South Central Ambulance Service NHS Foundation Trust

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• 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.

We assessed a total of 6 quality statements from this key question.

At the last inspection we rated this key question requires improvement.

At this inspection the rating has changed to good.

This meant people’s needs were met through good organisation and delivery.

This service scored 71 (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 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 always prioritised the individual patient’s needs, preferences and values throughout their care journey. They explained when entering a patient’s home, they had to be mindful of cultural sensitivities to ensure respectful and effective care. This included respecting religious or cultural practices regarding modesty or physical contact.

They made a conscious effort to actively listen and understand their patients, taking their concerns, symptoms, and preferences seriously. By considering the patient's perspective, they ensured that care was both empathetic and responsive. All relevant information was documented in the electronic patient record to support ongoing care planning.

When appropriate, ambulance crews would acknowledge and respect the patient’s choice regarding their care, including the right to refuse treatment.

Crews prioritised the patient’s physical comfort and safety throughout the process, for example giving analgesia (pain relief) when appropriate or keeping a patient warm if they were being cared for outside.

When appropriate, crews involved the patient's family and friends in the decision-making process, providing emotional support and information.

Ambulance crews communicated clearly and effectively with the patient, explaining procedures and options in an understandable way. They had access to interpretation services, and aids on their electronic hand devices to aid effective communication, including pain assessments for adults, child and those with learning disabilities. Crews also received training on how to communicate with more complex patients, such as people with learning disabilities.

The service made sure people receive care and treatment from services that understand the diverse health and social care needs of their local communities.

The service knew it needed to work closely with other healthcare providers to be able to deliver safe, effective and timely care to the community it served.

Due to high demand and increasing pressures on the service, response times for attending to patients had fallen below optimal levels and were not meeting agreed national targets. Prolonged delays in handing over patients at hospitals further compromised ambulance crews’ ability to respond to new emergencies in the community. As a result, some patients had experienced harm due to delayed access to urgent care.

The trust and senior staff in the emergency and urgent care service, had worked in collaboration with other healthcare providers and the integrated care systems to look at ways to reduce handover delays and response times. Initiatives had included the release to respond initiative, which was an agreed process between the ambulance service and receiving hospital. This saw the safe withdrawal of the ambulance crew within 45 minutes to release them to respond to patients in the community, thus creating continued patient safety across all areas of healthcare.

Since the initiative went live in December 2024, there had been a significant improvement in response times to patients in the community and lost crew hours waiting to hand patients over at emergency departments.

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

The trust had an up-to-date website that people could access to find out about SCAS and the services it provided which including the emergency and urgent care services and how to access these services.

The trust was committed to making the website as accessible as possible, in accordance with the Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018 and The Accessible Information Standard (DCB1605 Accessible Information). People could use a range of browsers, for example change colours, contrast levels and fonts and navigate most of the website using speech recognition software.

People could request information from the website in a different format, such as an accessible PDF, large print, different languages, easy read, audio recording, or braille via the patient experience team.

The service had developed and co-produced a range of accessible resources to better support people with additional communication needs when using ambulance services and to meet the accessibility standards. These included a communication booklet to help crews communicate with patients and easy read documents co-produced with people with learning disabilities which covered topics like calling 999, response times and going to hospital. However, we did not see any of these booklets on the vehicles we inspected.

The trust was piloting the "Message in a Bottle" scheme to support communication between autistic individuals and healthcare professionals. The initiative involved storing essential personal information such as allergies, current medications, and emergency contact details, and how best to communicate and engage with the individual during emergencies, in a clearly recognisable bottle. Ambulance crews were trained to look for this bottle, enabling them to quickly access critical information and provide more informed and sensitive care. One thousand bottles had been distributed, and the pilot had already been shown positive outcomes for patients helping to reduce stress and improving care quality since it was introduced in 2025. The service had also produced a 360 degrees ambulance tour video which was an interactive video to help patients explore the inside of an ambulance ahead of time.

The service used posters as a key communication tool to share important information with the public. These posters aimed to raise awareness about when it is appropriate to call 999, inform people about available healthcare services, and promote targeted health campaigns. Many of these messages were also displayed on the ambulances themselves, helping to extend their reach and visibility within the community.

Staff received General Data Protection Regulation training (GDPR). Patient records were held on a secure electronic patient record system, which was accessed by individual staff log in.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support and acted on it.

The service actively wanted to hear the peoples’ voice, as this helped them understand how care and treatment felt from the patient’s perspective and their lived experience. The service used this information to improve the quality of care, enhance patient satisfaction and foster a more patient-centred approach.

