London Ambulance Service NHS Trust

London Ambulance Service NHS Trust

Address: Ambulance Station, 220 Waterloo Road, London, SE1 8SD Unique reference number (URN): 2510867

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Safeguarding standards met

The safeguarding standards are met. This means that leaders and/or those responsible for governance and oversight fulfil their specific responsibilities and have established an open culture in which safeguarding is everyone's responsibility and concerns are actively identified, acted upon and managed. As a result, learners are made safer and feel safe.

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How we evaluate safeguarding

When we inspect providers for safeguarding, they can have the following outcomes:

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How we evaluate safeguarding

Met: The provider has an open and positive culture of safeguarding. Not met: The provider has not created an open and positive culture of safeguarding. Not all legal requirements are met.

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Inclusion Expected standard

Leaders have created an inclusive culture across the organisation. Learners and apprentices from disadvantaged backgrounds, including those with special educational needs and/or disabilities (SEND) and other barriers to learning, feel valued and well supported to succeed.

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Inclusion Expected standard

Staff, including tutors and SEND specialists, identify support needs accurately through suitable initial assessment and at regular review points. They monitor changes in behaviour, attendance and progress effectively and adapt support in response. Consequently, learners and apprentices with additional support needs engage fully in learning and make progress in line with their peers.

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Inclusion Expected standard

Staff work well together with specialist services across the trust and with external agencies to support learners and apprentices facing mental health problems, financial hardship, anxiety or other wellbeing challenges. They work closely with tutors and managers to put in place personalised interventions and reasonable adjustments to reduce barriers to learning and work.

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Inclusion Expected standard

Learners and apprentices benefit from suitable assistive technology, such as immersive readers for those with dyslexia, and specialist equipment, including adapted boots to support long-term injury, alongside flexible working arrangements. Tutors maintain effective communication with welfare staff and managers, when learners or apprentices are receiving support or are identified as at risk of falling behind. This helps most of these learners and apprentices to complete their courses successfully.

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Leadership and governance Expected standard

Leaders and governors have a clear vision and strategy to widen participation and offer a high-quality curriculum in emergency care services. This is clearly reflected in their decision- making. Since the previous inspection, leaders have carefully strengthened and expanded their provision, purposefully building a diverse workforce that closely reflects the communities they serve.

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Leadership and governance Expected standard

Leaders now offer new entry routes and clear progression opportunities for adult learners and apprentices from diverse and non-clinical backgrounds to become well-trained and qualified paramedics. They engage effectively with clinical leads and professional networks, including the Royal College of Paramedics. This ensures that the curriculum offer aligns well with emerging skills needs and sector developments.

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Leadership and governance Expected standard

Governors have a sound oversight of the organisation’s performance. They provide rigorous challenge and support senior leaders to drive improvements. Senior leaders check the quality of teaching and training effectively and use their findings to inform action plans and set ambitious improvement goals. They know the strengths and weaknesses of their provision. However, leaders lack sufficiently detailed oversight of apprentices' progress on work placements. A few apprentices struggle to balance work and study, and fall behind. Leaders prioritise staff welfare and wellbeing. Tutors find their workloads manageable and highly value the support they receive from their managers to relieve work pressures, especially during busy marking periods. Tutors, who are highly skilled paramedics and qualified teachers, benefit from ongoing and well-developed professional development. This includes frequent clinical practice updates and clinical placements to maintain and enhance

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Leadership and governance Expected standard

their occupational expertise, professional registrations and licenses to practise.

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Participation and development Strong standard

Learners have highly positive attitudes to learning and demonstrate excellent behaviours in training. Attendance and punctuality are high. Learners participate enthusiastically in discussions and engage fully in training.

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Participation and development Strong standard

Through well-planned training, tutors expertly link wider topics, such as fundamental British values, to the professional values of the London Ambulance Service (LAS). Learners explore their own unconscious bias and discuss the importance of cultural awareness and respectful behaviour when working with diverse communities. They demonstrate a strong understanding of these topics and how they relate to their lives and work.

