Make your own way to appointments, say health bosses

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An NHS boss says more patients need to make their own way to doctors appointments as non-emergency transport services struggle to meet increasing demand.

Non-emergency patient transport activity data provided by the Yorkshire Ambulance Service (YAS) has revealed the number of journeys in 2017/18 has increased by 10.6 per cent compared to the previous year, with an average of 6,200 journeys per month.

People who are typically eligible for patient transport services (PTS) include those that have a medical condition which prevents them from getting to their appointment by any other means.

However, after a rise in non-eligible people requesting on-demand transport to appointments, Jane Hawkard, chief officer at East Riding of Yorkshire CCG, said more needs to be done to sign-post patients to other means of transport to prevent a further strain on already stretched services.

She said: “People do demand transport as if it’s a right, and it’s not, we come across this every day and there’s probably just not enough clarity as a system about what we will provide and actually what people need to provide for themselves and I just think we’ve probably skirted round it quite a lot of the time and perhaps now is the time to come up with a system offer.

“The alternative is that you have to find your own transport whether that’s a taxi, a friend, a patient, and we’ve come up against this quite a lot with our urgent care and through NHS 111, but we’re really clear with patients that really you do have to find your own way there.

“I know it’s a hard message but sometimes it’s just better to be really clear rather than just trying and trying when we know actually we can’t do it. We can only provide so much, and people have to be realistic.”

The East Riding Clinical Commissioning Group (CCG) currently does not have a commissioned patient transport service in place for non-emergency patients who fail to meet the eligibility criteria. Transport is often arranged at short notice and on an ad-hoc basis, at an annual cost of around £50,000.

Colin Walker, transport services manager at East Riding Council, suggested that a more planned approach is needed in what is a predominantly rural area as there isn’t currently the capacity to deliver an on-demand patient transport service (PTS).

He recommended that a joint task and finish group be set up between the CCG and East Riding Council to consider how signposting for non-eligible patients from YAS to other appropriate non-emergency transport provision can be developed, implemented and funded.

He said: “If such a mechanism isn’t established there is a danger that there could be escalation of people’s conditions if they don’t manage to access the care that they need.

“The position at the moment is that outside of what the CCG commissions with YAS for eligible transport through PTS there is no other commissioned services in place to meet the sort of needs that may well arise when the eligibility criteria are significantly tightened.”

YAS is one of the largest providers of patient transport in the UK, undertaking almost a million non-emergency journeys every year. It has a fleet of more than 370 vehicles, employs over 600 team members and has in excess of 200 volunteers helping to operate the service.

At the moment the CCG receives requests from social workers, the Continuing Healthcare team, Child and Adolescent Mental Health Services (CAMHS), Humber Teaching NHS Foundation Trust and Hull and East Yorkshire Hospitals NHS Trust.

The transport service exists primarily to support discharges from hospital to social care placements and for mental health conveyance. It is also used to transport individuals to and from respite placements, to move individuals between residential and nursing homes, and to carry out journeys beyond the YAS boundary in cases where YAS or their other providers out of area cannot pick this up.

Councillor Jane Evison said: “We’ve been trying for years to work with Yorkshire Ambulance Service to help them with patient transport and for whatever reason it just hasn’t happened and it should’ve done because it made absolute sense.

“You’ve got community transport, you’ve got vehicles going in exactly the same direction and passing patient transport at the YAS with perhaps one person on it, it’s been stupid.”

Members of the Health and Wellbeing Board agreed with recommendations that a task and finish group be set up to better establish how non-eligible patients can be redirected from YAS to other appropriate non-emergency transport provision.

Jack Muscutt , Local Democracy Reporting Service