The trust had launched a patient panel in February 2024, which was designed to increase the involvement of patients, as well as their families and carers, in improving and shaping the future of their services. The panel was made up of patients, family members or carers of patients who have used SCAS services, including the emergency and urgent care services, as well as representatives from voluntary groups and partner organisations. The panel had the opportunity to gain insight and have their say on service developments and improvements, which included the 999 emergency services. Members of the panel were invited to attend meetings, share views on specific areas of interest, including the design, development and delivery of services through focus groups or via surveys and other online feedback. There were sub-groups to the panel which focused on mental health, learning disabilities and a young person’s group for people between 16-25 year old. These groups had helped with designing easy read and accessibility documents, highlighting barriers to accessing the services and co-produced training.

Staff from the service regularly engaged with the community and attended many and various community events, to educate the public about their role, train people in cardiopulmonary resuscitation and life-saving interventions, and promote an understanding of when and how to use emergency services. The service had attended university student fairs to help recruit volunteers to the young person’s and mental health groups.

The service actively used feedback and complaints from people who had accessed their care to identify areas for improvement and drive enhancements in the overall quality of care. By listening to service users’ experiences, the organisation was able to implement meaningful changes that better met patient needs and expectations.

The service did not always make sure that people could access the care, support and treatment they needed when they needed it.

The service was available 24 hours a day all year round and saw people regardless of residency status.

Equity in access to emergency care meant that all individuals, irrespective of their socioeconomic status, ethnicity, disability, location, or any other characteristic, had the same opportunity to access timely and appropriate emergency healthcare services. This involved addressing barriers to access and ensuring fair treatment for all patients.

The service measured equity in access by analysing data such as, complaints, incidents, utilisation, wait times, and patient outcomes to identify and address disparities. The service worked to national operational targets and assessed their performance against those.

Due to high service demand, delayed hospital handovers and a reduced fleet, national targets had not been met. For example,

From March 2023 to February 2025 SCAS had not met national response targets of 7 minutes for category 1 calls, with SCAS being between 8 minutes 14 seconds and 9 minutes 38 seconds to respond, this was slightly higher than that of England as a whole.

From March 2023 to February 2025 SCAS had not met national response targets of 18 minutes for category 2 calls, with SCAS being between 24 minutes 14 seconds and 42 minutes 11 seconds to respond. However, no ambulance trust in England had met the national target, with England as a whole having a mean response time between 27 minutes 24 seconds and 47 minutes and 26 seconds.

From March 2023 to February 2025 SCAS had not met national response targets of 120 minutes for 90% of category 3 calls, with SCAS being between 3hours, 4 minutes and 44 seconds and 7 hours 52 minutes and 44 seconds. However, no ambulance trust in England had met the national target, with SCAS’s performance being similar to or slightly higher than England overall.

The Ambulance Response Programme stipulates that category 4 incident response times should have a 90th centile of 3 hours (there is no mean target). From March 2023 to February 2025 neither SCAS nor England overall had met the 90th centile 3 hour target. SCAS’s performance has been consistently worse than that of England overall, however from November 2024 to February 2025 the response times have been relatively close.

Ambulance vehicles were equipped with ramps, powered stretchers and securement systems to accommodate patients in wheelchairs and on stretchers. The service used specialist equipment such as high weight-bearing stretchers to ensure that bariatric patients could be safely and comfortably accommodated. This commitment to inclusive care helped ensure that all individuals, regardless of their physical needs, could access the service with dignity and safety.

The service recognised that some communities were less likely to access emergency services due to factors such as cultural beliefs, language barriers, or lack of awareness. In response, the service proactively engaged with these harder-to-reach groups within local communities. They provided information about the service, delivered lifesaving skills training, and encouraged appropriate use of emergency care, which all helped to build trust and improve health outcomes across diverse populations.

The service was working towards making sure people’s care, treatment and support promotes equality, removes barriers or delays and protects their rights.

The service was in the early stages of triangulating information collected to identify potential inequities in patient experience and outcomes and therefore be able to highlight disparities and take informed targeted measures to promote greater equity across all patient groups.

The service was working to understand the diversity of populations across their patch and how people accessed their services. They knew the demographics of people who used services and areas of highest deprivation, typically clustered in urban areas, and the highest populated areas. They used this information to model their services and to make sure they had resource in the right place to provide a timely response to emergency calls.

The service used patient feedback gathered through surveys, complaints, and incident reports to assess satisfaction levels and identify areas where patient experience and outcomes were not optimal. This information was used to inform service improvements and enhance the quality of care delivered.

The service used performance data to monitor key areas such as response times, clinical care quality, patient experience, and the effectiveness of interventions to know how the service was performing and where improvements needed to be made.