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Participation and development Strong standard

Learners feel safe and know how to report concerns, including bullying and harassment. They frequently benefit from external speakers and learn about managing fatigue, developing resilience and adopting a growth mindset. Learners develop a good understanding of emotional wellbeing and how to manage stressful situations.

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Participation and development Strong standard

Learners, including those from disadvantaged backgrounds, greatly benefit from a wide range of opportunities that prepare them effectively for future employment and active participation in the community. They volunteer in the community, signing up as first responders and participating in charity events. They develop their CVs, take part in mock interviews and shadow staff across different areas of LAS. They gain a clear understanding of different career pathways.

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Achievement Expected standard

A high proportion of adult learners, including those with barriers to learning, complete their training and achieve their qualifications.

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Achievement Expected standard

Most learners make significant progress from their starting points, developing the new knowledge and skills that they need for their next steps. They improve their understanding of the London Ambulance Service (LAS) and develop professional behaviours essential for success in future careers. On intensive response courses, learners develop essential digital skills through the use of driving theory software and online hazard perception activities. Blue light driving learners also use specialist navigation and driving software to respond to incidents and develop safe driving skills. In addition, learners acquire specialist skills and vocabulary specific to emergency response procedures and patient care.

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Achievement Expected standard

Most learners are successful at interview and progress into apprenticeships or employment in LAS frontline roles. They typically demonstrate relevant vocational knowledge and practical skills. However, their written work is not of a consistently high standard.

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Curriculum and teaching Expected standard

Leaders have designed bespoke short courses for adult learners to develop the knowledge and employability skills needed for employment in the London Ambulance Service and other NHS trusts. They work with stakeholders effectively, including the Greater London Authority and Jobcentre Plus, to support Londoners from disadvantaged backgrounds, including unemployed people and Black, Asian and minority ethnic groups. Through this collaborative approach, leaders widen participation for disadvantaged adults and successfully respond to local demand for trained staff across emergency care services.

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Curriculum and teaching Expected standard

Leaders structure the curriculum logically to teach learners sector-specific knowledge and practical skills progressively. For example, learners on the blue light driving course begin by learning underpinning theory, including road markings and vehicle safety, before progressing to pre-driving checks, driving assessments and low-speed manoeuvring. Staff then teach more advanced driving skills, such as motorway driving and map reading. Learners, including those with barriers to learning, develop confidence and competence quickly.

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Curriculum and teaching Expected standard

Tutors are knowledgeable and keep their expertise up to date through regular professional development and sector-specific training. They typically explain concepts clearly, check learners’ understanding routinely and use relevant industry examples that help learners see how their new skills apply in practice. Tutors develop learners' professional language and develop their self-awareness, empathy, motivation and emotional intelligence. Learners on inclusive response courses also develop their understanding of the specialist language used in emergency response procedures, including cardiopulmonary resuscitation and trauma management. Tutors adapt teaching and support appropriately for adult learners who face barriers to learning. They make suitable reasonable adjustments for those with health problems or special educational needs and/or disabilities.

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Achievement Strong standard

Most apprentices, including those with barriers to learning, achieve their qualification. A high proportion of apprentices gain distinctions in their final assessments, with the majority doing so at the first attempt.

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Achievement Strong standard

Apprentices make substantial progress and apply their learning competently at work. They demonstrate excellent knowledge and understanding of their role, clinical decision-making and professional behaviours, when managing medical emergencies, such as cardiac arrests or fractures. In stressful and challenging situations, apprentices remain calm and carry out complex emergency procedures with precision.

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Achievement Strong standard

Apprentices produce written and practical work of a consistently high standard. Their portfolios are comprehensive and well organised and demonstrate strong knowledge of ethical and competent clinical practice. Apprentices are highly valued at work for their resilience and technical competence. Most apprentices remain in employment and progress to higher-level qualifications.

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Achievement Strong standard

Apprentices develop their English, mathematical and digital skills thoroughly. They use medical terminology proficiently, calculate drug dosage accurately and use NHS patient care systems effectively.

