Agenda item - Patient Transport Services (PTS): February 2018 Update

Update on Patient Transport Services performance from High Weald Lewes Havens CCG (copy attached)

42          Patient Transport Services (PTS): February 2018 Update

42.1    This item was introduced by Derek Laird, PTS Adviser to High Weald Lewes Havens CCG, and by Ian Thomson, South Central Ambulance Service (SCAS). Mr Thomson gave a slide presentation.

42.2    Derek Laird noted that he welcomed the Healthwatch report on PTS. The service has made significant progress in recent months, although there is still plenty of room for improvement. It also needs to be recognised that SCAS took on the contract at very short notice.

42.3    Responding to the Healthwatch report, Ian Thomson told members that PTS performance at weekends was always going to be a challenge because demand can be inconsistent and sometimes exceeds available capacity. However, the introduction of a local (i.e. Sussex-based) control centre has improved things. Drop-offs at the Royal Sussex County Hospital (RSCH) are problematic due to the 3T construction work taking place, although SCAS does liaise with the trust around this. SCAS would like to involve Healthwatch in its improvement work, but has struggled to make contact.

42.4    Cllr Wealls noted that members had not had been able to study the performance data presented in the slides and were consequently not in a position to make informed comments about SCAS performance. It would have been much more helpful to have had this data in advance of the meeting. Other members agreed, and it was noted that the data presented was of limited value because it reported % performance, but gave no indication of the KPI targets that SCAS is contracted to achieve: e.g. there was no way of telling whether, say, 90% performance was outstanding or disappointing.

42.5    In response to a question from Cllr Deane on the issues at RSCH, Mr Thomson told members that some of the problems were due to traffic congestion in the vicinity of the hospital and were outside the trust’s control. There are also on-site problems, such as the lack of parking outside the renal unit, which means that PTS drivers can face lengthy waits to drop off patients. SCAS is planning to meet further with BSUH to try to resolve some of these access issues.

42.6    In response to a question from Cllr Morris on whether SCAS took on the Coperforma contract or were awarded a new contract, Mr Laird told the committee that SCAS took on the existing contract for 3 years with an option to extend for a further two years. In an ideal world the contract would have gone out to tender, but a tender process would have taken 12-18 months and a new provider had to be in place within three months, so this was not a realistic option.

42.7    In answer to a question from Dr James Walsh (West Sussex HASC representative) on on-line bookings, Mr Laird replied that there has been a significant improvement in the percentage of appointments booked on-line. There are no specific targets for on-line booking, but it is nonetheless good practice to record performance.

42.8    Cllr Deane noted that RSCH appears to have much higher levels of PTS activity than other Sussex hospitals. Mr Laird explained that this is partly due to the fact that RSCH operates the main renal unit in the Sussex area: renal patients form a substantial part of PTS activity. As a regional specialist centre, RSCH also has more activity from out of area (i.e. non-Sussex based patients) than the other Sussex hospitals, although Sussex PTS only provides pick-ups to Sussex patients. In addition, trusts operating two or more hospital sites may have differing approaches to how they spilt particular services, which may impact on how PTS activity is recorded.

42.9    Mr Thomson told members that it was much harder to run effective PTS when bookings are made at short notice. RSCH makes more than 40% of its bookings after 3pm, which presents a challenge, although having a control centre in Sussex helps. Mr Laird added that Worthing hospital has managed to turn around its discharge performance in recent months and learning from this could assist RSCH in making similar changes. There has been some improvement since Western took charge of the RSCH.

42.10  In response to a question on planning access to RSCH during the 3T works, Mr Thomson told members that SCAS holds regular meetings with the renal matron and is in regular contact with the 3T Project Management Office. There is less of an impact on transport to RSCH outpatients, as this is not part of the 3T build. Communications with the hospital trust have generally been good, although this does not address off-site traffic congestion issues.

42.11  Mr Thomson acknowledged that discharge was frequently delayed by patients having to wait for their discharge medications. This is a problem nationally.

42.12  In response to a question from Dr James Walsh (West Sussex HASC) on the location of the SCAS call centre, Mr Laird told members that it was important to ensure that there was local knowledge in the services which would benefit from it. However, the call centre is a generic service which does not rely on local knowledge and there is therefore no pressing case for it to be located in Sussex.

42.13  Mr Bryan Turner (West Sussex HASC representative) noted that he had concerns about the management of the Coperforma contract which have not yet been addressed by High Weald Lewes Havens CCG. It was also worrying that there appear to have been disclosures of information to the media in advance of communication with local HOSCs.

42.14  Mr Laird noted that he was brought in by the CCG in 2016, but was not party to the award of the PTS contract to Coperforma or the early months of the contract. He had asked Alan Beasley of High Weald Lewes Havens CCG if he could attend this meeting, but Alan was unable to. Sussex CCGs have taken legal advice about elements of the Coperforma contract, and this limits what can be discussed in public. However, it was possible to confirm that a total of £14.1 million was paid out under the Coperforma contract with an additional £2.1 million to meet acute transport demand and to invest in the contract transfer.

42.15  In response to questions from Mr Turner about payments of pension contributions for PTS sub-contractors, Mr Laird told members that he was not aware of any significant issues here. The CCGs had paid contractors directly rather than via Coperforma in the last months of the contract. The CCGs did all they could to protect sub-contracted staff and ensure their safe transfer to SCAS’ management, although with hindsight they should probably have intervened earlier.

42.16  Mr Turner noted that it appeared that Coperforma had been paid the full value of its contract and more despite its performance. Dr Walsh told members that it was important that local HOSCs held the CCGs accountable for the failures of the PTS contract whilst there is still organisational memory of what transpired. A large amount of public money was spent unnecessarily and this needs proper investigation. Members agreed that Brighton & Hove HOSC should take this matter up with the CCG Accountable Officer and Chief Financial Officer in the near future. Dr Walsh suggested that full disclosure of information to the Sussex HOSCs Chairs would be a helpful interim measure.

42.17  RESOLVED – that the report be noted.