A message from our chief executive

It has been another busy and successful year for North West Ambulance Service, and this booklet provides an opportunity to reflect on everything we have achieved together during 2025/26.

Within these pages, you will find a selection of the many accomplishments that have shaped our year, highlighting the dedication, professionalism and compassion of our staff and volunteers across the organisation.

From improvements in patient care and the development of new facilities, to investing in leadership and strengthening our reputation as a great place to work, we have continued to make significant progress. These achievements reflect the commitment of our people and their determination to deliver the very best for the communities we serve.

I am proud to lead such a forward-thinking and ambitious organisation. Looking back on our key moments from 2025/26 shows what can be achieved when we work together with a shared purpose.

As we look ahead, let us continue to challenge ourselves, support one another, and build on our achievements to provide an even better service for our patients, communities and each other.

As we celebrate the trust’s 20th birthday, we also have the opportunity to look to the future through our new five-year strategy, which sets out how we will improve patient care, support our workforce and tackle health inequalities.

Together, these milestones give us a strong foundation for the years ahead and a shared ambition to make an even greater difference to the people we serve.

Progress against our 2022 – 2025 strategy

The below achievements provide a strong platform, but the health and care environment is changing rapidly and new challenges are emerging.

For our patients

Key highlights include:

• Integrated 111 and 999 triage systems
• Improved call handling and response performance
• Expanded community referral pathways
• Above national average performance in Ambulance Clinical Quality Indicators
• Increased opportunities for patients and public engagement

For our people

Key highlights include:

• New leadership structures and area directors introduced
• CPD and Learning Hub launched
• Violence prevention team established
• OfSted rated our education provision as Good
• Launch of sexual safety campaign and anti- racism statement

For our organisation and partners

Key highlights include:

• Stronger partnerships across five integrated care systems
• Mobile data and vehicle solutions implemented
• Smart programme pilots and digital innovation initiatives
• Nationally recognised performance through the NHS Oversight Framework

Whatever our role, we all share a common purpose: To help people when they need us most.

Our values are the behaviours that underpin all that we do. They describe how we should approach our work. They can be found in our systems and processes, from appraisal paperwork to planning tools for large-scale projects for change.

Putting our values into practice supports us to provide compassionate care and improve outcomes and experiences for our people, patients and communities.

A year in numbers

• 1.4 million emergency calls
• 1.1 million incidents attended
• 17% of patients were treated or signposted over the phone (hear and treat)
• 26% of patients were treated or signposted face to face (see and treat)
• Average hospital handover time was 28 minutes 5 seconds
• 1.4 million Patient Transport Service (PTS) journeys were made
• 2.1 million 111 calls
• Patient satisfaction:
  • Paramedic Emergency Service (PES) – 93.2%
  • PTS – 91.6%
  • NHS 111 – 86.1%
• 119 new vehicles
• 97 decomissioned vehicles
• 816 staff recruited

Provide high-quality, inclusive care

Faster, safer, more effective care

• Improved response times and achieved our best performance since the pandemic, with Category 1 and 2 responses significantly faster than 2024-25.
• Reduced hospital handover delays, with an average fall of five minutes and a substantial reduction in 45+ minute waits, improving our ambulance availability for patients.
• 95% of 999 calls were answered within five seconds, maintaining rapid access and strong public confidence during continued high demand.
• Increased use of hear and treat, with nearly one in five patients receiving care over the phone without needing an ambulance.

Highest-rated ambulance trust in England

We ranked first among ambulance trusts in the new national league tables from NHS England and maintained this position throughout 2025/26.

This reflects our strong performance across response times, patient care, leadership and overall performance.

Strong clinical outcomes

• Cardiac arrest survival rates continued to outperform national benchmarks, reflecting strong clinical practice and effective community response.
• High-performing stroke and heart attack care delivered faster access to specialist treatment, contributing to better patient outcomes and recovery.
• Improved falls care for older people, with performance above national averages – supporting safer care closer to home and reducing hospital admissions.
• Improved mental health response, with better pathways reducing patient safety incidents, and better partnership working strengthening care for vulnerable patients.

High-quality patient experience

• We received over 55,000 pieces of patient feedback via surveys, compliments and complaints,
• Survey feedback shows over 90% said they were treated with dignity.
• Friends and Family Test feedback increased by 11%.
• Nine out of ten people rated their NHS 111 experience as good or very good.

National patient safety recognition for Learning Loop

Our Learning Loop patient safety initiative received national recognition when it was shortlisted for the Patient Safety Education and Training category at the national HSJ Patient Safety Awards.