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Curriculum and teaching Strong standard

Leaders have designed an ambitious and well-sequenced curriculum that meets the demand for highly skilled and qualified emergency care professionals in London and nationally.

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Curriculum and teaching Strong standard

Tutors, who are qualified teachers and experienced clinicians and paramedics, teach apprentices complex content skilfully. They bring scientific concepts, such as anatomy and pharmacology, to life using clear explanations, diagrams, charts and models. Apprentices

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Expected standard

also visit ambulance stations and shadow experienced paramedics to see how their learning is applied in real-life practice. This deepens apprentices’ understanding and strengthens the link between theory and practice.

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Expected standard

Tutors plan and teach the curriculum in a logical order. Apprentices on level 3 ambulance support worker courses learn the foundations of human biology and physiology. They then revisit these topics in greater depth at level 4, when studying drugs, treatments and more complex clinical interventions. Tutors carefully plan practical activities so that apprentices can practise less common but essential skills, such as neonatal and paediatric resuscitation, helmet removal and burns management. This enables apprentices to consolidate their learning and apply their skills confidently across a wide range of emergency scenarios.

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Expected standard

Tutors use effective assessment methods to check apprentices’ understanding and monitor their progress. They observe apprentices on ambulances and in practical simulations to assess what apprentices can do in practice. Tutors also review apprentices’ reflections and feedback from workplace supervisors to evaluate how well apprentices apply their learning at work. They assess work regularly and provide comprehensive feedback. They also identify spelling and grammar errors systematically and support the development of apprentices' academic writing skills needed for higher level studies.

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Expected standard

Apprentices develop fluency in the use of specialist medical vocabulary as they progress through their courses. Tutors introduce essential technical vocabulary from the early stages of the programmes and insist on the accurate use of Latin clinical terminology in both spoken and written work. They adapt teaching and learning resources effectively so that all apprentices, including those with barriers to learning, can access the curriculum and achieve as well as their peers. Tutors provide individualised support for apprentices who fall behind. As a result, most apprentices complete their courses in a timely manner.

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Participation and development Expected standard

Apprentices learn and work in highly supportive and respectful environments. Leaders set high expectations of behaviour from the outset and do not tolerate bullying, harassment or derogatory language.

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Participation and development Expected standard

Apprentices attend their lessons regularly and take part in learning activities enthusiastically. They thrive in their clinical placements, rapidly building competence, confidence and resilience through practice and under the close supervision of specialist colleagues.

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Participation and development Expected standard

Apprentices have access to a range of opportunities across the organisation to support their wider development. They participate in charity initiatives and represent the London Ambulance Service at external events. Tutors and managers provide apprentices with detailed guidance on health and safety, mental wellbeing and physical health. Apprentices demonstrate extensive knowledge of personal, patient and colleague safety in high-risk situations and incidents. Tutors teach apprentices regularly about fundamental British values, equality and diversity and the importance of respecting protected characteristics. Apprentices develop a secure understanding of these concepts and apply them consistently well in their daily practice and interactions with patients and colleagues.

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Participation and development Expected standard

Towards the end of their programmes, apprentices become confident, independent and valued ambulance crew members. They are well prepared to take their next steps. Most apprentices sustain their employment and progress to higher-level apprenticeships or to university.

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What it's like to be a learner and/or an apprentice at this provider

Adult learners and apprentices take great pride in their studies and work. They are largely positive about their training and quickly embrace the London Ambulance Service (LAS) values of working together and being responsible professionals in demanding work environments. Learners and apprentices, including those with specific support needs, feel well supported by their tutors and colleagues as they apply their learning in real-world situations, driving ambulances safely and managing medical emergencies confidently.

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What it's like to be a learner and/or an apprentice at this provider

Adult learners on short courses gain vital employability and interview skills alongside a deep understanding of the ambulance service. They highly value the opportunity to learn in excellent facilities and the chance to serve their communities. The large majority of learners successfully secure roles at LAS and move on to level 3 apprenticeships, describing the courses as life changing.

