Patient Transport Booking

Patient Transport Booking UCLH policy Version 6 Version Date September 2013 Version Approved By Executive Board Policy Approval Sub Group Publication Date October 2013 Author Ridha Gabsi, Transport & Contact Centre Operations Manager Review By Date September 2016 Responsible Director Jonathan Fielden, Medical Director, Medicines Monitoring Patient Experience Committee Committee Target Audience Staff responsible for booking patient transport for the purpose of discharge, admission or to attend outpatient appointments. Related UCLH-wide Discharge Policy and Procedure Policies Number of Pages and 13 pages, including 4 appendices Appendices Equalities Impact Low Assessment Policy Category Clinical Policy Number 032/CLN/T

Table of Contents Page Numbers 1.0 Summary 2 2.0 Introduction 2 3.0 Objectives 2 4.0 Scope 2 5.0 Definition 2 5.1 Medical Need Eligibility Criteria 3 5.2 Eligibility for Escorts 3 5.3 Exclusive use of Vehicle 4 5.4 Review of need for transport 4 6.0 Duties 5 7.0 Details of Policy 5 7.1 Outpatient Assessment 5 7.2 In-patient Assessment 6 7.3 Transfers 6 7.4 Appropriate clothing 6 7.5 GP referrals 7 7.6 Appointments for UCLH patients at other hospitals 7 7.7 Appeals 7 8.0 Monitoring/ Audit 8 9.0 References 8 Appendix- A Ward Assessment Form 9 Appendix- B Electronic Booking Form 10 Appendix- C Booking Hospital Transport Leaflet 11 Appendix- D Assessment & Booking Form 13 UCLH - 2013 2

1.0 Summary The Department of Health Ambulance and other Patient Transport Services set out guidance for the NHS on the operation, use and performance standards for emergency and urgent ambulances. It also sets out the criteria for establishing which patients are eligible for non-emergency patient transport services (PTS). This Policy follows such guidance when assessing patients against the eligibility criteria for non-emergency patient transport services. 2.0 Introduction University College London Hospitals NHS Foundation Trust (UCLH) is committed to providing an appropriate, efficient and cost-effective Non-emergency patient transport service (PTS) which takes account of each patient s medical needs. This policy applies to all patients being treated at University College Hospitals (UCLH). 3.0 Objectives The purpose of this policy and associated procedures is to ensure there is a consistent approach to booking patient transport, and that risks associated with transporting patients are recognised through effective planning with the patient at the centre of that process. 4.0 Scope of the Service UCLH treats patients from all over the country and particularly from southern England. This policy is for all patients who are unable to travel to hospital without the assistance of the Transport Service. 5.0 Definition of the Service Non-emergency Transport is provided to patients who are unable to attend hospital appointments or be discharged without the assistance of hospital transport but in all cases do not need any medical intervention during transportation. High Dependency Transport is provided to patients whose medical condition requires intervention of a technician or paramedic crew during the journey to either administer or oversee the administration of drugs or manage any medical equipment in situ. 5.1 Medical Need Eligibility Criteria Patients being booked for hospital transport must meet one of the medical needs eligibility criteria listed in this section. The Patient Transport Assessment Team is UCLH - 2013 3

responsible for determining the medical need by assessing each patient, against the following criteria:- The patient has a disability or condition which makes it difficult or impossible to access the hospital by other means The patient requires skilled assistance to transfer them to and from a vehicle and/or to manage stairs The medical condition of the patient is such that it would be detrimental to the patient s condition or recovery if they were to travel by any other means The patient s condition or behaviour is likely to be a risk to themselves or to others if the patient was to travel independently The patient would fail to attend for hospital-based treatment because of a confused state The patient suffers from a mental illness. Patients are asked pre-set questions to establish if they meet the criteria. The focus is not on the medical condition of patients but on the effect of the condition on their ability to travel independently by public or other methods of transport. If the result of the assessment is that a patient is eligible to travel with the PTS the assessor will determine the type of vehicle needed for the safe transportation of that patient. If following assessment, a patient DOES NOT meet the eligibility criteria, and is dissatisfied with the decision, the patient can appeal as outlined in 7.7 of the policy. 5.2 Eligibility for Escorts Escorts take up valuable seats on PTS vehicles which could be used by other patients. Places can therefore only be booked for escorts if the patient meets the escort criteria listed in this section: The patient is under 16 years of age The patient s condition is such that they require the constant attention of an escort during the journey The patient requires support from an escort, e.g. for assistance with toilet facilities during the journey The patient has severe communication difficulties, i.e. has a profound sight or hearing impairment, or has speech and language difficulties and cannot travel alone The patient suffers from a mental illness. UCLH - 2013 4

