About us
North West Ambulance Service NHS Trust (NWAS) serves more than 7 million people across approximately 5,400 square miles – the communities of Cumbria, Lancashire, Greater Manchester, Merseyside, Cheshire and a small part of Derbyshire (Glossop).
The trust’s vision is to deliver the right care, at the right time, in the right place; every time for patients accessing its urgent and emergency care service (999), non-emergency patient transport service (PTS) and NHS 111 service.
To achieve this ambitious vision, the trust has to balance getting the basics right while continuously striving for excellence. Its approach to this is outlined in its 2022 – 2025 strategy, developed with input from its people.
The trust’s workforce of 7,074 staff undertakes over 300 different roles and is supported by over 1,000 volunteers as members of its patient and public panel, volunteer car driver network and community first responder network.
The trust is part of a complex health and care system, working collaboratively with 4 integrated care systems, 42 NHS provider trusts, 22 Healthwatch organisations, 2 air ambulance charities, more than 160 primary care networks and 5 police and 5 fire services across the region.
In July 2022, Integrated Care Systems (ICS) replaced the Clinical Commissioning Groups (CCGs). Previous to July 2022 they had 31 CCGs covering the North West. They now work to five ICS areas in the North West.
- Lancashire and South Cumbria
- Cheshire and Merseyside
- Greater Manchester
- North East and North Cumbria (For North Cumbria)
- Derbyshire (for Glossop)
Nationally there are 42 ICS, and their aims are:
- Improving population health and healthcare
- Tackling unequal outcomes and access
- Enhancing productivity and value for money
- Helping the NHS to support broader social and economic development
Along with North East, Yorkshire and East Midlands ambulance services, NWAS forms part of the Northern Ambulance Alliance, which has an ambition to do things better in partnership to deliver patient-centred, efficient and forward-looking services.
The diversity in the region makes the North West a unique place to live, but also presents some challenges. In the North West, 32% of people live in the highest levels of deprivation and have significantly worse health outcomes, healthcare experiences and life expectancy than the general population. People living in the north west’s communities are sicker than before the Covid-19 pandemic. There are more people living with poorly managed long-term conditions and, as people get older, it is expected there will be more people living with illnesses.
The overall health of the region’s population has a huge effect on demand for NWAS’ services. Therefore, the trust aims to address health inequalities help tackle the causes of illness by looking at the wider factors that affect health; helping people to stay healthy and reducing the need for them to have care from the NHS.
Key challenges
NWAS faces several ongoing and emergent challenges which include:
- Sustainable delivery of performance – we are not sustainably achieving our performance standards as this is dependent on having the right levels of resource to meet increasing demand, and a workforce who are appropriately skilled to meet patients needs. Our performance is also impacted by pressures in the wider urgent and emergency care system, with national focus on recovery across several performance indicators including category 2 performance and hospital handover.
- Financial efficiency and productivity – due to significant national and system-level deficits, NWAS has a responsibility to demonstrate that we are delivering value for money and being efficient with the resources available to us. There is also a specific requirement for NWAS to reduce spending each year through cost-improvement schemes.
- Workforce and culture – ambulance services are tackling huge cultural challenges within the workforce, most notably issues around sexual safety and misogyny have been identified as part of sector-wide independent reviews. NWAS continuously strives to improve ‘Freedom to Speak Up’ reporting and staff confidence that concerns raised will be addressed.
- Health inequalities – the challenging socio-economic context is continuing to affect the health of the population, particularly those from minority groups who face inequality in access, experience and outcomes. NWAS demonstrate how we are taking action to reduce health inequalities in partnership with other health and social care organisations.
- Partnership working – our footprint is large and diverse and NWAS operates across five ICB footprints which poses challenges when trying to balance local priorities with delivery of a consistent regional service.
Excellence Accreditation- Level 3
NHS Finance Leadership Council has agreed that North West Ambulance Service NHS Trust should awarded Towards Excellence Accreditation, at level 3, with effect from 14 May 2025. The accreditation lasts for three years and so will expire on 14 May 2028.
Background
The One NHS Finance Accreditation process recognises organisations with exemplary finance skills development practices.
It consists of three levels, encouraging continuous improvement and professional development within NHS finance functions.
- Accreditation is reviewed and updated annually by One NHS Finance (ONF) and the North West Skills Development Network.
- The latest standards were approved in May 2023 by the NHS Finance Leadership Council.
- Organisations in the North West must follow separate guidance available on the Skills Development Network website.
Levels of Accreditation and Requirements
The accreditation process includes three levels, each reflecting the maturity and capability of the finance function within an organisation.
Transitioning between levels requires specific criteria to be met and evidence to be provided.
- Level 1 is a self-assessment requiring sign-off from the Finance Director/Chief Finance Officer (FD/CFO).
- Level 2 and Level 3 applications must be assessed by peers, ensuring a higher standard of evaluation.
- Organisations must demonstrate sustained performance and a culture of continuous development to progress through the levels.
Good Practice and Evidence Requirements
Organisations must show adherence to good finance staff development practices as outlined in national and local strategies.
Our strategy
NWAS’ published a new strategy in 2022, outlining its vision is to deliver the right care, at the right time, in the right place; every time.
What does this mean?
Right care – proving outstanding care that is safe, effective and focused on the needs of the patient.
Right time – achieving all operational performance standards for the paramedic emergency service, NHS 111 and patient transport service.
Right place – providing care in the most appropriate setting for each patient’s needs, taking fewer people to emergency departments by providing safe care closer to home or referring people to other health and care pathways.
Every time – providing services which are consistent, reliable and sustainable.
