Patient First Transport Survey 2006/07 Report Vicky Lowe Mark Liquorish Clinical Audit Department & Appliances/Transport Liaison Manager
Contents 1. Background & Methodology 3 2. Results 4 2.1 Arrival 4 2.2 Departure 4 2.3 Patient First Transport Staff 5 3. Comments 6 3.1 Patient Survey Comments 6 3.2 Ward Comments 9 3.3 Additional Comments 9 4. Conclusions 10 5. Recommendations 11 2
1. Introduction & Methodology Patient First Transport Services are a locally based, family run business. The ethos of the company, as its name implies, is that the patient comes first. The Trust has used them on an ad-hoc basis for four years. However, in April 2006, Patient First Transport Services were rewarded the contract for the Trust in place of the Shropshire Patient Transport Services, part of the West Midlands Ambulance (WMA) Service. It is estimated that over the next three years the Trust will avoid costs of 1.2m based on forecast costs of WMA compared to those of Patient First Transport Services. This is after fully providing for 150k of costs currently in dispute between S&TH and WMA relating to the handover period between April and June 2006. Following the award of the Patient Transport contract to Patient First, the Board asked that a patient satisfaction audit be undertaken to ensure that the quality of service had not deteriorated. The results presented in this report are for the Patient First Transport Survey, carried out at the Shrewsbury and Telford Hospital NHS Trust. The survey was carried out during winter 2006/07. Questionnaires were given to patients at the end of their hospital appointment. Patients were advised that the survey was both voluntary and anonymous and that if they chose not to take part in the survey their NHS care would not be affected in any way. Patients who chose to take part in the survey were given a covering letter, questionnaire and an envelope. Patients were asked to complete the questionnaire and return it to a member of staff (in order to reduce trust costs). However, patients were also given the opportunity to complete the questionnaire at home, and in these instances patients were asked to return the completed questionnaire in the FREEPOST envelope provided. The covering letter provided patients with a freephone number to contact the Clinical Audit Department with any queries or concerns regarding the survey. As questionnaires were returned they were scanned into a database and at the end of the survey period, all data quality checks were carried out. The Clinical Audit Department carried out the analysis for the questions included in the survey. 3
2. Results A total of 69 patients completed the Patient First Transport questionnaires. The survey data was analysed by the Clinical Audit Department. 2.1 Arrival 41 patients (67.2%) arrived at the hospital 5-45 minutes prior to their scheduled appointment time. A further 4 patients (6.6%) arrived more than 45 minutes before their appointment was due to start. 7 patients (11.5%) arrived at the hospital at the time that their appointment was due to commence. 9 patients (14.7%) arrived late for their appointment. For patients who arrived late for their appointment, the longest time recorded was 1 hour. Calculations exclude the 8 patients who did not answer questions pertaining to these results. 2.2 Departure 42.2% did not experience a wait for Patient First Transport to arrive to take them home. 45.3% experienced a short wait 12.5% experienced a long wait. It is notable that two of these patients were also late for their scheduled appointment How long did you wait for the hospital transport to arrive to take you home? Answer Number % I did not experience a wait 27 (42.2%) I experienced a short wait 29 (45.3%) I experienced a long wait 8 (12.5) NR 5 The 37 patients who experienced a wait were asked if they had received an explanation. Over half of these patients -18 (51.4%) were given a complete explanation for the delay, whilst 7 (20%) were given an explanation to some extent. A further 7 (20%) of patients did not receive an explanation for the delay they experienced. Did you receive an explanation for the wait you experienced? Answer Number % Yes, completely 18 51.4 Yes, to some extent 7 20 No 7 20 Don t know/can t remember 0 0 Not applicable 3 8.6 NR 2 4
2.3 Patient First Transport Staff 59 patients (92.2%) felt the Patient First Transport staff were very reassuring, and a further 3 patients (4.7%) felt this was the case to some extent. Two patients (3.1%) felt this was not the case. Were the transport staff reassuring? Answer Number % Yes, definitely 59 92.2 Yes, to some extent 3 4.7 No 2 3.1 Don t know/can t remember 0 0 NR 5 64 patients (95.5%) felt that Patient First Transport staff had treated them with complete respect and dignity, and a further two (3%) felt this was the case to some extent. Only one patient (1.5%) of respondents felt this was not the case. Overall, did the transport staff treat you with respect and dignity? Answer Number % Yes, definitely 64 95.5 Yes, to some extent 2 3 No 1 1.5 Don t know/can t remember 0 0 NR 2 64 patients (95.5%) felt the Patient First Transport staff had made them feel comfortable and welcome, and a further three (4.5%) felt this was the case to some extent. There were no respondents in the survey who had been made to feel uncomfortable or unwelcome. Overall did the transport staff make you feel comfortable and welcome? Answer Number % Yes, definitely 64 95.5 Yes, to some extent 3 4.5 No 0 0 Don t know/can t remember 0 0 NR 2 5
3. Comments 3.1 Patient Survey Comments The final section of the survey invited patients to comment on aspects of their Patient First Transport experience. 33 patients made one or more comment regarding the service. Whilst the majority of comments were either clearly positive or negative, some comments covered both positive and negative aspects of the service and thus have been separated and placed into the appropriate sections. The comments were largely positive (73.7%) and were primarily related to staff attitude and care. The patient comments are listed below.! " $ % & '( ) ( $ * %% 6
