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 last assessment in 2016, 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 79 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

Treatment was provided promptly. Staff completed a comprehensive health assessment of the patient in a timely manner. Patients were seen for initial triage less than 15 minutes after their arrival. The service monitored patient waiting times and time spent in the department. They had consistently achieved 95% of patients meeting the 15 minute target of arrival to triage, the 30 minute target of triage to treatment, and 4 hour target of being discharged from the department.

The care and treatment we observed was holistic and patient centred. Staff demonstrated good clinical knowledge of health conditions which presented higher risks for patients. This included more commonly known as well as less well-known conditions. The risks and impact on treatment options were communicated clearly to patients to aid their decision making. Patients confirmed this was their experience following any visit to the urgent treatment centre. Patients knew what to do if their condition worsened.

Care records were updated and clearly documented and shared with relevant health professionals. Staff accessed existing patient records to aid their assessment of patient conditions using documented medical history. Patients who were high users of the service were treated with respect and had their individual risks assessed and treatment options explained.

Managers and clinical leads monitored patient records to ensure any errors were identified. For example, misdiagnosis of fractures. Electronic systems between the hospital and the urgent treatment centre did not communicate easily. This meant some processes used paper such as requesting plain film x-rays. A process of matching the paper request to the x-ray report was used to ensure all requested x-rays had been completed and what the findings were. Any discrepancies were sent to senior clinicians for further review and action if needed. Staff contacted patients if additional treatment was necessary.

Senior clinicians were always available to provide support if clinicians needed to discuss best options for patients. We saw how clinical discussions were held in a supportive way with patients’ best interests as paramount.

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 were experienced and qualified and had the right skills and knowledge to meet the needs of the patient group. There was a range of nursing staff, GPs, specialist practitioners and paramedics staffing the urgent treatment centre. Additional staff training was provided to cover areas such as minor injuries and minor illnesses in children, mental health training, severe nose bleeds and conditions specific to the urgent treatment centre. Staff could request additional training if they felt they needed to update their knowledge and skills and managers arranged this.

The team included or had access to the full range of specialists required to meet the needs of patients in the service. Specialist services, such as ophthalmologists, senior clinicians in emergency care and doctors were available for additional advice. GPs with additional skills were present in the department between 9am and 5pm each day. Outside of these hours specialist practitioners and doctors were available remotely for advice.

Staff received supervision from managers and audits of their practice were completed regularly. Staff finding some areas difficult were supported to improve using a structured system.

Team meetings allowed staff to contribute to improvements and managers responded to the requests.

Policies and standard operating procedures were accessible for staff as guidance. Managers attended working groups with regional colleagues to provide relevant information. The policy for the use of point of care testing devices was being developed and involved the regional pathology network. However, staff were able to use the devices by following guidance provided by the manufacturer.

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 shared information about patients for an effective handover. Colleagues consulted each other routinely to check they were providing the most appropriate care.

Staff communicated with staff from other hospitals when they referred patients for ongoing care. This was sent electronically, or where electronic systems did not link effectively, written summaries were provided.

Managers and staff had initiated and continued effective working relationships with emergency departments and other colleagues in a range of specialties. This had supported patients to receive care directly from other specialties and shortened the referral process for patients.

Managers met with partner services such as radiology, GP services and ambulance colleagues to discuss how services were provided.

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 by providing information on how to manage their presenting condition. Patients were able to access a comprehensive range of information leaflets and staff could provide these in alternative languages.

Staff assessed patients’ needs and identified underlying chronic conditions and provided advice on additional support available. GPs were informed when patients attended the service and of ongoing care needed.

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 they met both clinical expectations and the expectations of people themselves.

Staff used recognised tools to improve the detection and response to clinical deterioration in patients for patient safety and improving patient outcomes.

Senior staff reviewed patient records to ensure care and treatment provided was in line with national standards and guidelines. Any improvements needed were shared with staff and managers continued to monitor practice.

Staff used technology to support patients effectively for example, for prompt access to point of care testing equipment to support a quicker diagnosis.

The service was seeing and treating an increasing number of patients each day which had an impact of reducing ambulance journeys, unnecessary attendances and delays at hospital emergency departments. In December 2026 1,409 emergency department attendances had been avoided. This rose to 1,837 avoided attendances to emergency departments in April 2026.

Time from attendance to triage and triage to treatment were consistently better than the national targets. The national target for urgent treatment centres was for 95% of patients to be triaged within 15 minutes of arrival. Tiverton urgent treatment centre had consistently achieved this target. The centre had also consistently exceeded the national target of 95% of patients being treated and discharged within 4 hours. This was also better than the England average when compared against other similar units. The national target for average time between triage and starting treatment was 30 minutes. Between December 2025 and May 2026, the average time for patients to receive treatment after triage in the urgent treatment centre was between 19 minutes and 25 minutes.

The improvement in times to triage, treatment and discharge had been achieved using an improvement project. Registered clinicians now triaged patients and were able to request any tests earlier in the patient journey meaning effective treatment was provided more quickly.

Managers monitored unplanned re-attendances at the department to identify where treatment could have been more effective. Between June 2025 and May 2026 these had reduced from 10% to 8.13% indicating effective care at first treatment.

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. Communication between staff and patients was clear and at a level patients could understand. Patients confirmed they knew what their choices were and next steps in their care.

For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately.