South Western 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.

At our last assessment in 2018 we rated this key question outstanding. At this assessment the rating has remained outstanding. This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

This service scored 95 (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 4. The evidence showed an exceptional standard. The service was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

Staff attitudes and behaviours when interacting with patients showed they were discreet, respectful and responsive, providing patients with help, emotional support and advice at the time they needed it. Call handlers used a nationally developed script when taking calls from patients or their representative. This was to ensure the most relevant clinical information was used to assess patient needs. They did this with complete calmness to reassure people that help was on its way. Staff consistently went beyond their script to protect patient dignity, demonstrating empathy and with a genuine focus on care for the patient. Examples included advice on maintaining patients’ privacy, speaking in a respectful manner and expressing understanding of a difficult situation.

Staff supported patients as well as their carers or person who called 999, to understand and manage their care, treatment or condition and did so with compassion and empathy. Staff directed patients to other services when appropriate and, if required, supported them to access those services or stayed on the line with patients until help arrived.

Staff understood the individual needs of patients, including their personal, cultural, social and religious needs and spoke with great sensitivity to gain details of their condition.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences.

Staff maintained the confidentiality of information about patients.

We scored the service as 4. The evidence showed an exceptional standard. The service treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The service took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff communicated with patients in a way they could understand and checked understanding. Language lines were readily available for staff to use if a patient’s first language was not English. Staff ascertained what was normal for patients’ conditions to assess clinical need. All staff talked to patients in a respectful manner and listened to patients’ responses without assuming the answer first. Interactions with patient carers or relatives were equally individual, checking their relationship with the patient. Staff explained what options were available to receive care more quickly. For example, if patients needed hospital care, staff asked if they could get their own transport to hospital as there may be a longer wait for an ambulance. This was after an individual assessment and if not possible an ambulance was sent. All patients were treated with equal care and understanding and carers were provided with encouragement and praise for their immediate actions in distressing circumstances.

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 explained choices to people and repeated information as often as was needed for patients and callers to understand what their options were. Clinicians could explain reasons for actions such as delays in ambulance responses due to high demand for the service and alternative options for patients to get to hospital. Staff took account of advance decisions patients had made about how they wanted care to be provided when options were explained.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional in how they 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.

The two emergency operations centres worked together as one. This meant all call handling staff could see calls waiting to be answered. Call handlers responded to calls within 1 second and quickly and calmly ascertained how urgent the situation was. We never heard staff use raised voices or display anxiety to patients. Staff gave appropriate advice to promote patient safety with calmness and understanding. Staff understood patient or callers’ anxieties particularly if this was displayed in an angry way. All staff were encouraging to callers in stressful situations telling them they were doing a great job and reassuring them that actions were the correct ones. Some patients were difficult to understand due to their anxiety and staff continued calmly to help reduce the patient's anxiety. This was particularly challenging when patients were suffering a mental health crisis but we saw the effectiveness of how call handlers helped these patients to remain safe.

Staff identified and responded to changing risks to patients by assessing their needs and changing the priority of ambulance response if this was needed.

We scored the service as 4. The evidence showed an exceptional standard. The service always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.

Staff felt respected, supported and valued. Staff were able to take short screen breaks and breaks for emotional wellbeing after taking an upsetting or aggressive call.

Staff felt positive and proud to be working for the provider and their team. Team leaders monitored staff wellbeing and followed up with a conversation or suggestion to take a break. There were quiet rooms in each base for staff to use for a bit of time out.

Dispatchers were allocated specific regions each day and supported each other to respond when colleagues were working under pressure, to dispatch appropriate crews to patients’ locations.

Staff had access to support for their own physical and emotional health needs through a staying well service. Staff felt able to speak with team leaders or managers if they had any concerns. Managers demonstrated a focus on providing support that staff could easily access which would promote wellbeing. Reorganisation of staff groups in the call and dispatch areas were planned to provide greater staff support with more team leaders in roles. Staff appraisals proactively included conversations about career development as well as individual staff wellbeing. Staff could choose from a range of rota choices and could swap with staff if needed for personal reasons.

Managers were implementing a trial of virtual reality headsets for staff to use as a distraction when they needed a break from the screen, taking calls or dispatching ambulances.

Adjustments were made to support staff to remain in their role if they were finding difficulties. For example, altering shift starting times, number of weekly hours worked. Desks which could rise or lower were available for staff to use to protect their physical health.

Staff performance was rewarded with certificates for consistently meeting targets.

Managers had reviewed staff survey results, had identified actions and were planning to share improvement actions with staff. Some of these actions were already underway in improving visibility of managers in the EOCs and supporting staff to remain in their roles.