South East Coast Ambulance Service NHS Foundation 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 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 requires improvement. At this assessment the rating has improved to good. This meant people’s needs were met through good organisation and delivery.

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 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 prioritised patients’ individual needs, including their mental health, physical health, language and cultural aspects. The service had provisions for communicating with patients with hearing difficulties, they had immediate access to an online interpreting service, and staff received training to deal with a variety of mental and neurological health needs. Staff had received training relating to equality and diversity. Ninety-two percent of staff across the Emergency Operations Centre (EOC) were compliant with this training.

Staff explained the importance of listening and giving patients their full attention so they could understand why someone had requested an ambulance. They took people’s concerns, symptoms and preferences seriously.

The provider ensured frequent callers had individualised care plans to support their needs. They had access to mental health services to help develop these patient specific care plans. The service attended a national ambulance frequent caller group to share experiences and best practices.

We heard the service was in the process of introducing video conferencing. This would enable clinicians to view patients via video, allowing them conduct visual assessments and provide guidance.

When staff talked to children during calls, they tried to speak slowly and repeat questions or statements. NHS Pathways did not have a child-friendly script; however, staff had received training to change questions and their delivery, as long the questions did not lose clinical meaning. However, staff tried their best to adapt their communication style to help children understand them.

Staff involved patients’ family or carers in any decision-making process during calls, if appropriate, providing emotional support and information.

Staff accessed person-centred patient information via special notes on the system. These included, for example, Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions. Electronic records used information flags to highlight significant events in patients’ medical history; for example, a risk markerrelated to any information about previous patient behaviour, dogs at a property, hygiene concerns at properties, or frequent caller information. This was important information for crews to be prepared for any potential hazards when attending to patients.

We scored the service as 3. 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.

The trust worked collaboratively with other ambulance services through the national intelligent routing platform (IRP), launched in late 2022. The IRP was designed to reduce delays in emergency care by automatically redirecting 999 calls to other ambulance services when the Emergency Operations Centre (EOC) was experiencing high demand or operational pressures.

The trust had special arrangements with 2 providers where they offered call handler support to them faster than the standard IPR programme in times of peak demand. At the time of the inspection SECAmb was in discussion to make this a mutual arrangement so they could get help to meet their own demand.

The service worked continuously with their partners to develop effective pathways to help elevate pressures. We heard managers were in communication with another neighbouring NHS ambulance provider to look at introducing mutual aid vehicle tracking technology. This would help keep patients informed of how close crews were and help dispatchers plan which crew was closest to an incident. This could include a response by the neighbouring NHS ambulance provider.

Almost all clinicians in the EOC had backgrounds in urgent and emergency and primary care and they understood the need for fast-paced care. All teams within the EOC worked together to ensure help got to those people who needed it. Dispatchers used two-way radio communication with ambulance crews, ensuring they received important dispatch information quickly. Critical care paramedics continuously monitored calls in the queue and listened to calls they identified as needing emergency care. This ensured ambulances for high priority patients could be dispatched quickly.

We scored the service as 3. The evidence showed a good understanding of the need to create information suitable for all patients’ needs. The service had a strategy in place but were not yet providing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The trust had a public facing website which people could access to find out about SECAmb and the services it provided and how to access these services. For example, it contained details about how to give feedback on care, how to request information in line with the Freedom of Information Act 2000, how the service dealt with and learnt from incidents, and information on careers with the service.

Staff explained next steps to patients in simple ways and repeated any information patients did not understand or hear. At the end of calls, staff asked patients whether they wanted to receive further advice via text message or verbally. Not all 999 calls led to an ambulance dispatch. Staff explained this to patients and signposted them to other services, for example, GP services, urgent treatment centres, or community based services.

The service displayed signs around the Emergency Operations Centre (EOC) to remind staff of the importance of patient confidentiality and General Data Protection Regulation (GDPR) legislation. We saw staff locked their computers whenever they left their desks to ensure patient confidentiality was maintained. Posters reminded staff to approach other people’s desks from the front so they did not see open screens and any information displayed, which may be confidential.

The provider had identified the need to adapt information to meet the needs of various patient groups. In June 2025, they published a Patient and Public Engagement Strategy. We reviewed the draft strategy and saw it included plans to create easy read materials and information appropriate for people with learning disabilities and underrepresented groups, such as younger people (16–34 years old), adults aged over 75, minority ethnic communities, LGBTQ+ patients, and minority faith groups. The service had identified this from data obtained through patient experience questionnaires. At the time of the inspection, these resources were not yet available.

We scored the service as 3. 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.

The provider had an up-to-date, comprehensive, and ratified complaints policy.

Although not yet due for formal review, it was undergoing early revision in response to significant organisational changes. The policy clearly outlined complaint categories, responsible leads, and response timescales, including a requirement to acknowledge patient communication within three working days.

Patient Advice and Liaison (PALS) officers responded to level 1 concerns, enquires, and information requests and level 2 complaints. The chief nursing officer or deputy chief nursing officer responded to level 3 complaints.

The provider’s public facing website had clear information for patients on how to give feedback. Patients could access the complaints policy online. There was information on who could support people to make complaints and what to do if a response to a complaint was not satisfactory.