Unless the patient meets the criteria listed above patients who require an escort during their visit to the hospital must arrange to meet their escort at the hospital. Only one escort will be booked per patient unless circumstances are exceptional. 5.3 Exclusive use of vehicle Single use of vehicle will be provided to patients: who are neutropenic or post transplant who place a risk to other patients due to their medical condition who have or are at risk of infection. Exclusive use transport must be requested by Clinical Nurse Specialists and must be reviewed by a Clinical Nurse Specialist within 6 weeks of the initial authorisation. 5.4 Review of Need for Transport A patient s need for hospital transport must be reviewed prior to each visit by the Patient Transport Assessment Team to ensure that the eligibility criteria continue to apply. If a patient no longer meets the eligibility criteria for hospital transport, hospital transport must be withdrawn and the patient s records amended accordingly. When a patient s medical condition is deemed unlikely to improve sufficiently for them to be able to travel independently, they will no longer be required to go through the assessment process. 6.0 Duties The Transport Services Manager has overall responsibility for this policy. On a day to day basis transport bookings and coordination will be the responsibility of the transport Call Centre Supervisor. Duties and responsibility of each staff group are detailed below. Transport Call Centre Supervisor The Transport Call Centre Supervisor is responsible for a team of assessors who carry out the transport eligibility assessment for all patients who contact the department to request hospital transport. The Assessment Team The Assessment Team are responsible for taking calls from all potential service users, their relatives, carers or health professionals (including GPs) and carry out UCLH - 2013 5

an eligibility assessment as defined by the Department of Health s Hospital Transport Eligibility Criteria using a standard questionnaire. Ward Sisters/Charge Nurses The Ward Sister/Charge Nurse in charge of the discharging clinical area is responsible for ensuring that staff within their area of responsibility are aware of the content of this policy and follow it in practice. The Ward Sister/Charge Nurse is also responsible for ensuring that transport for all patients that meet the criteria is booked in a timely manner and reaches the transport department no later than 3pm the day before discharge. In all cases the assessment form (Appendix A) needs to be completed and emailed with the transport booking form (Appendix B) to the Transport Department. The assessment task cannot be delegated to any other person without the prior consent of a General Manager. Failure to request transport by 3pm on the previous day will result in the journey falling outside the scope of the transport contract and the cost of the journey will be charged to the clinical area that discharges the patient. 7.0 Details of the Policy 7.1 Outpatients & admission assessment All patients attending outpatient clinics throughout UCLH will undergo an assessment to determine whether they meet the hospital transport eligibility criteria to establish their medical need and the type of vehicle which is best suited to transport them to/from their outpatient appointments. Patients who ask for hospital transport will be provided with a Booking Hospital Transport leaflet (Appendix C) when they make their next appointment and will be asked to ring the Assessment Team no later than one week before their appointment date. The Assessment Team will ask each patient the same number of preset questions (Appendix D) and score the answer to reach a decision. If the decision is that the patient meets the eligibility criteria this will be recorded on Carecast. The Assessment Team will process the request. If the decision is that the patient does not meet the hospital transport eligibility criteria than that patient will be informed and advised of alternative methods of transportation. 7.2 In-patients Assessment In-patients being discharged from any UCLH hospital need to be assessed by a staff nurse using the same transport and escort eligibility criteria as listed in 5.1 and 5.2 and in all cases an assessment form must to be completed and emailed with the transport booking form to the Transport Department. The assessment task UCLH - 2013 6

cannot be delegated to any other person without the prior consent of a General Manager. 7.3 Transfers In-patients being transferred between hospitals within UCLH must be provided with hospital transport. In-patients being transferred to other health care providers or repatriated to their local hospitals must be provided with hospital transport. It is the responsibility of the receiving hospital to provide transport and therefore wards will need to contact the UCLH Transport Department so that they can liaise with the hospital to which the patient is being transferred. At least 24 hours advance notice of the transport request is required so that the appropriate arrangements can be made. It is the responsibility of the staff nurse to make sure that patients are appropriately dressed, have all their belongings and all medical notes must be handed to the transferring crew who should be instructed to transfer them to the relevant clinical staff at the receiving hospital. 7.4 Appropriate Clothing In order to maintain patient dignity, patients using hospital transport must be properly dressed in outdoor clothing and wear appropriate shoes when discharged from hospital or when being transferred to or from any other health provider. If there are clinical reasons for wearing other sorts of clothing, e.g. night wear, then the ward sister/charge nurse must inform transport, discuss this with the patient and record this in the patient s notes. The driver must also record this on the patient transport request form. Nursing staff must provide blankets so that the patient can be properly covered. If the patient specifically makes a request not to wear outdoor clothing and appropriate shoes, this must be recorded in the patient s notes by the ward sister/charge nurse and the transport department must be informed. The driver must record this information on the patient transport request form. 7.5 GP Referrals GP s book the patient s initial journey to the hospital, GP bookings are sent directly to the Transport Department. GPs use the same medical and escort criteria to determine whether a patient needs hospital transport. To book transport for further appointments the patient, their relative or carer will need to contact the Assessment Team. 7.6 Appointments for UCLH Patients at other hospitals Hospital transport, where appropriate, is normally arranged by the hospital treating the patient. Therefore if a UCLH patient has an appointment at another UCLH - 2013 7

