Isle of Wight NHS Trust

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes

We looked for evidence that people and communities were always at the centre of how care was planned and delivered. We checked that the health and care needs of people and communities were understood, and they were actively involved in planning care that met these needs. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality characteristics. At our last assessment we rated this key question good. At this assessment the rating has remained good.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

We observed examples of staff within the service basing patient care around individual needs and preferences. Staff asked about patient’s wishes as part of general communication. They sought their view on options for care and treatment and adapted their approach accordingly.

We saw staff empowering patients to make their own decisions about their care and treatment. They did this by giving them information about options and next steps for their care and treatment depending on the best option for them.

Staff supported patients to make decisions about their care and treatment Staff gave patients time to discuss their needs, wishes and feelings as appropriate.

Care for people who were nearing the end of their life was managed and communicated in a sensitive and dignified way. Staff received training relating to death and dying. This included verification of death, do not attempt cardiopulmonary resuscitation (DNACPR) decision making and advance decision making around future treatment and care when patients had DNACPR decisions in place.

Urgent care specialist paramedics provided care within the community, supporting patients to receive care at home where a non-hospital setting is the most appropriate place of care. This included patients at the end of life who wished to stay at home and required additional community support to ensure appropriate end of life care.

Specialist paramedics in urgent and emergency care supported patients and their families to make informed decisions regarding future treatment and care. This included completing Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) documentation where appropriate, facilitating referrals to community-based services such as hospices, and developing coordinated end-of-life care plans. They were also able to prescribe or supply anticipatory (‘just in case’) medicines to support symptom control and ensure patients receive timely, person-centred care that is aligned with their wishes and preferences.

The service had access to DNACPR forms, these were sent to the emergency operations centre (EOC) from GPs, acute hospital and community staff. Forms were logged on the clinical system.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service had standard operating procedures for how they worked with other services within the local community. There were arrangements with the local fire and rescue service to respond to cardiac arrest calls, to ensure the quickest response possible for patients requiring resuscitation in the community. Arrangements included the dispatch of fire and rescue personnel in addition to ambulance crews and first responders.

The service had a team of volunteer first responders who provided support for category 1 and category 2 calls. There was also a volunteer team providing a falls response service, assessing patients who had fallen and identifying if any further emergency support was required.

There were joined up arrangements across services and clearly defined standard operating procedures for transferring patients off the island when emergency care was required on the mainland. This included arrangements with the helicopter emergency service (HEMS), coastguard, lifeboat, car ferry and hovercraft services. There was a prehospital emergency transfer (PHET) group made up of representatives from organisations involved in the transfer of patients. They had regular governance meetings to review standard operating protocols and other metrics around the effectiveness and safety of the service.

There were arrangements in place to work with other services in the community to undertake live action simulation training with multi-agency input. This included working with the police, fire service, coastguard, HEMS, lifeboat and hospital services to replicate emergency situations to ensure a collaborative response and learn from this.

We observed staff working collaboratively with other services in the community. This included GPs, hospice services, care homes, hospital and other emergency services.

Staff made notifications to external bodies as needed. This included safeguarding notifications that were raised with the local authority by staff. Information was provided in line with good practice and legislation.

Information governance systems included confidentiality of patient records. Staff had completed information governance training and were aware of their responsibilities. We observed staff keeping records secure when on calls.

The service complied with the Accessible Information Standard. Staff told us they could provide information in different languages and formats when needed through their online systems

Staff ensured that patients could obtain information on treatments, local services, patients’ rights and how to complain. We saw staff signposting patients appropriately and ensuring they had access to the information needed.

Staff provided information to patients and family members as appropriate.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

There was information on ambulances on how patients could complain and staff told us they shared information on the complaints process with patients. This included the availability of an online complaint form through the trust’s patient advice and liaison service (PALS).

There had been 23 complaints about emergency and urgent care services in the last 12 months. Themes were identified and included issues with communication. We saw the trust had addressed this with additional training around public expectations and the responsibilities of staff in frontline roles. The training also supported staff in understanding how their actions influence how patients feel.

Complaints were responded to in line with the trust’s complaints policy. Responses included details of investigations and where appropriate, an apology and action taken. Patients were also signposted to the Parliamentary and Health Service Ombudsman (PHSO) if they felt the response did not address their concerns. The service had not had any complaints referred to the ombudsman in the last 12 months.

The service made sure that people could access the care, support and treatment they needed when they needed it.

