Agenda item

The Director of Adult Social Care submits a briefing note on concerns regarding the performance of Arriva Transport Solutions, the contracted provider by the NHS of non-emergency transport to and from Leicester’s hospitals.  (Attached at Appendix B1)

Also attached for information are the following:-

a)     Article entitled “Arriva Transport Solutions fails key 'tests' on hospital transport”, published in the Leicester Mercury, 21 July 2014 (Appendix B2);

b)     Article entitled “Leicester's deputy mayor calls for Arriva Transport Solutions to improve”, published in the Leicester Mercury, 23 July 2014 (Appendix B3);

c)     Letter from East Leicestershire and Rutland Clinical Commissioning Group, “NHS non-emergency patient transport”, received 25 July 2014 (Appendix B4); and

d)     Letter from the Chair and Vice-Chair of the Adult Social Care Scrutiny Commission published in the Leicester Mercury on 26 July 2014 (Appendix B5)

The Commission is recommended to consider the information presented and consider whether any further work is needed on this issue and, if so, whether it should be undertaken by this Commission, the Health and Wellbeing Scrutiny Commission, or jointly by the two Commissions.

The Director of Adult Social Care submitted a briefing note on concerns regarding the performance of Arriva Transport Solutions, the contracted provider by the NHS of non-emergency transport to and from Leicester’s hospitals. 

It was noted that a small number of patients discharged from hospital to receive a social care package were reliant on hospital transport.  However, it was difficult to quantify the impact of poor performance of the transport service on these people, as different elements of the package could be provided by a wide range of providers and thus was not easily captured.  As such, much of the evidence available was anecdotal.  Officers could only capture information about the impact on care packages, although it was recognised that problems with patient transport services could affect people in other ways, such as getting to outpatient appointments.  The impact of problems with patient transport services was only one of a number of issues that affected how well acute care was working.

The Commission welcomed the letter sent by the Deputy City Mayor to the Managing Director of the East Leicestershire and Rutland Clinical Commissioning Group (CCG) confirming that he had proposed that if there had not been clear improvements within three months the contract should be terminated.

Members noted a letter from the Managing Director of the CCG, drawing particular attention to the comments in that letter relating to the impact of clinical assessment requirements for non-ambulatory stretcher vehicles and the need to re-align staff and vehicles.  In view of these comments, the Commission questioned whether the correct type of transport was being used.  It also was noted that the CCG had provided little information on what had gone wrong with the service and no information on what the service’s target were.  This would make it difficult to assess whether problems had been properly rectified and sufficient improvements made.

Mr Philip Parkinson, on behalf of Healthwatch, advised the Commission that:-

·           Healthwatch had had concerns about the apparent lack of control over the contract for approximately 15 months.  Some of the issues were highlighted in a report by the Care Quality Commission, such as staff training still not having been done six months after Arriva Transport Solutions had said it would be done;

·           Healthwatch was aware that Arriva used some taxis to provide passenger transport, but patients reported that the drivers of these could be unhelpful;

·           Even though the Care Quality commission was aware of the problems with passenger transport services, it was not known at present if changes in the operation of the contract would be made; and

·           In view of this, Healthwatch shared the concerns raised by the Commission and the Deputy City Mayor.

The following points were then made in discussion:-

o    Arriva Transport Solutions was a big company, but did not seem to be able to deliver the service required;

o    It would be useful to know if the cases reported by the local press were exceptions, or represented a general experience;

o    There was a lack of information available on the causes of the problems and the standards expected of the service.  Without this information, it would not be possible to assess whether the service had improved.  For example, it was stated that the company had failed in three of five standards, but no information was provided on what any of these standards were;

o    Three months was a long time to wait for service improvements to be made;

o    It was not known if the contract for patient transport services was a stand-alone contract, or one of a number of contracts being run by the provider;

o    At least some of vehicles being used for patient transport were just ordinary cars, which could be difficult for some people to use.  This raised the question of whether the transport provided was fit for purpose;

o    Even if patients got to hospital on time for appointments, they did not know when their return transport would be available, so could have a long wait.  This also raised the question of whether enough drivers were being employed;

o    It would be useful to receive a further report on these problems, particularly in relation to delays caused by transport being late;

o    When Arriva Transport Services advertised vacancies for drivers, the posts were at minimum wage.  This could affect who would apply for these posts;

o    Patient transport services drivers would be aware of the problems with the service, so some lack of courtesy could be due to frustration;

o    It was not known if the service provider had any kind of tracking system for the vehicles used.  Using such a system could help ensure that timings were improved;

o    People had made reports to Councillors of cars arriving late, (even when satellite navigation systems were used), and on the wrong day.  Some of these people had not complained to the service provider as there could be some embarrassment about needing to use patient transport;

o    The CCG should procure this service with a provider experienced in the provision of a service of this nature.  If such a provider was not available, the service should be returned in-house; and

o    Anecdotal evidence showed that, on occasions, patients had to stay in hospital longer then needed when transport to return them home did not arrive.

RESOLVED:

1)    That the Scrutiny Support Officer be requested to ask Arriva Transport Solutions for a clear explanation of:-

a)     Precisely what the problems are that are causing issues with providing non-emergency patient transport to and from hospital; and

b)     Precisely when and how these problems will be addressed and who is responsible for putting things right;

2)    That the Scrutiny Support Officer be asked to advise East Leicestershire and Rutland Clinical Commissioning Group that this Commission seeks assurances that, if it is decided to re-procure non-emergency patient transport services, only providers experienced in this type of service will be considered and that bringing the service “in-house” also will be considered;

3)    That the Scrutiny Support Officer be asked to make the East Leicestershire and Rutland Clinical Commissioning Group aware of this Commission’s concern that that the passenger transport services currently being provided are totally inadequate;

4)    That the Deputy City Mayor and the Assistant Mayor (Adult Social Care) be asked to continue to seek to address the concerns of the Commission, as recorded above; and

5)    That the Managing Director of the East Leicestershire and Rutland Clinical Commissioning Group be asked to report to the Commission later in the year, when it is known what changes are to be made to non-emergency patient transport services in view of the points recorded above.