hospital, transport will need to be organised by the hospital to which the patient is being transferred. In this case, the referring clinic or ward will need to contact the UCLH Transport Department so they can liaise with the hospital to which the patient is being transferred. At least 24 hours advance notice of the transport request is required so that the appropriate arrangements can be made. 7.7 Appeal If the patient does not agree with the decision of the Assessment Officer, the patient has the right to speak to a Supervisor or the Transport Services Manager who will try to resolve the transport issue or escalate to a Senior Medical Nurse who will contact the patient for a final assessment. The process will be as follows: The Supervisor will either overturn the decision of the Assessor and grant transport or uphold the decision. If the patient is still dissatisfied with the Supervisor s decision, the matter will be referred to the Transport Services Manager who will review the case. The Transport Services Manager will either overturn the decision and grant transport or escalate the case to the Senior Outpatient Sister. If the Senior Outpatient Sister determines that the patient meets the criteria then transport will be provided for the patient for that visit. If the Senior Outpatient Sister cannot make a decision over the phone; transport will be provided for the patient to attend their outpatient appointment and a face to face assessment will be carried out once the patient attends their appointment. It is the responsibility of the Senior Outpatient Sister to inform the Transport Department of the outcome of this assessment. The Senior Outpatient Sister s decision is final. If the patient remains dissatisfied with the decision they will be advised to follow the Trust s complaint process. 8.0 Monitoring/Audit. All patient transport requests will be checked by the Transport Call Centre Supervisor who will monitor the following: That transport provided is in line with the Department of Health s eligibility criteria That all assessments are carried out in a fair and equitable manner That all unsuccessful transport requests under appeal are reviewed by the Supervisor, Transport Manager or the Senior Outpatient Sister as appropriate The timeliness of all discharge requests The number of daily assessments The number of unsuccessful transport requests The number of escorts granted/refused. UCLH - 2013 8

The Call Centre Supervisor will report to the Transport Services Manger on a weekly basis who will report monthly to the relevant General Manager regarding transport activities within their area of responsibility. The findings of the department s audit and performance against service level agreements will be reported monthly at the divisional meetings and will also be available for Patient Issue Committee. 9.0 References Department of Health: Eligibility Criteria for Patient Transport Services (PTS) Transport Department Email: xxxxxxxxx.xxxxxxxxxx@xxxx.xxx.xx UCLH - 2013 9

Appendix A UCLH - 2013 10

PTS TRANSPORT ASSESSMENT/BOOKING FORM Appendix B Please tick the appropriate option. Use the mouse or Tab key to move between fields. 1. Does the patient have their own transport or a friend / relative that can help out? 2. Is there a medical reason for booking transport? 3. Is it medically necessary for an escort? If question 2 has been ticked then proceed to book a transport. Book an escort if one is needed. Day & Date of Discharge Time of Discharge Budget Code Family Name: First Name: Title: Patient s Telephone Number: Patient s Hospital / NHS Number: DOB: Please Tick Type of Journey: Discharge Transfer Home visit Treatment & Return COLLECT FROM: Hospital: CONVEY TO ADDRESS Ward: Bed Number: POST CODE WARD/DEPT/CLINIC Type of Transport: 10 Car Suitable 11 Ambulance 1 crew 12 Ambulance 2 crew for lifting 21 Car suitable but takes own chair 22 Ambulance 2 crew for lifting + own chair 31 Exclusive use of a car 32 Stretcher Ambulance 41 Ambulance 1 crew. Patient travels in own wheelchair 42 Ambulance 2 crew. Patient travels in own wheelchair 62 Exclusive use of an ambulance Escorts: Private escort: Medical escort: Special Note: e.g. Patient requires Oxygen, Blind, requires front seat, leg in plaster Assessed by: Print Name Extension number: UCLH - 2013 11

