Non-Emergency Transport for Health Patients in Somerset

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(Health Scrutiny Sub-Committee – 10 March 2008)The Social Exclusion Unit report ‘Making the Connections’ requires LocalAuthorities and other agencies, including Health Trusts, to work in partnership toachieve integrated, joined up solutions thus improving access to services.In 2005 ‘Our Health, Our Care, Our Say’ white paper set out a vision to providepeople with good quality social care and NHS services in the communities inwhich they live. The paper made a commitment to extend eligibility for theHospital Travel Cost Scheme (HTCS) and Patient Transport Services (PTS) toinclude procedures that were traditionally provided in hospitals but are nowavailable in a community setting.Somerset’s Local Transport Plan 2 identified access to Health care as a majorconcern for Somerset’s residents. The Accessibility Strategy stated that:28% of rural residents have to travel (by public transport) for longer that30 minutes or have no bus service at all to their nearest GP.43% of Somerset residents have to travel longer than 1 hour or have nobus service at all to their nearest General Hospital (51% from rural areasand 37% from urban areas).24% of rural residents have to travel longer that 1 hour or have no busservice at all to their nearest Community Hospital.The plot in Appendix 1 shows General and Community Hospital accessibility inSomerset between the hours of 07:00 and 10:00 by public bus transport – whiteshowing no access at all. Worth noting this plot does not include access to anycommunity transport or demand responsive transport. It shows a largeproportion of rural locations have no public transport access to General orCommunity Hospitals between the hours of 07:00 and 10:00, with only thoseliving alongside main roads and arteries managing a reasonable journey (lessthan 2 hours).The Department of Transport have introduced free off-peak local bus travel forolder and disabled people in England. From April 2008, a national concessionaryfare scheme will be introduced to offer these groups free off-peak travel on busesanywhere in the country.3.3. Who provides patient transport in Somerset?In Somerset, the South Western Ambulance Trust (SWAST) delivers the majorityof non-emergency health transport.3.3.1. Providers of PTSSouth Western Ambulance Trust (SWAST) delivers the majority of PTS inSomerset. This is done through service level agreements (SLA) with the acutetrusts and the PCT.Providers usually use a mix of multi-seat ambulances and cars to meet demand.These vehicles are often similar to the minibuses used by local authorities tocarry social services clients and those with special educational needs, containingboth seats for people who are able to walk and space to carry wheelchairs.4 of 9
(Health Scrutiny Sub-Committee – 10 March 2008)3.3.2. Providers of VACSSouth Western Ambulance Trust (SWAST) delivers the majority of VACS inSomerset. This is done through service level agreements (SLA) with the acutetrusts and the PCT. Private providers are sometimes used by acute trusts.The Ambulance Trust has given notice on the VACS contracts side. Althoughthe SLA expires at the end of March 2008 the Ambulance Trust have agreed tocover this service for another year or until such time that the Trusts can either retenderthe contract or work with the local authority to provide the service underan SLA.There are Service Level Agreements for VACS in Somerset with the followingTrusts;Taunton and Somerset NHS Foundation Trust;Yeovil District Hospital NHS Foundation Trust;Somerset Partnership NHS and Social Care Trust;Somerset Primary Care Trust;Weston Area Healthcare NHS Trust;North Somerset Primary Care Trust.Cars are be used to provide the services and may include taxi and hired carservices (typically used for work outside the patient transport service’s normalweekday hours) and volunteer car services in which volunteers use their owncars to carry people to and from hospital (mileage allowances paid coveringadditional motoring costs).3.4. Who commissions patient transport in Somerset?The key Commissioners on behalf of Cornwall, Isles of Scilly, Devon, Dorset andSomerset Trusts are the ‘Dorset and Somerset Procurement Confederation’ andthe ‘Peninsula Purchasing Alliance’. The PCTs are ultimately responsible for thecost of PTS, as it remains within the relevant tariffs of Payment by Results.Where it is decided the acute trust should not be responsible for providing PTSthen the tariff should be adjusted to allow the PCT to contract for PTS directlywith the providers. Provider units (e.g. hospitals) are responsible for theadministration of Hospital Travel Costs Scheme (including VACS) and theprovision of payments to patients. PCTs are responsible for reimbursing providerunits for the payments made under the scheme for all patients resident withintheir districts, also through the Payment by Results tariff with the exception ofmental health where other reimbursement must be made.3.5. Who is eligible?3.5.1. Eligibility for PTSIn response to the 2006 white paper in September 2007 the Department ofHealth reissues its guidance on the eligibility criteria for patient transportservices. The guidance states that eligible patients are those: where the medical condition requires the skills or support of PTS staff orwhere use of other means of transport would be detrimental to the patientscondition.5 of 9
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Non-Emergency Transport for Health Patients in Somerset

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