Agenda item

(To receive a report from the NHS Lincolnshire West Clinical Commissioning Group, which provides the Committee with an update on the Non-Emergency Patient Transport Service.  Sarah-Jane Mills, Chief Operating Officer Lincolnshire West Clinical Commissioning Group and Tim Fowler, Director of Commissioning and Contracting Lincolnshire West Clinical Commissioning Group will be in attendance for this item)

The Committee gave consideration to a report from the NHS Lincolnshire West Clinical Commissioning Group, which provided the Committee with an update on the Non-Emergency Patient Transport Service, which was provided by Thames Ambulance Service Limited (TASL).

The Chairman welcomed to the meeting Tim Fowler (Director of Commissioning and Contracting – Lincolnshire West Clinical Commissioning Group (CCG)).

The Committee was advised that the previous update had been provided to the Committee at its June 2019 meeting.  Since that time, there had continued to be issues with TASL's delivery and their performance against Key Performance Indicators (KPIs).  

It was advised that the CCG had issued a further Contract Performance Notice in late September 2019 and had continued to seek to drive TASL to deliver improvements across their services.  Actions were now in place and there had been a marked improvement in outbound journeys from the main hospital sites; improvement in call handling; and improvement in the service to renal patients as confirmed by the renal dialysis unit in Lincoln.

However, it was recognised that these improvements need to be maintained and further improvements made in order for the service to be of an acceptable standard.  In order to maintain focus, the CCG had agreed two further KPIs with TASL.

The Committee was advised that the CCG was working to put in place new arrangements for patient transport for renal dialysis patients attending the dialysis units at Boston, Grantham and Skegness following notice given to the CCG on the current contract, which had been operated by University Hospitals of Leicester NHS Trust.  Assurances were given that there would be a smooth transition to the new arrangements with very little disruption to patients. TASL had been informed that the CCG would not be commissioning this service from them.

A summary of the activity and KPI position for the contract for the period to April 2019 was detailed at Appendix A to the report.  For December 2019, TASL had achieved the contracted level of performance for one out of twelve KPIs (call handling) and had delivered month on month improvement for five KPIs.

TASL had delivered generally poor performance against contract KPIs during the autumn of 2019.  Moreover, there had been a number operational issues and significant noise in the system around poor delivery of discharges and outpatient homeward journeys from United Lincolnshire Hospitals NHS Trust and at the Lincoln renal dialysis unit.

Further improvements were required and the CCG remained focused on driving improvement in the TASL service and had recently introduced two further KPIs to the contract for zero tolerance of 're-bedding' patients, due to transport failures and thresholds and maximum time targets for outpatient journeys from hospital.

The Committee was also advised that the CCG continued to commission third party capacity outside of the TASL contract to support discharges at Lincoln and Boston hospitals.

In conclusion, the Committee was advised that the CCG would continue to closely monitor the delivery of the contract.  The Committee was advised further that the CCG was not intending to give notice to exit the contract at this time.

A discussion ensued, from which the Committee highlighted the following points:-

·         Serious concern was expressed to the lack of improvement across the performance indicators, and how much longer the CCG was prepared to continue with the contract.  In response, it was advised that the assessment of risk of termination of the contract remained as previously reported, in essence there was more risk of disruption to patients by terminating the contract compared to working with TASL to improve their performance;

·         Serious concerns were expressed regarding the inconsistency of the service and the impact on patients;

·         It was advised that for January 2020 performance reporting, further improvements and some marginal improvements had been made by TASL.  It was advised that a breakdown of performance for January 2020 could be provided to the Committee at the next scheduled update.

·         Reference was made to the penalties that could be applied through the contract through poor performance, and it was agreed that information on the penalty charges, which had already been applied would be provided to the Committee.

·         The Committee was assured that when the contract was originally awarded to TASL, this had been following a rigorous, open, fair, and transparent procurement exercise.

·         The Committee reiterated its wish for the CCG to give notice to exit the contract with TASL, owing to its continued poor performance.  Reference was made to other CCGs across the East Midlands terminating their contracts with TASL without any significant repercussions.

·         The Committee was advised that it would be provided with the high level risk assessment relating to TASL on email, to provide the Committee with an understanding of why the decision not to terminate had been made.

RESOLVED

(1)  That the proposed new transport arrangements for renal dialysis patients, which do not involve Thames Ambulance Service Limited, be welcomed.

(2)  That a further report be received from the Lincolnshire West CCG in six months' time.

(3)  That the Committee's view that the Lincolnshire West CCG should strategically exit the contract with Thames Ambulance Service Limited be reiterated.