Agenda item

This report provides the Committee with a performance update on the non-emergency Patient Transport Service (PTS) for Kent and Medway, which is delivered by G4S.

Discussion

The Accountable Officer of NHS West Kent Clinical Commissioning Group introduced the report. A G4S representative was also in attendance. The Committee was informed that considerable progress had been made in relation to patient transport in the last three months. The number of complaints about the service had reduced significantly. The healthcare system as a whole was facing significant winter pressures at present but patient transport was not a significant part of the problem.

Training of staff in relation to complaints handling was due to be completed by  early February and it was anticipated that the backlog of complaints would be clear by this point. Concerns were now limited to the ability of G4S, as provider of the service, to collect patients within target timeframes with it being acknowledged that much work was still required in this area. Progress had been made with patients no longer experiencing very long waits for transport.

The original contract had underestimated demand for the service. In particular, there were more patient escorts than anticipated and patients were sicker than predicted. There had also been an increase in some renal activity. Work was being undertaken regarding performance measurement as the analytics had not differentiated between a collection time target being narrowly missed and one that was missed by a significant margin.

G4S was working with local hospitals to look at patient discharges and ensure that they were spread throughout the day. A dedicated discharge vehicle was located in Medway and a dedicated patient discharge lounge had been introduced at Medway hospital. Overall performance of patient transport was gradually  improving with a CQC inspection of the business in October 2017 having had a positive outcome. Staff providing the patient transport service were caring and compassionate and there had been independent validation that the core service was good.

It was noted that 10% of the Kent and Medway non emergency patient transport journeys(30,000) were to London Hospitals.

Members of the Committee asked a number of questions which were responded to as follows:

Other providers – G4S worked with local providers such as hospitals and mental health providers. It was sometimes necessary to supplement patient transport capacity with other private providers. These providers were fully checked and accredited and came from a small pool of well know providers.

Adjustment of contract – In response to Member concerns that the original contract had underestimated the demand for patient transport and that winter pressures had not been adequately taken into account, it was confirmed that remodelling work was being undertaken to identify how much patient transport activity was required that was over and above what had been included in the original contract. Where demand was in excess of the contract, additional funding would be required for this activity. The existing contract had been based upon the data and forecasts available.

It was important to ensure that the transport needs of patients were fully understood to ensure that an appropriate vehicle attended and that resources were not used unnecessarily. Education and awareness raising for hospital staff booking the vehicles was important.

Increase in primary care activity – If the number of patients being cared for in primary care settings rather than acute hospitals was to increase then it was not likely that there would be a significant impact on the demand for patients transport as the total number of journeys required would be similar.

Patient escorts – It was clarified that while some other areas did ban patient escorts from travelling with patients in the provided transport, there were no proposals for this to happen in Kent and Medway.

Patient Transport as part of the wider healthcare system – It was considered important for Patient Transport to be seen as key element of the wider healthcare system as performance of one element affected performance of another area and also investment in patient transport could improve the efficiency of other parts of the system.

Performance Data – It was confirmed that, within the charts included in the report, the bars represented actual activity while the blue lines and dots represented forecast activity. It would be clarified following the meeting why expected activity was only shown until June 2017 when actual activity was shown until November 2017.

Complaints – In response to a Member comment that he was still receiving as many complaints from local residents as previously, the G4S representative said that complaint volumes had reduced significantly. They currently stood at 8 complaints a month in Medway which equated to 0.2% of patient transport journeys. Medway hospital had received 1 formal complaint about patient transport in the last 6 months. Complaints received previously had often been about the length of time taken to respond to a previous enquiry or complaint.

Overall performance – A Member said that there had been no improvement in performance since G4S had become the patient transport provider. The G4S representative said that July 2017 service levels had been 60% and had increased to Jan 82% by January 2018. There had been significant improvement in the service but it was acknowledged that there was a lot more to do, which included looking at hospital discharges to ensure that these were as effective as possible.

It was requested that the next report presented to the Committee should include more data, along with clear explanations and that the data should be circulated to the Committee in advance of the main Committee agenda being sent out.

Decision

The Committee considered and commented on the update provided and determined that a further update should be presented to the Committee in June 2018.