South Western Ambulance Service NHS Foundation Trust

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 70 (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 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 demonstrated a consistently caring and compassionate approach towards patients. Interactions between staff and the patient were positive and respectful during a transfer. Staff introduced themselves and maintained a professional, reassuring manner throughout. They took the necessary time to ensure the patient’s comfort and warmth during the transfer. One person told us, “The staff were amazing, reassuring and friendly.”

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

We scored the service as 3. The evidence showed a good standard. 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.

People’s individual needs and preferences were identified during the booking process. Staff took time to understand people’s needs, and these were reflected in their care and support. One patient told us “The staff know me very well. They know what I like and don’t need to tell them anything.”

Staff described seeking advice where needed and asking individuals about their beliefs and preferences. They gave examples of accommodating cultural modesty, including facilitating access to same-sex staff where appropriate.

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.

People were supported to have choice and control over their own care and to make decisions about their care, treatment and wellbeing. People were supported to understand their rights by using different ways to communicate. Staff described using alternative communication methods for people with communication needs, including non-verbal individuals and those who are deaf. They used writing and visual cues, and involved relatives where appropriate to support understanding. They also used translation services for people whose first language was not English.

There was a range of equipment to support and maximise people’s independence and outcomes from care and treatment. Staff and leaders told us one of the main difficulties was transferring immobile patients on and off the boat. This was managed by coordinating with the coastguard for support when needed and there were plans to introduce a rigid stretcher for this purpose.

We scored the service as 3. The evidence showed a good standard. 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.

Staff were alert to people’s needs and took time to observe, communicate and engage people in discussions about their immediate needs. One patient told us “They were kind, when we got to the airport they informed me of what was happening while waiting and asked if I needed the toilet or a hot drink. They made sure they provided things that I needed.”

Staff were able to respond appropriately to patients who showed signs of deterioration. Staff were also trained in de-escalation techniques.

We scored the service as 2. The evidence showed some shortfalls. The service did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Staff felt confident to provide feedback, raise concerns and suggest ways to improve the service or staff experiences. However, they did not always feel that their feedback was acted on.

Some staff said there were problems with leadership, including slow responses and not enough support from managers. Staff told us they mostly worked through their lunch breaks without being paid for this time. Following the inspection, senior leaders told us staff on the Isles of Scilly self-managed their breaks in line with the Trusts policy.

The 2025 National Education and Training Survey (NETS) results showed SWAST was the 2nd highest ranked English ambulance trust for wellbeing. However, the isolated location created challenges, including caring for people they know. Staff supported each other but told us they felt they did not get enough wellbeing support from the provider. Staff had access to a wellbeing support package.

Staffing levels were supported by bringing in staff from the mainland, with travel, hotels and meals covered, particularly when staff were unable to leave the island due to adverse weather. Staff living on the island said they often worked flexibly to cover gaps.

Staff told us they didn't have access to showering or changing facilities, and they had to change in the garage or travel home. Following the inspection, senior staff told us there were showering and changing facilities available for staff to use in the building next door to the garage and in the office.