South Western Ambulance Service NHS Foundation Trust

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that people and communities had the best possible outcomes because their needs were assessed. We checked that people’s care, support and treatment reflected these needs and any protected equality characteristics, ensuring people were at the centre of their care. We also looked for evidence that leaders instilled a culture of improvement, where understanding current outcomes and exploring best practice was part of their everyday work.

At our assessment in September 2018, we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Call handlers used a national system to assess patients’ needs and respond appropriately. Specialist clinicians reviewed and reassessed needs to either confirm the initial response or provide advice on a more suitable pathway. This could include referral to community health providers or mental health specialists. Staff spoke clearly to patients and checked they understood next steps. Clinicians used a video link system to review patients more accurately and speak with them personally. All patients received advice on what to do if their condition worsened.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff participated in clinical audit, benchmarking and quality improvement initiatives. Staff audited practice using International Academy of Emergency Dispatch Standards. The team included a range of specialists to meet the needs of patients using the service. Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the patients using the service. All staff received training when they commenced their roles and at regular intervals to update skills and knowledge.

Managers provided staff with supervision, using discussion to reflect on and learn from practice, professional development and personal wellbeing. The percentage of staff that had an appraisal in the last 12 months was above the 85% trust target.

Managers were proactive in identifying strengths in staff and supporting their learning needs. A skills passport had been introduced to record learning and identify skills staff needed to learn to progress their career.

Managers dealt with poor staff performance promptly and effectively with supportive actions. If staff were unable to meet the standards of the service, they left the service.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff recorded patient information on an electronic system which was visible to authorised staff across the service. Call handlers recorded initial response, emergency medical dispatchers identified available crews, clinicians could review patient details who were waiting for an ambulance using the same system. Clinicians also had access to NHS patient records to give a more complete medical history for assessment. This supported information sharing with crews who were attending patients and for clinicians to continue to review patients who were waiting for an ambulance. Dispatchers would additionally and frequently talk with crews to highlight any issues. Twice daily huddles shared information with staff about any issues across the service for that shift.

Managers encouraged ambulance crews and emergency operations staff to shadow each other to understand their roles and support team working across the service. Dispatchers were frequently in touch with ambulance crews to make sure staff were able to take breaks and when they were available for being allocated to a waiting patient.

Health partners external to SWAST worked within emergency operations centres to provide more specialist support. Mental health teams, SWAST staff and the police worked together to identify which service was best suited to a patient's needs.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

Staff supported patients to live healthier lives and provided them with advice on alternative pathways if it was assessed an ambulance and hospital care were not the best options. This included calling a GP service, community or social care support. Flags on patient notes highlighted patients who used the service frequently and what actions were appropriate for their care.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Managers used national reportable data to assess performance of the emergency operations centre. Where there were no national indicators, managers developed additional benchmarks to assess where improvements could be made.

Staff used recognised tools to improve the detection and response to clinical deterioration in patients as a key element of patient safety and improving patient outcomes.

Speed of responses to patients was a key element in providing safer care for patients. Managers monitored national Ambulance Quality Indicators and compared this with other ambulance services. SWAST call handlers were consistently better than the national average in answering 999 calls quickly. This helped to get the right help to a patient who called in.

Clinicians reviewed patient details and provided advice if an ambulance was not needed. This was referred to as ‘hear and treat’. In March 2026 hear and treat numbers were the 3rd best in the country.

Team leaders and the quality assurance team reviewed calls and safety incidents and contributed to improvements to national protocols used by call handlers to provide advice. An example is the use of tourniquets.

Staff used technology to support patients effectively. Clinicians used an audiovisual electronic aid to assess patients over a secure link. This was effective in providing the right support for patients.

Staff had taken part in a project of using ambient voice technology for 6 months. The aim was to record clinical notes more efficiently and free up clinical time to review more patients. Initial feedback was positive and plans were underway to implement it more widely.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff took all practical steps to enable patients to make their own decisions. Where possible clinicians spoke directly to the patient and ascertained what their wishes were. Call handlers used an assessment tool to monitor mental capacity and stayed on the line with patients until they were safely cared for. Details of advanced decisions made by patients were documented.