Freedom of Information Act Request Non Emergency Patient Transport Contracts Question 1 Please provide the total number of current non emergency patient transport contracts within the Health Board area. Response 2 Question 2 - Who are the contracts with? Response - Welsh Ambulance Services NHS Trust (WAST) & St John Cymru Wales Question 3 Provide the start and expiry dates of current contracts. Response - WAST is a rolling Service Level Agreement between the two NHS organisations. St John Cymru Wales is a two year contract which commenced 1/12/09 due to expire 30/11 2011 (with an option to extend in accordance with standard tendering process). Question 4 Provide the total annual spend on each contract Response WAST circa 3.4m. St John Cymru Wales circa 210,000. Question 5 Provide the specification of original contract. Response Please see attached. Question 6 Provide details of the commissioning process for contracts. Response - WAST is a rolling Service Level Agreement between the two NHS organisations. St John Cymru Wales contract was awarded under an EC procurement process
CARDIFF AND VALE NHS TRUST SPECIFICATION FOR THE PROVISION OF A DEDICATEDVEHICLE TO PROVIDE A PATIENT DISCHARGE/TRANSFER SERVICE CONTENTS SECTION 1 SECTION 2 SECTION 3 SECTION 4 SECTION 5 SECTION 6 SECTION 7 SECTION 8 SECTION 9 SECTION 10 SECTION 11 SECTION 12 SECTION 13 SECTION 14 SECTION 15 SECTION 16 SECTION 17 SECTION 18 APPENDIX 1 PREAMBLE OBJECTIVES AND DURATION NATURE AND DEFINITION OF SERVICES SCOPE OF PATIENT TRANSPORT SERVICE CATEGORIES OF PATIENTS STATUTORY OBLIGATIONS STAFF RECRUITMENT AND EMPLOYMENT VEHICLES QUALITY STANDARDS CONTRACT MANAGEMENT CONFIDENTIALITY COMPLIANCE CONTRACT MONITORING INFORMATION PERFORMANCE REVIEW MEETINGS VARIATIONS OF CONTRACT TERMS ARBITRATION PAYMENT ENQUIRIES QUALITY STANDARDS 1
CARDIFF AND VALE NHS TRUST SPECIFICATION FOR THE PROVISION OF A DEDICATED VEHICLE TO PROVIDE A PATIENT DISCHARGE/TRANSFER SERVICE 1. PREAMBLE The Cardiff and Vale NHS Trust was formed on 1 April 2000, is one of the largest NHS Trusts in the UK, comprising ten hospitals and over 34 health centres and clinics, in and around the City of Cardiff. The Trust is regarded as a centre of excellence for many clinical services. There are close links with the Cardiff University, Wales College of Medicine, with both the College and the Trust having a major teaching, research and development role both nationally and internationally. The Contract is to be between Cardiff and Vale NHS Trust (hereinafter referred to as the Purchaser) and a Patient Discharge/Transfer Service (hereinafter referred to as the Provider). 2. OBJECTIVES AND DURATION 2.1 The objective is to secure a discharge/transfer service for the conveyance of patients to or from Cardiff and Vale NHS Trust, to or from their homes or transfer to other hospitals. One vehicle will be based at University Hospital of Wales Heath Park Cardiff, CF14 4XW (10.00-18.00) and 1 vehicle based at Llandough Hospital, Penlan Road, Llandough, CF64 2XX (10.00-18.00 hours). 2.2 All services are to be carried out to the standards stipulated in Appendix 1 2.3 The contract will be for a period of 2 years with an option to extend for up to a further two years, on an annual basis, following review. 2.4 The Provider will be informed of any significant intended changes in existing or future services, such as new developments or changes in journey patterns and including those arising from other Purchasers initiatives. 2.5 The Provider should be responsive to the changing needs of patients. This is underpinned by the commitment of both parties to the overall objectives of the NHS in Wales. 2.6 In line with these aims both parties must develop a partnership which incorporates priorities for developing services that take account of the following: Health Improvement Programmes How the effectiveness of Patient Transport Services can be enhanced 2
How the view of patients can increasingly influence the delivery of services How the speed of access to appropriate health care can be improved How the quality of the environment within which patients are conveyed and cared for can be improved How the standard and level of communication with patients, relatives and Purchasers can be improved. 2.7 This partnership between the Purchaser and Provider must be committed to the development and realisation of services to improve performance, patient care and productivity. 3. NATURE AND DEFINITION OF SERVICES 3.1 The Patient Discharge/Transfer Service is seen as part of an integral programme of patient care. 3.2 The principle, which should apply, is that each patient should be able to reach their destination in a reasonable time and in reasonable comfort. It is envisaged that journey times within the Cardiff and Vale NHS Trust will not normally exceed one hour. 3.3 The vehicle required will be a double manned vehicle with stretcher, sitting, wheelchair and oxygen provision. 