Developed with operational, patient safety and quality improvement teams, it helps turn learning from incidents, investigations and coroners’ outcomes into clear, practical changes in practice.

It shares key safety messages in accessible ways like posters, team huddles, social media and CPD platforms, so guidance is easy to understand and use in day-to-day clinical decision-making.

After piloting in Fylde and Greater Manchester, it has now been rolled out across the trust, with growing engagement and contributions from frontline staff.

Opening of new HART base at Elm Point

2025 finally saw the opening of our brand-new HART base at Elm Point, the official opening ceremony in September led by the High Sheriff of Merseyside and the Lord Mayor of Liverpool, staff and special guests.

The £14.5 million purpose-built base replaced the old Elm House site. New facilities include a climbing tower and training tunnel, specialist training rooms, indoor depot for our specialist vehicles, a fully equipped gym, modern office space and larger mess room and kitchen.

Throughout the 64 week construction, which was managed by the Estates and Programme Management Office, local schoolchildren were invited to help decorate the walls with their artwork on what they thought of the ambulance service, bury a time capsule, and learn about lifesaving skills and equipment.

Head of Special Operations Matt Calderbank said: “This new base is a significant and vital investment, giving our Liverpool HART the facilities they need to train, prepare and respond to incidents across the region.”

Quality Improvement Academy

In June 2025 we launched our second Improvement Academy which involved ten teams attending seven days of classroom teaching across a nine-month period, delivered through a blend of face to face and virtual teaching. This offer was also run in collaboration with four northwest hospital trusts and included patient and public panel members. The Improvement Academy brought together multidisciplinary teams across NWAS to address a range of patient safety, clinical quality and sustainability priorities. Improvement projects focused on improving:

• Cardiac arrest outcomes
• Strengthening maternity assessment and management
• Increasing Mental Capacity Assessment completion
• Enhancing clinical supervision
• Reducing the environmental impact of ambulance stations.

Using quality improvement methodology, teams engaged staff, patients and system partners to identify barriers, test changes and embed sustainable improvements. Staff engagement, training, digital innovation and data were central to delivering measurable change.

Key improvements included cardiac arrest ROSC rates rising from around 50% to 71%; the maternity tool being embedded in electronic patient records and used in 88.4% of maternity incidents, contributing to reduced on-scene times; and Mental Capacity Assessment compliance increasing from 8% to 32%. Clinical supervision was redesigned to improve access, consistency and psychological safety, while sustainability initiatives reduced utility usage.

Together, these projects demonstrate how improvement methods can deliver safer care, better staff experience and more sustainable services, with learning embedded and scaled across the organisation.

“I think it’s been such a great opportunity for others to see the impact of their role on direct patient ourcomes and care.”

Elaine Strachan-Hall, Director of Quality Improvement

Rollout of Call Before Convey

We rolled out NHS England’s Call Before Convey programme across parts of Cumbria, Greater Manchester and Cheshire and Merseyside. This enables our clinicians to speak directly with specialist teams and services before deciding whether to take patients to hospital or not.

Through closer working with community services and same-day care teams, more patients with non life-threatening conditions are now supported in the most appropriate setting, including care closer to home. This improves patient experience, supports better clinical decision-making and helps reduce unnecessary hospital attendance and pressure on emergency departments.

Maternity and newborn care modules

Led by our Consultant Midwife and Maternity Quality and Governance Lead, we developed a new suite of e-learning modules to support frontline colleagues caring for maternity patients and newborns, as well as those in corporate and support roles.

These bring together learning from incidents, emerging themes from maternity and newborn care, and help to strengthen staff confidence in recognising, escalating and managing these patients in the pre-hospital setting.

Over 400 people joined us for our Awareness Day events

Throughout the year, we held three fantastic Ambulance Awareness Day events at Preston (September), Chester (December), and Aintree (February), with over 400 people joining us across the three action-packed events.

These days offer the chance for local people, schools and colleges, as well as under-represented communities, to learn more about our care and various services, speak to staff, and get hands-on with equipment and vehicles and even learn life-saving skills like CPR.

We had fantastic representation from across our various teams, services, staff networks, volunteers and the NWAS charity, as well as colleagues from the Police, Fire, Mountain Rescue, Air Ambulance and other emergency services.

Patient Engagement Manager, Yunus Mogra said:

“The Ambulance Awareness Days have proven to be a continued success, enabling us to connect with a wide range of diverse communities, raise awareness of our services and career pathways, and strengthen collaboration with partners.

“They have provided an important platform for us to engage, educate and better understand local ambulance service needs.”

