range of wellbeing support services. Leaders told us they provided occupational health referrals, employee wellbeing resources, and a confidential wellbeing helpline. Staff could also access mental health support services and speak to mental health first aiders. The service also had staff engagement champions and freedom to speak up arrangements.

Staff feedback showed most employees felt supported by their immediate managers. Staff survey results demonstrated that most staff felt able to approach their manager if they were struggling with their physical or mental health. Most staff  confirmed their manager cared about their wellbeing. Staff were also aware of available mental health support and wellbeing resources.

Staff provided examples of receiving support following significant incidents. One staff member described receiving counselling and wellbeing support after managing a traumatic incident. Other staff told us they had positive relationships with managers and colleagues and felt able to seek support when needed. 

Staff consistently demonstrated pride in their work and commitment to patients. Several staff described the satisfaction they gained from helping patients access healthcare and supporting vulnerable people. They felt they made a positive difference during difficult periods in patients' lives. Staff also described strong working relationships and peer support among frontline crews.

However, some staff did not feel valued by the organisation or receive recognition for good work. Not all staff said they would recommend the organisation as a place to work. Some staff also described challenges relating to communication and engagement across the service. Senior leaders recognised the importance of staff wellbeing and engagement and had introduced a range of opportunities for staff to share feedback and raise concerns. These included regular engagement events and team meetings that were available to all staff. Leaders told us these forums enabled staff to discuss issues, receive updates and contribute to service improvements.