3.4 The vehicle would be for the sole purpose of same day discharges/transfers, within area, but will also on occasions be expected to travel out of area, within a radius of approximately 20 miles, to places such as Caerphilly, Ystrad Mynach, Vale of Glamorgan and to other neighbouring Trusts, but with some flexibility depending on need. The day to day organisation of the dedicated vehicle would come under the management of the Head of Patient Access. 4. SCOPE OF PATIENT DISCHARGE/TRANSFER SERVICE 4.1 The Dedicated Patient Discharge/Transfer Service is required to convey:- Patients for discharge or transfer as directed through Discharge Lounge (UHW) and Patient Access based at the University Hospital of Wales and Llandough. The annual number of patient s discharged/transferred via this service is anticipated to be approximately 4,000p.a. [1,000 per quarter]. It is envisaged that one vehicle would cover in the region of 75,000 miles in a 12 month period. 4.2 The service provided must be capable of conveying patients between 10.00 hours and 18.00 hours, Monday to Friday with no relationship between individual patient transport times and hours of service provision on a daily basis. Flexibility may be required of start/finish times to meet transport requirements, even at short notice i.e. less than 24 hours. 3
4.3 The provision of a service over Bank Holiday periods is routinely not required at UHW but is required at Llandough. However, it is expected that the provider will work flexibly with the purchaser to ensure such a service is available, in exceptional planned circumstances. 4.4 If a patient s condition deteriorates whilst in transit, Patient Access must be contacted immediately for further advice. In the event of a patient suffering a cardiac arrest, 999 Emergency Ambulance assistance should be called for immediately by the transport crew. 4.5 It is agreed that in the event of a patient having an entry in their medical records, that states that they are not for resuscitation, this must be communicated to the Ambulance crew at the time the transport is booked and confirmed in writing by the ward when the patient is collected. If the patient deteriorates to a level requiring immediate attention during transportation, the Ambulance crew should contact Patient Access without delay. 4.6 Patients who have infections (such as M.R.S.A.) can be transported, in compliance with the Purchaser s infection control requirements. 4.7 The Provider agrees to deliver all the resources required for the provision of services outlined above to fulfil the patient activity and must not Sub-Contract any part of these services, without the agreement of the Purchaser. 4.8 The Provider shall not assign any of its rights or duties defined in the specification without the agreement in writing of the Purchaser. 5. CATEGORIES OF PATIENTS Patients requiring transport will be designated as follows: (AMB) Stretcher (STR) Patients who need to be transported on a stretcher and/or requires Ambulance aid/medical Attention on route. (AMB) Chair (C2) Patients who are unable to negotiate steps without the assistance of Two persons, or patients who require two persons to assist mobility, or if Patient requires to be lifted on or off an ambulance, or the patient requires attendance whilst travelling. (CAR1)Crew of 1 (C1) Patients who are able to walk unaided, or is able to walk with the assistance of One person, or is able to negotiate steps unaided or with the assistance of One person. The patient is an infant capable of being carried. Patients with Special Needs Some patients may have special needs such as requiring oxygen therapy en route, or may require to take with them specialist equipment, such as walking aids, or to be conveyed in their own wheelchair. Escorts Friends, relatives or medical/nursing staff may accompany a patient if authorised by the Purchaser. Children being conveyed should, whenever possible be accompanied by a parent or guardian. 4
6. STATUTORY OBLIGATIONS The provider will comply with relevant legislation including those covering the following aspects: Health and Safety at Work Environmental Health Fire Precautions Appropriate branches of Employment Law Data Protection Act 1998 Medicine Act 1968 and related statutory instructions Mental Health Act 1983 Motor Vehicles (Construction and Use) Regulations Road Traffic Acts/Highway Code 7. STAFF RECRUITMENT AND EMPLOYMENT 7.1 The Provider must recruit and employ staff taking into account their personality and attitude, education, driving ability, and overall suitability to care for patients. 7.2 The Provider must ensure that there are sufficiently trained and competent staff (See Appendix 1). During periods of staff holidays or absence due to sickness or voluntary absence, sufficient reserves of competent staff should be available to provide the service to the specified standards. 7.3 The Provider shall employ for the provisions of service, staff who are competent drivers and who hold a valid full UK driving licence. Should a driver incur penalty points during the period of the contract it must be reported to and discussed with the Purchaser. 7.4 All staff must be Criminal Records Bureau checked. 7.5 In respect of all persons employed, or seeking to be employed by the Provider in and about the provision of the Service, the Provider shall comply with each and every provision of employment law including those relating to Health and Safety, and those which prohibit discrimination in relation to employment or service on grounds of sex, colour, race, ethnic or national origin or religion. 7.6 The Provider will have in place framework of employment policies. 7.7 At the request of the Purchaser, the Provider may be asked to remove a member of the providers staff from direct working on the Purchasers premises. 5