UCL HOSPITALS NHS FOUNDATION TRUST Patients who have multiple appointments over any three month period will only need to be assessed once for all their appointments within that tim e. Patients with clinical conditions or mobility which is unlikely to improve will be exempt from the assessment process but will still need to contact the assessment team so that their transport can be booked. Following a longer stay in hospital as an inpatient, transport will be arranged, if required, by the ward staff who will undertake an assessment on discharge to assess your transport needs. Cancellation: If your appointment is cancelled by the hospital or you can not attend your appointment, please ring us on 020 344 7010 to cancel your transport. How do we decide if an escort can accompany a patient in hospital transport? We use Department of Health guidelines to decide whether an escort is needed. The criteria are also based on a patient s clinical condition or mobility. If you meet the criteria then an escort will be booked to accompany you to and from the hospital. However, we aim to keep these to a minimum as escorts take up seats that would otherwise be used for patients. Types of vehicle An ambulance car or ambulance bus for patients with restricted mobility An ambulance bus or a stretcher ambulance Putting patients first We undertake to be friendly, helpful and welcoming, to treat all our patients with respect and to give assistance where necessary. Quality Standards W e aim to ensure that: 95% of patients who use hospital transport arrive at the hospital no earlier than 45 minutes before and no later than 15 minutes after their appointment time. 95% of patients leave hospital within 60 minutes of reporting ready to the transport desk. If you wish to comment on our patient transport services, please complete one of our Patient and Visitor comment card and place it in the grey comment boxes, or write to: Mr Ridha Gabsi, Transport Services Manager Transport Department 250 Euston Road London NW 1 2PG Email: ridha.gabsi@uclh.nhs.uk Contact details: Transport assessment-booking team: Telephone: 020 344 7010 (Mon to Fri, 9am-5pm Complaints Department 2 nd Floor west 250 Euston Road London NW 1 2PQ If you need a large print, audio or translated version of this document please ring XXXX. We will try our best to meet your needs. Publication date: Last review date: Next review date: Leaflet code: University College London Hospitals NHS Foundation Trust Main switchboard: 0845 155 5000 Inform ation for patients The Patient Transport Service If you are a patient coming to UCL Hospitals for the first tim e, this leaflet explains what you can expect from our transport services. UCLH - 2013 12 Review by Date: 30 Oct 2016

UCL HOSPITALS NHS FOUNDATION TRUST If you possibly can, we ask you make you own way to the hospital by using public transport or by getting a friend or relative to take and collect you by car. Please note that street parking near all the Trust hospitals is extremely limited. How hospital transport is booked? For your first visit to hospital, transport will be requested by your GP who will only book this for medical or mobility reasons. For any follow up appointment you will need to contact the transport assessment team to book transport. How do we decide who qualifies for transport? Under Department of Health guidelines, hospital transport is only provided to those patients whose clinical condition or mobility makes it difficult or impossible for them to attend hospital without our assistance. To help us decide whether patients meet these requirements they are given a short assessment. If you think you may be eligible and wish to be assessed, you can contact the transport assessment team on 020 7380 9757 as soon as you receive your appointment. What does the assessment involve? This is a brief, very confidential, interview by a nurse-led assessment team to make sure that you meet the criteria. The questions you will be asked are based on your clinical condition and your mobility. If you are coming to hospital for day surgery, please advise the assessor so that your homeward journey can be booked at the same time. If you need help to apply for hospital transport, a friend, a relative or a carer can call on your behalf. What can you do if you fail the assessment? You will need to find an alternative way of getting to the hospital. However, if you feel that the decision of the assessment team is incorrect, you have the right to ask to speak to a supervisor or the transport manager. They will try to resolve your transport issue or will pass your details to a designated senior nurse who will contact you for a final assessment. This senior nurse s decision will be final. If you still disagree with the decision, you have the right to write to our complaints department. What happens after you have been assessed? If your request for hospital transport has been approved by the assessment team, a booking will be placed on the transport computerised booking system. On the day before your hospital appointment (Friday, if your appointment is on a Monday) a member of the transport team will contact you to: Make sure you are attending your appointment Confirm your address Check that the correct type of vehicle has been requested for you Make sure you still need hospital transport When will you be collected? Your collection time will depend on how near your address is to the hospital. You will be told the day before your appointment what the approximate pick up time will be. Journeys are planned to make the most effective use of our resources. This means that other patients may be collected by your transport on route to the hospital. Please be ready when your ambulance arrives, as drivers cannot wait more than 10 minutes. What happens when you get to hospital? You will be taken from your transport to the main hospital reception area and then given directions to the department where your appointment is taking place. If you need help, a porter will be arranged to take you there. After your appointment You should return to the patient transport waiting area. If you need help, a porter will take you back. This will be arranged by hospital staff in your clinic. You should report to the transport desk where your transport home can be organised. Going Home The Transport Department does its best to make sure that patients have as short as possible wait time for their journey home. However, you should be prepared to wait up to 60 minutes for transport home. Please remember that journeys are planned to make most effective use of our resources, which means the route may be arranged to drop off other patients on the way. What happens if you have another appointment or I am being admitted for more than one day? Patients who need to attend hospital on a regular basis radiotherapy patients, for example will be assessed for transport for the entire block of treatment. UCLH - 2013 13 Review by Date: 30 Oct 2016

UCL HOSPITALS NHS FOUNDATION TRUST UCLH - 2013 14 Review by Date: 30 Oct 2016