Be a brilliant place to work for all

Named 27th in Apprenticeship Top 100 employers

The Sunday Times’ Top 100 Apprenticeship Employers for 2025 ranked us 27th in the UK.

These prestigious rankings recognise employers’ commitment to creating new apprenticeships, the diversity of their apprentices, and the number who successfully complete their apprenticeships.

2025/26 saw us continue to deliver and grow apprenticeships across the workforce, with colleagues registered on apprenticeships, including:

• 583 EMT1 Apprentices
• 237 Paramedic Apprentices
• 33 Apprentices on other programmes such as data, finance, fleet, communications, public health

Learning Governance Manager Rebecca Leach said:

“The top 100 ranking provides national recognition of our ongoing commitment to investing in the professional development of the workforce.”

Integrated Contact Centres

Over the year, our Integrated Contact Centres (ICCs) strengthened operational performance through enhanced command training, focused inductions, and 24/7 Regional Operations Coordination Centre (ROCC) cover.

Collaborative working improved regional oversight and helped achieve Call Pick Up and Hear & Treat targets.

Staff experience also improved through higher appraisal rates, consistent practices across the ICC, completion of Workforce Management and sickness management rollout, and better use of the Employee Engagement Module.

Improved compliance with meal breaks has also supported the wellbeing of operational colleagues.

Project 365

3.9 million files removed from legacy servers

Project 365 made significant progress throughout the year in transforming corporate records management across the organisation. The programme is delivering a standardised, controlled and accessible approach to information storage and management, ensuring compliance with government guidance and GDPR requirements.

Work, supported by the Programme Management Office, has focused on two key areas: improving records management through the cleansing of the existing Microsoft 365 environment, and migrating information from legacy systems into Microsoft 365 platforms, including OneDrive, Teams and SharePoint, while establishing the governance and structures needed for long-term success.

By providing staff with modern, secure technology and an efficient digital working environment, Project 365 is helping to support outstanding patient and staff outcomes, while contributing to the attraction, development and retention of a skilled, engaged and diverse workforce.

Stop, Speak, Support – improving sexual safety in the workplace

In December, we launched our Sexual Safety Policy, building on our Stop, Speak, Support campaign to make NWAS a safe place to work for everyone.

The policy encourages staff to reflect on behaviours, challenge inappropriate conduct and support colleagues who may be affected. It also strengthens what we will do to reduce the risk of sexual misconduct and sets out how concerns are reported, investigated and acted upon.

Stop – Stop and think, is your behaviour appropriate? Is the behaviour of others appropriate?

Speak – Have you spoken up to protect yourself and to protect others?

Support – Do you need help and support?

Improved induction for new starters

We introduced a new onboarding and induction programme to give all new starters a consistent and supportive welcome to NWAS.

This includes a virtual induction session and a dedicated online hub with guidance, tools and resources tailored to different roles, including leadership and patient-facing positions. Together, these improvements help staff feel prepared, supported and confident as they begin their roles.

Wellbeing roadshows

More than 1,200 colleagues took part in our various wellbeing festivals, roadshows and other wellbeing initiatives throughout the year. These offered practical advice on physical and mental health, access to specialist support, and opportunities for colleagues to share experiences, to help people feel valued at work and reduce the risk of burnout.

Success for our Finance Directorate

ur Finance Directorate saw two major successes this year. They were named the first ambulance trust team to receive the highest rating (Level 3) of the One NHS Finance Towards Excellence accreditation.

This process acts as a quality mark for NHS finance departments, and recognises teams’ commitment to creating a positive work environment and looking after staff, investing in training, development and innovation, and showing high professional standards and best practice.

While in December, Michelle Brooks was named Deputy Finance Director of the Year at the prestigious HFMA National Healthcare Finance Awards. As well as supporting her directorate to achieve the Level 3 One NHS Finance accreditation, this also recognised her inclusive, people-focused approach to make finance accessible to other teams, managers and clinicians, and build their skills and confidence around this.

Retained ‘Good’ Ofsted rating

ollowing July’s inspection, September saw us retain our ‘Good’ rating from Ofsted for our commitment to delivering high-quality education and training for our Emergency Medical Technician (EMT) Apprentices, through our level 4 associate ambulance practitioner apprenticeship program.

Inspectors praised our bespoke and ambitious curriculum, which combines theoretical knowledge, practical skills, and real-world experience, and noted that apprentices develop substantial knowledge and skills early in their training, enabling them to make informed decisions and provide compassionate care in time-critical situations.

Inspectors also commended our outstanding approach to behaviour and attitudes, with apprentices embracing trust values to become resilient, empathetic, and confident professionals who treat patients with respect and care.