We reviewed the trust’s 2024 to 2025 PALS annual report. This outlined data relating to complaints and concerns. For the 12-month period we reviewed, Emergency Operations Centre (EOC) staff answered 1,036,160 calls and received 287 complaints, equating to approximately one complaint per 3,610 calls. This represented a 53% increase from 187 complaints in 2023–2024. Leaders acknowledged the rise and planned a detailed review to identify underlying causes and implement improvements where required in quarter 1 of the financial year 2025 to 2026.

In the financial year 2024 to 2025, the provider responded to 93% of complaints within the agreed timescales which was almost equal to the trust target of 95%. Leaders had identified actions to improve response rates. We reviewed 5 examples of complaints responses and saw patients’ concern had been investigated comprehensively. Each response included learning that had taken place because of their complaint. The complaints team included advice on what to do next if patients were not happy with their response; for example, contact the Parliamentary and Health Service Ombudsman.

Complaints data was analysed and grouped into themes, alongside incidents and patient feedback, within the quarterly integrated patient safety report presented to the Quality and Patient Safety Committee. Themes were categorised into areas such as equipment, medicines, and EOC processes, with corresponding quality improvement actions. For example, all EOC staff were to be enrolled in system partner learning sessions to strengthen learning from audit findings.

The trust produced quarterly PALS reports outlining complaints and compliments received from patients. The reports contained trust wide information, not just the EOC.

The trust was developing its engagement with communities. It already held a virtual community forum every 2 months, open to members of the public, which allowed people to share experiences and contribute to service improvements, both for the EOCs and the trust. For example, feedback from attendees informed improvements such as service information clarity, accessibility of communication, and responsiveness to specific population needs. The trust planned to communicate changes resulting from feedback through ‘You said, we did’ posters, demonstrating a commitment to transparency and patient involvement.

We scored the service as 3. 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 Emergency Operations Centres (EOCs) at SECAmb operated 24 hours a day, 7 days a week. The service had arrangements for times of increased pressure to ensure patients could reach help. Internally, if pressure increased, team leaders put up a visible sign which read ‘emergency rule’. During times of emergency rule, call handlers used a refined triage process within the NHS Pathways system. This allowed for the prioritisation of immediately life threatening presentations, organise an ambulance response and then release the call handler to answer another call. Externally, the provider had an agreement with other trusts to help when the number of calls became unmanageable.

The provider benchmarked their performance against other ambulance providers. For example, the national average of call response times for 999 calls stood at between 3 and 4 seconds. SECAmb’s average for the months June to November 2025 was 3.4 seconds.

The NHS Pathways system allocated categories to calls depending on the triage outcome reached by call handlers. Category 1 (immediately life-threatening injuries and illness) calls went straight to dispatch teams to ensure immediate help was sent to patients. Call handlers arranged an ambulance during the call and could continue asking questions with an ambulance already dispatched.

Category 2 calls (emergency calls) underwent ‘Category 2 streaming’, which was a clinical triage process used to prioritise the most urgent patients and is part of the NHS Ambulance Response Programme. This meant a clinician called patients back to assess what type of response they needed. For example, a clinician assessed a patient and could determine if they required a faster response, such as a Category 1 ambulance. Alternatively, they could assess as a ‘hear and treat’, which was a clinical assessment of 999 calls over the phone without dispatching an ambulance. This included signposting patients to other services, for example, their GP or urgent treatment centres; or providing clinical advice over the telephone. ‘Hear and treat’ has become a growing component of NHS ambulance services in England and was used to reduce the number of ambulance dispatches where they were not necessary. We found SECAmb’s ‘hear and treat’ figures to be in line with the national average.

Category 3 and Category 4 calls handled urgent to less-urgent calls. These categories received a clinical callback, and clinicians made decisions on the most appropriate care required for example, an ambulance dispatch, referral to another service, or advice over the telephone.

The service ensured patients waiting for clinical callbacks remained safe whilst waiting. The service used an automated welfare text system to patients waiting. This provided them with timely updates regarding any potential delays. Texts were sent at defined intervals. Patients could reply to text messages advising to cancel an ambulance via text if they no longer needed one.

Data submitted about the abandonment rate of 999 calls of the past 6 months showed a consistent trend of very low levels. For example, in November 2025, 0.15% of calls were abandoned. This represented a daily average of 4 calls abandoned per day against a volume of approximately 2700 calls answered.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The service actively gathered feedback from the public and from stakeholders to understand the communities they served and identify gaps. They did this through community forums and questionnaires. Using this feedback, the service planned how to ensure people from underrepresented groups had equal access to care and treatment. This included people from different cultures and ethnicities, people with learning disabilities, and neurodivergent people.

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; relevant legislation, policies and ways for staff to raise concerns. The organisational target for this training was 85% and compliance exceeded this.

The service used data from patient feedback together with performance data to monitor themes and make improvements, with the aim of ensuring all patients received the same service, treatment and outcomes. For example, feedback from community members informed recruitment and deployment strategies to increase availability of volunteer support for patients who might face barriers. Adjustments to location, timing, materials, and communications were made in response to patient feedback to reduce barriers for participation, ensuring a wider range of voices influence service delivery.

The service dealt with numerous frequent callers and had processes to manage these fairly and safely. They liaised with several community and mental health services to ensure these patients were safe. Additionally, the service linked into networks with NHS trusts who dealt with high intensity service users (HISUs).

We spoke with many staff members and noted an in-depth understanding of matters relating to people who may be at a disadvantage due to their varying backgrounds. Staff knew how to treat patients depending on their individual needs.