Agenda item

(To receive a report from the Thames Ambulance Service Limited (TASL), the provider of non-emergency patient transport in Lincolnshire.  The report provides the Committee with an update on the latest position on service delivery performance.  Mike Casey, General Manager, Thames Ambulance Service Limited (TASL), will be in attendance for this item)

The Chairman welcomed to the Committee Mike Casey, Director of Operations, Thames Ambulance Service Ltd and Andy Hill, Contract Manager, Thames Ambulance Service Ltd.

A copy of the "To Follow" report had been emailed to members of the Committee prior to the meeting and a hard copy of the aforementioned report was circulated at the meeting.

The Director of Operations guided the Committee through the journey of Thames Ambulance Service Limited (TASL) had made since taking over as provider of the non-emergency patient transport services in Lincolnshire on 1 July 2017.  Details of which were shown within the report represented. 

The Committee noted that originally there had been 900 complaints outstanding of which 369 had related to Lincolnshire.  It was noted that to date there was two outstanding complaints, one of which had been upheld; and one that was still on going.

The Committee was advised that TASL had been inspected by the Quality Care Commission (CQC) in November 2018, and that TASL was working with NHS England and the CQC prior to publication of the final report.  The Committee was advised further that TASL continued to work with the CQC and the Commissioners.

It was reported that the performance KPIs had not achieved the expected trajectory since the 12 September 2018 Health Scrutiny Committee for Lincolnshire meeting.   The Committee was advised that the two main factors for this were data collection and staff attrition, as the service was carrying a number of vacancies.  The Committee noted that TASL had lost a number of staff as a result of the recent NHS ambulance recruitment drive; TASL had found it hard to keep up with the staff turnover.  The Committee was advised further that TASL had brought in additional third party support and taxis to support the service, but these had not been always as efficient.  It was reported that TASL was trying alternative ways to increase its recruitment drive.  It was noted that TASL had appointed seven apprentices working in partnership with Lincoln College, in addition to this, agreement had been reached for TASL to utilise the NHS jobs website; and that there was a rolling recruitment drive for front line staffing in Lincolnshire.

The Committee was advised that the Operations Team remained focussed on delivering the action plan which underpinned attainment of improvement in KPI performance.

In was highlighted that in October 2018, performance had dropped against all contract performance indicators; and that the reason for this had been the current contract reporting process.  The Committee noted that a new reporting process had commenced in early October 2018, which had led to some issues relating to data capture.  The Committee noted further that contractual requirements had meant that TASL had to continue to report performance and where there was no recorded time the contract dictated that this was a failed journey.

The Committee was advised by TASL that by April 2019, 8 of 18 of the KPIs would be on target; and by June 2019, 15 out of the 18 KPIs would be on target.

Reassurance was given that a lot had been achieved during the course of the journey and that there was recognition that more could be done, one of which was using resources more efficiently.

During discussion, the Committee raised the following points:-

·         One member highlighted that the performance data provided was very difficult to understand.  The Committee was advised that the purpose of the red/green was that the KPI was either achieved or not achieved.  It was highlighted that the amber indicator was for internal use only;

·         One member extended thanks to the Director of Operations for his openness; and questioned how TASL were going to address the issue of EMAS recruiting ambulance personnel.  The Committee was advised that certain things had already been achieved, for example a fixed number of staff for contracts; and the implementation of a rolling recruitment programme.  It was highlighted there had also been links with EMAS; and linking with Lincoln College with regard to apprenticeships;

·         Clarification was given that there were currently only two outstanding complaints for Lincolnshire patients.  It was highlighted that so far for November only three complaints had been received;

·         Accuracy of Data – The Committee was advised that for renal services there had been data issues, and the system had not captured time; these had been entered in manually.  It was highlighted that the move forward to the on-line platform would be more accurate on point of delivery.  Clarification was given that for November TASL could not confirm if the recording system had worked satisfactorily.  There was recognition that moving forward performance needed to be recorded accurately;

·         One member enquired whether there were any cultural issues. The Committee was advised that there was variants as there were five different contracts.  The Committee was advised that the workforce's opinions had changed and that now there was a feeling of being part of a team, which was evident in Lincolnshire; and that staff wanted to stay with TASL;

·         Improvement – The Committee was advised that the CQC had recognised that there had been some improvement, however, they did have concerns; and as a result a lot of work had been put into the action plan.  It was stated that if there was to be another CQC inspection, it would highlight that things had improved; and

·         Recruitment – A question was asked as to whether volunteers would be considered for paid work.  The Committee was advised that the opportunities were there and anyone was free to apply.  Most volunteers liked doing what they were doing, as they liked the flexibility; which also helped TASL with extra capacity.

In conclusion, the Chairman in summing up expressed concern at the continued low performance levels.  Whilst there was an understanding of why performance had dropped as a result of the new reporting system, there were frustrations that the system had not been tested enough prior to going live.  Further concern was expressed that again no papers had been received to send out with the agenda for the Committee to consider; and to the on-going problems since TASL had taken over the contract; and to the fact that there was still not an agreed performance recovery action trajectory agreed by commissioners. 

As a result of the concerns raised the Chairman advised he had no confidence in TASL being able to deliver a good enough service for the residents of Lincolnshire and the Committee agreed that a letter should be written to Lincolnshire West CCG (the lead CCG commissioner) advising them that the performance of TASL was unacceptable and requesting that the CCGs should seriously consider a managed strategic exit from the contract as soon as possible; and that representatives from Lincolnshire West CCG should be invited to attend the next Health Scrutiny Committee for Lincolnshire meeting to respond to the issues raised.

RESOLVED

1.    That the Health Scrutiny Committee for Lincolnshire record that it had no confidence in TASL being able to deliver a good enough non-emergency patient transport service for the residents of Lincolnshire.

2.    That a letter be written to Lincolnshire West CCG advising them that the performance of TASL was unacceptable and that the Lincolnshire CCGs should seriously consider a managed and strategic exit from the contract as soon as possible.

3.    That representatives from Lincolnshire West CCG be invited to attend the next Health Scrutiny Committee for Lincolnshire meeting due to be held on 23 January 2019 to respond to the issues raised.