Assistant Director of Workforce Development, Carol Offer, said, “We are committed to providing high-quality training that prepares our apprentices for the challenges of the job while ensuring they feel safe and supported throughout their journey.”

Improving flexible working

To help staff better balance work and home life, we introduced new policies, clearer processes and better tools around flexible working.

Not only does this help improve staff wellbeing, it also helps us retain our great staff and make NWAS a more attractive place to work for others.

Leadership development and recruitment

It’s been a bumper year for how we recruit and develop staff in leadership positions.

In October we launched a new approach to leadership recruitment for all line manager and at Band 8 and above. Through practical tools, training and templates, this focuses on shared values, behaviours, leadership styles and potential, not just past experience, to ensure we recruit the right people, help candidates feel more prepared, and ensure fairness at every stage of recruitment.

We launched our Senior Leadership Development programme. This offers coaching, collaborative projects and mentoring to help strengthen senior leaders’ ability to deliver large-scale, strategic change and influence continuous improvements across the trust.

We delivered our first Development Leaders cohort. This supported 40 aspiring leaders across different roles and departments to build their core leadership skills and prepare them for potential leadership roles in the future, through a blend of workshops and regular 1-1 mentoring with existing leaders.

Overall, more than 75% of our managers completed leadership training throughout the year – a fantastic achievement!

Staff benefits

Reward and recognition work included the development of a staff benefits booklet, the formation of a recognition framework and improvement to the process for staff receiving compliments form the public. Impact has been seen through a significant improvement in staff survey scores related to the We Work Flexibly theme.

Major boost to our LGBT+ e-Learning

To coincide with February’s LGBT History Month, our LGBT+ Network and the Learning Governance Team launched brand new e-learning resources for staff to help us create a more supportive and inclusive workplace and culture.

The new ‘Back to LGBT Basics – Plus’ module helps colleagues explore the LGBT+ acronym in a clear and accessible way, demystifies key concepts, and shares real lived experiences of LGBT+ colleagues.

Celebrating our women

The Women’s Network brought colleagues together in Southport to celebrate International Women’s Day with the theme ‘Give to Gain’, recognising the power of supporting, inspiring and learning from one another.

The event featured inspiring guest speakers, networking, interactive workshops, and a maternity session highlighting support available for new and expectant mothers, including the Maternity Matrix Tool. Colleagues also heard inspiring career journeys from the Leadership Panel and learned how the NWAS Charity supports staff and patients.

Moving towards becoming an anti-racist organisation

We took important steps towards becoming an anti-racist organisation, including launching our Anti-Racism Statement and establishing a dedicated steering group, which includes members of our Race Equality Network.

These actions set a clear direction for improving inclusion, challenging discrimination and supporting colleagues from ethnic minority backgrounds.

The Disability Network

The Disability Network joined forces with Greater Manchester Police for a powerful event on hate crime, lived experience and allyship.

Colleagues and guest speakers shared how hate crime affects our staff and communities, and how we can work together to create a safer, more inclusive environment for everyone.

The Armed Forces Network

The Men’s Advocate, Nexus is a group open to anyone interested in men’s health and wellbeing, not just men. An event brought together over 30 like-minded colleagues discuss together how to create an environment where men feel comfortable to share, talk, and seek help.

Recognising our people

Long Service and Good Conduct Awards

Every year, NWAS colleagues from across the region were honoured for their career milestones of 20 through to 40 years, along with the King’s Medal for service and good conduct.

The three regional events were hosted by the respective head of operations and Chief Executive Salman Desai, with Chair Julia Mulligan and Salman presenting awards. Lord Lieutenants for each respective area presented the Long Service and Good Conduct medals.

Vounteer Celebration Event

Our 2025 Volunteer Celebration Event, held on 7 November, was a truly memorable occasion, bringing together volunteers, staff and leaders from across the organisation to honour the incredible contributions of our volunteers.

Held at Garstang Country Hotel and Golf Course, the day was split into two parts, a daytime conference and an evening gala dinner, both hosted by Regional Community Engagement Lead, Mark Evans, who compered the events with warmth, humour and energy, supported by his dedicated team.

Digital developments

Network upgrade

As part of its digital improvement programme, the Infrastructure team completed a major upgrade to the organisation’s network.

The connection speeds between the main data centres have been increased from 1Gb to 10Gb, providing much more capacity and improving performance.

This upgrade will help us better support systems that need high bandwidth, enable faster sharing of information, and provide a stronger foundation for future digital developments across the region.

Keeping our systems safe from cyber attacks

In October we introduced the NHS England Cyber Security Operations Centre (CSOC) Device Isolation Service, strengthening our ability to respond to cyber threats.

