Birmingham, Sandwell and Solihull Non-emergency patient transport service. Staff briefing

Transcription

1 Birmingham, Sandwell and Solihull Non-emergency patient transport service Staff briefing

2 Contents Key points of this briefing:... 2 What is non-emergency patient transport?... 2 Who provides non-emergency patient transport?... 3 Inclusion and exclusion from NEPT... 3 GP referral for same day assessments at an acute NHS trust... 4 Guidance for GPs referring out-of-hours... 4 Transport to neighbouring trusts... 5 Core geographic area covered by service... 6 Eligible patient transport... 6 Outpatients... 7 Discharges... 8 Renal... 9 High dependency Bariatric service Out-of-area referrals Equipment Patient eligibility Escorts Patient mobility Booking NEPT services Collecting a patient earlier or later than planned Online system access NEPT waiting time Patient experience Healthcare Travel Cost Scheme Service standards Contact details Appendix 1: Full list of associated CCGs Appendix 2: GP referral process Appendix 3: Out-of-area transport process

3 Key points of this briefing: The new non-emergency patient transport service (NEPT) launches on 01 May 2017 and is provides by West Midlands Ambulance Service NHS Foundation Trust (WMAS). New NEPT bookings: Enquiry line: Both numbers are open 24/7, all year round The eligibility criteria will be applied to all patients, regardless who is requesting NEPT, and will be re-checked during transportation. All patients will have the facility to let the NEPT service know if their appointment has finished earlier than expected. Escorts are only permitted to travel with a patient in-line with the eligibility criteria. NEPT will only wait 10 minutes for a patient who has already been booked as ready to be collected. Text message updates are available for patients and will notify patients when the ambulance is on its way. Patients will be offered the opportunity to provide instant feedback, via text message, of their experience on completion of their journey. What is non-emergency patient transport? NEPT helps eligible patients who have a medical need, and who are unable to travel by private or public transport, to get to and from NHS healthcare services. This service helps eligible patients who are: Accessing hospital services; Being transferred between services; or Returning home from hospital. NEPT services aim to give patients safe, timely and comfortable transport. These services are available free of charge for eligible patients. 2

4 NHS Clinical Commissioning Groups (CCGs) are responsible for commissioning NEPT services for eligible patients providing a range of services to meet their needs. This NEPT service is commissioned by seventeen West Midlands CCGs, whose patients access NHS trusts services in Birmingham, Sandwell and Solihull. A list of the associate CCG commissioners is set out in appendix 1. Who provides non-emergency patient transport? Following a competitive procurement process in 2016, West Midlands Ambulance Service NHS Foundation Trust (WMAS) was appointed as the provider of the Birmingham, Sandwell and Solihull NEPT services, which will commence on 1 May WMAS is very experienced in delivering NEPT services and has been commissioned to provide this service for the next five years - until April WMAS utilise the latest technology and vehicles to ensure services meet the standards as set out in the service specification. There are two operating locations, in Aston and Frankley; that latter houses the ambulance vehicles and is where NEPT staff commence their duties. The non-emergency operations centre (NEOC) is located in Frankley. The NEOC controls and plans the transportation of patients daily and operates 24 hours, seven days per week. Transport requests are facilitated at this site by experienced booking agents who ensure that all patients meet the Birmingham, Sandwell and Solihull eligibility criteria for non-emergency patient transport, which can be accessed here: If patients do not meet the NEPT eligibility criteria, alternative information will be provided by the WMAS booking office staff. Inclusion and exclusion from NEPT WMAS will provide safe, comfortable and timely transport to eligible patients, working collaboratively with all NHS trusts in the scope of this contract. The NEPT service will transport eligible patients of the following NHS trusts: Birmingham Women s Hospitals NHS Foundation Trust Birmingham Community Healthcare NHS Foundation Trust Heart of England NHS Foundation Trust Royal Orthopaedic NHS Foundation Trust (from January 2018) 3

