Patients travelling to and from non-emergency medical appointments are usually expected to use their own transport, or the range of public, community or voluntary transport available locally. Some people may be eligible for help with their transport costs if they have either a medical need which prevents them from making their own arrangements, or have a financial need based on income and benefit entitlement through the Healthcare Travel Costs Scheme (HTCS).
We spend £6.4 million a year on NHS funded transport and there are multiple providers delivering the service, including hospital trusts, the ambulance service and the voluntary sector. This has led to a disjointed service, with areas of duplication which is not only costly, but also confusing for staff and patients who use the service. The way we have previously assessed someone’s eligibility for the transport service has not been consistent or in-line with national policy and a recent review found significant shortcomings. This has resulted in an inequitable service, where an individual living in one part of the county might receive a different service to someone in another part of the county, which was unfair and not cost effective.
Earlier this year we reviewed the way we fund non-emergency patient transport and asked people to give their thoughts on proposed changes to the service. During January and February 2017 we spoke to people at 14 different locations across Cornwall at the following locations to understand their experiences of the service – both good and bad – and how we could improve things.
We also gave people an opportunity to share their thoughts with us via an online survey which was published on our consultation webpage.
Nearly 800 people contributed to our consultation, and as a result of what people told us, we revised the criteria we use to assess someone’s eligibility to receive funding for their transport to and from appointments to ensure consistency across the whole county.
We also worked with clinicians on these proposals and as a result, the following changes were made to our NHS funded patient transport policy:
- The removal of discretionary funding of transport and accommodation costs for people who are not eligible based on the nationally set criteria for medical or financial need.
- People who frequently use the service will no longer be automatically eligible for transport. All patients will be assessed against the nationally defined criteria for medical and financial need. This will ensure that everyone is treated in the same way and against the same criteria, no matter how many times they use the service or where they live.
NHS Kernow agreed that from Tuesday 15 August frequent users would no longer have an automatic eligibility for non-emergency funded transport but would continue to receive their existing transport arrangements until Saturday 30 September 2017 - after this time it is only be provided to them if they have a medical or financial need as defined by national criteria. This change will affect someone if they:
- receive free transport to frequently attend appointments; or
- receive part-funded transport and purchase a frequent traveller pass for appointments at Plymouth Hospitals NHS Trust.
During the last couple of weeks we have been contacted by a number of people who receive renal dialysis and who are worried about the decision. We have also been contacted by Kidney Care UK on how these changes affect people who need to use non-emergency transport to attend dialysis appointments.
We met with Kidney Care UK, MP Steve Double, Healthwatch Cornwall and clinicians from RCHT’s renal team last Thursday to discuss changes to our NHS funded non-emergency transport policy and how they affect renal dialysis patients. It was an open and constructive meeting and we are all now working together to produce and agree an appropriate assessment criteria to assist in determining dialysis patients’ eligibility for transport.
We will continue to work with clinicians, led by Paul Johnston, RCHT Renal Consultant, on the development of this assessment criteria and once agreed this assessment process will be incorporated into our non-emergency patient transport policy.
The planned actions have not yet been completed and we are continuing to work with renal consultants on the development of the assessment criteria for this specific group of patients to ensure it is clinically evidenced, robust and transparent to support clinicians and transport booking staff to correctly assess someone’s eligibility. As a result we have further extended the transition period to 15 January 2018 to allow completion of this important work.
Once agreed this assessment process will be incorporated into our non-emergency patient transport policy. Our aim is to ensure equity for all people living in Cornwall that use non-emergency patient transport and as such we are also in discussion with Plymouth Hospitals NHS Trust.
Note: Changes to this policy do not apply to emergency transport such as 999 ambulances, air ambulance, helicopter search and rescue and secure mental health transport.