The new service allows the CSOC to remotely disconnect tagged devices from the network at any time, day or night. This helps stop cyber threats from spreading across our systems.

The key benefits are:

• Reduced risk of data exfiltration
• Immediate threat containment
• Minimised business disruption
• Real-time response

Electronic patients records improved for patient care and staff

Our EPR system, OneResoonse, has seen major developments over the past year with the following introduced to improve patient care:

• New Hospital Handover tile, incorporating ‘Fit to Sit’ form.
• New Maternity tile, which incorporates the New Maternity Decision Tool, which is for pregnant patients, suspected pregnant patients, or those post pregnancy ( up to four weeks). Alerts for high concern, medium concern and low concern presentations, based on observations.

Improvements which benefit staff with patient care and usability:

• Transferring records – PINs now displayed on the ‘Transfer Screen’ of the App.
• Referral attempts – the number of referrals that can be recorded has been increased to five and a ‘declined reason’ field is now included.
• Addition of Falls and Diabetes referrals flag to the Comms, consent and notifications (CNN) tile
• Diagnosis of Death (DOD) ‘Police notified, not attending’ now added as an option.
• General appearance – option to toggle to ‘dark mode’.

Working together to shape a better future

Developed our 2026-31 Strategy

The Strategy and Planning Team have developed and launched our new five-year strategy for 2026–2031, setting out how we will improve patient care, support our workforce and tackle health inequalities.

Shaped by staff, patients and partners, it gives us a strong foundation for the future, helping us meet rising demand, embrace innovation and deliver high-quality, sustainable services.

Highest recorded Staff Survey participation

53% of staff took part in the 2025 NHS Staff Survey – our highest ever response!

This means we have a stronger and more representative staff voice and can better understand experiences as we start to take action and make improvements from the feedback.

Stronger speaking up culture

We improved awareness and access to Freedom to Speak Up, helping more staff feel confident to raise concerns or share ideas.

This is creating a more open and inclusive culture, where issues are identified early and staff voices help shape change.

Community and volunteer impact

arly support can make a life-saving difference, and our Community First Responders attended over 20,000 incidents.

Over 125 new defibrillators were rolled out in local communities – improving the chances of surviving cardiac arrests.

We celebrated 25 years of NWAS volunteering and the vital contribution our volunteers make to our patients, communities and staff.

Best Value Group

Our Best Value Group ran a trust-wide ‘If it was up to me’ ideas campaign, receiving over 100 staff submissions on how to improve services and make best use of public money.

Ideas included uniform supply, savings on consumables and equipment, reducing energy use, and using technology to streamline processes, with many now being taken forward into 2026/27 work programmes.

Improving patient transport services

The PTS Improvement Project is helping make services more reliable, efficient and patient-focused.

Improvements include stronger leadership, better communication and clearer day-to-day processes, reduced use of third-party vehicles and safer equipment for patients and staff.

Major boost to EV infrastructure

In July we were awarded £298,000 to expand our network of electric vehicle (EV) chargers, to help pave the way to expand our fleet of electric vehicles.

Part of the Government-backed NHS Chargepoint Accelerator scheme, new chargepoints will be installed across nine of our stations – including a new fast charger at Fazakerley station to support the trial of a new fully electric ambulance in Liverpool.

This builds on our existing network of 170 chargepoints across our various sites, and more than 100 electric vehicles across our frontline and support fleet.

These chargepoints help reduce costs from fuel and maintenance across our fleet which can be redirected into frontline care, and as well as help reduce our emissions and improve air quality.

£8 million to upgrade our ambulance fleet

n June, NHS England awarded nearly £8 million in funding to decommission 40 diesel ambulances and replace them with brand-new converted Fiat Ducatos.

£900,000 of this is also being used to purchase four new fully electric ambulances to expand our green fleet, alongside trials to test a new model of fully electric Ford Transit ambulance – the first trial of its kind in the North West.

Newer vehicles mean fewer breakdowns, and therefore better response and care for our patients.

Improving access to Patient Transport Services

In collaboration wih the Office for Health Improvement and Disparities (OHID), we launched a ‘health literacy’ project to make Patient Transport Service information and booking easier to access, understand and use.

The aim is to help patients feel better informed about their transport and what to expect, by improving information on our website and other communication channels.

The project brings together colleagues from PTS, public health, evaluation, patient engagement and communications, working with members of our Patient and Public Panel to shape improvements based on lived experience.

Work will continue through 2026/27, supporting a better patient experience and helping reduce missed appointments and cancelled bookings.