7.8 The Provider shall not employ without the written consent of the Purchaser anyone who:- Has previously been dismissed from National Health Service employment. Has previous convictions for dishonesty, offences of a serious nature, physical assault, or drink or drug offences. Posts will be exempt from the provisions of Section 4 (2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation Act 1974 (Exemptions) Order 1975. Applicants for posts are, therefore, advised not to withhold information about convictions which for other purposes are spent under the provision of the Act. Suffers from a physical or mental condition, which would present a hazard to the safety of staff of the Purchaser, members of the public or employees of the Provider. All drivers hare appropriately trained and qualified to drive the specified vehicle. The Provider shall not place young people working under the Youth Training Scheme to work on the transportation aspects of the specification. The Provider shall maintain records including individual employees current qualification records, open to inspection by the Purchaser as part of the monitoring system to demonstrate their compliance with these requirements. 7.9 In the event of industrial disputes by staff employed by the Provider, or other Providers affecting the service supplied by the Provider, the Provider shall be required to co-operate with the Trust in order to ensure the continued provision of the services and/or agree the level of service deemed to be necessary. 8. VEHICLES 8.1 The Provider shall ensure that all vehicles and equipment are suitable for the provision of the services to the specified standard, and comply with the Quality Standards (see Appendix 1) 8.2 The Provider must supply detailed proposals of the vehicles to be used including, numbers, sizes, ages and arrangements regarding maintenance and repairs. The Provider should also give details of any new vehicles expected to be delivered between the award of the Contract and the start date. 8.3 Vehicles must be appropriately insured and roadworthy and comply with Road Traffic legislation, the Motor Vehicles (Construction and Use) Regulations and other Road Traffic Regulations. The vehicles must have a current V.O.S.A. Certificate of Roadworthiness (MOT Certificate) if appropriate. 6
8.4 No vehicle must be more than 7 years old from the date they were first registered with the DVLA. 8.5 The Provider will immediately notify the Purchaser of any changes in the vehicle fleet that have a major impact on the working and delivery of this contract. 8.6 To ensure continuity of service provision the Provider will be required to demonstrate adequate cover for non-availability of vehicles for any reason. 8.7 The Provider must ensure that all vehicles are maintained to a high standard of reliability and roadworthiness and at least to the Manufacturer s Recommendations on maintenance schedules. 8.8 The Purchaser reserves the right to examine or arrange to examine all vehicles and vehicle documentation (including licences), Registration Certificates and Certificates of Roadworthiness (MOT), used in conjunction with the Contract and may (but not unreasonably or vexatiously) request the Provider not to use the said vehicles in the provision of the services. 8.9 The Provider will be responsible for maintaining the interior and exterior of the vehicles in a clean and serviceable condition. The Provider will be responsible for supplying cleaning equipment and materials. Processes that meet the Purchaser s decontamination requirements are to be used for vehicle cleaning. 8.10 All vehicles must be equipped with a quick and reliable method of communication to ensure that contact can be made at any time or to summon an Emergency Ambulance in the event of an untoward occurrence affecting the patients or Staff. 8.11 By agreement with the Purchaser a proportion of vehicles must be fitted with ramps or tail-lifts. All vehicles must enable easy access for the disabled and must be capable of restraining / securing a wheelchair with the patient in-situ. All passenger ramps must be subjected to the six monthly LOLAR test. 8.12 In the interest of vehicle security and the safety of patients, hospital staff and visitors, vehicles are not to be left unattended with the ignition keys in place. 8.13 All vehicles must have a seating capacity of no more than 10 passenger seats, either forward or rearward facing or a combination of stretchers and seats, each stretcher providing four side facing seats. Small children must be conveyed in the appropriate baby / toddler or child safety seats. 8.14 All seats must be fitted with restraining belts and all stretchers fitted with safety straps. 8.15 Vehicles must clearly display suitable notices which indicate no smoking and that seat belts must be worn 7
