South Western Ambulance Service NHS Foundation Trust

Ratings - Emergency operations centre (EOC)

• Overall

  Good

• Safe

  Good

• Effective

  Good

• Caring

  Outstanding

• Responsive

  Good

• Well-led

  Good

Our view of the service

We carried out a comprehensive two-day assessment on 29 and 30 April with follow-up remote interviews on 5 and 6 May 2026.

The service was inspected in September 2018 and rated as good overall. It was also inspected in November 2021 but not all key questions were reviewed and the rating of good remained

South Western Ambulance Service NHS Foundation Trust (SWAST) provides emergency response to 999 calls for injuries and illnesses. They do this using two Emergency Operations Centres (EOCs), which receive calls, triage need and dispatch ambulance responses, emergency vehicles manned by a range of clinicians, air ambulance services and other specialist teams such as the Hazardous Area Response Team and mental health specialists.

Safe:

The service had a good learning culture and staff and patients could raise concerns. Managers investigated incidents thoroughly and lessons learned and improvements were identified and shared with staff. Patients were protected and kept safe because staff understood local safeguarding arrangements and safe systems of working.

There were enough staff with the right skills, qualifications and experience to ensure high quality care and treatment. Managers made sure staff received training and had regular appraisals to maintain high-quality care.

Staff supported patients to manage medicines safely. Staff identified and reacted to unexpected deterioration in a patient’s condition. Staff understood and managed risks from the environment. The facilities and equipment met the needs of staff who were supporting patients.

Effective:

Patients, and where appropriate those close to them, were involved in assessments of their needs. Staff reviewed assessments taking account of patients' physical, emotional, communication and personal care needs. Care and treatment were based on the latest evidence and good practice guidance. Patient outcomes were monitored to identify where improvements could be made. Staff made sure patients understood their care and treatment to enable them to give informed consent.

Caring:

Staff treated patients with kindness and compassion. Staff protected their privacy and dignity. They treated patients as individuals and supported their preferences. Staff responded to patients in a timely way. Patients had the opportunity to ask questions and were given access to specialist services, including from allied health professionals. The service supported staff wellbeing.

Responsive:

Patients, or their representatives, were involved in decisions about their care and treatment. The service provided information which patients could understand. Patients were invited to give feedback, knew who to speak with if they had concerns and were confident the service took their concerns seriously.

The service monitored and worked to improve access. Services were adjusted to meet the needs of people with conditions which could create a barrier to access.

The service worked to reduce health and care inequalities through service planning, quality monitoring, staff training and feedback. Patients were involved in planning their care and understood options around choosing to withdraw or not receive care.

Well led:

Leaders and staff knew the service’s local vision, aims and objectives and understood how their service aligned with this. There was a culture based on speaking up, listening, learning and trust.

Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment.

Staff understood their roles and responsibilities.

Leaders had sound oversight of the quality of service being delivered through effective governance and risk management systems.

Staff with protected characteristics felt supported.

There was a culture of continuous improvement with staff able to contribute ideas through a quality improvement programme.

We found staff wellbeing was supported and processes were constantly under review to improve working lives of staff. Staff morale had improved since our last assessment. Staff received training in all aspects of their role and were trained in supporting people who called in with mental health issues. However, staff felt they would like more training in this field. People who were high volume users of the service were identifiable to call handlers and plans of how to manage their issues were visible to SWAST staff.

Staff were knowledgeable about incident reporting systems. Managers reviewed each complaint to identify learning points. Staff were involved in transformation programmes for the service and demonstrated how they contributed to improvements. All staff showed a calm attitude with kindness, respect and individual care for patients and their families/carers.

Technology was being used to improve systems of record keeping and develop greater efficiencies in the service. There was evidence of partnership working across the Southwest region and beyond which contributed to providing care that was needed for patients who called 999 for help. These did not always need a hospital visit but did need some form of support. Leaders assessed what future demands on 999 services were likely to be using a range of data collection. Governance processes monitored and supported staff to meet their targets of activity and ensured it was provided safely using evidence-based practices.

We did not identify any breaches of regulation at this assessment.

People's experience of this service

At this assessment it would not have been appropriate for us to ask callers or patients for their individual feedback due to the stressful situations people were in at the time. As an alternative we observed staff interactions with people who had called 999 for help. Without exception, staff spoke to people with calmness and kindness while still finding out how urgent the situation was. Individual patient needs were assessed and staff were still able to provide assurance and instructions to people to preserve life. This was provided with compassion and empathy including when people were upset, worried or displaying aggression. We heard how anxieties were reduced by this empathetic approach and people were better able to cope until further help arrived. People were always informed of the next steps for their care and what to do if patient conditions worsened.

All staff and managers expressed and displayed actions keeping patient care at the centre of the service they provided and did this with understanding of how difficult emergency situations can be.