PROTOCOL AND GUIDANCE FOR AUTHORISATION AND MANAGEMENT OF PATIENT TRANSPORT JOURNEYS OUT OF NORMAL CORE HOURS

Transcription

1 PROTOCOL AND GUIDANCE FOR AUTHORISATION AND MANAGEMENT OF PATIENT TRANSPORT JOURNEYS OUT OF NORMAL CORE HOURS Background Nene and Corby CCGs commission NSL Care Services Ltd. to operate a non-emergency patient transport service to convey patients to or from agreed Points of Care sites (see end of document) and any other site as required by the commissioner. In addition, patients who are being treated outside of county i.e. falling ill whilst away on holiday may require transportation back to the county for further treatment or repatriation. Typically, this will include general hospitals, community wards, nursing and care homes, specialist care centres, patient s home or place of residence. This is a jointly commissioned contract that covers both Nene CCG and Corby CCG areas and is managed by Nene CCG. In addition to NSL Care Services Ltd, there may occasions when alternative providers may be used if NSL are unable to fulfil the journey, for example, bariatric vehicle, limited local capacity. A list of alternative providers can be found at the end of this document. Responsible Commissioner Guidelines There may be occasions when non-northamptonshire patients are being treated within the county and require repatriation to their home CCG area. Under Responsible Commissioner Guidelines if the transport provider is unable to obtain authorisation for the journey from the home CCG it will seek approval and underwriting from the host CCG area where the patient is currently being treated. In these circumstances, the host CCG area will agree to underwrite the cost. It should be made clear to the provider that they are responsible for seeking retrospective authorisation for payment from the home CCG and that proof of three attempts to do so will be required before Nene and Corby CCGs will pay in-lieu. Eligibility for Services There is an East Midlands-wide commissioning agreement for eligibility criteria (EMPACT NEPTS Eligibility Criteria- V3) The NHS has limited resources and providing non-emergency patient transport must be reserved only for those whose medical conditions warrants it and the expectation is that patients are expected to make their own transport arrangements. NEPTS must only be targeted at those patients who have a clinically stated medical need that prevents them using private or public transport. Prior to booking transport, the protocol will demand that enquiries have been made to determine whether the patient is able to make their own way or alternative arrangements via friends or family. It should also be made clear that NEPTS services will not be provided for social or financial reasons. Patients attending NHS treatment do not have an automatic right to NEPTS; if they do not fully meet the agreed eligibility criteria, then transport will not be awarded. In general, patients are expected to make their own arrangements for travelling to and from healthcare premises; this ensures that limited resources are available for those who really need them.

2 If a patient has a medical or mobility condition where they need NEPTS staff to support them to and from a hospital or clinic for treatment, they may be eligible for patient transport. NEPTS caters for those patients where the medical condition will require the skills of NEPTS staff and/or it would be detrimental to their diagnosed condition or recovery if they were to travel by any other means. Patients in receipt of mobility allowance are not usually eligible for NEPTS as their mobility allowance should pay for their transport to and from hospitals. They may be entitled to NEPTS if there is a medical need i.e. if they have leg in plaster and cannot get to hospital by any other route Qualifying Criteria The following sets out the eligibility criteria to determine if NHS funded Non-Emergency Patient Transport Services will be provided for patients in the East Midlands who: Require to be moved on a stretcher. Defined as, the patient needs to be lying down on a stretcher within the ambulance or have a physical reason for using the stretcher facility e.g. leg in a cast Are in a wheelchair and cannot transfer in and out of a vehicle without assistance and who have no other way of getting to hospital The patient attending for treatment is likely to have diagnosed severe physical side effects following treatment that would impede driving e.g. for renal dialysis or oncology treatment, judgement must be made whether transport is required for both parts of the journey Have a diagnosed disability (physical and or psychological) which makes them medically unfit to travel by any other means, and who have no alternative method of travelling to or from the hospital A recognised parent/guardian where children with a medical condition, as outlined above, are being conveyed For medical reasons, the patient requires a trained escort. Normally designated ambulance transport staff will escort the patient to and from hospital. In most cases relatives and friends are welcome to meet a patient at their point of destination, although they will be unable to accompany the patient on their journey unless the patient satisfies one of the following criteria defined in Table 1 below. It would be expected that there will be no exceptions to the eligibility criteria; if the patient fails to meet the criteria the request for NEPTS must be declined and the patient sign-posted to known services, including; Local authority provided transportation Public transport, including bus routes Voluntary sector transport provision Private hire/taxi services For those patients who do not have a medical need for ambulance transport, but may require help in meeting the cost of travel to and from their care may be entitled to financial assistance under the Hospital Travel Costs Scheme (HTCS). To be eligible for assistance under the HTCS, a patient must be in receipt of at least one of the following: Income Support Income Based Jobseekers Allowance Income Related Employment and Support Allowance Guarantee Pension Credit Child Tax Credit Working Tax Credit