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26.3% of comments were negative, and mainly focused on picking up times, and travelling with other patients. It is notable that a number of the negative patient comments were related to previous transport services, ambulance services and/or to aspects of the service which are standard procedure at the trust. This further reflects the improvements that the new service provides. If adjustments were made to exclude these comments from calculations, the percentage of negative results would be reduced considerably. However, as these comments can not always be clearly defined it is not possible to provide an accurate calculation of these results. 0 0 ') ') 1 ( <! > ( " 0?! ( 4+ " ". @ ( < 3 0 55A9! 3( 5 ( 3 (. ( 5;7:;( 3 3 @ ;B7:;5:7:; 8
0. 0 3 3.2 Ward Comments In addition to the patient survey, the ward staff at the Trust were asked to give their views on the service provided by Patient First Transport. As wards are in continual contact with transport services they are often better placed to comment on both the previous and current transport service. Overall ward comments were very positive, primarily focussing on a more patient focussed service, a more flexible service and an improved service with regards to transporting patients to and from the hospital. Some of the specific comments are listed below. The Stroke Unit at RSH felt the service was much better, more patient focussed and that patients were delivered on time. The Intensive Therapy Department was happy with the service and felt staff were extremely helpful and polite and turned up on time. The Day Hospital was pleased with the service provided by Patient First Transport. They thanked the transport department for the new transport service and advised that transport teams had shown great patience with the staff when patients were delayed or return destinations had changed for patients. They added that the flexibility and co-operation was really helping them to establish the service they provide at the Day Hospital and TRASE. When asked to compare Patient First with the previous service, provided by Shropshire Patient Transport Services, ward staff felt that there had been a considerable improvement in recent months. Overall, it was felt that the previous service had been unable to meet the demands of SaTH, with comments focussing on the frequent delays in transport, (particularly with regards to the Renal department and Outpatients Department), and numerous cases where transport services had failed to arrive. It was also suggested that the new contract with Patient First Transport Services provides complete assistance 365 days a year, compared to the week day only service provided by Shropshire Patient Transport Services. 3.3 Additional Comments A number of additional comments were made regarding the Patient First Transport service. Lord Biffen of Tanant wrote from the Houses of Parliament expressing delight at a much improved service. During the recent bad weather, Shropshire Ambulance reported that Patient First responded magnificently and delivered all patients home safely despite severe weather and traffic chaos. The chief ambulance officer for the West Midlands Ambulance Service said that private companies working in the West Midlands on patient transport all ceased to operate because of the weather. Some GP Practices were a little unhappy with the service due to the rigid adherence to booking criteria and inappropriate patients being refused. 9
4. Conclusions The Patient First Transport Survey was carried out during winter 2006/07. A total of 69 surveys were returned from patients visiting both sites in the Trust. The results of the survey were very encouraging and highlighted a good level of patient satisfaction with regards to transport services. The majority of patients were transported to their hospital appointment on time. For patients who arrived late, the longest reported delay was one hour. With regards to leaving the hospital, patients frequently reported that they did not experience a wait for Patient First Transport to take them home. Responses pertaining to staff were excellent. The majority of survey respondents felt that transport staff had been reassuring, had treated patients with respect and dignity and had made patients feel comfortable and welcome during their transportation to and from their hospital appointment. Almost three-quarters of patients commented on positive aspects of their transport experience. These comments covered areas pertaining to staff attitude and care. Negative comments focused primarily on waiting times and patients sharing transport vehicles. In addition to the patient comments, staff on the hospital wards were also asked their views regarding the new transport service. In general, staff felt the new system was more patient focussed, better at time keeping and that staff were more polite and caring. In addition to the patient survey, the ward staff were also asked to give their views on the service provided by Patient First Transport. As wards are in continual contact with transport services they are often better placed to comment on both the previous and current transport services. Ward comments were very positive, primarily focussing on a more patient focussed service, a more flexible service and an improved service with regards to transporting patients to and from the hospital. Staff also commented that the previous service had been unable to meet the demands of SaTH, but that as the new service provides assistance 365 days a year, this is no longer a problem. Overall, Patient First Transport Services has succeeded where the previous service did not. They are well on their way to meeting the existing performance indicators which state that patients should be removed within 1 to 2 hours of discharge and that 95% of patients should be delivered to their outpatients appointment on time. 10
5. Recommendations The Trust will share the results of the survey with Patient First Transport Services The results will be used as a basis for the development of performance indicators for the service. The survey should be repeated in 12 months time, in order to monitor performance. To monitor and improve compliments and complaints To continue to ensure that the high standard is maintained 11