South East Coast Ambulance Service NHS Foundation 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 people were always treated with kindness, empathy and compassion. We checked that people’s privacy and dignity was 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 people’s wishes into account and respect their choices, to achieve the best possible outcomes for them.

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.

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

We listened to many calls during the inspection and found staff to be patient, supportive and calm. We heard callers speak to patients in mental health crises, to parents worried about ambulances not arriving, and to children in pain and distress. Staff treated all patients with kindness and respect and provided emotional reassurance and practical support. A review of patient feedback indicated patients frequently praised staff for their professionalism, behaviour, and compassion.

Some patients, or those with 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.

Staff understood about patient confidentiality. They used electronic patient records to log patient information and only shared information with others that was pertinent to the situation, for example with ambulance crews.

We scored the service as 3. 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.

Staff treated people as individuals and placed patients at the centre of their care. They explained 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 children or patients with mental health needs. They checked patients’ understanding throughout calls.

Staff understood the tension and worry people calling 999 could be in and took this into account when communicating with patients.

EOC staff received mandatory training in equality, diversity and human rights. We reviewed training data, which showed 92% of staff working in the Emergency Operations Centre (EOC) had completed this. Staff could access an online translation service as and when required.

The service’s text messaging system allowed patients to cancel ambulances if they no longer needed this response.

We scored the service as 3. 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 make a decision. They frequently dealt with patients who requested more urgent care than deemed necessary and managed these patients with care and respect.

We heard Emergency Operations Centre (EOC) staff frequently explain 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 call handlers needed help from a supervisor, they explained to patients they would be put on hold and not to worry.

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 maintain control.

We scored the service as 3. 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 responded appropriately to changes in patients’ conditions. If patients’ conditions deteriorated during the call, staff re-started triage and could change the category of the call to get faster help. Equally, if patients’ conditions improved over time, they could re-triage and downgrade the urgency of the response.

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

We scored the service as 3. 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.

Most staff we spoke with felt supported and valued and enjoyed working for SECAmb. We heard stories of staff receiving ‘random act of kindness’ cards from their leaders. These cards were used to boost staff morale by spreading positivity through notes, surprises, and encouraging messages.We also spoke to a staff member who had received a bunch of flowers in recognition of their performance during a recent difficult call.

The trust had recently finalised a 5-year wellbeing strategy. This had been introduced following a previous CQC inspection in 2022 when staff wellbeing had been identified as lacking. The strategy clearly defined 3 main themes to ensure staff wellbeing would be embedded in everyday working. It was underpinned by relevant legal frameworks, such as the Health and Safety at Work Act (1974) and the Human Rights Act 1998.

Staff accessed a senior mental health professional for anything related to health and wellbeing. They could do this via a booking progress or ad hoc, when they needed it. Further, across the 2 Emergency Operations Centres (EOCs) the provider had trained 9 members of staff to be wellbeing advocates who could support colleagues or signpost them to relevant services.

The service sent out a bi-monthly newsletter with a focus on wellbeing. This included celebrating and thanking staff who had been identified as going above or beyond.

Staff had access to support when they needed it. Each team of call handlers had allocated team leaders who they contacted when they needed help during or after a call. Following difficult calls, staff could leave their desks and take a break. Each EOC had a quiet room for staff to use.

The service provided trauma risk management (TRiM). The TRiM framework isa means of supporting staff after a potentially traumatic experience or accumulation of experiences, and to identify symptoms of stress early.

The provider had created a Wellbeing Hub which was a non-clinical service to support and promote the health and wellbeing of staff. Managers told us the wellbeing hub had almost 30,000 interactions with staff in 2024 and dealt with almost 2,000 referrals for both physical and emotional health. The service displayed wellbeing information on wellbeing boards across offices and control rooms.

Additionally, staff had access to chaplains across SECAmb. Chaplains provided support to staff of any faith or no faith. Their role was to listen to staff and to be completely non-judgemental in their approach. The chaplaincy operated a telephone service which could be accessed 24 hours a day.

However, we also spoke with some staff who did not feel supported. We heard staff felt care for the workforce was “sincere but not always consolidated”. Some staff felt leaders said the right words but did not always follow this up with the right action. For example, a comment from staff was “It feels like window dressing”.

Feedback about career development was varied. Some staff reported they received regular communications about available developmental roles and training available. Other staff told us progression was not available to them.

The service had introduced a new lunch and rest break system. Historically, team leaders arranged breaks for their staff; however, this system had issues leading to inconsistent timings and fairness issues. The trust developed an electronic tool, which now allocated lunch and rest break sessions automatically. We saw evidence this tool had been trialled and staff feedback gained to monitor its effectiveness. Some staff mentioned the automated tool felt less flexible and had caused some problems, such as staff being allocated their main break too early in the shift. Managers told us they continued to monitor this system as it was new.