Agenda item

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

The Chairman welcomed Tim Fowler, Assistant Director of Contracting and Performance, Lincolnshire Clinical Commissioning Group (LCCG) to the meeting and invited him to present the report to the Committee. 

The item as detailed on pages 83 – 89 of the agenda pack enabled the Committee to receive an update from NHS LCCG on the Non-Emergency Patient Transport Service (NEPTS).

The Committee was reminded that the last update from NEPTS had been considered at the February 2020 meeting.

The report presented covered the key period of Covid-19, including the period of 'lockdown' and the start from September 2020 of the restoration of NHS Services to pre-Covid-19 levels.

The Committee was advised that Covid-19 had caused a significant number of issues for patient transport services.  It was noted that the approach to managing Covid-19 in Lincolnshire had resulted in much closer working between TASL, hospitals, the CCG and other transport providers.  It was noted additional support from Ambicorp to support discharges at Boston Pilgrim and Lincoln County Hospitals had continued during the peak Covid-19 period, and as with TASL had generally worked well.

The Committee noted that as a result of the restoration of elective services, there had been an increase in journey distances for patients travelling from across Lincolnshire, for example to receive their treatment at Grantham Hospital.  It was noted that to support this, the CCG had put in place additional elective patient transport arrangements to and from Grantham outside of the TASL contract.

Appendix A to the report provided the Committee with a summary of the Activity and Key Performance Indicator (KPI) position for the TASL Contract for the period to August 2020.  It was highlighted that TASL had achieved contracted level of performance for 2 out of 15 KPIs.  The Committee noted that the report also included three new KPIs relating to 're-beds' and the timeliness of return journeys for outpatients.

The Committee noted that the CCG was starting to work up options and planning for the patient transport service once the current TASL contract ended.  The Committee was advised that the current contract had been let on an initial term of five years to 30 June 2022, with an option for a two year extension to 20 June 2024.  The Committee was advised further that the option to extend the contract with TASL would not be exercised.  Details of the proposed outline planning and procurement timeline was set out on page 86 of the report.

In conclusion, the Committee noted that TASL had generally responded well during the peak of Covid-19.  However, the KPI performance for TASL had continued to be below contracted levels

The Committee noted further that the assessment of risk of termination on the contract remained as previously reported.

During discussion, the Committee raised the following issues:

·         Changes to the eligibility criteria – The Committee was advised that the CCG was not aware of any changes to the eligibility criteria and agreed to look into a particular case outside of the meeting;

·         What the current market was for patient transport.  The Committee was advised the contract would be for all Lincolnshire registered patients. The Committee was advised that there were other patient transport providers;

·         Success of the voluntary car scheme in Lincolnshire and the need to maintain such a scheme.  The Committee was advised that the CCG was working with TASL to encourage them to put in extra capacity.  It was highlighted that the reduction in the number of voluntary car drivers was a national issue  as well;

·         Whether it was possible for the new contract to be spilt to suit smaller operators and create a more flexible arrangement, and more control, than having just one provider.  The Committee was advised that this was an option that could be considered.  It was however noted that this might cause some issues, as patient transporters would need to have a call centre, there would then be multiple call centres with different telephone numbers.  In relation to vehicles, the Committee noted that TASL provided their own vehicles.  The Committee noted further that the CCG would want to make sure that there was sufficient time for mobilisation from one provider to another.  Some concern was expressed that the current arrangements had left the CCG with little control and that it was essential to plan for the next contract to avoid a repeat of the situation;

·         Cost to the CCG for having to provide third party providers; and whether the cost was being recovered by imposing penalties on TASL for their poor performance.  The Committee was advised that the money for the third party provider was coming from the CCG;

·         Clarification was sought as to whether the KPI's presented were separated from those third parties that were now offering additional support.  Confirmation was given that the KPIs presented related to TASL; and

·         Concern was expressed that there had been little or no improvement for service users since the contract had been awarded to TASL.  The CCG was asked what they were doing differently.  The Committee was advised that the CCG had been working with TASL throughout the three years; and there had been some improvements.  The issue for TASL was keeping sustainable improvement month on month.  It was highlighted that TASL may well submit a tender for the new contract and that Procurement Rules stated that no account should be taken of prior knowledge; it was therefore important to ensure that questions for potential contractors were treated equally.  It was noted that with the help of the CCG, TASL had put in processes to improve the service and it was noted further that there had been fewer complaints from patients and hospitals.  The main issue with TASL was not meeting the contract KPI's.   

The Chairman on behalf of the Committee extended his thanks to the Assistant Director of Contracting and Performance, Lincolnshire Clinical Commissioning Group (LCCG) for his presentation.

RESOLVED

1.    That although the current challenging circumstances are recognised, the Committee's continuing concerns with the performance of Thames Ambulance Service Limited, the non-emergency patient transport service provider in Lincolnshire, be noted.

2.    That Lincolnshire Clinical Commissioning Group's decision not to offer an extension for the contract to Thames Ambulance Service Limited beyond July 2022 be supported and the Clinical Commissioning Group be urged to make every effort that the lessons learned from the existing contract are implemented as part of the procurement for the new contract, due from 2022.

3.    That a further update on the non-emergency patient transport be received in six months.