Patient Transport Service - Workshop

Transcription

1 Patient Transport Service - Workshop 26 th November 2014 Additional information and contact details info@healthwatchsouthtyneside.co.uk Report prepared by: Healthwatch South Tyneside This report is based on information provided by members of: South Tyneside residents Representation from: CAST and Age Uk Gary Collier Senior Commissioning Manager NHS North of England Commissioning Support Unit

2 Patient Transport Service - Workshop Patients looking to book an ambulance for medical appointments must now undergo an over-the-phone eligibility assessment under changes brought into force last month. Evidence from National Health Service states the use of patient transport by people who do not have a medical need is increasing. This increase is substantially more than would be expected. From October 2014, ERS Medical will take on the role (previously provided by the GP practice) of providing a PTS booking service for patients requiring non-emergency transport across South Tyneside. To make a transport booking, patients, their family members or their carers will dial where they will be taken through the national eligibility criteria by an ERS Medical call handler to ensure there is a medical need for transport. The move was met with anger by many service users, in response to which Healthwatch South Tyneside arranged two round-the-table discussions between concerned residents and NHS North of England Commissioning Support Unit s senior commissioning manager, Gary Collier. Residents were invited to influence how the questions that make up the eligibility criteria address the complex needs of the individual requiring access to the Patient Transport Service. Information collated from these discussions is presented in this report.

3 Patient Transport Service Workshop Service User Feedback on their experience of using the new Booking System with ERS Medical, and of the Eligibility Criteria Group 1 Has used the new service only once so far. Did not get through to the call handler the first time phoned. He rang not to book; rather to enquire if he would be eligible for a PTS ambulance. Informed by call handler that outpatients appointment for cataracts, at which eye drops will be administered, renders that journey eligible. Was asked and answered several questions. Eligibility criteria implemented without prior warning. No prior warning that new booking system is not through GP surgery. Feels it should be a GP decision if a patient is eligible. Re. the process of finding out about the new booking system- got the details easily from GP surgery. Current criterion on which a patient qualifies for a PTS ambulance e.g. appointment being Oncology related, or patient requires oxygen whilst in the ambulance, will not permanently qualify at any/all times in the future where the patient recovers from cancer or no longer requires oxygen. Use of PTS to date - happy with and appreciative of the service, ambulance staff attitudes/helpfulness etc. Patient is tolerant that there needs to be multiple pick-ups and drop-offs of patients.

4 Patient appreciative that on one occasion Freeman Hospital nursing staff booked him a taxi to return home as they thought an ambulance would not be available after 5pm. Patient is on oxygen- they learnt only from the presentation at this event that being on oxygen qualifies for a PTS ambulance. What is ERS Medical? What is their role? The call handler asked her one question only i.e. regarding her mobility. Call handler said that she walks with a walker renders her ineligible for an ambulance. Call handler seemed not amenable to learning about being on public transport buses with both mobility problems and using a walker being problematic e.g. drivers pull away from bus stops before she sits down, walker can be too wide to manoeuvre through the aisle. [Training need for drivers, structure/dimensions of buses]. Quickly after the call handler told her she was ineligible, call handler hung up on her. The Red Cross transport service Has a Sunderland phone number; not on NEAS PTS literature for the public. She to inform HWST of this number First call handler informed patient she believed the cost to the patient would be just a little less than the cost of a taxi, and she would be invoiced for it. As of the patient has still not yet been invoiced. Red Cross driver suggested, on the day, a one third of usual taxi

5 fare contribution to Red Cross. Patient posted cheque for about one third of the cost to Red Cross. NB do not hand over cash to the driver. [clarification of booking process, cost/contribution fee, and payment system is needed] Patient was happy that the driver acted as her escort from his car to her clinic / accompanied her, waited in the clinic for her for the return journey, was discrete when waiting in the clinic. Group 2 If the patient says yes to one of the questions, does this mean that they are automatically eligible? Inter-hospital transfer is this organised by ward staff? Answer: Yes, they use the same system as ERS Medical but complete this on-line i.e. on-line booking. Hospital discharge is this for every discharge? Or just with medical need? Is this organised by ward staff? Answer: Not for every discharge; only where there is a medical need, although more people being discharged early owing to pressure on hospital beds. Sometimes this is a taxi, not an ambulance. One person was transferred from South Tyneside District Hospital to Newcastle General by taxi. Where would you get the volunteer patient transport service from? The ERS Medical call centre do not currently signpost people. There is no signposting for ineligible people, i.e. to The Red Cross. It was all so sudden, a sudden change. Concerns re. patients/users having to remember any further

6 information to provide until the end of the conversation (when the pop up appears for the call taker) the answers should be unpicked during the conversation by the call taker; not rely on the patient/user knowing what to say/add. Distance relevant not in terms of cost necessarily but in relation to, for example, how many buses the person needs to take etc. Answer: Appreciate that but this is not generally flagged up in South Tyneside. This is more an issue that comes up in rural areas, for example Northumberland. Taxi costs can be prohibitive for those who cannot use public transport. Some people have PIPs or the mobility component of DLA but this is not enough. One person with an eye problem had to go to Sunderland Eye Infirmary twice in one week at 36 each time, and the mobility component does not cover this in two weeks this person s mobility component was gone through attending out of area hospital appointments. One lady is an unpaid carer for a person with learning disabilities and Alzheimer s and for another person with learning disabilities, visual impairment and stroke-related communication problems. Both need support to attend hospital and both have issues using the phone- neither would be able to answer the eligibility questions or even understand them. What should they do in this system? Answer: GPs could still book for that person as before. Do the GPs know that this is the arrangement? Gender of escort a male escort given to attend a women s clinic. Answer: NEAS do not provide escorts; this is the responsibility of the hospital. Concerns that the most vulnerable will not be able to work the system. Concerns re. call centre being scripted and not unpicking what the caller is saying to get the right information.

7 Answer: PALs would unpick the information. The appeals process of ineligible patients/users is managed within 24 hours. This sits within the Teesside call centre as they have more experience and have been managing NEAS calls for the last 5-6 years. The call takers here are employed by NHS England. They are the NHS England Health Care travel cost team. PALs have the appeals telephone number. It was suggested that a logo was placed on patient notes to assist the call takers e.g. an eye for visual impairment or a hearing loop for those with hearing difficulties. Can you flag individual patients? If people answer yes to the first few questions, does that mean automatic entitlement? Are the questions weighted? Answer: Yes It is the principle of it all, the way this change was sneaked in. Need better patient leaflets. Should the escort question be the last on the list? It should be more widely advertised that if you are having drops that create blurred vision, you have a medical need for an ambulance. Can you request an escort at the same time as you are booking an ambulance? It would be worth advertising on Talking News for those who have a visual impairment or are registered blind. The mental health question should be reframed- a lot of people

8 with mental health issues are not in contact with mental health services as difficult to engage or their mental health managed through GP. People who suffer from anxiety would have difficulty with ringing and may have problems using public transport. Group 3 Culture change for those only requiring two or three hospital appointments per year and have always accessed the Patient Transport Service in the past and may now find they are not eligible. An important need for additional information to be given to ERS Medical call centre- the bigger picture needs to be clearly understood. Case study gentleman able to drive but then unable to walk any distance resulted in him falling twice trying to make his way to the hospital entrance. Are the questions in the correct order? Reference to being registered blind and do you have a sight or hearing impairment - should they not be closer together? How do you know the individual is telling the truth with their responses to the questions? Answer: Every request for transport is issued with a reference number, which is then registered against the patient s appointment details.