Agenda item - NHS Patient Transport

Report of the Head of Law on the launch of the new contract for Sussex NHS patient transport services (copy attached).

10.1    This item was introduced by John Child, Chief Operating Officer, Brighton & Hove CCG; Sally Smith, XXXXX, High Weald Lewes Havens CCG; Alan Beasley, Director of Finance, High Weald Lewes Havens CCG; and Michael Clayton, Managing Director, Coperforma. Terry Parkin, SECAmb Non-Executive Director; and Geraint Davies, SECAmb Acting Chief Executive, also contributed to this discussion.

10.2    John Child told members that, in 2014, SECAmb had announced its intention to cease providing patient transport services (PTS) in Sussex when its contract ended in 2015. A one year contract extension until March 2016 had subsequently been agreed to allow time to procure an alternative provider. A tender process had been undertaken. This was led by High Weald Lewes Havens CCG (HWLH), on behalf of Sussex CCGs. All decisions with regard to the tender were unanimously agreed by all Sussex CCGs.

10.3    Coperforma was eventually appointed as the new PTS provider. However, there have been significant issues with the performance of the new service. The CCGs have commissioned an independent review of the tender and of the contract handover, and an improvement plan is in place to try to address performance.

10.4    Terry Parkin told the committee that he wished to correct some misunderstandings about SECAmb’s role in this matter. SECAMb’s view was that the PTS model proposed by the CCGs would have been neither safe nor appropriate for the trust to run (although this did not necessarily mean that it would be so for a different organisation). They therefore withdrew from the tender process as did all but one of the other bidders.

10.5    Alan Beasley noted that some bidders had withdrawn because of timing issues, and that SECAmb had told the CCG that they were withdrawing for financial rather than forsafety reasons. Geraint Davies responded that safety and finance are inexorably connected: SECAmb felt that it would be unable to deliver the specified service safely within the available financial envelope, and had withdrawn, as it did for similar reasons from the Kent PTS contract. The trust had, however, bid for the Surrey contract because the financial envelope there would allow SECAmb to deliver a safe service.

10.6    Geraint Davies told members that SECAmb had engage positively with all issues relating to the contract handover, including TUPE. 84% of staff eligible to transfer in fact did so. SECAmb had been criticised for not releasing patient data, but this data was in fact not held by SECAmb but by the (CCG controlled) Patient Transport Bureau.

10.7    In response to a question from Cllr Marsh as to why the procurement went ahead even when it became apparent that there was only one bidder, Mr Beasley told members that the PTS market is a specialist one and not very many bidders were anticipated. There is no requirement to halt a tender process if there is only one bidder. In this instance, the evaluation criteria were not changed: Coperforma still had to meet these criteria even though there was no alternative bid. At every stage, the decision to proceed with the procurement was agreed by all seven Sussex CCGs.

10.8    In answer to a question from Cllr Cattell as to why Coperforma had missed its performance targets by such a distance, Mr Clayton told members that the KPIs were based on the data available, but the actual activity had been much higher (by up to 30%) than this data predicted. Coperforma has now put extra transport capacity resources in to deal with this – something that it is only possible because of the ‘Managed Service’ model. Call volumes have been much higher than anticipated: many patients are very anxious and need reassurance, which takes up a good deal of call handler capacity. However, the actual level of transport required is not far in excess of that predicted. Mr Beasley added that the contract KPIs will ensure a high quality service once they are met.

10.9    Mr Clayton also claimed that performance in some significant aspects of the contract was good and represented an improvement from performance under the old contract. Mr Davies did not recognise the performance figures quoted by Mr Clayton, and Sally Smith told committee members that comparing performance was complicated because many of the KPIs have changed, meaning that there is no simple way to compare performance across the old and new contracts. The CCG will seek to produce comparative performance information and will share this with the HOSC.

10.10  Mr Beasley told members that there was no real terms financial saving on the new contract, although the new provider is expected to absorb future demand growth.

10.11  In response to a question from Cllr Taylor on whether there was a ‘plan B’ should Coperforma prove unable to deliver, members were told that the CCG could not break the contract by appointing a different provider and was committed to supporting Coperforma to improve.

10.12  David Liley told the committee that Healthwatch organisations across Sussex are working together on this issue, and have offered to assist in terms of providing information on PTS, speaking directly to consumers and supporting those who may wish to make complaints. Healthwatch want to see the independent enquiry report published, want to see details of any clinical impact review published, and would like to see a Learning Event. Ms Smith welcomed Healthwatch support and agreed to publish the enquiry report and to hold a Learning Event.

10.3    In response to a question on TUPE from Cllr Peltzer-Dunn, Mr Clayton told the committee that only 15 of the 51 staff expected to TUPE in fact did so. However, Mr Davies told members that 154 out of 184 staff TUPED over (the latter figure includes SECAmb drivers who transferred to organisations other than Coperforma). Mr Child noted that this was a complex issue, not least because it was important to differentiate between headcount and Full Time Equivalent posts.

10.4    In response to questions from the Chair about volunteer drivers and the use of the app, Mr Clayton told the committee that it had been assumed that the number of volunteers would reduce due to more rigorous vehicle and driver vetting. Coperforma is investigating whether it may be possible to relax some of these rules whilst maintaining quality: for example waiving the demand that all cars be less than six years’ old in certain situations. Mr Clayton claimed that the app has generally been welcomed by volunteer drivers, as it reduces the time they are sat around waiting. Mr Davies told members that he wanted it made clear that SECAmb had previously operated a robust vetting regime, and would never have used drivers with convictions.

10.5    RESOLVED – that the HOSC requires an update report at its July 2016 meeting. This should include current performance data and the independent investigation report.