Agenda item

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 of staff to SCAS

1.6.        Alan Beasley informed HOSC that negotiations are underway to transfer staff from Docklands Medical Service to SCAS, and external legal advice was being sought. Further details would be available once negotiations were complete.

Structure of new contract

1.7.        Maninder Singh Dulku said that the TIAA report concluded that the previous PTS ‘managed service provider’ model – one provider managing bookings and separate subcontractors providing patient transport – was not the right one for the service. The new PTS model is tried and tested, involving one provider (SCAS) carrying out both bookings and patient transport. Mr Dulku assured HOSC that due diligence has been undertaken on SCAS capacity and capability, its finances, and its estates, and he was confident that the ambulance trust had the capacity to take on the service despite recently also taking on the Surrey PTS contract.

Transformation plan and continued Coperforma improvement

1.8.        Mr Dulku explained that one of the reasons for a phased transfer of the contract was to ensure that Coperforma remain committed to improving the service as they will continue to have a stake in it. HLWH CCG is mindful of the need to have SCAS mobilise whilst keeping Coperforma on board, so regular transformation plan meetings are held between the CCG and the two providers.

1.9.        He added that the NHS contract between the CCGs and Coperforma contained performance indicators and penalty clauses; it remained ‘business as usual’ in terms of Coperforma needing to meet these performance indicators and HWLH CCG invoking the penalty clauses within the contract if necessary.

Position of South East Coast Ambulance Service NHS Foundation Trust

1.10.      Alan Beasley confirmed that South East Coast Ambulance Service NHS Foundation Trust (SECAmb) was committed to improving its core business of emergency transport following its Care Quality Commission (CQC) inspection and had not expressed interest in taking over the PTS contract.

Cost of contract transfer

1.11.      Alan Beasley informed HOSC that the cost of the transition from Coperforma to SCAS cannot be disclosed at this stage as it is part of contractual discussions around closing out the contract between the two parties, and is commercially sensitive. Additional costs incurred by other providers, such as hospital trusts for patient transportation, are already deducted from Coperforma’s contract.

SCAS’s current involvement

1.12.      Alan Beasley confirmed that SCAS is not yet providing any of the PTS. The phased transfer was still being agreed, for example, the contract needs to be broken down into blocks and timelines for the phased transfer of these blocks from Coperforma to SCAS agreed.

1.13.      The Committee RESOLVED to:

1) note the report

2) request a further update on the progression of the phased transfer at its March meeting – a representative of SCAS to attend.