3 Patients must be assessed every time they request NEPTS as their condition may have changed. Patients will only be able to claim back the full travel costs by using the cheapest form of public transport available. If travelling by private car patients may be able to claim for the fuel used and unavoidable car parking costs, up to the cost of the same journey by public transport. Further information can be found at;- Help With Health costs Alternative Providers Name Contact No Comment St Johns (national office) Ambulance WELLINGBOROUGH Used by both acutes, has 1 bariatric vehicle in county, able to undertake paramedic conveyances B. N. Gibson s Can do paramedic conveyances Arriva Can do DNAR conveyances, bariatric, paramedic UK Event Medical WheelChair Bus Service (M Steers) Emergency Response Services Ltd. First Care Ambulance Bariatric, HDU, paramedic Wheelchair transfers- no cases likely to require medical/paramedic /HCA interventions Paramedic, ICU, incubator, bariatric For repatriations from SW area (based in Exeter). Oxygen, entonox, bariatric, paramedic/hdu

4 Protocol for Approval of Transport Requests Out of Hours An eligibility criteria is in operation and each request for transportation will be assessed by the provider, NSL, to ensure that it meets the criteria. Extra Contractual Journeys requiring authorisation Patients needing to travel outside of county Patients needing to travel outside of normal operating hours Patient journeys costing in excess of 250 Out of Hours Authorisation Process Requester contacts NSL booking office to request transport NSL assess request against eligibility criteriameets criteria? No Transportation refused- provider sign posts to known services Yes NSL call handler contacts Nene CCG On-Call number to request authorisation Northants CCG On-Call number: NSL Patient Transport Service booking number: On Call Tier 1 reviews request against criteria and if appropriate authorises journey. On-call s nepts.northamptonshire@nhs.net summary of authorisation next working day (date, to, from, cost, patient initials, GP surgery)

5 Protocol for Authorisation Requests from Non-NSL Care Services Providers Out of Hours Authorisation Process Requester contacts Northants CCG on-call to request authorisation Does the request meet the eligibility criteria? No Transportation refused- sign post to known services Yes Northants CCG On-Call number: On Call Tier 1 reviews request against criteria and if appropriate authorises journey. On-call s nepts.northamptonshire@nhs.net summary of authorisation next working day (date, to, from, cost, patient initials, GP surgery)

6 Agreed Points of Care Site Northampton General Hospital Kettering General Hospital Isebrook Hospital Nene Park Danetre Hospital Howard Johnson Day Unit John Notley Day Unit Favell House (MOH) Corby Hospital, Corby Minor Injury Unit and Corby Diagnostics Kettering St Mary's Hospital Cynthia Spencer (MOH) Princess Marina Hospital Willowbrook and Lakeside Health Centre Site Orthotics Clinic Blatchfords (Kettering) Harborough Lodge Renal Unit Orthotics Clinic Blatchfords (Northampton) Turn Furlong Specialist Care Centre (NHS beds only) Spinney Fields Specialist Care Centre (NHS beds only) Avery Home Cliftonville (NGH ICT beds only) Spencer House, Cliftonville Cransley Hospice Highfield House, Northampton Battle House, Northampton Brackley Cottage Hospital Thackley Green Specialist Care Centre (NHS beds only) Longlands Specialist Care Centre (NHS beds only) Forest House Kettering Leicester Royal Infirmary Leicester General Hospital Leicester Glenfield General Hospital Berrywood Hospital Rushden Hospital Rushden ORC Stuart Road Resource Centre St Marys Hospital Service Acute & Acute, & Renal Acute & Acute Acute & Acute & Acute & Acute & Acute & Renal / Acute / Acute Acute Acute (Dementia) / Acute / Acute Acute & Renal Acute & Renal Acute & Renal Mental Health