9. QUALITY STANDARDS The Provider will ensure that all stipulated quality standards are maintained at all times. (See Appendix 1). The Purchaser as part of the ongoing monitoring of the service will wish to develop quality standards and improvements in partnership with the provider. 10. CONTRACT MANAGEMENT 10.1 The Provider is required to nominate a Contract Manager who will be notified to the Purchaser. 10.2 The Provider will have in place a mechanism for receiving patient transport requests and will notify the Purchaser of these arrangements. The Provider will also have systems for planning and scheduling journeys. 10.3 The Provider will have a clearly defined Complaints procedure. A copy will be held by the Purchaser. 10.4 The Provider will have reporting procedures for accidents or injuries to patients, vehicle accidents and other untoward occurrences. These procedures will be agreed with the Purchaser who will be given copies of the Procedures. These reports will form part of the regular monitoring meetings as required by the Purchaser. 11. CONFIDENTIALITY The Purchaser and Provider agree to maintain a high standard of confidentiality at all times and must not communicate this information to a third party, and will respect the need for such confidentiality as it relates to the contractual agreement between them. In addition, the Provider will uphold the confidentiality in respect of information relating to patients. 12. COMPLIANCE The Purchaser has the right to check that the Provider is complying with any or all aspects of the specification. Agreements for such checks and visits should be arranged through the Provider s Contract Manager, whenever possible. 13. CONTRACT MONITORING INFORMATION 13.1 The Provider is required to maintain systems which will produce accurate information to enable activity levels and quality standards to be maintained unless otherwise agreed at the time of the signing of the contract, the monitoring of activity will be profiled each calendar month. 13.2 The Provider undertakes to furnish the Purchaser with the following information within the time scales. Failure to do so will be regarded as noncompliance with the contract and remedies for non-performance may be brought into action, unless factors outside the control of the Provider are the 8
cause. In this case the Purchaser will require notice of the late submission at least 3 working days before the due date. 13.3 Calendar Month Details of: Financial information in an agreed format Patient journey information in an agreed format Quality monitoring information in an agreed format 13.4 The purchaser may from time to time request additional information for the purposes of monitoring performance and managing the contract. The provider will supply such information by mutual agreement. 14. PERFORMANCE REVIEW MEETINGS 14.1 The Provider will attend Quality Performance Review Meetings on a quarterly basis with the Purchaser. The key agenda items for these meetings will include: activity achievement to target funding issues quality monitoring (including recorded incidents and complaints) service developments management issues 14.2 The Provider and Purchaser shall ensure that the appropriate personnel are in attendance at the Review Meetings in order that the agenda items can be fully addressed. 14.3 The Provider will attend periodically meetings with the users of the service as nominated by the Purchaser. These meetings will inform the drive to improve quality of service delivery within the parameters of this contract. 15 VARIATIONS OF CONTRACT TERMS 15.1 There may be exceptional circumstances during the contract period which are beyond the reasonable control of either party that prevent the discharge of the contract in whole or in part. 15.2 As soon as the necessity becomes apparent, both parties will discuss any proposed variations in accordance with the agreed protocol and agree a timetable leading to the resumption of normal contractual arrangements in order that any change of non performance by either part can be avoided. The 9
