Cornwall and Scilly’s ambulance service rated good by watchdog

Call it a report card with one red mark. Health inspectors spent the spring and summer watching crews on the road, call handlers in Bristol and Exeter, and the boat and plane crew on the Isles of Scilly, and the verdict has just landed.

What inspectors found

The Care Quality Commission (CQC) has rated five services at South Western Ambulance Service NHS Foundation Trust as good, following inspections carried out between April and July. The trust runs the 24-hour clinical response to 999 calls, an urgent treatment centre at Tiverton and District Hospital, a non-emergency transport service on the Isles of Scilly, and a resilience service that plans for major incidents. Between them, these services cover more than five million people across Gloucestershire, Somerset, Wiltshire, Devon, Dorset, Bath, Cornwall and the Isles of Scilly, a figure that climbs to 23 million once summer visitors are counted in.

The emergency operations centres kept their good rating, with effective, responsive and well led all holding steady, safe upgraded from requires improvement, and caring re-rated outstanding. The emergency and urgent care service moved up from requires improvement to good overall, with caring also rated outstanding there. Tiverton Urgent Treatment Centre stayed good, with safe upgraded. Resilience moved from outstanding to good under a newer assessment method. And the patient transport service on the Isles of Scilly climbed from requires improvement to good overall, though its well led rating remains requires improvement.

The trust’s overall rating across all its services stays good.

Faster help for people having a stroke

One figure stood out to inspectors. The average time from a 999 call to hospital arrival for a stroke patient has come down from two hours and 20 minutes in 2021 to one hour and 41 minutes now, a change put down to investment in the stroke pathway and quicker category response times.

At Tiverton, the urgent treatment centre kept people out of hospital altogether in a lot of cases. In April alone, 1,837 people were treated there instead of going to an emergency department, and the centre consistently triaged patients within 15 minutes of arrival, treated them within 30 minutes of triage, and discharged them within four hours.

Outstanding marks for kindness

Both the emergency operations centres and the emergency and urgent care service picked up an outstanding rating for caring, the joint-highest mark CQC gives. Inspectors described staff reassuring a person who had overdosed that the incident would stay confidential, and call handlers who never raised their voices even when callers were frightened or aggressive. In the urgent and emergency care service, one patient said they “could not fault the crew.”

On Scilly, the same theme ran through the patient transport service. One person told inspectors, “the staff were amazing, reassuring and friendly.” Journeys involving the boat are planned around tide times, and the trust has introduced a plane fitted with a medical bed so patients relying on transfers to the mainland need fewer separate services to get there.

Where the Isles of Scilly service fell short

The patient transport service was the one area found in breach of regulations, covering safe care and treatment and the overall management of the service. Inspectors found an out-of-date Entonox cylinder, another so rusted its label could not be read, and oxygen cylinders in the ambulance and on the boat that were not secured, a risk that staff addressed on the spot during the inspection. Storage areas were cramped enough that staff used a kick stool to reach equipment, and one fire extinguisher was overdue for service with no record of it having been done.

Leaders were not monitoring cancellations or delays to collections and drop-offs, which meant there was no data to support planning or spotting problems early. Inspectors put some of this down to the genuine difficulty of running the service, where the same crew answering 999 calls also carries out patient transport, and weather and tides can upend a schedule without warning.

Staff feeling the strain

The picture on staff wellbeing was mixed. More than half of staff in the emergency and urgent care service reported feeling unwell due to work-related stress in 2025, and some said they were given less than fifteen minutes to recover after a traumatic incident before being sent to a new job. Against that, the emergency operations centres were praised for wellbeing support, including quiet rooms, flexible rota swaps, and a trial of virtual reality headsets as a distraction tool for staff needing a break from the screen.

What happens next

Catherine Campbell, CQC’s deputy director of hospitals, secondary and specialist care for the South West, said inspectors found people receiving safe and effective care “across the board,” with staff treating people “with kindness and dignity which made all the difference in distressing situations.”

“We did identify some areas for improvement, particularly in the patient transport service, where leaders weren’t monitoring performance and weren’t doing enough to identify and address risks,” she said. “We’ve told the trust to provide us with an action plan setting out how it will respond to these concerns. With good ratings for all services, this is a strong foundation for the trust to build on in future.”

That action plan has not yet been published.