Isle of Wight NHS Trust

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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

We looked for evidence that the service involved people 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 people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 75 (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 an exceptional standard. The service was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity.

Staff treated all patients with kindness and respect and provided emotional reassurance and practical support. We observed staff interacting considerately with patients. Staff did not try to rush patients but instead encouraged them and kept their attention when patients became distracted.

Wherever possible, staff proactively anticipated when patients might be in discomfort and distress, and they took all practical steps to minimise those risks.

Some patients, or people accompanying them, became distressed and panicked. During those times staff needed to be firm to ensure they obtained the most important information from patients and to get the right help arranged. We observed this was done in a professional and patient manner, which supported the caller to remain calm.

We observed staff acted to protect patients’ dignity. A paramedic working on the clinical support desk compassionately encouraged the patient to cover themselves so their dignity would be protected when the ambulance crew arrived. The ambulance crew arriving was a mixed sex crew, so the paramedic asked that the crew member of the same sex as the patient went into the house first to support the patient with their privacy and dignity.

We observed some outstanding support provided to patients in emotional distress. An example included a paramedic working on the clinical services desk who chose to remain on the phone to a patient while they were waiting for the ambulance to arrive. From the telephone conversation and assessment, the patient was clearly in pain and emotional distress. There was a palpable relief heard from the patient when the paramedic offered to remain on the phone with the patient until the ambulance arrived.

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

Staff treated people as individuals and placed patients at the centre of their care. They understood the need to be aware of individual circumstances, such as language barriers, family dynamics and cultural sensitivities. We listened to calls and heard staff adapt their communication style as needed, for example, when talking to patients with mental health conditions. They checked patients’ understanding throughout calls.

The service ensured that patients whose first language was not English could use the service. Staff had access to an online translation service as and when required.

The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Staff understood people calling 999 needed clear information and instructions to be able to be part of their care. We heard staff speak clearly and slowly to patients and repeated information when necessary. Staff knew people’s rights to accept or refuse care and gave them the information needed to decide. They frequently dealt with patients who requested more urgent care than deemed necessary and managed these patients with care and respect.

Health advisors and clinicians explained to patients what was happening at each stage of their call. This helped people to understand their care and helped them maintain choice and control. For example, if health advisors needed help from a senior health advisor or from a clinician, they explained to patients they would be put on hold and provided reassurance to reduce any concern.

Patients often had family members in the background. At times, staff needed to speak with them if patients had difficulty explaining their clinical situation. Staff always asked patients if they consented to them speaking with their family members. This helped patients to maintain control over their call for assistance.

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

Staff identified and assessed peoples’ medical needs and risks using the NHS Pathways assessment tool. They asked questions according to the system’s pathways and categorised calls according to urgency. Each category had a target response time to ensure the highest risk patients would be seen as fast as possible.

Staff identified and responded appropriately to changes in patients’ conditions. If patients’ conditions deteriorated during the call, staff re-started assessment and could change the category of the call to get faster help. Equally, if patients’ conditions improved over time, they could downgrade the urgency of the response.

Clinical Coordination Centre staff had training in providing cardiopulmonary resuscitation (CPR) advice over the telephone. We listened to a call where a staff member commenced guiding a member of the public through CPR and stayed with them on the telephone until the ambulance arrived.

The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff spoke positively about the wellbeing support they received. They said they could always seek support from the senior health advisors or the hub duty manager. Staff were supported during and after difficult calls. Staff could mark themselves as having a ‘difficult call’ following which they could rest in the quiet room. Managers could refer staff to trauma risk management (TRiM) practitioners. A TRiM practitioner is a trained, non-clinical peer who provides support to colleagues after a potentially traumatic event. They are not counsellors, but staff trained to identify signs of distress, conduct structured assessments, and offer early intervention or signposting.

Staff could access the trust’s wellbeing resources which included access to the occupational health services. Information boards provided staff with details about how to access wellbeing support. This included how to access TRiM practitioners, and mental health support available for staff to access. The service had introduced a care dog scheme to support staff welfare. Members of staff volunteered, on a rotation basis, to bring their dogs into the workspace for staff to spend time with. Leaders had assessed that as there were no members of the public or patients in the building, there was no requirement to have a registered pet visiting scheme for this purpose. Staff told us they were happy to contribute with their dogs to the wellbeing of staff. The ambulance service also had kayaks and paddleboards that staff could borrow for leisure activities.

Staff received recognition if they successfully guided someone on the phone through CPR (cardiopulmonary resuscitation) or a birth. Staff received a badge to put on their lanyards if they were successful. A back to life board displayed praises for staff who had supported callers to carry out CPR.

The service responded and acted on the results of staff surveys. The last staff survey published identified that some staff did not always feel their thoughts and views were listened to. In response the service was reintroducing team meetings to give staff the opportunity to have their thoughts heard. Staff also raised concerns in the staff survey and subsequent meetings about the management of frequent and abusive callers. The service was taking action to educate the public about use of the 999 and 111 service and action had been taken to address the behaviours of a member of the public who had been inappropriately calling the 111/999 service.

The CCC supported the personal safety and wellbeing of ambulance crews attending to patients. All ambulance crew staff had panic alarms on their radios to use if they were concerned for their personal safety. The alarm came through to the dispatcher. The dispatcher could then call back to the crew member, listen into what was happening on site and call for support from the police service if needed.

There were opportunities for staff career progression. Many staff spoke about how the service had supported them to progress from health advisor to roles such and dispatcher and hub duty manager.