South Western Ambulance Service NHS Foundation Trust

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• 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

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

However, the service was in breach of legal regulations for the governance of the performance of the service.

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.

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.

People were involved in the assessment of their needs, and support was provided where needed to maximise their involvement. The booking process captured relevant information about patient’s needs. Staff continually assessed people’s needs during transport, we observed staff putting a blanket over a patient. One person told us “The staff know me very well. They know what I like and don’t need to tell them anything.”

Staff described adapting care for people with learning disabilities, autism, and communication needs by working with relatives to understand preferences and triggers. They used alternative communication methods including writing, yes/no signalling, translation services for non-English speakers, and visual cues for those with hearing impairments.

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.

The service had an escalation procedure for managing patients who deteriorated during a journey, ensuring staff understood their responsibilities, acted within the limits of their training, and recorded any incidents.

Staff were experienced, qualified and had the right skills and knowledge to meet the needs of patients. Records showed 100% of staff had an up-to-date appraisal. Staff participated in clinical audit processes. However, some staff told us they did not always have regular feedback and one-to-one conversations.

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 had access to the information they need to appropriately assess, plan and deliver people’s care, treatment and support. Staff attended multidisciplinary meetings twice a week with other healthcare professionals from the local GP practice and the hospital. They shared relevant information effectively at handovers and team meetings.

The teams had effective working relationships with other relevant teams within the organisation. Staff worked closely with local healthcare providers and other emergency services to provide coordinated care when transferring patients.

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. Staff described offering lifestyle advice in a non-judgemental manner and signposting to local services, including smoking cessation, alcohol support, and gym-based initiatives.

We scored the service as 2. The evidence showed some shortfalls. The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

The service did not carry out performance monitoring, including tracking cancellations, as well as delays to collections and drop-offs. This meant there was no outcome data available to support service planning and improvement.

Leaders told us it was difficult to measure performance due to the unique challenges faced by staff on the islands including weather and coordinating transfers between boat, ambulance and plane. The patient transport service was carried out by the same crew who were responsible for the emergency calls so more urgent calls were prioritised over patient transport journeys which may result in delays. However, staff worked closely with the local hospital to coordinate journey times where possible.

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 obtained consent to transport people. Staff received training in consent and demonstrated a good understanding of the consent process. They had a process to follow if a patient changed their mind or refused to travel which included communicating with the relevant teams.