Agenda item

The Committee considered a report and presentation updating it on Patient Transport Service performance. The Committee also considered an updated report and presentation from Healthwatch Nottinghamshire on the experience of renal patients using the Patient Transport Service. Representatives from Arriva Transport Solutions (ATS) and commissioners attended the meeting.

Patient Transport Service Performance Update

Arriva Transport Solutions (ATS) representatives Paul Willetts, Director of Governance and Quality, Andrew Cullen, National Head of Patient Transport Services and Philip Hennessey, Communications and Engagement Manager gave a presentation, providing the following information:

(a)  ATS undertook to introduce significant changes to the Patient Transport Service, and in the past 6 months have:

o  Established an Operational Improvement Plan, with a particular focus on 3^rd party provider performance and flexible rostering to match demand;

o  Developed a range of winter pressure readiness measures;

o  Continued to champion Transport Working Groups;

o  Implemented a Renal Improvement Plan, including appointing a Renal Co-ordinator and implementing a missed treatment escalation process;

(b)  councillors went on a visit to the ATS Ashville base to gain a better understanding of the service and the conditions under which it operates;

(c)  there has been significant communications and engagement activity, with renal roadshows delivered across Nottinghamshire, a new patient survey launched, and patient reminder cards and a quarterly stakeholder newsletter published;

(d)  9 out of 10 patients would recommend the service to friends and family, and patient satisfaction with most elements of the service had improved;

(e)  ATS acknowledged that renal dialysis performance required further significant improvement;

(f)  ATS will look to build on recent performance improvements, will continue to work with Healthwatch to inform service improvements and to liaise with NHS staff to explain how the service operates and to minimise disruption to patients.

The following points were made during discussion:

(g)  all 3^rd party providers go through a compliance check and sign up to the Service Level Agreement (SLA). The SLA has been revised in the light of feedback to incorporate consequences of not complying with SLA requirements;

(h)  all performance information used by ATS was channelled through the organisation’s Business Intelligence Unit and was independently collated and verified;

 (i)  the Operational Improvement Plan addressed basic elements within the control of ATS. However, there were a number of issues outside the organisation’s control that impacted on its ability to deliver its services. For example, if a health and social care package was not in place for a patient then the resulting delays impacted on ATS’ performance. Similarly, if a care home had closing ‘cut off’ time then affected patients could be prioritised at the expense of other patients;

(j)  ATS representatives confirmed that winter pressures were less to do with transport conditions and more about the impact of wider pressures on health and social care services on the Patient Transport Service.

Paul Fitzgerald, Patient Transport Service Contract Manager at the Greater East Midlands Commissioning Support Unit (GEM CSU), and Neil Moore, Director of Procurement and Market Development, Mansfield and Ashfield Clinical Commissioning Group, provided additional information and responses to Committee questions and comments from the commissioning perspective as follows:

(k)  key performance targets for the current contract had been set on the basis of partial historic information inherited from the previous provider, and delivering to contract had proved very challenging from the outset;

(l)  commissioners will re-tender for the service in the next 12-18 months, and the process to determine the future service specification will be based on much  better quality information than previously;

(m)  depending on financial and other resource constraints, it may be necessary to redefine the service to be delivered in future. In any event, commissioners will need to incorporate sufficient flexibility in the specification and tendering process to cope with potentially high levels of change over the length of the contract. The Committee asked to be involved in the development of the service specification.

Healthwatch Renal Transport Summary Report

Donna Clarke, Evidence and Insight Manager, Healthwatch Nottinghamshire, provided information on its recent update to its original report on renal patients’ experience of the Patient Transport Service. Key points were:

(n)  the update survey engaged 73 renal patient users of the service, but not necessarily those originally engaged;

(o)   punctuality and consistency of service has improved, and the appointment of the Renal Co-ordinator was welcomed. However, problems persisted with the quality of care from taxi providers, and with consistency of evening service provision. The lack of availability of the Co-ordinator for evening patients was also criticised;

(p)  several respondents reported having been ‘forgotten’, with no transport booked.

In the discussion which followed, ATS confirmed that the operation of the post of Renal Co-ordinator was under review and would be revisited in the light of patients’ comments, and that ATS and Healthwatch will continue to work together to deliver improvements, particularly on 3^rd party service provision.

RESOLVED to

(1)  request that the full Healthwatch report will be circulated to the Committee, when available;

(2)  request that commissioners come back to the Committee to discuss development of the service specification for the Patient Transport Sevice when the re-procurement process commences.