Agenda item

Non-Emergency Patient Transport Service for NHS Lincolnshire CCGs - Thames Ambulance Service Limited (TASL)

(To receive a report from Thames Ambulance Service Limited (TASL), which provides the Committee with an update on service provision, and an overview of the actions being taken by the Lincolnshire West Clinical Commissioning Group (CCG). Sue Flintham, Regional Director, Thames Ambulance Service (TASL); Blanche Lentz, Chief Operating Officer, Lincolnshire, TASL; and Mike Casey, Manager, Lincolnshire, TASL will be in attendance)

Minutes:

Pursuant to Minute No 49 (2) from the meeting held on 13 December 2017, the Committee gave consideration to a report from the Thames Ambulance Service Limited (TASL), which provided the Committee with an update on service provision, and an overview of the actions being taken by Lincolnshire West Clinical Commissioning Group.

 

At the meeting held on the 13 December 2017, the Committee had recorded a vote of no confidence in relation to the non-emergency patient transport service provided by the Thames Ambulance Service Limited.  The Committee had also requested that performance reports should be received on a monthly basis, and that such reports should include any available comparative information on the service provided by Thames Ambulance Service Limited in other areas.

 

The Committee had received a revised table to replace page 76 of the circulated agenda.  The revised information included validated figures for KPI6a (Renal Patients); and a new column with week 7 figures.

 

The Chairman welcomed to the meeting the following presenters from TASL, Mike Casey, Interim Manager for Lincolnshire, and Chris Miller.

 

The Interim General Manager advised that he was aware of the concerns and the vote of no confidence agreed by the Committee at their meeting on 13 December 2017; and reference was also made to the concerns raised with TASL (Risk Summit) led by NHS England on behalf of Lincolnshire, Leicestershire and Northamptonshire Clinical Commissioning Groups.  Details of the main concerns raised were detailed on page 74 of the report presented.

 

It was reported that the Lincolnshire West Clinical Commissioning Group (LWCCG) was continuing to work very closely with the management team at TASL.  The Committee were advised that following the issue of a Contract Performance Notice on the 7 November 2017, TASL had been issued with an Exception Notice for failure to achieve the agreed trajectory in the Recovery Action Plan (RAP) in January 2018, in line with the NHS Contract. 

 

The Committee was advised that TASL was determined to drive change within its organisation to ensure continuous improvement to service delivery.  The Committee was advised further that TASL wholeheartedly recognised the current organisational pressure they were under with regards to service delivery and contractual commitments.  Some assurance was given that the appointment of a new management structure, including a new Chief Executive, the current recovery action plan, and support from the parent company HTG, TASL were expecting improvements to service delivery to be seen in the first few weeks of 2018, to continue and become more sustainable to deliver the contracts KPIs from April 2018.

 

There was a recognition that TASL had expanded too quickly in a short space of time without having robust processes and systems in place to accommodate the increased workload.  The Committee was advised that there had been significant involvement from the Parent Company of TASL, HTG.  This involvement had included the provision of a stronger internal governance structure, and direct support for the leadership of the organisation.

 

The Committee noted that following reporting to the Quality Surveillance Group; NHS England had called a Risk Review meeting on 20 November 2017 with all interested parties; this was then followed up with meetings held in December 2017 and January 2018.  It was highlighted to the Committee at the January 2018 meeting with NHS England, NHS England had agreed that progress had been made; and as a result NHS England had agreed to move from monthly to two monthly reporting. 

 

During discussion, the Committee raised the following issues:-

 

·         Some members felt that the item should have been included on a future agenda at a later date, as little progress had been made.  The Committee was advised that for the March meeting representatives from the Lincolnshire West CCG would be attending the Committee to provide an update relating to Non-Emergency Patient Transport contract monitoring of TASL.  Then, at the April meeting representatives from TASL would be providing the Committee with an update report identifying progress made;

·         Some members welcomed the changes to the TASL Management Team and to the openness and honesty of the two representatives in attendance at the meeting;

·         Some members felt that having sight of the Recovery Action Plan would help them see the direction of travel and help them identify what was happening with regard to organisational cultural issues relating to voluntary drivers.  The Committee was advised that TASL was more than happy to share the action plan, subject to the agreement of the CCGs, as it was a key driver as to what needed to be achieved by TASL.  With regard to organisational cultural issues, representatives from TASL advised that a significant amount of work had been carried out with voluntary car drivers; and at a recent North East Lincolnshire meeting apologies had been extended to voluntary car drivers in that area for TASL's hasty decision in applying processes.  It was noted that work was ongoing with voluntary car drivers relating to uplifting mileage, training for drivers and the provision of mobiles.  The Committee was advised that a significant amount of work had been undertaken with regard to TASL's complaints, as the complaints system had not been fit for purpose.  It was highlighted that a required action from NHS England had been to set up a central complaints system, a better government structure; and changes to organisational policies.  It was noted that some progress had been made with the NHS;

·         One member requested a further breakdown of patient activity, as it was felt that each category of patient were equally as important. Representatives from TASL advised that the information presented was standard activity.  It was felt that information might be able to be broken down further into ward activity;

·         One representative acknowledged that there had been some improvement, however, the fact remained that complaints were still being received.  One area highlighted was the eligibility criteria.  The Committee was advised that the initial model provided, which had been the national model was currently under review with commissioners.  The TASL representative confirmed that a copy of the action plan once it had been signed off would be forwarded on to the Health Scrutiny Officer to circulate to all members of the Committee, subject to the agreement of the CCG;

·         One member enquired as to whether TASL had reversed its decision in relation to voluntary car driver's mileage from home to first pick-up.  The Committee was advised that the arrangements had been changed to enable volunteer car drivers to qualify after the first ten miles;

·         Clarification was given by TASL that all complaints were being dealt with by central complaints, even those prior to November 2017;

·         Number of journeys not meeting deadlines – The Committee was advised that in some areas, hospitals had brought third parties to provide non-emergency patient transport, which would be an additional cost to the NHS;

·         Some questions were asked with regard to certain aspects of the contract, which included: whether TASL had put in enough money to recruit employees to deliver the KPIs; and whether the organisation had the right calibre of staff to deliver the contract; and when it was anticipated the majority of KPIs would be changing to either amber or green.  Confirmation was given that TASL was now moving forward in the right direction with the establishment of a new management team.  Reassurance was given that TASL would be focussing on call handling, journey planning; transporting patients to and from hospital in a timely manner; and having positive conversations with voluntary car drivers to get them back to helping bridge any gaps in service, as TASL was committed to drive changes to ensure better service provision.  The Committee was also advised that there was sufficient money in the contract to deliver the service; and that that the parent company HTG was 100% committed to making the contract a success.

 

The Chairman on behalf of the Committee extended his thanks to the two presenters form TASL for being open and honest in their responses.

 

RESOLVED

 

That two monthly progress reports be received from TASL concerning the performance of non-emergency transport services, with the next report at the Committee's April meeting.

 

Note: At 12:40pm, the Committee adjourned for lunch and re-convened at 2.00pm.

Supporting documents:

 

 
 
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