Patient Transport Services: Northern Lincolnshire
(Limited Text - Ministerial Extracts only)
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The Minister of State, Department of Health and Social Care (Caroline Dinenage)
I congratulate my hon. Friend the Member for Brigg and Goole (Andrew Percy) on securing the debate. As he has so elegantly articulated, the provision of patient transport services is important to many people throughout the country.
Let me take this opportunity to give heartfelt thanks to all the staff in the health and care system. They work tirelessly in often difficult circumstances, routinely going above and beyond the call of duty to keep patients safe. Those dedicated people make our NHS truly great. No one knows that better than my hon. Friend, who spends weekends volunteering as a first responder with the Yorkshire Ambulance Service. He deserves massive thanks for everything that he does in that role, as do all first responders up and down the country.
We recognise that effective patient transport services are vitally important, not only to ensure the provision of high-quality, safe services for patients, but to ensure that patient flow through hospitals is not slowed by missed medical appointments or delayed patient discharges. We are clear that local NHS CCGs must ensure that reliable, safe and comfortable patient transport services are delivered and maintained.
Patient transport services, like almost all other health services, are locally commissioned and provided to ensure that they are well adapted to local conditions. It is for local CCGs to set appropriate expectations of service with their providers and to take swift action where they fall short. However, that is not to say that the Government have no expectations of how these services should be delivered and should function. There is well-established national guidance on who is eligible to use patient transport services which makes it very clear that patients should reach appointments in reasonable time and comfort without detriment to their medical condition. NHS England has also communicated with the CCGs about their responsibilities when commissioning patient transport services via its CCG bulletin.
Nic Dakin
I congratulate the Minister on taking up her new post, which I am sure she will do very well. She said that CCGs should take swift action when things are not working. What does swift action look like? This has been going on for some time now; how quickly should the people of northern Lincolnshire expect to have the patient transport service they deserve?
Caroline Dinenage
Of course, we have devolved this matter locally and it is up to the local CCG to take action. I know that a recovery plan is in place and the delivery of the plan is now being monitored weekly, but the hon. Gentleman is right, and, like my hon. Friend the Member for Brigg and Goole, he has kept on articulating this issue and asking these questions on behalf of his constituents, to try to find out when they will see a visible difference to the service, because it is currently not good enough.
Patient transport providers are also required to be registered and inspected by the Care Quality Commission, the independent regulator of health services. This Government have given the CQC more powers, and it is now able to rate independent healthcare transport providers in the same way as NHS ambulance services. We fully support the CQC in its work to ensure that users of patient transport services are protected, and where services are not good enough and the necessary improvements have not been made, it can take further action, including issuing fines, service restrictions, and ultimately the cancellation of a provider’s registration.
Additionally, we are very supportive of the Department for Transport-led total transport initiative, which I think was what my hon. Friend the Member for Brigg and Goole was referring to, and which is currently piloting the joint commissioning of public sector-funded transport in order to reduce the risk of services overlapping, improve efficiency, and provide a better overall service to passengers.
From the local work carried out so far, it has become clear there are a range of potential benefits for the NHS, including helping to avoid bed blocking—where patients sometimes cannot go home because non-emergency patient transport is not available—and improving access to NHS services by reducing missed appointments due to late or unavailable transport. We have asked NHS England to ensure that CCGs are all engaging in this important work.
Melanie Onn
I welcome the Minister to her new role and wish her the best of luck, but from what she is saying I am not entirely clear how the Government will follow up and pressure will be brought to bear on the CCGs in the delivery of the contract. I had a 97-year-old lady, whom the new chief executive of the Diana, Princess of Wales Hospital and the Northern Lincolnshire and Goole NHS Foundation Trust met. She had had to wait for eight hours in the emergency care centre for transport to go home. There needs to be a little more urgency in the Minister’s response.
Caroline Dinenage
I completely understand why the hon. Lady is articulating that; every one of these incidents is absolutely unacceptable and in many cases very distressing. The issue with devolving such clinical decisions to local areas, however, is that we have to allow the CCG to take the necessary steps to ensure the service is put back on to a better footing.
Diana Johnson
This is not just one CCG; it involves more than one. I have already mentioned the fact that Hull contracts with Thames Ambulance Service. Does the Minister really think that this business—it is a profit- making business—is fit for purpose?
Caroline Dinenage
The hon. Lady is absolutely right to raise that point. I am aware that similar problems have been identified with the same provider in other parts of Yorkshire and the east midlands. Improvements must of course be made, which is why commissioners are working to oversee and manage the necessary improvements and trying to achieve the level of performance that is required.
Turning to the particular issues affecting northern Lincolnshire, my hon. Friend the Member for Brigg and Goole and other hon. Members across the House are absolutely right to point out the problems with the services commissioned in and around their constituencies. I have read some of the cases today, including some distressing cases involving patients with conditions such as dementia and cancer experiencing long delays with their transport. Such delays are clearly a source of incredible distress for people who are already facing a very difficult time in their lives. Many of them may be very vulnerable, and we are absolutely clear that this needs to change.
North Lincolnshire CCG awarded a patient transport contract to Thames Ambulance Service in October 2016 following an open procurement process. Issues around the quality of service are acknowledged, and we are aware that people have experienced delays. That is clearly unacceptable. I assure my hon. Friend and other Members that a range of actions is being undertaken to ensure the delivery of an appropriately high-quality service. The CCG is working closely to support Thames Ambulance Service to achieve the required level of performance. It has served a contract notice to the provider based on delivery against key performance indicators, the number of patient complaints, and issues associated with data reporting.
A robust recovery plan has been put in place, and delivery against this is carefully monitored on an ongoing basis. Key actions include the recruitment of six additional staff in north Lincolnshire and the mobilisation of additional vehicles. I understand these staff have recently been trained and deployed. A patient transport co-ordinator has also been employed, working with the hospital to improve the process for patients being discharged. The CCG has also worked with the provider to improve its complaints process, and I am advised that its backlog of complaints has now been cleared.
I hope that my hon. Friend is also reassured by the level of Care Quality Commission engagement with Thames Ambulance Service. In its inspection report of April 2017, the CQC uncovered a number of areas for improvement, ultimately issuing enforcement action against the provider in respect of regulation 17, which covers good governance; regulation 13, covering safeguarding; and regulation 5, which deals with requirements relating to registered managers. The CQC continues to monitor the provider closely to ensure that the required improvements are being made. It is currently undertaking a fresh review of the service and will issue a further report when its latest inspection is complete. We expect this to be published and available online before the end of March. That will be exactly the same for the provider in the constituency of the hon. Member for Kingston upon Hull North (Diana Johnson).
Finally, I am also advised that the CCG has reviewed the application of the eligibility criteria for patient transport services across the area to ensure that they are being applied evenly. Through this process, it has determined that some patients who have historically accessed these services may no longer be considered eligible. We obviously have to take steps to ensure that the service is more consistent and that the CCG is working with the provider to ensure that affected patients are informed as soon as possible and given helpful advice on how to access alternative services if they are required. I would like to thank my hon. Friend again for bringing these matters to our attention, and I very much hope he is reassured that all appropriate actions are beginning to be taken to restore the delivery of effective patient transport services to his constituents.
Question put and agreed to.