The trust routinely monitored average ambulance response times and took action to improve these. We saw that on average, emergency category 1 (C1) response times had improved since January 2025 with an average of 8 minutes in November 2025, in comparison to 10 minutes in 2023.This was against a 7-minute national target. The amount of category 1 calls requiring transportation was slightly higher than national (9.7) and regional (9.83) results at 10.35 minutes. The trust was performing better than national averages in response times for category 2, category 3 and category 4 calls.

The service has seen a marked improvement since February 2025 in the form of a reduction in the number of handovers over 60 minutes and 120 minutes. Ambulance handovers to emergency departments should be as short as possible. From February to December 2025, data showed that 38 patient handovers had exceeded 60 minutes compared with 91 for the same time period in 2024. There were 6 handovers exceeding 120 minutes in 2025 compared with 25 in 2024.

Data provided by the trust showed the amount of handovers exceeding 60 minutes between December 2025 and February 2026 ranged between 1.7% and 16.2%. Leaders told us this was due to an increase in January 2026 due to patient flow challenges where demand exceeded capacity because of temporary staffing shortages. Action taken to improve flow included support from specialist paramedics for crews and to help identify alternative locations for patients. In addition, operational station managers worked jointly with emergency department staff to support improvements to patient flow. We were told there had been an increase in senior clinical staff oversight within the emergency operations centre to support decision making and the use of alternative pathways. Other initiatives at the time included working with local authority partners to reduce ambulance dispatch to patients who had fallen at home but did not have an injury.

Staff made reasonable adjustments for patients. For example, people with mobility issues. Equipment was available to support the transportation of patients irrespective of their physical abilities.

There was adequate emergency care cover day and night. The service had increased the number of critical care and specialist paramedics to support the service and the provision of ‘see and treat’, where patients could be treated without conveyance to hospital where appropriate. They also had a mental health paramedic car to support patients experiencing poor mental health.

We scored the service as 4. The evidence showed an exceptional standard. Staff and leaders were innovative in how they listened to information about people who are most likely to experience inequality in experience or outcomes. Staff and leaders actively used this information to provide exceptionally tailored care, support and treatment in response to this.

Managers and staff worked proactively to ensure the service remained accessible to the island’s population, despite the challenges associated with geography and health inequalities. The service recognised patients living on the Isle of Wight faced increased risks of delayed care and reduced access to treatment compared with mainland residents. To address this, managers worked with system partners to improve access to mainland services. For example, the service collaborated with cross-Solent transport providers to support timely patient transfers for patients requiring emergency care that could not be provided on the island. This helped to ensure patients could access specialist care without being disadvantaged by their location.

The service also planned for and responded to the complex demographic needs of the local population. Managers understood the island had an ageing population, with a projected 36% increase in residents aged over 85 by 2030, alongside higher levels of deprivation and long-term conditions compared with national averages. Staff used this population data to inform service planning and tailor care to those most at risk of unequal outcomes. By aligning resources with local need, the service reduced the risk of gaps in provision for vulnerable patient groups.

The service ensured its care provision supported safe, dignified and equitable access for people with a range of physical needs. Staff used a variety of specialised equipment, including different wheelchair sizes, leg raisers, vehicle winches, secure restraints and stair-climbing chairs for patients unable to manage steps. Crews also carried bariatric stretchers supporting up to 400kg, vacuum mattresses and essential clinical equipment such as oxygen and defibrillators. This helped to ensure patients with complex mobility and health needs could travel safely and without barriers.

The service incorporated patient feedback and lived experience into its governance processes to support improvement. Managers gathered feedback through a range of methods, including accessible paper forms, informal feedback during journeys, public engagement events and liaison with care homes and supported living services. In addition, a patient representative with reduced mobility and long-term conditions was a member of the Ambulance Quality Sub-Committee, supported by the Trust Patient Council. These approaches helped to ensure the views of people at risk of inequality informed service development, including booking processes and transport accessibility.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. Staff had received training in communication and equality. Staff used a language guide that had been developed locally with input from people with lived experience, to ensure communication was inclusive.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

Staff were trained in equality, diversity, inclusion and human rights with training compliance in this area at 98%. In addition, 100% of staff had completed training in dementia awareness and 98% had completed training in learning disability (LD) and autism awareness. In addition, face to face LD and autism training was being planned for later in 2026.

We observed staff communicating with patients and family members in a supportive and inclusive way.