Lincs and Notts Air Ambulance Charity

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes

This is the first assessment for this service. This key question has been rated outstanding. We rated responsive as outstanding. People and communities were always at the centre of how care was planned and delivered. Patients and their families received person-centred care. The service worked closely with other emergency services to deliver a multidisciplinary approach. Staff provided information to patients and their families at the time of the incident and in follow up contact. Patients were able to give feedback about their experiences. Staff understood knew about duty of candour and how to apply it. Due to the nature of the service, it was highly responsive to patients in their time of need.

This service scored 86 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Patients and their families told us they felt reassured that the care given to them was responsive and timely. They confirmed the focus of care was clearly on the patient, although they were kept in the picture at all times. They said the staff continually monitored the patient’s situation and responded promptly to changes.

Staff told us the patient was at the very centre of everything they did and what the service stood for. Staff told us good communication was key to providing person-centred care. They aimed to make speaking with patients and their friends or families as easy as possible and used various tools to help with this, such as online translation services and Makaton picture boards. They also told us the service was always looking at ways to enlarge their scope of communication methods to help staff communicate in the most effective way. The service wanted to ensure it was exposed to the different needs of individual patients and their wider community. There service had a strong connection with the local RAF airbase. It arranged a speaker connected to the RAF to meet with staff and discuss the meaning of death and how this is different for some people and some communities.

The trauma network team said the service staff provided care tailored to the individual patient. They also noted the teams provided signposting and guidance for the patient as they moved onwards to a place of care. The local NHS ambulance service told us the service provided effective geographical cover which ensured patients were transferred to the most appropriate care facility within the region.

The policies and procedures put the patient at the centre of the service. The service had a privacy, dignity and confidentiality policy and standard operating procedures which provided guidance on care for specific patient groups, such as maternity patients and newborns or those with urgent mental health issues. The service’s aftercare team followed up on patients they had treated. They also gathered feedback from patients and their families to enable the service to enhance person-centred care.

Patients told us they thought the service communicated effectively with other agencies to ensure a smooth transfer into other care environments. Some families said they were particularly impressed with how the teams had looked after family members, particularly children, at the time of the incident. This reassured patients who were concerned about their loved ones, and people appreciated the continued family-oriented care in the aftercare sessions.

Staff and managers told us the service aimed to efficiently cover its operating patch by either the helicopter or critical care car. The service maintained a 24-hour service, with the helicopter operating between 7am and 2am, and the critical care car responding to calls between 2am and 7am. The service conducted monthly reviews of mission data and other analysis to ensure operations were as responsive as possible. The service had good links with other emergency services to ensure there was strong integration and continuity of care.

Members of the trauma network team and the local NHS ambulance service we spoke with confirmed the service worked closely with other emergency service and healthcare providers to ensure the best outcomes for patients. The local NHS ambulance service told us the service was well regarded in the local community, which was reflected in the success of the service's charitable arm.

The service had set up service level agreements with the local NHS ambulance service and other agencies. These detailed the operational roles and responsibilities of the services and how they should work together.

Patients and families confirmed the staff were clear when explaining next steps during their care. They said that staff gave further explanations during the follow up meetings after the incident and would respond to any further questions or concerns.

Staff told us they talked to patients and explained what treatment and care they would be providing before they carried this out. If communication was complicated by language or cultural differences, staff used language translation tools on their devices, symbol cards, or asked other adults at the scene to help them communicate most effectively. Staff also confirmed the service would share information after incidents with patients and their families about their care and actions taken, using translated documents. The service was also developing documents in Braille.

The service trained staff to ensure they kept patients informed about their care and treatment actions at the time. The service also offered the aftercare system to give information to patients and their families after an incident. They also had a signposting document which provided links to other agencies that could help patients and their families with ongoing care and treatment. Patient information was held confidentially and in accordance with data protection legal requirements.

All patients and their families were invited to share feedback about their experiences in aftercare sessions with the service. Most patients were complimentary about the care and follow up care they received. However, if families had ongoing worries about their care, the patient liaison team arranged specific meetings with the team involved at the time, so that staff members could explain what happened and answer questions directly.

Staff told us they knew about the service’s complaint’s procedure and how to support people if they wanted to share concerns or make a complaint. The teams would aim to handle concerns at the time but if patients were not reassured, staff could provide details of the complaints process. Feedback from complaints would be shared during de-brief meetings and through a ‘situation awareness memo’ (known as SAM). Any concerns which highlighted specific topics or identified themes were covered in subsequent newsletters.

The service had a general complaints policy and one for clinical care complaints. It also had an aftercare strategy to enable feedback whether positive or negative to be shared and welcomed both. The aftercare team used various ways of gathering feedback from patients after incidents. The service also recommended longer term support groups, including a patients’ groups on social media platforms. If there was any information of concern or positive feedback shared with other partners, this would be fed back to the service.

There were no barriers to patients receiving this service. It was commissioned by the local NHS ambulance service and there was no discrimination as to who received the service and there was equity in access for everyone. The only barriers to the service not being available were for practical purposes or safety. Leaders and staff were alert to discrimination and inequality. Managers acknowledged that in some places in their area, the local population had different language and cultural preferences. They told us the service was looking at ways to enlarge their scope of communication methods to help staff communicate in the most effective way. Staff confirmed that at the scene of incidents they considered each patient as an individual and adapted their communication methods and care to provide the best outcome for that person at that time.

Policies and procedures were designed to ensure people had equal access to care, treatment and support and it complied with legal equality and human rights requirements. This included avoiding discrimination, considered the needs to people with different protected characteristics and making any reasonable adjustments. Staff had completed their required equality, diversity and inclusion training.

The focus of staff was on ensuring patients in all circumstances received the best outcomes which avoided any discrimination and took account of inequalities. By the nature of the service, patients received care without delay wherever they were. Leaders and staff told us they were alert to people suffering inequality in outcomes if they were from disadvantaged groups. They said it was a priority to ensure patients all had a consistent level of high-quality care regardless of their background. Adjustments were made to ensure outcomes were as positive as they could be in all circumstances.

The service aimed to provide the best care for individuals, ensuring the input into care and treatment was adjusted to give the best outcomes. Policies and procedures and staff training reflected this.