5 University Hospital Birmingham NHS Foundation Trust This includes conveyance to many of their main healthcare premises: Birmingham Chest Clinic Birmingham Women s Hospital Good Hope Hospital Heartlands Hospital Solihull Hospital The Royal Orthopaedic Hospital (from January 2018) Queen Elizabeth Hospital Birmingham West Midlands Rehabilitation Centre Moseley Hall Hospital West Heath Hospital Birmingham Dental Hospital GP referral for same day assessments at an acute NHS trust This service is for patients registered with a GP in the following CCG areas: NHS Birmingham CrossCity CCG NHS Birmingham South Central CCG NHS Sandwell and West Birmingham CCG Solihull CCG who have been referred by their GP, or another healthcare professional (HCP), to an acute NHS trusts for a same day assessment or admission (typically to a Clinical Decision Unit or an Acute Medical Unit). It is the responsibility of the GP or referring HCP to decide whether the patient is suitable for conveyance via the non-emergency patient transport service (NEPT) within 2 hours, rather than via the WMAS urgent and emergency contract. The decision should be based on the patient s clinical condition, with consideration of the length of time the patient may have to wait and/or if they require paramedic trained staff to attend. If the patient s condition is likely to deteriorate and be life threating, GPs should call 999. GPs should make the referrals for their patients via the Birmingham Community Healthcare NHS Foundation Trust Single Point of Access (SPA). Staff within this service will check suitability for NEPT and if the patient meets the eligibility criteria policy. 4

6 The detailed pathway and principles are set out in Appendix 1. Guidance for GPs referring out-of-hours GPs are responsible for providing the patient with the necessary information to enable them, or their representative, to book NEPT services. Such requests must be made at least 48 hours in advance and will require a booking form to be completed. Repatriations will typically be booked by a healthcare professional responsible for the discharge of the patient; for long distance journeys this needs to be arranged at least 48 hours in advance. Late bookings may lead to a delay in discharging the patient. The process for managing out of area NEPT services can be found in Appendix 3. There is a separate briefing for GPs available. Transport to neighbouring trusts Patients who are eligible and registered with a GP in the following CCG areas: NHS Birmingham CrossCity CCG NHS Birmingham South Central CCG NHS Sandwell and West Birmingham CCG NHS Solihull CCG May also be conveyed to and from: Worcestershire Acute Hospitals NHS Trust University Hospitals Coventry and Warwickshire NHS Trust South Warwickshire NHS Foundation Trust George Eliot Hospital NHS Trust This includes conveyance to or from any of the following: Alexandra Hospital, Redditch Kidderminster Hospital Worcester Royal Hospital 5

7 Warwick Hospital Hospital of St. Cross, Rugby Royal Leamington Spa Rehabilitation Hospital Stratford Hospital Ellen Badger Hospital, Shipston on Stour University Hospital of Coventry and Warwickshire NHS Trust George Eliot Hospital NHS Trust, Nuneaton Core geographic area covered by service The main NEPT service, other than where indicated, is provided to the patient populations of the seventeen West Midlands CCGs listed below, this is the core geographic area covered by this contract: NHS Wolverhampton CCG NHS Dudley CCG NHS Walsall CCG NHS Sandwell and West Birmingham CCG NHS Shropshire CCG NHS South Worcestershire CCG NHS Telford and Wrekin CCG NHS Birmingham Cross City CCG NHS South East Staffs and Seisdon Peninsular CCG NHS Cannock Chase CCG NHS Stafford and Surrounds CCG NHS Redditch and Bromsgrove CCG NHS Wyre Forest CCG NHS Herefordshire CCG NHS Solihull CCG NHS Birmingham South and Central CCG NHS South Warwickshire CCG Eligible patient transport Eligible patient transport can include: Inpatient admissions Inpatient discharges Outpatient and day case attendance 6

8 Transfer between destinations, including on occasions outpatients who require further consultation on another site and require transport between the sites (excluding place of residence) Patient assessment home visits Renal dialysis Transfer of low-risk mental health patients (as determined by a clinical risk assessment) High dependency patients End-of-life patients for their final journey, to a preferred place of death However, the following are not included: Patients requiring an emergency ambulance Patients attending A&E for an inward journey (except GP referrals, please see relevant section) Out-of-area transport request where the patients home CCG have not agreed funding High-risk mental health patients or those requiring secure mental health transport Transport for primary care services (e.g. GP surgeries, health clinics, dental services) Prisoner transport Neonatal transport Non-NHS patients (i.e. private patients) Patients requiring transport outside of the United Kingdom Unaccompanied children under 16 years of age Visitors to hospital Inward journeys for patients registered at a GP outside of the core geographical area Deceased patients Transporting NHS staff Laboratory samples Outpatients Patients attending an outpatient appointment will be taken to the booked department and the ambulance staff will inform the reception or a clinician of the patient s arrival. If the patient is in a WMAS wheelchair or stretcher, the patient will be transferred to a suitable location. 7

