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Joint Health Overview & Scrutiny Committee Meeting
11 April 2014
Title:
Patient Transport Services
Presented by:
Neil Le Chevalier, Deputy Director of Service
Delivery
Main aim:
To update Joint HOSC members on the patient
transport service (PTS) provided by SWASFT within
BNSSG, including criteria for use and current
pressures
Recommendations:
To note the contents of the report
Patient transport service (PTS)
Introduction
The Patient Transport Service (PTS) is commissioned by NHS Bristol (as lead commissioner) for patients who are registered with a GP in Bristol, North Somerset and South Gloucestershire (BNSSG).
Since 1October 2010, two PTS contracts have been in place for BNSSG patients:
Main PTS contract for patients registered to GPs in Bristol, North Somerset and South
Gloucestershire
Renal PTS contract (for patients able to travel by taxi) for renal dialysis patients registered to GPs in Bristol, North Somerset, South Gloucestershire
All other patients who attend NHS facilities within the BNSSG area, but who are registered to a GP practice outside the BNSSG area, are not supported by the BNSSG PTS contracts.
The service provides transport for patients in cases of medical need, for outpatient appointments, admissions, discharge, and transfers between hospitals. The service is not provided for social means, and is only made available to those who meet strict eligibility criteria, based on Department of Health guidance.
For the reporting period April 2013 to February 2014, the PTS service has transported 93,609 patients. It is expected that 102,000 patients will be transported in this financial year.
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Department of Health guidance
The Department of Health describes Patient Transport Services as the non-urgent transportation of patients who have a medical need, to and from a health service provider and between health service providers. This covers a range of vehicles and levels of care:
Where the medical condition of the patient is such that they require the skills or support of
PTS staff on/after the journey and/or where it would be detrimental to the patient’s condition or recovery if they were to travel by other means.
Where the patient’s medical condition impacts on their mobility to such an extent that they
would be unable to access healthcare and/or it would be detrimental to the patient’s condition or recovery to travel by other means.
BNSSG guidance in amplification of the broad DH guidance is that the following patients are entitled to PTS:
Patients who require the continual support and skill of patient transport staff to enable them
to travel. This typically includes the following patients, but may also include others (this is an illustrative, not an exhaustive, list):
1. Patients who have received treatment which requires the skill of patient transport staff
to ensure a safe journey home
2. Patients who require patient transport staff to administer oxygen during the journey
3. Patients with dementia or other mental health conditions who require patient transport
staff to ensure a safe journey
4. Renal dialysis patients who are able to travel by car
Patients who are required to travel by stretcher
Inter-hospital transfers
BNSSG provides PTS for renal dialysis patients to enable them to attend weekly dialysis and related outpatient appointments.
Authorised to decide entitlement to PTS
The Department of Health specifies that PTS must be authorised by a healthcare professional. Individual arrangements may be put in place if a healthcare professional is not regularly available to
authorise transport requests. Administrative staff may authorise transport requests, but only where
approved protocols are in place locally to support appropriate assessment of eligibility by a healthcare professional.
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Escorts
Escorts may be medical or non-medical.
Medical escorts are to be determined by those booking PTS where the patient’s condition is such they require the constant medical attention of a medical escort (beyond the capability of the PTS crew) throughout their journey.
Non-medical escorts are not expected to be routinely authorised. Department of Health guidance states that medical escorts (ie friends or relatives) are to be the exception. Typically non-medical escorts are only appropriate for circumstances where:
The patient is under 18 years of age
The patient requires a translator
The patient has severe communication difficulties, eg has a profound sight or hearing/speech
impairment and cannot travel safely without a known carer
The patient suffers from a physical or mental health problem, eg Alzheimer’s or Dementia,
which prevents them from travelling unaccompanied safely without a known carer
Assistance dogs (including guide and hearing dogs) are permitted on the service, providing this is specified in the booking.
Current pressures
The current pressures impacting the service include:
A growth in activity of 4% on last year;
The number of aborted journeys (currently 16%). Aborted journeys are journeys cancelled
at very short notice by patients and/or the hospital;
The number of escorts (currently 25%). When patients bring an escort who has not been
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Patient Transport Service key performance indicators April 2013-February 2014
Scorecard Year-To-Date
(based on 93,609 patient journeys)
1a
Patients living up to 10 miles away from the treatment centre (Band A) should not spend more than 60 minutes on the vehicle on either an outward or return journey
(Red: <80%, Amber: 80-90%, Green: >90%)
95.97% 8c
Pick-up time to be confirmed by text, email or personal phone call to the patient within a week of appointment (phone call being the preferred
method) Quarter
100.00%
1b
Patients living over 10 and under 35 miles away from the treatment centre (Band B) should not spend more than 90 minutes on the vehicle on either an outward or return journey
(R: <80%, A: 80-90%, G: >90%)
95.95% 9b
Commissioners to be satisfied with the level of service received. (G – no issues of concern or minor issues and resolved within 1 month; A – minor issues and not resolved within 1 month / major issues, resolved within 1 month; R – major issues not resolved within 1 month)
100.00%
1c
Patients living over 35 and less than 50 miles away from the treatment centre (Band C) should not spend more than 120 minutes on the vehicle on either an out/return journey
(R: <80%, A: 80-90%, G: >90%)
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2a Patients should not arrive more than 45 mins before their booked arrival time
(R: <80%, A: 80-90%, G: >90%) 83.87% 10a
Agreed activity performance report received in correct format and on time within 10 working
days of the start of the following month 100%
2b Patients should not arrive after their booked arrival time
(R: <87%, A: 87-97%, G: >97%) 87.18% 10b
Activity and finance queries are acknowledged within 3 days of receipt and resolved within 28
days from date of query 100.00%
3a
SWASFT is to arrive to collect patients from the agreed location within 45 minutes of the outwards
time (R: <80%, A: 80-90%, G: >90%) 84.38% 12h
Nil Serious Untoward Incidents (SUIs).
Any SUIs are to be reported and action plan put in place - in line with NHS Bristol standard and timeframes (reported immediately; investigated within 24hrs and lesson learnt shared, then closed within 60 working days of incident). (G –
no SUI’s, A – SUIs reported but resolved within
timeframe, R – SUIs reported but not resolved within timeframe)
100.00%
SWASFT is to arrive to collect patients from the agreed location within 75 minutes of the outwards
time (R: <80%, A: 80-90%, G: >90%) 92.37% 9a
Patient satisfaction with the level of service
received from the provider annual patient
satisfaction survey
(R: <75%, A: 75-85%, G: >85%)
97.80%
3b
A summary of reasons and actions is to be provided, for each month, for all cases where collection was outside, i.e. later than, the KPI limits. This may include case-by-case analysis as deemed necessary
12d Compliance with agreed GWAS complaints procedure –full response made in a timely