To achieve this vision, the trust focuses on three aims, which are to:
Provide high-quality, inclusive care
The trust recognises there are health differences between groups in the communities it serves. It will listen to understand and make sure its services are accessible to everyone. It will work to prevent harm while using learning and research to continuously improve patient care and experience.
Be a brilliant place to work for all
The trust will create an environment where its people feel happy and safe, have access to equal opportunities and are supported to be at their best.
Work together to shape a better future
The trust will work together to improve the services it provides. It will work with its partners and the public to find solutions which improve access, outcomes and experience for everyone. It will work together to become more sustainable and have a positive effect on its communities and environment.
Our vision
to deliver the right
care, at the right time,
in the right place;
Right care
We will provide outstanding care that is safe, effective and focused on the needs of the patient.
Right time
We will achieve all operational performance
standards for our paramedic emergency service, NHS 111 and patient transport service.
Right place
We will provide care in the most appropriate setting for each patient’s needs, taking fewer people to emergency departments by providing safe care closer to home or referring people to other health and care pathways.
Every time
We will provide services which are consistent, reliable and sustainable.
Our values
The trust’s values form the foundation of the whole organisation, setting out the behaviours expected from its staff for patients to receive the right care every time. Putting its values into practice supports the trust to provide compassionate care and improve outcomes and experiences for its people, patients and communities.
Urgent and Emergency Care
Our emergency crews respond to over 1.2 million emergency incidents every year, delivering expert pre-hospital care across both rural and urban areas.
Emergency responses are measured through the Ambulance Response Programme (ARP), which ensures patients with life-threatening conditions are identified quickly and receive care within the right timeframe.
For patients whose conditions are not serious or life-threatening, we work to reduce unnecessary hospital visits by using alternative pathways of care. This includes treating patients by telephone, at the scene, or in community settings. By collaborating with healthcare partners, our patients get better outcomes, and pressure on the wider NHS is reduced.
As a region-wide service, NWAS plays a central role in shaping urgent and emergency care across the North West.
Resilience
Our Resilience Team develops and delivers emergency and contingency plans to ensure the trust can respond effectively to risks and hazards. The team works closely with multi-agency partners, including fire and rescue services, to prepare for and respond to a wide range of incidents.
Plans cover everything from mass gatherings in stadiums and town centres to major incidents. We also play a key role in supporting the NHS Emergency Preparedness, Resilience and Response (EPRR) Programme through Local Health Resilience Partnerships (LHRPs).
The hazardous area response teams (HART) form part of the resilience department. They are made up of specially trained paramedics who respond to high-risk incidents such as chemical spills, explosions, unsafe structures, water rescues, and other complex or dangerous environments.
Emergency Operations Centres
NWAS handles approximately 1.4 million 999 calls every year from the public and healthcare professionals.
A clinical assessment tool called NHS Pathways is used to ask questions about the patient’s condition and provide helpful instructions, such as how to do CPR to assist a patient in cardiac arrest.
Based on the nature of the illness or injury, patients are prioritised into one of several categories to determine the type of response and the speed at which it will be provided.
Our Clinical Hub is staffed by a range of clinicians such as paramedics, nurses, pharmacists, and mental health practitioners and is available to support staff on the road with clinical advice and decision-making and triage patients who call 999 or 111 to determine the best course of action.
EOCs also handle requests from healthcare professionals whose patients urgently need taking into hospital or transferring from one hospital to another.
NHS 111
We provide the NHS 111 service across the region for people who need medical help or advice, handling 1.9 million calls in 2024/25.
People who call 111 speak to a specially trained health advisor who asks a series of questions about the patient’s health concern or condition to determine what clinical help they need and where to get it. When appropriate, these calls can be referred to a nurse or paramedic for assessment.
111 can help patients access the most appropriate care, which could come from out-of-hours doctors, pharmacies, community nurses, emergency dentists, walk-in centres, minor injuries units and emergency departments.
The NHS Service Finder used by 111 provides quick access to the Directory of Service (DoS) for healthcare professionals to enable them to signpost patients to the most appropriate service.
Calls from patients who have originally contacted 111 that require an emergency response go automatically into the ambulance dispatch system for a response.
111.nhs.uk is available for patients online – the service is provided nationally, but patients using the online service who live in the North West and need a clinical assessment over the phone are referred to the NWAS 111 team for a response.
Patient Transport Service (PTS)
We are the largest provider of non-emergency patient transport across the country, undertaking 1.4 million journeys annually. PTS crews assist eligible patients in getting to and from their healthcare appointments.
We currently operate patient transport services in the counties of Cumbria, Lancashire, Greater Manchester and Merseyside (another provider operates within the Cheshire area).
PTS is a contracted service awarded following a competitive tendering process.
The criteria for entitlement to transport are set nationally and depend on specific requirements, medical conditions and mobility; therefore, patients must meet the eligibility criteria as defined by local commissioners before using the service.
PTS crews play a vital role in health promotion and prevention by sharing health information and advice with patients and raising concerns with other support services if necessary.
Support Services
A variety of corporate support functions support our frontline services, ensuring safe, effective, and efficient operations.
Patient and Public Engagement
We are committed to listening to patients and the public, acting on feedback, and shaping our services to meet community needs.
We gather insight through:
- Postal surveys
- Community engagement events
- Focus groups
- Comment cards
- The national Friends and Family Test
In 2019, we established a Patient and Public Panel, now with close to 250 members, to give local people a stronger voice. Members can get involved at different levels:
- Consult: Share views via surveys or provide feedback on specific strategies, initiatives, or publications.
- Co-produce: Join meetings or discussion groups to help review and improve services.
- Influence: Take an active role in high-level committees and influence indecision-making.
More than half of our panel members are in the 16-24 age range with other age ranges being well represented. We attract members representative of all protected groups and currently have around 30% of panel members from mixed ethnic groups.