Before finalising and publishing our Quality Account, we send a draft version to a number of organisations in our community for their feedback and comments.

While we’d like to express our thanks to those who provided their valuable comments (please see below), we also apologise to those organisations who were unable to feedback due to the short timescales given – Bolton Council, Healthwatch Cheshire and Healthwatch Wigan.

Healthwatch Westmorland and Furness, Cumberland and Lancashire

Thank you for sending through the draft North West Ambulance Service (NWAS) quality account for 2024-2025. This written response is on behalf of three local Healthwatch: Westmorland and Furness, Cumberland, and Lancashire.

I was pleased to read about the work done by the Patient Engagement Team, particularly that there is a commitment to using face-to-face methods to compliment digital. I hope that, despite low completion rates for physical postcards, that these will continue to be provided for those who are ‘digitally excluded’, and that new, accessible sites for placement, support for completion, and collection will be considered.

It’s heartening that patient satisfaction with treatment (dignity, compassion and respect), as well as overall satisfaction and experience are so high, and have either stayed the same or risen since quarter one. From the personal stories shared it is also clear that reasonable adjustments are made by paramedics and other staff, these efforts are appreciated, and that there is a high regard for the ambulance service generally.

Healthwatch Westmorland and Furness supported NWAS with a patient experience survey on Alston Moor from May 2023 to April 2024 about the pilot response model there, and these findings are in line with those.

I noted the comment on the need to get more feedback from different demographics, including young people and those with learning disabilities. It’s good to read about the innovative ways of gathering patient stories, such as video.

Regarding PALS, I hope that the response to complaints will continue to evolve, including making reasonable adjustments for communication to meet the Accessible Information Standard, and that the availability of Language Line, BSL and Easy Read materials are promoted on-site and through different media.

Generally, it is also good to read that challenges facing Trust teams, such as those around call response times are being met, and that a handover improvement scheme is in place to address this patient safety issue.

All three local Healthwatch will continue to feed back patient experience about NWAS patient transport, ambulances and emergency care. We look forward to working alongside NWAS to increase patient engagement and experience in 2025-2026.

Patient and Public Panel

  • I find the report clear, concise & easy to navigate. The information is presented in a logical sequence. I was surprised to see however that 999 calls are seeing a decrease year on year, but this could be due to the increasing efficiencies of the 111 service! Good to see also that the calls are picked up within one second, very impressive.
  • What a comprehensive account, I am blown away. I thought everything was explanatory and whilst I know that this is not the final draft, whoever carried it out has done an amazing job collating the information together and then actually bringing it all together.
  • I know all in a day’s work. I did notice a spelling error of ‘leaning disabilities’ instead of ‘learning disabilities’ although that happens.
  • I was concerned to not see a directive within the account regarding how staff within hospital environments are navigating the handling of patients who are full time wheelchair users. I am making this point because of a very concerning incident that happened to me. I was dropped when admitted to Bolton Hospital and the staff were not able to accommodate straight away and instead told me to get up, when I informed them, I couldn’t, it was 2 hours later before a hoist was found whilst I lay on a cold floor. I am able to verbalise my needs, and I worry about those who are not able to do so for.
  • I do hope that transferring patients who cannot walk is now part of the training of staff.
  • I personally would have liked to have seen the training transferring of patients of patients who are full time wheelchair users within the Quality Account if it has been carried out not just within the hospital setting but also within ambulance crews. One occasion I was asked by the ambulance crew to walk to the ambulance.
  • I would also like to make a suggestion as to whether it is possible that the PTS could be helped by the local accessible school buses that transport special needs children to school and deliver meals and wheels. Obviously, there would have to be a liaison between the providers, i.e. council and the NHS for a contract to be drawn up to assist with the managing of getting patients to and from hospital appointments.
  • I was extremely pleased to learn that the trials for electric wheelchairs to access PTS vehicles went well, this makes facilities accessible for all.
  • Not read the Quality Account in detail but it seems a true representation of what NWAS stands for and wishes to achieve. The only comment I have is why are NWAS getting involved with medicine management? Surely that is either the chemist or the doctors to deal with and any issues should be passed on to them.

Mersey and West Lancashire Teaching hospitals

Thank you for the opportunity to review the NWAS Quality Account, sincere apologies for the delay in responding.

The report reflects clear progress in areas such as 999 call answering, digital integration, and patient safety culture. Notable strengths include a strong focus on continuous improvement and a commitment to equality, diversity, and inclusion.

From our Trust’s perspective, key areas for continued focus include improving hospital handover delays (which impact our patient flow), addressing underperformance in Patient Transport Services (PTS), and accelerating digital interoperability. I’m sure there may be opportunities to align more closely on urgent care pathway redesign, digital record sharing, and system-wide patient safety improvements.

Overall, I’d say a fairly positive report, but closer collaboration with acute and system partners remains critical to realising the full benefits for patients and services.

Some comments for your consideration:

Hospital Handover Delays:

  • While improvements are acknowledged, there remains a significant system risk.
  • From our Trust’s perspective: Continued delays at hospital EDs (especially in Cheshire and Mersey) can directly impact our flow and patient safety.
  • Suggestion: NWAS could include more detailed collaborative action plans or pilot initiatives aimed specifically at problem sites (with measurable KPIs).

Workforce Resilience:

  • Although improvements in sickness rates and turnover are mentioned, the reliance on volunteer car drivers and potential workforce fragility for PTS could become a risk point.
  • From our Trust’s perspective: Any staffing issues at NWAS could lead to secondary impacts on acute and community services.

Limited Detail on Digital Interoperability:

  • The reference to PRISM delays impacting access to GP records was brief.
  • From our Trust’s perspective: As we move toward an integrated, multi-provider ecosystem (especially under the Cheshire and Merseyside Digital Strategy), delays in data sharing can hamper real-time clinical decisions.
  • Suggestion: Greater detail on timelines and mitigations for PRISM and wider digital integrations would be useful.

Opportunities for Alignment and Collaboration:

  • Hospital Flow and Discharge: MWL’s ward round initiatives (‘criteria to admit’, ‘home for lunch’) could be strengthened through aligned operational approaches with NWAS on conveyances and community referrals.
  • Digital Integration: Working more closely with NWAS around real-time information exchange (e.g., alerts, shared records) is really important.