Issue - meetings

1.1.        The Committee considered a report on the latest developments regarding the Patient Transport Service (PTS).

1.2.        Maninder Singh Dulku, PTS Programme Director, Sussex CCGs; Paul Stevens, Director of Commercial Services, South Central Ambulance Service NHS Foundation Trust (SCAS); and Stacey Warren, Business Manager, SCAS, responded to questions from the Committee.

Key lessons from previous contract

1.3.        Mr Dulku said that a key recommendation of the independent report into the previous mobilisation of PTS was to employ a specialist PTS advisor. The CCGs appointed one in August 2016 and they have been pivotal in the process, and will be retained for a further six months to ensure an ongoing monitoring of the new contract. The CCGs have also avoided the mistake of attempting a one day contract transfer and have instead opted for a two phase transfer: phase one commenced on 1 March and phase two will commence on 1 April. Some lessons were learned from phase one that have been adopted for phase two.

Online booking systems

1.4.        Paul Stevens explained that there was a problem with the online booking system during phase one. SCAS quickly had the software supplier resolve the issue and, following further testing, there have been no further issues. Online booking will be available from 1 April.

Capacity of SCAS to take on both Surrey and Sussex PTS

1.5.        Paul Stevens explained that the Sussex contract will have its own management team that will report to SCAS’s Board. It is standard practice throughout the area in which the trust operates for SCAS to have a local contract team manage the PTS, as each area has their own locations and demands.

1.6.        Paul Stevens said that he did not expect every aspect of the new contract to be perfect from the outset and it will take time to embed and understand some of the issues and concerns about the service over the past year. However, the transition team has worked extremely hard and has carried out 150 one-to-one TUPE meetings with future team members– this is resource heavy and demanding but must be done in order to get TUPE contracts right. SCAS will continue with its established managers for the first 2 weeks of April, rather than bringing in new managers, to help reduce issues with the transition.

1.7.        Paul Stevens added that the activity levels experienced from 1 March were different to the expected levels developed beforehand from the data provided – certain assumptions are now being made about the level of demand from 1 April.

1.8.        Catherine Ashton said that ESHT considers that the PTS it is in a better position than it was this time last year. There have been a few problems but they have been nothing more than anticipated for a new service and are being resolved in the way ESHT would want to see. The Trust has no clinical risks or safety concerns that have been identified about the PTS. 

Complexity of phased approach

1.9.        Paul Stevens argued that  ...  view the full minutes text for item 35

1.1.        The Committee considered a report providing an update on the Patient Transport Service (PTS) in Sussex.

1.2.        Alan Beasley, Chief Finance Officer, High Weald Lewes Havens (HWLH) Clinical Commissioning Group (CCG) updated the Committee on recent developments with the PTS:

·         Performance continues to improve according to the statistics, although the data is subject to quality assurance by the CCG’s PTS specialist and there remain performance issues to be worked on.

·         The sudden closure of Docklands Medical Services (DMS) has had minimal impact on patients as Coperforma has secured alternative capacity.

·         Payments were made to all staff of DMS by HLWH CCG in September and October and have been organised for November. They have also been organised for December if required.

·         Coperforma wrote to the seven CCGs that commission the PTS to say that it was not economic for the company to continue to provide a PTS in Sussex. Although this communication was unexpected, the CCGs activated their contingency arrangements which involved approaching South Central Ambulance Service to take over the contract. SCAS is rated good by the CQC and has recently been awarded the PTS contract for Surrey.

·         HLWH CCG welcomes the six ‘areas of improvement’ issued by the Care Quality Commission (CQC) following its inspection, and welcomes the CQC’s involvement in the transition process.

·         The CCGs are undertaking a transparent, phased process of transferring the contract to SCAS that will begin early next year and be complete by 31 March 2017. This process is based on the recommendations of the independent report by the TIAA into the adequacy of the mobilisation arrangements for the PTS contract.

·         Coperforma will continue to deliver the remainder of its contract and is committed to continuing to improve its performance.

·         Other subcontractors have expressed concerns to the media about alleged underpayment by Coperforma. HWLH CCG is mediating between the parties and talks are progressing well.

1.3.        Alan Beasley and Maninder Dulku, PTS Programme Director, HWLH CCG, gave the following responses to questions from the Committee.

Reason for a ‘no fault’ termination

1.4.        Alan Beasley explained that all CCGs involved in the PTS contract agreed that a managed transfer to SCAS would be in the best interests of patients, and in order to do that it was necessary to declare a ‘no fault’ termination of the contract. The CCGs looked at the financial costs, impact on patients, and timescales to change the contract without a managed transfer, and agreed that the risk and cost to patients was too high, particularly as the contingency plan with SCAS was already in place. 

Recommendations of the independent report

1.5.        Alan Beasley said that the TIAA review included a recommendation to hire a patient transport specialist which has been actioned – HWLH CCG has employed Maninder Singh Dulku as the PTS Programme Director. The review also made recommendations regarding managing transfers between providers and the CCG is acting on these by agreeing a phased transfer between Coperforma and SCAS to be completed by 31 March 2017.

Transfer  ...  view the full minutes text for item 27

1.1.        The Committee considered a report which provided a further update on the performance of the Patient Transport Service (PTS) in Sussex.