9 NEPT can be requested to wait and return with a patient; this is only where the patient will receive treatment on immediate arrival and takes no longer than 10 minutes to complete. Some outpatient clinics will have a kiosk installed for patients, so they can inform the NEPT booking office they are ready for their transport home. This will be an easily accessible touch-screen computer, provided by WMAS. Alternatively, outpatient clinics should inform the NEPT booking office when patients are ready for collection. The patient will then be collected from the booked pick-up location. Please note all patients attending outpatient clinics will have an automatic booked collection time, there will be the facility to book patients ready to collect, if they are ready earlier than planned. Discharges Healthcare professionals can book NEPT 24/7, for eligible patients who are being discharged, however the eligibility criteria will be applied to all patients. This means that NEPT will only be provided for patients who have a medical need for conveyance. It is important that all other means of travel have been exhausted, such as family, friends, public transport and private hire taxis services. NEPT services are not provided for social or financial reasons, it is strictly based on a patient demonstrating they have a medical need and are prohibited from travelling by other means, as per the eligibility criteria policy. For patients who do not meet the eligibility policy criteria, alternative transport information will be provided. Discharge co-ordinators (DisCo) will be employed by WMAS to assist in the facilitation of prompt discharges across NHS hospital services. Their role will be to liaise closely with NHS site teams and to ensure correct eligibility and mobility of patients. These co-ordinators will operate as a shared resource, Monday to Friday (times to be confirmed), on the following NHS sites: One WTE (DisCo) for University Hospitals Birmingham NHS foundation Trust and Birmingham Women s Hospital NHS Foundation Trust. One WTE (DisCo) for the Heart of England NHS Foundation Trust. One WTE (DisCo) for Birmingham Community Hospitals NHS Trust and Royal Orthopaedic Hospital NHS Foundation Trust. 8

10 Renal Patients, who receive regular renal dialysis treatment, will be conveyed if they meet the eligibility policy criteria. Patients will automatically have a collection time added of 4.5 hours from the appointment time. Patients, who have shorter dialysis, will have a collection time of 3.5 hours from the appointment time. The standards for collection are within 30 minutes of scheduled collection time; please see full standards in the following sections. It is expected renal treatment times are separated into morning patients at 08:00 hours, afternoon patients at 13:00 hours and twilight patients at 18:00 hours. In circumstances where a patient s collection time requires altering, renal staff can contact the NEOC and inform NEPT of the appropriate ready time of the patient. We aim to get patients in on time for their appointment, however if patients are late due to unforeseen circumstances, the staff at the renal units are to advise if they require the pick-up time to be adjusted or if it is to remain the same. In order to do this, staff are required to follow the ready time section. WMAS will employee two renal co-ordinators (RenCo) to liaise closely with renal dialysis centres on patient matters, ensure efficient use of NEPT services, and assist in ensuring renal patients undertake eligibility and mobility assessments. They will also focus on working collaboratively to ensure services are offered to a high standard and agree service improvements for renal patients. These co-ordinators will operate as a shared resource as follows: West Hereford Dialysis Worcester Dialysis Queen Elizabeth Hospital Woodgate Valley Dialysis Smethwick Dialysis Great Bridge Dialysis East Redditch Dialysis Kings Norton Dialysis Solihull Dialysis Heartlands Dialysis Sparkhill Dialysis Balsall Heath Dialysis 9

11 Castle Vale Dialysis Aston Cross Dialysis High dependency NEPT services will operate a 24/7 high dependency provision, which can be used for patients requiring cardiac monitoring or ongoing observations during their transport. As an example high dependency patients may typically include: Patients requiring transfer for cardiac care and require ongoing cardiac monitoring Patients who require inhaled analgesia during transportation Patients who are likely to require suctioning during transport End-of-life patients who have complex medical needs, but do not require further clinical capabilities Urgent referrals to an acute trust made by a GP The high dependency service will only operate as an extension to NEPT services for eligible patients and within the mobility classification; it does not include conveyance where invasive techniques and/or paramedic crew are required. High dependency NEPT staff will receive additional training in the management of such patients. Bariatric service All WMAS ambulance vehicles have the capability to undertake the conveyance of bariatric patients. These are complex transport requirements and will need to be prebooked. Out-of-area referrals It is recognised the local NHS trusts (as set out on page 3 and 4), do offer services for patients who are registered with a CCG outside of the core geographic area. The patient s home CCG is responsible for provision and funding of NEPT services for their patients. NHS trusts are responsible for planning discharges for these patients and liaising with the patient s home CCGs to arrange transport. In such circumstances, NHS trusts may approach the WMAS NEPT booking office to see if they are able to arrange and/or undertake the NEPT journey on the basis that 10

