Agenda item

(To receive a report from NHS Lincolnshire Integrated Care Board and East Midlands Ambulance Service NHS Trust, which provides the Committee with an update on the Non-Emergency Patient Transport Service. Tim Fowler, Assistant Director of Contracting and Performance, NHS Lincolnshire Integrated Care Board, Sue Cousland, East Midlands Ambulance Service (EMAS) Lincolnshire Divisional Director and Joy Weldin, Head of Non-Emergency Trasport Services EMAS will be in attendance  for this item)

Consideration was given to a report from NHS Lincolnshire Integrated Care Board (ICB) and East Midlands Ambulance Service NHS Trust (EMAS), which provided the Committee with an update on the Non-Emergency Patient Transport Service (NEPTS).

The Chairman invited the Assistant Director of Contracting and Performance, NHS Lincolnshire Integrated Care Board, and the EMAS Head of Non-Emergency Transport Service, to remotely present the item to the Committee.

The Committee noted that the ICB had taken a modified approach within areas of the contract by transforming the traditional penalty Key Performance Indicators (KPIs) within the contract to overarching aims and objectives.  It was noted further that in addition there was a Local Incentive Scheme which was designed to continuously improve delivery in three key areas over the period of the contract:

·       Zero re-beds;

·       Delivery of a social value plan; and

·       Patient and Healthcare professionals’ satisfaction and partnership working.

EMAS Service Delivery Principles were detailed in Appendix A and details of the Performance of Service Delivery Principles were shown in Appendix B to the report presented.

In conclusion, it was noted that EMAS NEPTS services in Lincolnshire had seamlessly mobilised and were continuing to develop in line with the mobilisation plan and contractual requirements.

During consideration of this item, the following comments were noted:

·       The Committee was advised that with the structured contract, EMAS had to demonstrate as the contractor/provider that they were working to a local incentive scheme that included patient and healthcare practitioner satisfaction. For instance, for patients being collected from their appointment on time, if this was not achieved then when work was being done to assess patient satisfaction, patients would not be satisfied, which would mean that EMAS potentially would have a financial penalty, which would result in them losing some income from the contract.  It was noted that there was not a penalty attached to each of the delivery principles.  It was noted further that doing the contract this way provided a more holistic approach which helped the ICB as commissioners and EMAS have an insight into how patient satisfaction overall might work.  There was recognition that there was more to be done, but it was hoped that having EMAS as the transport provider allowed for greater synergy between patient service and the emergency service, and it also provided more career opportunities for individuals who joined the Patient Transport service who might want to progress into the emergency service. Some concern was expressed to the lack of outcomes and financial penalties. The Committee noted that the NHS was moving away from KPIs to working more collaboratively, and that the best way to find out whether that would work was to measure whether patients felt they were getting a good service or a poor service. There was recognition that this was a new way of working, but representatives were optimistic that the new way of working would provide a better service;

·       It was reported that at the moment there was no consistent comparison data in terms of performance targets.  However, it was highlighted that there was a lot of national work ongoing to try and pull together some national data. Representatives advised that as this developed, a request would be made to counterparts in the East Midlands region to see if they would be willing to share their data;

·       It was reported that to improve performance numerous surveys and conversations with stakeholders and patients were being undertaken. The information gathered would then help the service to make improvements or develop the service further. It was also noted that the service was in the next stage of mobilisation, which would help strategically, moving from five locations to eleven locations, which would then reduce the number of journeys being undertaken without patients being on board, which would improve service effectiveness;

·       It was reported that in addition to contract meetings, EMAS had monthly quality meetings at which information from all surveys captured were shared and discussed to improve performance;

·       Representatives agreed to provide activity volume information for the Committee to consider;

·       Clarification was provided that the NEPTS report was about patients who were eligible for patient transport. It was noted that for NEPTS there were strict criteria for patient’s eligibility, which was set nationally by NHS England. It was noted further that the wider transport issue was something the ICB was aware of and that discussions were at an early stage regarding how patients could be better supported.  Representatives confirmed that they were happy to share the eligibility criteria with the Committee. The Committee also agreed to including a wider transport item in the work programme;

·       The Committee noted that EMAS’s view was that the incentive scheme enabled the service to be held to account and enabled a more collaborative approach across the system, focusing on patient need and system need to help maintain patent flow; and

·       It was reported that EMAS was continuing to grow its voluntary car scheme. The Committee extended their support to the volunteers.

The Chairman on behalf of the Committee extended his thanks to the presenters.

RESOLVED

1.      That the current performance by the East Midlands Ambulance Service against the service delivery principles be noted, and the Committee’s desire for improvements to meet the delivery principles be recorded.

2.      That patient feedback information, and a copy of the eligibility criteria be made available to members of the Committee.

3.      That a further update report on the Non-Emergency Patient Transport Service be received in six months’ time.