Isle of Wight NHS Trust

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question as good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 83 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff assessed patient eligibility through structured clinical and mobility screening at the point of booking. This ensured that only patients with a clear clinical or mobility need, who were suitable for non-emergency transport, were accepted. Where risks or complexities were identified, staff requested additional information or escalation to ensure appropriate planning and safe transfers. Despite this process, staff recognised patients’ conditions could change following booking, and adjusted plans where required to maintain safety.

Staff identified risks to patient transport by completing mandatory assessment questions, including those relating to COVID-19 status and clinical stability. These included whether the patient was a suspected or confirmed case of COVID-19, and whether they were clinically stable and able to maintain their own airway. This ensured patients were appropriate for transport within the scope of the Patient Transport Service (PTS). This process enabled staff to identify infection prevention and control requirements in advance and to escalate or redirect patients who required a higher level of clinical care.

Staff confirmed booking accuracy by contacting all patients 24 hours prior to their scheduled journey. During these calls, staff confirmed journey details, reviewed mobility needs, and checked access arrangements at both the collection and destination addresses. This enabled staff to identify any changes or emerging risks since the original booking. Where required, staff updated transport plans or referred patients for further risk assessment. This helped to reduce the risk of failed journeys and unsafe transfers.

Staff minimised operational risks by requesting formal risk assessments where patients met defined criteria. These were triggered where wards or departments anticipated manual handling or behavioural challenges, or where journeys involved stretcher transfers to or from private home addresses. Further triggers included where crews identified bariatric, cognitive or environmental risks, or where previous journeys had required additional support, such as backup crews or the fire service. This ensured staff could assess and plan for complex manual handling and environmental barriers, such as stairs or restricted access within properties. As a result, staff deployed appropriate equipment, vehicles and personnel, supporting safer transfers for patients and staff through proactive planning.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff routinely considered patients’ psychological and emotional needs, as well as those of relatives and carers, during handovers. Staff told us they had access to trust policies and protocols online and used IT systems to access key safety-related documentation, including equipment check logs, incident reporting systems and safeguarding records.

The service followed relevant National Institute for Health and Care Excellence (NICE) guidance to support safe care, including infection prevention and control, patient transfer processes, safeguarding and recognising patient deterioration. For example, staff described using the safeguarding adults’ policy when returning a patient home. When a patient’s home environment was found to be unsuitable, staff escalated concerns to the Clinical Support Desk, and the patient was returned to hospital until a safe environment could be arranged.

We scored the service as 4. The evidence showed an exceptional standard. The service always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

The Patient Transport Service (PTS) built strong internal working practices by using its position within the Isle of Wight NHS Trust, which managed both transport and acute health services. The ambulance medical lead also worked as a consultant in the hospital’s emergency department (ED). This shared clinical leadership fostered effective daily communication between the Clinical Coordination Centre, the PTS teams, and the ED. This helped to remove organisational barriers. By aligning transport and hospital operations, staff improved working practices, which allowed the PTS to coordinate patient arrivals and discharges more efficiently with acute wards.

The service successfully managed the geographic challenges of island-based patient care by establishing formal agreements with external travel and emergency operators. Recognising the difficulties of transferring patients off the island for specialist treatment, the service secured agreements with ferry companies and the coastguard. This partnership gave PTS dispatchers a wider breadth of resources to support crews. As a result, the service maintained continuous, reliable patient transport links to and from the mainland, ensuring patients reached their appointments safely and on time.

The service maintained continuity and balanced its daily workload through participation in daily multi-team tactical meetings. PTS teams met regularly with frontline services and the control centre to review transport demand and resource availability over the next 24 to 72 hours. This collaborative approach provided early visibility of potential pressures. By sharing operational data, managers identified potential vehicle and staffing shortfalls in advance, allowing them to adjust booking schedules, manage demand and secure support across teams before delays occurred.

We observed an example where the service provided additional support to the local community beyond its commissioned role. During the assessment, a local care home contacted the service for assistance after a lift breakdown had left several residents on the ground floor, away from their bedrooms, for an extended period. Although this was not within the scope of the PTS, managers responded due to the potential risk of harm. A patient transport manager attended the care home to assess the situation and explore how the service could safely support residents to access their bedrooms on other floors.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

We did not look at supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We scored the service as 4. The evidence showed an exceptional standard. The service monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

The service monitored its operational performance and aligned its activity with national benchmarks to meet local population needs. During the reporting period between 28 February 2025 and 28 February 2026, the Patient Transport Service (PTS) completed 16,153 journeys. Data from the patient transport dashboard showed 2,735 cancelled journeys over a 6-month period. The most common reasons for cancellations were ‘cancelled during ring back’ (388), ‘hospital inpatient’ (350), and patients being ‘too unwell to travel’ (342). Cancelled during ring back referred to journeys cancelled by the original referrer at the point of booking confirmation. Other cancellations occurred where patients had been admitted to hospital prior to the planned journey, or where patients who were initially considered well enough for discharge had subsequently deteriorated and were no longer fit to travel. This demonstrated that, although the service used appropriate screening and risk assessment processes at the point of booking, some cancellations were unavoidable due to changes in patients’ clinical condition. This data provided managers with a clear understanding of why journeys did not take place. By analysing trends and causes of cancellations, the service was able to adjust scheduling and better align capacity with patient demand.

The service maintained a reliable fleet and responded to mechanical faults to support service continuity. Of 16,153 journeys, 3 were unable to proceed due to vehicles being taken out of service because of mechanical defects, representing 0.018% of activity. In these instances, a suitable replacement vehicle was not immediately available. In response, engineering teams reviewed the fleet, and managers strengthened pre-shift safety checks and contingency planning. While these incidents resulted in journeys being unable to proceed, the actions taken reduced the likelihood of future mechanical failures and supported improvements in fleet resilience.

The service monitored timekeeping and took action to reduce the impact of operational delays on patient care. Of all activity, 10 journeys (0.062%) were cancelled because transport arrived too late and patients would have missed their appointment windows. The main causes of delay included road traffic, limited resource availability and knock-on effects from earlier delays. In response, managers improved dispatch sequencing, strengthened early warning communication with clinical departments and enhanced escalation processes. Although these 10 journeys were disrupted, in other delayed cases the PTS team liaised with clinics to rearrange appointment times and complete journeys. This level of coordination with hospitals, clinics, dialysis units and receiving teams helped to minimise the impact of delays on patient care pathways.

Although the service did not have access to externally validated benchmarking data, it maintained safety through internal oversight and collaborative learning. A standardised national dataset for PTS-specific safety indicators was not available to enable direct comparison with other providers. The service monitored safety through a range of internal measures, including incident reporting and review, complaint monitoring, vehicle and equipment audits, staff training compliance and safeguarding referrals. The service also reviewed findings from the Quality Assurance Accreditation Scheme 2025 report and held regular meetings with a neighbouring PTS provider to share learning, monitor performance and compare outcomes. These arrangements supported ongoing improvement and provided opportunities to identify and implement changes to practice.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff followed a consent policy aligned with relevant legislation and national guidance, which set out how and when to obtain consent, including for patients who lacked capacity. We observed staff consistently seeking consent before interactions, clearly introducing themselves and explaining the purpose of the journey.

Staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. They assumed capacity unless there was evidence otherwise and escalated concerns to the Clinical Support Desk where required to ensure safe decision-making. While transport staff did not complete capacity assessments, they acted appropriately within their role, including liaising with relatives when needed to support safe discharge. Evidence showed capacity and consent were also considered during the booking process.