12 the home CCG funds. This will be subject to capacity and journeys within the core geographic area shall take priority. WMAS cannot guarantee a same day service for out-of-area patients can be provided, so advance notice of at least 24 hours is usually required. In addition to the above, WMAS are also contracted to undertake out of area journeys to enable a patient of one of the four Birmingham, Sandwell and Solihull CCGs to access NHS services outside of the core geographical area or be repatriated. Equipment Patients will be transported with personal belongings that can be secured; usually this is limited to one bag. Patients may travel with equipment, if this is required for medical or mobility reasons, such as walking aids and prostheses, where this has been booked in advanced. Healthcare professionals arranging NEPT should make arrangements for other items to be transported. Patient eligibility All patients requesting NEPT services will have their eligibility checked. The only exception to this is when a patient is determined by a clinician as end-of-life and requires transportation to a preferred place of death, where death is imminent. No patient groups automatically qualify for NEPT and it is the responsibility of the patient, or their representatives, to demonstrate how they meet the eligibility criteria policy. The Birmingham, Sandwell and Solihull eligibility criteria for non-emergency patient transport is available here: The eligibility criteria explores the patient s medical need for NEPT and non-eligible patients will be directed to alternative methods of travel, including: Friends and family Public transport Community transport providers Ring and ride transport Volunteer services Taxis 11

13 Healthcare Travel Cost Scheme (HTCS) Other charitable organisations Patients do not have a formal right to appeal a decision, however where patients have called the NEOC to make a booking and subsequently did not meet the eligibility criteria, a reconsideration of the decision can be requested if they feel they have additional information that demonstrates how they meet the eligibility criteria. This will be completed by the NEOC supervisor. If the patient remains dissatisfied, they have the right if they wish to make a complaint via WMAS Patient Experience Team (PALS); details can be found on page 17. NHS trusts are encouraged to only make NEPT bookings when all other alternative methods of travel have been exhausted (e.g., if a patient is able to self-care and can travel by a private taxi, then they would not meet the eligibility criteria). All healthcare professionals are encouraged to use NHS resources appropriately. A patient s eligibility for NEPT services will be reviewed by the booking office, or NHS trust, for every new journey requested unless they have been assessed by staff as either: a) A regular user requiring transport for an indefinite period, or; b) A user requiring the service for over six months in any one treatment episode. Patients in the walking mobility category, attending outpatient appointments, cannot be assessed as a regular user. Their eligibility will be reviewed by the booking office for every new journey booked, to ensure they continue to meet the eligibility criteria. This will enable booking staff to provide patients in the walking category with information on other travel options to enable them to undertake self-care and travel independently where appropriate. All other patients will have their eligibility checked for each journey and are required to make a booking for each appointment. There will be a feedback system in place, to ensure there has been honesty when answering eligibility questions and where staff identify a discrepancy, a review will be commenced in collaboration with the NHS Trust. To view the full NEPT Eligibility Policy, please visit: 12

14 Escorts Where an eligible patient requires an escort to travel with them, then this will only be permitted in line with the eligibility criteria. Escorts may only be able to travel where they provide additional support or services that cannot be provide by NEPT staff. Only escorts that are able to self-care and are mobile are eligible; this includes access for wheelchair bound escorts. Escorts are not permitted to travel with NEPT if they are required to support the patient only at the destination; the escort will have to arrange their own travel. Escorts are not entitled to a return journey, where the patient isn t being conveyed. Patient mobility Patients who have been assessed as eligible for NEPT service will be offered care based on their medical and mobility needs following the NEPT categories shown in the diagram below: 13

