Isle of Wight NHS Trust

On this page

• 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 the service met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

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.

Staff understood the importance of listening and giving patients their full attention to understand the reason for requesting an ambulance, and took their concerns, symptoms and preferences seriously.

The service had a number of frequent callers, which were members of the public who called 999 or 111, sometimes several times a day, for concerns that were not in the ambulance services role to respond to. Although there was no official policy to guide staff on how to manage frequent callers, all staff we spoke to described following the same process. The health advisor triaged each call following the NHS pathways process. If a caller was identified as a frequent caller, they were discussed at a multi-agency integrated care review meeting to plan the best way forward to manage and meet the person’s needs.

Staff could access person-centred patient information via the special notes on the system. These included information about frequent callers, and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions. This meant staff, including health advisors, dispatchers, and ambulance crews, had the relevant information to advise and guide patients to meet their individual needs.

The service had introduced video calls through an external provider. This enabled clinicians in the CCC to deliver person-centred care. They could review patients via video, conduct visual assessments and provide guidance.

The evidence showed a good standard. 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.

Leaders had a good understanding of the diverse needs of the local population and the challenges in meeting those needs. Although the service was required to work towards meeting national targets, conversations with staff at all levels showed their overarching commitment was to meet the needs of the local population.

Leaders were aware that for some of the remoter areas of the island, ambulance response times would be longer than the national target. To support meeting the need of people who lived in remoter areas the service had an extensive group of community first responders. Community first responders are volunteers trained and dispatched by UK ambulance services in their local communities. They provide essential lifesaving treatment and support in those crucial minutes before the ambulance crew arrives. This includes responding to patients suffering a life-threatening emergency such as a cardiac arrest, stroke or breathing problems. Community first responders logged into the system so dispatchers could see who was available and where they were located. Dispatchers sent relevant located community first responders to patients to start care and treatment while ambulance crews were travelling there.

The service worked with partner organisations and the acute services in the trust to support joined up care and treatment on the island. This included upskilling and dispatching community first responders to attend to patients who had fallen but were uninjured, to safely support them to get up. The service also worked with the local authority social care team who had the skills and training to attend to the same group of patients. This meant patients were less likely to suffer worse outcomes from being on the floor for long periods of time and were less likely to be conveyed and admitted to hospital.

The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The Isle of Wight NHS Trust had a public facing website which included information for members of the public and other professionals. For example, it contained details about how to complain, how to request information in line with the Freedom of Information Act, how the service dealt with and learnt from incidents, and information on careers with the service. There was detail about the ambulance service, which included information about the services it provided. The site also provided information about support for groups for people who had experienced a cardiac arrest, first aid training they could provide to community groups and detail about how to find the nearest automatic external defibrillator.

The website had accessibility tools, so the information could be translated into different languages. The information could also be displayed in different text sizes and in different coloured fonts and backgrounds which made it easier for some people to read.

The evidence showed a good standard. 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.

Detail about how to give feedback about care and treatment was detailed on the trust website. This included compliments, concerns, and complaints feedback processes.

A trust wide complaints policy gave staff guidance about managing and responding to complaints

Data provided by the service showed that in the 12 months prior to our assessment the Clinical Coordination Centre (CCC) had received 13 complaints that were about the 111 or the 999 service. The service monitored themes from complaints and took action accordingly. For example, one theme was concerns around staff attitude. Training sessions and facilitation of staff self-reflection on their behaviours, attitudes and the culture they contributed to had been introduced to support improvements in this area.

The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

The Clinical Coordination Centre operated 24 hours a day, 7 days a week. At times of pressure, national contingency plans meant other ambulance trust’s call centres could answer 999 calls for the Isle of Wight ambulance service and arrange for the dispatch of ambulances on the Isle of Wight. This ensured the population on the Isle of Wight could always reach help.

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.

The service had a relentless focus on identifying and addressing delays and inequalities to care, treatment or support. This included working with external partners.

Leaders were committed to ensuring the service was available to all the island population, despite challenging geography and health inequalities. Leaders were aware that the geography and service provision on the Isle of Wight meant that for some patients with certain conditions, there was risk staff in the Clinical Coordination Centre (CCC) would not be able to support patients to have the same access to timely treatment as those people living on the mainland. To address this, leaders were working with partners to improve access and conveyance to the mainland for treatment. Some examples of improvements made for patients was the collaboration with cross Solent travel companies for swift transfer of patients to the mainland for treatment for some cardiac conditions, and the collaboration with the helicopter emergency medical service (HEMS) to improve immediate treatment of critically injured patients. However, leaders said that commissioners did not always acknowledge the additional expense incurred to ensure patients did not have their healthcare disadvantaged due to living on an island.

Leaders understood the demographics on the island. The island had an aging population with predictions of a 36% increase in people over the age of 85 living on the island (from 5,378 to 7,358) by 2030, and only 30% of the island’s population would be of working age by 2041. There were 6 areas on the island within the top 10% most deprived areas in England. For 17 of the top 20 registered long-term conditions, the Isle of Wight had a higher prevalence compared to the England average. There were several quality improvement projects not only to improve response times, but to improve access to healthcare for the actual and projected population demographics of the island. Many of these included interventions from staff working in the CCC. For example, the dispatch of specially trained Community First Responders to attend to patients who had fallen but not injured themselves. A second example was a pilot to deliver an enhanced service for frail patients with the aim to provide more timely and personalised care and support and reduce the need for frail elderly patients to be admitted to hospital. A third example was the work with safeguarding midwives who had developed a system to flag unborn babies with child protection plans and women with high-risk pregnancies to staff in the CCC in case a 999 call was received. This system of flags had been established since June 2024. All pilots and on-going projects were aimed at improving timely and safe care and treatment to patients, reduce risk of harm to patients by providing timely support and care in the most appropriate environment.

All staff received training in equality, diversity, and inclusion (EDI) and human rights. This covered principles of equality, diversity and human rights and how staff applied this within their work, the relevant legislation, policies and procedures and ways for staff to raise concerns.

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.