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What it's like to be a learner and/or an apprentice at this provider

Apprentices particularly enjoy the clinical education aspects of their programme. Tutors skilfully use specialist simulation facilities, including a full-size underground train carriage and a fully equipped ambulance, to practise responding to a wide range of scenarios, including mass casualty events. Apprentices learn to manage their emotions during traumatic incidents. They build resilience and make informed decisions quickly, ensuring patients receive the right care promptly.

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What it's like to be a learner and/or an apprentice at this provider

Learners and apprentices demonstrate a high level of maturity and professionalism. They feel genuinely part of the LAS community, taking part in charity events and different network groups. They also feel valued and safe. They have access to comprehensive wellbeing support services, including a 24-hour GP service and bereavement counselling, to help them manage the pressures of emergency work.

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What it's like to be a learner and/or an apprentice at this provider

Learners and apprentices are typically prepared well for their next steps. Tutors and managers discuss career pathways to becoming paramedics from the outset and revisit these at progress reviews. However, this is not done consistently well, leaving a few level 3 apprentices less confident about what they need to do to achieve their career goals.

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Next steps

Leaders should further improve their approach to careers advice and guidance to ensure all apprentices, particularly those on level 3 apprenticeships, receive comprehensive and helpful information to enable them to achieve their next steps confidently. Leaders should ensure that tutors on adult learning programmes set clear expectations for the quality of learners' written work so that it is of a consistently high standard. Leaders should strengthen their oversight of apprentices’ progress on work placements to identify and deal with emerging problems more effectively, particularly for those who struggle to balance work and study, so that all apprentices make timely progress.

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About this inspection

Following our renewed inspection framework, all inspections are now led by His Majesty's Inspectors (HMIs) or by Ofsted Inspectors (OIs) who have previously served as HMIs.

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About this inspection

Inspection activities: Inspectors spoke with governors, leaders, managers, tutors, mentors, support staff, apprentices and learners during the inspection.

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About this inspection

The inspectors confirmed the following about the provider: London Ambulance Service NHS Trust (LAS) is an employer provider based in London. Leaders offer apprenticeships and short courses for adults, mainly in emergency care services. LAS's main office is in Waterloo, London. However, all teaching and training takes place face-to-face at its 2 education centres in Newham and Hounslow. Some training for adult learners also takes place at a site in Barking.

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About this inspection

LAS began offering employability-focused programmes for adults in 2024 under the Jobs and Skills for Londoners contract with the Greater London Authority. At the time of the inspection, there were 6 adult learners studying the 'our LAS inclusive response' short course. LAS also offers the blue light driving course for adult learners. However, learners had recently completed the course and there were no learners enrolled at the time of the inspection.

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About this inspection

LAS trains apprentices to become emergency ambulance crew members across the capital. At the time of the inspection, there were 354 apprentices in training. Almost all apprentices were studying either the level 3 ambulance support worker or the level 4 associate ambulance practitioner apprenticeship. Five apprentices were completing the discontinued level 3 team leader apprenticeship. All apprentices were over 18 and had previously achieved level 2 qualifications in English and mathematics.

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Team inspectors:

Maureen Gilmartin, Ofsted Inspector Ian Bamford, Ofsted Inspector Paul Breheny, Ofsted Inspector

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Facts and figures used on inspection

The data was used by the inspector(s) during the inspection. More recent data may have been published since the inspection took place.

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Exceptional

Practice is exceptional: of the highest standard nationally. Other providers can learn from it.

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Strong standard

The provider reaches a strong standard. Leaders are working above the standard expected of them.

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Expected standard

The provider is fulfilling the expected standard of education and/or care. This means they are following the standard set out in statutory and non ‑ statutory legislation and the professional standards expected of them.

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Needs attention

The expected standards are not met but leaders are likely able to make the necessary improvements.

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Urgent improvement

The provider needs to make urgent improvements to provide the expected standard of education and/or care.

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Urgent improvement

services providing education and skills for children and learners of all ages, and inspects and regulates services that care for children and young people.

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Urgent improvement

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Urgent improvement

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Urgent improvement

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Urgent improvement

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