15 The NEPT service applies to patients in categories B, C and D. If eligible, the appropriate NEPT resource will be allocated to patients and during transport booking questions will determine the mobility the patient. Mobility is assessed according to medical need and/or requirement not preference. These are: Category Mobility Description D A patient who can manage their own mobility with minimal C1 assistance of one person D As C1 but the patient requires to travel in a car or similar sized CAR vehicle as a result of their medical condition and/or mobility D As C1 but due to distances involved, the patient is likely to require some assistance (e.g. wheelchair) to/from the vehicles at CARA the collection/delivery address to/from the actual point of destination (e.g. Ward, Department or Home) D As C1 but the patient needs to travel in the front seat of a car or CARF similar sized vehicle as a result of their medical condition and/or mobility D As CARA but the patient needs to travel in the front seat of a car CARAF or similar sized vehicle as a result of their medical condition and/or mobility D A patient who can travel in their own wheelchair and has good WC1 wheelchair access at their home. They shall require the assistance of only one person for their mobility needs C A patient who can travel in their own wheelchair and has good wheelchair access at their home. They shall require the WC2 assistance of two persons for their mobility needs and requires an ambulance attendant during transportation C A patient who is immobilised and requires manual handling by two ambulance staff during transfer from any position to a sitting position. The patient can sit upright in the ambulance but may C2 need to be transferred with the use of an ambulance carry chair. This category can also be used for patients who require an ambulance attendant during transportation B A patient who is immobilised and can only travel lying down on a stretcher. The patient may be able to transfer into an ambulance carry chair for transferring into and out of properties where an ST ambulance stretcher is unable to access. If this is the case, please consider category C2 unless the patient has a medical condition meaning they have a requirement to be lying at all times or during transportation B A patient between 21 and 40 stone who may require a specialist BAR bariatric vehicle and additional staff to transport them safely. B A patient who requires assistance of NEPT staff with additional HD skills see HD section 14

16 Any patients requiring more than two staff will be classified as category B or C. Booking NEPT services New NEPT bookings: Enquiry line: Both numbers are open 24/7, all year round. Once connected, callers will be provided with an automated answer service informing them of the information required in order to make their transport booking. For patients whose first language is not English, the booking office employ a number of staff fluent in other languages, as well as access to Language Line to provide an interpreter to assist with the booking process. For patients who are deaf, or hard of hearing, the booking office systems are able to interpret patients own phone systems and allow us to communicate back to the patient by text message translation. Once through to a booking agent, the agent they will request basic information initially to determine if this NEPT service is applicable for this journey. The following information is required for all bookings: Patient s NHS number Patient s GP details Patient s home address Patient s full name Patient s date of birth Patient s contact number (ideally both a landline number and a mobile telephone, to receive text message notifications) Pick-up and destination location Date and time of appointment Any special requirements Following these questions, the patient or caller, will be asked a variety of questions to determine their eligibility and mobility needs before the NEPT booking can be confirmed. 15

17 If the patient is eligible, they or their representative will be provided with a unique booking reference number for their transport. They will be offered the opportunity to receive booking and journey travel text message alerts. If the patient opts for this service, and provides a mobile telephone number, they will receive a text message confirming their booking details. It is free to receive these text messages. It is important that this unique number is used when making any changes or enquiries. Patients, their representatives or healthcare staff, will be able to make a pre-booking request for NEPT online via the dedicated NEPT website. Such requests can be made at any time up to 24 hours, prior to any planned journey. An automated response will reply to the patient advising that if NEPT services are required within 24 hours, that they should instead contact the NEPT booking service by telephone ( ). When booking in advance online, patients can expect a call from a booking agent the same day. For all requests made outside of the core hours (08:00 18:00, Mon Fri) a booking agent will call back the next working day. Advanced pre-booking requests can be made via the online portal ( or via secure (bhampts@wmas.nhs.uk). A booking agent will then contact the patient to confirm eligibility, mobility and to ascertain the transport requirements. All calls will be recorded. It is important to wait for a booking agent, otherwise when re-dialling your call, will go to the bottom of the call list. Patients should be encouraged to provide a mobile telephone number, as they will have the option to receive free travel status notifications for their transport. The text service will notify the patient their transport has been booked and when the ambulance is on its way to them, for both the patients inward journey and journey home. The text message system will also give patient the option to provide experience feedback on the journey, please see the patient experience section for more information. Cancelling patients It is important that if services are no longer required, then they should be cancelled immediately either by calling the enquiry line or by using the online portal. 16