Provider shall not be liable for failure to perform the Contract Agreement directly or indirectly caused by Force Majeure, which terms includes Acts of God, Acts of Parliament, Fire, War, Embargoes, Strikes, Shortage of Labour and any other occurrence, whether or not similar in nature to these specified, beyond the control of the Provider. 15.3 All variations will be submitted in writing as a variation to the Contract Document. 16. ARBITRATION 16.1 Any dispute between parties to this agreement with respect to any matter or thing arising out of or related to this agreement which cannot be resolved by negotiation and except insofar as may be otherwise provided in this agreement shall be referred to arbitration under the provisions of the Arbitration Acts 1950 and 1979 or any statutory modification or re-enactment thereof by a single arbitrator to be appointed by agreement between the parties or in default by the Chairman for the time being of the Chartered Institute of Arbitrators. 17. PAYMENT 17.1 The Provider shall render to the Purchaser at the beginning of each calendar month of the contact period an invoice of 1/12 of the annual contract value as agreed. The purchaser will additionally pay for any variations in contract one month in lieu. 17.2 The purchaser will pay any amount properly due in respect of such an invoice as calculated in accordance with the terms of this contract within 28 days of the date of the invoice being submitted. 18. ENQUIRIES CONTACT If you have any queries relating to the tender please contact :- Mrs. J.P. Fudge Asst. Contracts Manager Procurement Department Cardiff and Vale NHS Trust University Hospital of Wales Heath Park CARDIFF CF14 4XW Tel No :- 029 2074 6227 Fax No :- 029 2074 6271 E-Mail :- jean.fudge@cardiffandvale.wales.nhs.uk APPENDIX 1 10
QUALITY STANDARDS The Provider must comply with the quality standards stipulated below. 1. Training The Provider must ensure that all employees are trained in first aid to a minimum standard of the Health and Safety Executive 4 day First Aid at Work Course. Staff should be capable of dealing with an emergency situation and also be trained in the safe use of a bag and mask resuscitator, aspirator, and the administration of oxygen therapy and lifting techniques. Training should also be provided with regard to all tasks that staff are required to perform. Staff should be instructed with regard to: All relevant Rules and Procedures concerning Health and Safety at Work at Work Regulations. The need to observe the highest standards of hygiene, courtesy and consideration to patients and personal appearance. The Provider will issue all staff with a written Code of Conduct. Not smoking whilst patients are in their care, nor in their vehicles, nor in property belonging to the Purchaser, except in designated areas. The non-consumption of alcohol whilst on duty and at all other times which could lead to being under the influence of alcohol whilst on duty. 2. Quality of Care Patients must be treated with respect and courtesy. Patients must be conveyed and, when necessary lifted, taking into account their medical condition and other personal needs. Vehicles must be driven smoothly and safely taking into account the patient's medical condition, and patients will be conveyed in warmth and comfort. The Provider must convey patients' personal belongings, medical notes/records (which will be sealed) and walking aids, all of which must be held securely in the vehicle. 3. Personal Appearance The provider will ensure that all times staff are properly and presentably dressed in uniform. The wearing of an excessive number of finger rings is to be discouraged, as are all other forms of jewellery. 11
Staff are to display an identification badge at all times and to carry a personal identification card which must be produced to anyone having reason to request. 4. Vehicles The Provider must ensure that all vehicles are maintained to a high standard of reliability and roadworthiness and at least to the Manufacturer's Recommendations on maintenance schedules. Vehicles must be cleaned internally and externally at least once daily. Any seats or interior fitments that become accidentally soiled should be cleaned immediately. All seats must be fitted with restraining belts and all stretches must be fitted with safety straps. All vehicles must be equipped with a quick and reliable method of communication to ensure that contact can be made at any time or to summon an Emergency ambulance in the event of an untoward occurrence affecting the patients or staff. When patients are being conveyed, the interior must be maintained at a comfortable temperature. By agreement with the Purchases a proportion of vehicles must be fitted with ramps or tail-lifts. All vehicles must enable easy access for the disabled and must be capable of restraining/securing a wheelchair with patient in situ, according to National recommendations. In the interest of vehicle security and the safety of patients, hospital staff and visitors, vehicles are not to be left unattended with the ignition keys in place. All vehicles must have a seating capacity of no more than 10 seats, either forward or rearward facing or a combination of stretchers and seats, each stretcher providing four side facing seats. Small children must be conveyed in the appropriate baby/toddler or child safety seats. All linen to be laundered to the standard required to meet the Purchaser s infection control requirements. 5. Equipment The purchaser and provider will work jointly towards the provision of the following equipment on appropriate vehicles: 6 x Blankets 1 x Bag and Mask Resuscitator with airways 1 x Oxygen Bottle with regulator, tubing and masks 1 x First Aid Box 1 x Aspirator 2 x Fire Extinguishers 1 x Carrying Chair - with safety strap Incontinence Sheets Vomit Bowls Paper Towels 12