South Central Ambulance Service NHS Foundation Trust

On this page

• 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.

We assessed all 5 quality statements from this key question.

At the last inspection we rated this key question good.

At this inspection the rating has remained as good.

This meant people felt well-supported, cared for and treated with dignity and respect.

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 service always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Staff treated patients and their families with kindness, compassion and dignity in their day-to-day care and support.

We saw pleasant interactions between staff and patients. We saw staff treat patients with warmth and care, they were respectful and non-discriminatory. Interactions were courteous, professional and demonstrated compassion to patients. Feedback from patients was positive. We were told ambulance crews introduced themselves and explained what was going to happen. Patients told us, ambulance crews were kind and caring, made people feel calm when they were feeling vulnerable and scared, and were respectful, polite and professional.

We mostly saw crews respecting people’s privacy and dignity, for example, closing curtains when they transferred patients from their trolleys to hospital beds. We saw an ambulance crew go fetch a privacy screen to put around a patient queuing in the corridor of an emergency department when they were getting them settled, to make sure their dignity was maintained.

Staff understood about patient confidentiality. They used electronic patient records to log patient information. Ambulance crews made sure these were always in their possession to stop unauthorised people having access to patient information.

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.

Ambulance crews told us they always treated patients as individuals. They made sure the patient was at the centre of their care and strive to build trust and rapport with the patient.

They explained when entering a patient’s home, they had to be mindful of cultural sensitivities to ensure respectful and effective care. This included understanding potential language barriers, respecting religious or cultural practices regarding modesty or physical contact, and being aware of family dynamics and decision-making processes.

Crews had access to language services and interpreters if required, and did not use medical jargon when talking to patients. They would talk to patients at their level, for example sitting on a sofa at the same height or kneeling in front of the patient, so they communication style was not intimidating to the patient.

Staff understood about protected characteristics and knew these were protected by law. Staff received training with examples around cultural, social and religious needs at induction and in the online mandatory training. Staff had also received training on cultural humility, which emphasises a commitment to understanding others, acknowledging power imbalances, and fostering mutual learning and growth.

Sensory boxes were being trialled in some of the ambulance stations, these contained cards, squeaky toys and earmuffs to see if they aided neurodivergent patients. These boxes aimed to provide a calming and supportive environment for individuals who may be overwhelmed by the sensory input of an ambulance setting. The goal was to improve the patient experience and potentially make it easier for them to receive care.

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

Ambulance crews made sure they communicated clearly and openly with patients about their condition, the treatment options available and the potential to convey them to hospital. They explained the reasons behind the recommended actions, including why a particular hospital or treatment was suggested, and what alternatives might be available.

Patients were encouraged to ask questions and express their preferences regarding their care. Ambulance crews would consider these preferences when making decisions, where appropriate and safe. Staff gave us an example where a patient did not want to be transferred into the ambulance using a stretcher, so making sure the patient was safe and it would not cause further harm, supported them to walk to the ambulance.

Patients told us things had been explained to them in a way they could understand, and they never felt rushed by the crews.

Adults were generally presumed to have the capacity to make decisions about their health, including refusing treatment, unless there was evidence to the contrary. Capacity was assessed on a case-by-case basis, considering the patient's ability to understand the information, weigh the options, and make a decision.

Staff told us patients had the right to refuse treatment or transport but they would always encourage patients to get the care and treatment they needed. However, if a patient refused and had the capacity to understand the consequences of their choice, ambulance crews knew they were obligated to respect this decision. If a patient with capacity refused treatment, even if it could improve their health, the ambulance crew respected that decision and documented the patient’s decision on the electronic patient record, for legal and clinical reasons.

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.

Emergency calls were triaged by staff at the emergency contact centre. Based on the triage, the urgency of the response would be decided and rated from category 1 to 4, with 1 being the most urgent. An ambulance would be dispatched to the location depending on the triage.

When the ambulance crew arrived, they would assess the safety of the situation for both staff and the patient before deciding on the course of action. If further support was required, for example, the need for police or fire service, these would be requested.

Crews assessed patients’ conditions using established protocols alongside their clinical judgment. If immediate care was required such as cardiopulmonary resuscitation (CPR) it was initiated without delay. In some cases, administering medication, particularly pain relief, was also necessary. Patients we spoke with told us their pain had been assessed and, when appropriate, they were given pain relief.

The service had previously experienced delays in reaching patients due to high demand, which resulted in incidents of harm from delayed treatment and was the primary source of patient complaints. However, as pressure on the service had eased, response times had improved. Patients we spoke with in the emergency departments who arrived by ambulance reported that the ambulance had arrived promptly.

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

The majority of staff, at all levels, praised their line managers and thought they cared about their well-being. However, as a collective the staff who worked in the service felt the organisation did not look after their wellbeing or emotional needs and this was evidenced in results of the recent staff survey 2024, where questions relating to wellbeing were mostly rag rated red, indicating a significant issue.

The service had a variety of programs and initiatives to help support staff. They offered access to mental health services, a 24-hour employee assistance program, occupational health services, and welfare schemes. Additionally, they provided support for managing various health conditions like obesity, diabetes, asthma, and COPD, and had a dedicated menopause support program. They offered staff the influenza vaccine to protect staff’s health. In all stations, we saw notice boards advertising these services, and information for health and wellbeing resources was available on the staff intranet. We were told of webinars and events that the trust had hosted on topics such as mental health, menopause and financial wellbeing.

The service had conducted training on bullying and harassment in the workplace and launched the sexual safety charter to eliminate sexual misconduct, harassment, abuse or violence in healthcare settings.

The service used debriefs, structured conversations designed to review the actions, decisions, and outcomes of patient care incidents. These sessions aimed to enhance future practice and support staff well-being by providing a safe space for emotional processing and promoting resilience. Staff found them beneficial especially after challenging incidents or emotionally demanding situations.

The service used trauma risk management (TRIM) which used trained individuals within the organisation to provide support to colleagues to cope with traumatic or potentially traumatic events. It was not a form of counselling or therapy but a structured approach to managing the potential mental health impacts of traumatic experience. Staff spoke highly about this service.

We were also told about the sustaining resilience at work (STRAW) programme. This was a peer support programme designed to help prevent and address mental health issues in the workplace.

However, although staff appreciated all of the things the trust offered to support them with their wellbeing, they were physically and emotionally exhausted from working at such a high demand and under high operational pressure for a continued amount of time. They referenced missed meal breaks, late finishes and issues that came with an aging fleet, and the long handover delays in hospitals which impacted on the role they were employed to do, and these were some of the issues impacting on their welfare.

Senior managers at the trust were aware of the sustained pressures staff had faced and understood that these issues were reflected in the recent poor staff survey results. In response, they had focused on key performance issues such as reducing hospital handover times and procuring new vehicles, which had achieved some success in easing workload and reducing staff stress. However, they acknowledged that staff welfare remained a significant concern and confirmed it would be a central priority for 2025/2026.