18 There will also be a dedicated 24/7 text cancellations number. Please note the unique reference number will be required in the text message and a response will be provided to confirm cancellation. Collecting a patient earlier, or later, than planned If a patient is ready for their return journey home earlier than expected, notify WMAS by: Calling the NEPT telephone number Selecting a patient on a NEPT kiosk on site By utilising the online portal in hospitals (Appendix 4) Where a return NEPT journey has already been booked, the patient will only need to contact us, if they are earlier or later than their scheduled return time. Where patients are attending a treatment or outpatient clinic, where they have been designated as exempt from be collected earlier or later, we will arrive at the agreed scheduled collection time. Online system access The online system will allow staff to book patients ready for collection, and allow them to view their clinic list of patients arriving by NEPT. The system can be access by the following link. You will need to contact WMAS for a username and password to access the system: A training guide will be issued when username and passwords are requested. Registration Enquiries. This allows you to search for particular journeys, patients and treatment centres. This can be used to look at historical, current or future journeys. Day control Book ready. Select appropriate hospital and clinic and submit. You will get a list of patients. To book ready, click on the clock icon. You can also access the booking via the file icon, and view the journey on the globe icon. 17

19 Arrival stack. Shows patients due at each unit and the expected time of arrival. Departure stack. Shows departure information including estimated pick up time. Incoming / outgoing stack. This allows you to filter patients by time band, name, hospital etc. Journey status. Shows the details of each individual journey. NEPT waiting time Where a NEPT ambulance arrives to collect a patient, and finds they are not ready for collection, or haven t been discharged from hospital, then the ambulance will only wait for 10 minutes until the journey is aborted. Exception to this is where a patient is at home and may require assistance from NEPT staff to exit their property. It will then be the responsibility of the patient, or healthcare professional, to contact the NEPT booking office by telephone to re-book the journey. This request will be rebooked and classified as a same day journey with collection within 120 minutes of the booking confirmation. There will be a regular review of any departments or NHS trusts that regularly request NEPT services for patients who are not ready to travel. This will be escalated to the nominated senior NHS Trust representative and commissioners. Patient experience Patient experience is extremely important to WMAS and the CCGs. Every patient who chooses to have the text messaging service will automatically be sent a text survey following their transport. This information will be collated and utilised to improve the service provision. Furthermore quarterly patient surveys will be released alongside a dedicated social media application. Complaints or compliments for the service can be sent to the WMAS Patient Experience Team (PALS): 18

20 Phone: Address: WMAS Patient Experience Team West Midlands Ambulance Service NHS Foundation Trust Millennium Point Waterfront Business Park Waterfront Way Brierley Hill West Midlands DY5 1LX Healthcare Travel Cost Scheme Where patients do not meet the NEPT eligibility criteria policy for NHS nonemergency patient transport, they may meet the criteria for the healthcare travel cost scheme. For information on this please visit: Service standards The following are the quality expectations of the NEPT service: Quality measure Threshold Patients receive text status notifications by SMS text for every 100% journey (those signed up to SMS notifications) Patient not signed up to SMS text service receive telephone call 100% alert 20 minutes prior to inward journey collection to confirm pick up Planned pick up inward journey: Patient collected within 30 90% minutes of scheduled collection time Arrival: Patient to be on time for their appointment 90% Same day collection inward & outward journey: Patient 90% collected within 120 minutes of agreed booking request being accepted or patient readiness notification Planned collection outward journey: Patient collected within 90% 30 minutes of scheduled collection time 19

21 Quick response same day collection: The provider shall collect 95% patients form Emergency Departments or Clinical Decisions Unit/ Acute Medical Unit for same day requests within 60 minutes of the scheduled collection time or patient readiness notification. Patient time on vehicle is no more than 60 minutes within 15 95% miles Eligibility Criteria applied 100% Contact details For enquiries please The following are the nominated representatives for each NHS trust: NHS trust: Lead: Birmingham Women s Hospital NHS Foundation Pam Cooper Trust Birmingham Community Healthcare NHS Emma Bridge Foundation Trust Heart of England NHS Foundation Trust Mary Ring/ Andrew Clements University Hospitals Birmingham NHS Foundation Neil Campbell Trust Worcestershire Acute NHS Trust Stephen Jezard University Hospitals of Coventry and Warwickshire Alan Cranfield Royal Orthopaedic Hospital NHS Foundation Trust Stuart Lovack GP Referrals for same day assessment WMAS & Lesley Lewis for Birmingham Community Healthcare NHS Trust 20