1.2.        Wendy Carberry, Chief Officer; Alan Beasley, Chief Finance Officer; and Sally Smith, Director of Delivery, attended on behalf of High Weald Lewes Havens Clinical Commissioning Group (HWLH CCG). Michael Clayton, Chief Executive, attended on behalf of Coperforma.

Accuracy of PTS data

1.3.        HOSC asked what the PTS data anomalies were; why there was a mismatch between the large improvements in the data and the continued negative anecdotes HOSC members have been receiving; how occasions when no ambulance arrived for a booked journey were recorded; and to what extent HWLH CCG trusted the data it received.

1.4.        Michael Clayton said that all journeys which do not meet the standards agreed in the service level agreement are recorded by Coperforma as ‘service exceptions’. They are then categorised on their severity and investigated accordingly – the categories are critical, high, medium or low. Medium or low exceptions are dealt with together whereas each high or critical level exception – for example, a vehicle not arriving at all – is investigated individually. The continuous improvement team works together with the operations team to record and resolve the service exceptions.

1.5.        Alan Beasley confirmed that Coperforma is providing the data as requested by the CCG. The data is of a good quality but it requires further analysis, which is being undertaken by the specialist Patient Transport Advisor who has now been recruited by the CCG. The Patient Transport Advisor had identified data anomalies and is working with Coperforma to understand whether the anomalies represent issues with the service or faulty recording methods. These findings will be fed into the CCG’s contractual discussions with Coperforma.

1.6.        Wendy Carberry added that the PTS contract specifies exactly what information the providers must provide to CCGs, rather than this being determined by the provider. One of the performance notices issued to Coperforma was around the data being provided. The CCG also triangulates Coperforma data with other sources, such as feedback from Trusts, in order to gain assurance about its accuracy.

1.7.        Alan Beasley said that HWLH CCG had not seen any evidence from the data that if one patient’s pick-up slot is missed they are then de-prioritised in favour of a different patient on the grounds that the target had already been missed. 

Complaints about PTS

1.8.        HOSC asked how the CCGs are recording and addressing complaints about the PTS.

1.9.        Sally Smith said that reports from patients about delays to their patient transport appointments are classed in the CCG’s complaints process as ‘incidents’. CCGs analyse the complaints through their Patient Safety Groups –whose remit is to investigate incidents and complaints. All acute trusts and other healthcare providers have an incident reporting process and any complaints about the PTS made to them are shared with Coperforma. HWLH CCG also holds a monthly forum with the patient transport leads of all acute trusts that use the PTS  ...  view the full minutes text for item 17

1.1.        The Committee considered a report by the Assistant Chief Executive, East Sussex County Council, on the performance of the Patient Transport Service (PTS) in Sussex following a change of provider on 1 April 2016.

1.2.        High Weald Lewes Havens Clinical Commissioning Group (HWLH CCG) and Coperforma apologised unreservedly for the failures of the PTS since 1 April, and promised to look at the learning from the independent incident review.

1.3.        Michael Clayton, Managing Director of Coperforma, updated HOSC regarding a meeting on 29 June following the news that VM Langford (a provider of ambulances for the PTS) had gone into administration. At the meeting Coperforma met with staff-side representatives and local management to assure staff that, whatever happened to VM Langfords, their pay, staff benefits, and pension contributions for June would be funded by Coperforma. All staff would also be able to take employment with designated Coperforma ambulance providers in the area that would protect their terms and conditions. Staff-side representatives were comfortable with the proposed changes and staff were appreciative.

1.4.        HOSC expressed concern at the performance of the PTS over recent weeks and more than one HOSC member spoke about the effect the PTS had on local residents who had contacted them directly with their experiences of the service.

1.5.        The Committee asked the witnesses from HWLH CCG, Coperforma and South East Coast Ambulance Service NHS Foundation Trust (SECAmb) a number of questions relating to the Patient Transport Service.

The tendering process and due diligence by CCGs

1.6.        HOSC queried the extent to which HWLH CCG had carried out due diligence on Coperforma, and asked whether the CCG was concerned that there was only one formal tender. The Committee also asked whether the CCG had considered the concerns of the GMB trade union about the tendering process.

1.7.        Alan Beasley, Chief Finance Officer, HWLH CCG, said that although Coperforma was the only organisation that submitted a final tender, the CCGs had looked into why the two other organisations which were invited to tender did not ultimately submit a bid. The feedback from SECAmb was that the Trust could not provide a substantive bid within the financial envelope that was offered. Arriva Transport Ltd. responded that it did not have the capacity to submit a tender in line with the timescale required.

1.8.        Alan Beasley did not take the view that the issues with the performance of the contract since 1 April were due to the funding provided by the CCGs for providing the PTS. He said that Coperforma did not express concerns about the funding offer during the tendering process.

1.9.        Alan Beasley assured the Committee that, although only one tender was submitted, the same process was followed as if there had been multiple submissions, for example, the same financial evaluations and due diligence.

1.10.      Alan Beasley said that HWLH CGG did review the capacity and capability of Coperforma and in turn Coperforma reviewed the capacity and capability of its subcontractors. Assurance was given by Coperforma  ...  view the full minutes text for item 5