PSS Birmingham

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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes, based on best available evidence. At our last inspection we rated this key question as good. At this assessment the rating has remained good. This meant people’s care was delivered in line with best practice.

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 did not observe any patient journeys during this assessment and were unable to speak to patients.

The effectiveness of people’s care was maximised by assessing their health, care, and communication needs at the stage of booking their journey. Staff within the hub completed an initial risk assessment for each patient to appropriately assign a team for their transportation. The RMN’s also risk assessed all patients on arrival to the departing location and ensured they were fit and appropriate for travel. Staff told us the jobs were mostly staffed well, but at times, the risks were not highlighted appropriately by the professional requesting the service, which resulted in not enough staff being allocated to a job. This meant at times, staff either cancelled the job if they did not feel they could undertake it, or it went ahead but staff did not always feel safe. Managers encouraged staff to use their clinical judgement to decide whether to undertake the job or implement appropriate mitigations where possible to ensure safety. This was in line with their policies. The service aimed to be with each patient within 2 hours of receiving the booking. Managers told us they were not meeting this at present due to lower staffing numbers and their average was 3 hours 40 minutes in October 2024.

All patients had a patient transfer record. The RMN recorded information related to their journey, care and risks on this document. We looked at 10 sets of patient transfer records and found them to be fully completed. The service audited these records. They looked at 4 records every month and results showed 100% compliance for July 2024, 77.5% for September 2024 and 83.13% for November 2024. Managers sent out a group message asking staff to complete all sections where audit results were lower. Staff members who had been identified as consistently leaving sections incomplete had a supportive practice meeting and they had seen an improvement in compliance.

We did not observe any patient journeys during this assessment and were unable to speak to patients.

Staff followed up-to-date policies to plan and deliver care according to best practice and national guidance. Staff told us they followed national guidance on patient restraint and use of force. They told us, and we saw, how they followed the MHA and ensured all section paperwork was lawful prior to transporting a patient. Their patient transfer records referenced internal policies for staff to refer to for further guidance. It included guidance on how to complete the risks assessments to ensure consistency across the staff groups.

The provider’s systems ensured that staff were up-to-date with national legislation, evidence-based good practice and required standards. All training was delivered in line with national legislation. Policies, processes, and other supporting documentation were based upon national guidance and standards. The service’s November 2024 newsletter had a policy spotlight which introduced new policies and updates for staff. The service were working towards the ‘Fleet Operator Recognition Scheme’ accreditation.

We did not observe any patient journeys during this assessment and were unable to speak to patients.

There was effective working across teams and services to support people. Staff mostly had access to the information they needed to appropriately assess, plan and deliver people’s transfer safely. The service completed complex transport cases and worked with other services to meet the needs of the patients. For example, the operations manager had done a visit to assess a patient in sheltered accommodation prior to arranging the transport. The patient had severe learning disabilities and needed to attend hospital for a minor operation. The patient did not interact socially with people. They had an initial meeting with the care provider and the local NHS trust to create a tailored care plan to ensure the patient was conveyed in the safest way to their operation.

Stakeholders we spoke to told us they worked well with the staff. One told us “I would describe our working relationship as highly professional and beneficial. We don’t hesitate to share ideas to help the service improve to be more beneficial for our patients.”

We were unable to observe any patient journeys whilst on assessment. We observed a call handler in the hub risk assess a patient and ask appropriate questions to gain an insight into their needs.

There were processes in place to ensure teams and services worked well together. Staff linked in with other services to plan transport for patients who needed further support to ensure they were transferred safely.

We did not observe any patient journeys during this assessment and were unable to speak to patients.

This was not assessed as part of this assessment.

This was not assessed as part of this assessment.

We did not observe any patient journeys during this assessment and were unable to speak to patients.

Managers and staff carried out a programme of repeated audits to check improvement over time. Managers told us they used the information from the audits to improve care and treatment. Most staff told us they did not receive feedback from the audits and were rarely told where improvements were needed. However, information we reviewed after the assessment showed information was shared with staff through their online application. We saw a high proportion of staff read these messages.

The service monitored compliance against its own key performance indicators (KPI) to continue to drive improvements in patient outcomes. The main KPI was response time from the booking to arrive at the transfer location. On average, 80% of their bookings were same day bookings. The target for this was within 2 hours, but due to recent transformation project, they had a decrease in staff and the response time had increased from 3 hours 2 minutes in August 2024 to 3 hours 40 minutes in October 2024. It was monitored and discussed at the weekly managers meeting. The service monitored cancelled transfers. Data showed that there had been a reduction in the number of jobs cancelled after the team had been allocated. In August 2024 this was 10% and had reduced to 7% in October 2024. We did not see the reason for cancellation was recorded. Each patient transfer record had a paper questionnaire for the patient to complete. The managers used this feedback to measure outcomes and patient satisfaction.

We did not observe any patient journeys during this assessment and were unable to speak to patients. All patients who were transported by the service were sectioned under the MHA and did not need to give consent to be transported.

All patients who were conveyed by the service were sectioned under the MHA and did not need to gain consent for their journey. All patient section documentation was checked by the RMN on arrival to the patient area to ensure it was lawful ahead of transferring the patient. Staff received and kept up to date with training in MCA, MHA and DoLs annually. Staff told us the service had an incident where a patient was conveyed without being sectioned under the MHA. Since then, they ensured they had an RMN on each team to check the MHA section paperwork and ensure the patients were detained lawfully. They improved their paperwork to include a check of the section paperwork prior to the patient being conveyed; we saw this was completed in all 10 notes we checked.

There was a MCA policy which detailed information about consent in relation to the MHA. We observed a RMN checking all section paperwork on arrival to convey a patient. They found that the Section 2 ‘medical recommendation for admission for assessment’ paperwork was invalid; it was only valid for 5 days once it had been completed and was overdue by 2 days invalidating the Section. The RMN handled it professionally, discussed all the options and liaised with the accepting hospital. The RMN advised the ward sister a new assessment would be required and to rebook the transfer once it had been completed.