22 Appendix 1: Full list of associated CCGs NHS Wolverhampton CCG NHS Dudley CCG NHS Walsall CCG NHS Sandwell and West Birmingham CCG NHS Shropshire CCG NHS South Worcestershire CCG NHS Telford and Wrekin CCG NHS Birmingham CrossCity CCG NHS South East Staffs and Seisdon Peninsular CCG NHS Cannock Chase CCG NHS Stafford and Surrounds CCG NHS Redditch and Bromsgrove CCG NHS Wyre Forest CCG NHS Herefordshire CCG NHS Solihull CCG NHS Birmingham South and Central CCG NHS South Warwickshire CCG 21

23 Appendix 2: GP referral process GP same day principles FAQs Who is the service for? Any eligible patient where a GP, or a HCP, has made a clinical decision to refer the patient for same day assessment at an acute NHS trust The patient must be registered with a GP practice within one of the four areas: Birmingham Cross City CCG, Sandwell and West Birmingham CCG, Birmingham South Central CCG and Solihull CCG Adults aged who are 18 or over When is the service available? The NEPT services will be available 24 hours, 365 days a year. Current service Currently, if a GP/HCP makes a referral, these are managed via WMAS urgent and emergency ambulance contract; patients are then allocated transport based on clinical needs. There are two outcomes: 999 immediate ambulance response; or NEPT response under urgent and emergency ambulance contract, with a maximum 4 hour response. Currently, some of these patients wait a long time for transport, which can delay access to treatment and therefore impact on the patient s care. It is important to note however, that such waits may be appropriate e.g. where the patient requires clinical support/monitoring. New service offer Starting on 1 May 2017, GPs or HCPs will be asked to make a decision about the patient s clinical need for immediate transportation based on the options outlined in the table below. 22

24 Option 1 Option 2 Option 3 Patient requires immediate care (999) Patient requires clinical support/monitoring from a paramedic crew Patient is appropriate for conveyance via NEPT service (e.g. mobility classes) Response time In line with agreed targets Max 4 hour (arrival at hospital) Max 2 hour (to patient collection) Booking Transport booking should then be made via the Single Point of Access (SPA) team, who can assist the GP or HCP in the triage of the patient in order help define whether the patient should be conveyed via an emergency vehicle or via a nonemergency patient transport vehicle. The SPA team will then action the appropriate transport booking. GPs will not be able to book the transport directly. Typically, patients who will have been assessed as being suitable for NEPT transportation will be going to one of the following urgent care services: Acute Medical Unit (AMU) Clinical Decision Unit (CDU) Accident and Emergency (A&E) where the entrance point to AMU/CDU is via A&E (typically surgical patients) NEPT WMAS responsibility NEPT staff may only convey patients where a GP or HCP has made a clinical decision, supported by the SPA, that it is appropriate for them to be conveyed via NEPT Where a patient deteriorates and/or is not appropriate for NEPT conveyance, WMAS staff will follow the organisational policy escalating the response to the 999 emergency operations centre. NEPT staff are only responsible for ensuring the patient arrives safely at their destination point and hand any documents to trust staff. NEPT staff will not wait with the patients at the NHS trust premises. 23

25 Appendix 3: Out-of-area transport process Birmingham, Sandwell and Solihull Non-Emergency Patient Transport Out of Area and ECR Algorithm Out of Area Where possible all requests should have 48 hours notice. GP Referral Repatriation Only for Birmingham, Sandwell and Solihull registered patients anywhere in the UK. Associate Discharges Patients registered with a GP aligned to a CCG who is an associate commissioner to the NHS trust contract for outward journeys only Although ECR s, WMAS will provide transport for patients within the 5 Associate CCG s up to the cost of 500 without prior approval. Any ECR transport booking is the responsibility of the NHS trust to arrange for patients outside the 17 CCG s that are associate commissioners to the NEPT contract. ECR Any patient within a Birmingham, Sandwell and Solihull healthcare site, not registered with the 17 associate CCG s. This includes CCG s that are signatories to the main Actue. ECR s will only be undertaken by WMAS if they have sufficient capacity to transport the patient. Booking Process Once an ECR patient has been identified, the ward will make contact with the NEPT Booking line on If WMAS has capacity to deal with the transport request, the booking will be taken. Otherwise the NHS trust will be asked to contact the appropriate provider WMAS will then contact the appropriate CCG for authorisation to undertake the journey. if the patients home CCG refuse to allow WMAS to undertake the journey. The booking will be passed back to the NHS trust to arrange transport with the appropriate provider. WMAS will provide details of the provider. 24