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Success Regime Non-Emergency Transport to Healthcare Services - Baseline Report September 2016 Success Regime Quality Management September 2016

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Success Regime Non-Emergency Transport to Healthcare Services - Baseline Report September 2016 Success Regime Quality Management September 2016 Success Regime Non-Emergency Transport to Healthcare Services - Baseline Report September 2016 Success Regime Quality Management September 2016 Quality Management Job No CS086289-01 Project Success Regime Non-Emergency Transport to Healthcare Services Location NWECumbria Title Baseline Report Document Ref Baseline Issue / Revision Final RevG File reference S:\Transport_Planning\Transport Planning Jobs\CS086289-01 - Cumbria NHS Transport Study\H7 - Documents & Specs\Cumbria Transport Planning for Healthcare\Baseline Report\160901 Transport to Healthcare Baseline Report RevG.docx Date September 2016 Prepared by 1 Melanie Taylor Signature (for file) MT Prepared by 2 Laura Wareing Signature (for file) LW Prepared by 3 Signature (for file) Checked by Walter Aspinall Signature (for file) WA Checked by 1 Signature (for file) Authorised by Andy Brookfield Signature (for file) AB Revision Status / History Rev Date Issue / Purpose/ Comment Prepared Checked Authorised H 08/2016 Final for Issue MT/LW WA AB G 08/2016 Final Draft for Comments MT/LW WA AB Success Regime September 2016 Introduction Contents 1. Introduction 1 1.1 Success Regime 1 1.2 Transport Agenda 2 1.3 Purpose of this Report 3 1.4 Structure of the Report 3 2. Context 4 2.1 Setting the Scene (Regional Context) 4 2.2 Policy Drivers, Strategies and Studies 8 3. Baseline 12 3.1 Data Collection 12 3.2 Current Patient Transport Services 12 3.3 Current Staff Transport Services 21 3.4 Car Parking and Car Park Management 24 4. Stakeholder Consultation 27 5. Stakeholders Summaries 28 6. Benchmarking and Best Practice 34 6.1 Methodology 34 6.2 Overview 35 6.3 Conclusion 36 6.4 Best Practice Examples 37 7. Conclusions and Recommendations 42 7.1 Overarching Key Issues and Challenges 42 7.2 Specific Key Issues and Challenges 43 7.3 Recommendations 43 7.4 Next Steps 46 Figures Figure 2.1 - Challenges and Opportunities 11 Figure 3.1 – Public Transport, Community, Voluntary and 3rd Sector Transport Provision 17 Figure 3.2 - Location of West Cumberland Hospital Staff and mode of transport to commute 22 Figure 3.3 - Location of staff at Cumberland Infirmary Carlisle and mode of transport to commute 23 i Success Regime September 2016 Introduction Tables Table 3.1- Number of aborted PTS journeys by Hospital and Clinics, April 2015 to March 2016 14 Table 3.2 - Private Ambulance Liaison Services - Costs 2015/2016 15 Table 3.3- Cost Summaries for NCUH, Cumbria County Council and PTS/NWPALS 19 Table 3.4 – Private Ambulance Liaison Service Weekly Hours and Costs for January to April 2016 20 Table 3.5 - Planned staff parking permit cost increase 25 Table 6.1- April to October 2014 Renal Transport Statistics: Mileage Analysis and Trip Volume within a 30 mile radius 38 Table 6.2 – Shuttle bus passenger numbers between RBH and BGH hospital Sites 2015/2016 40 Appendices Appendix A - Principles & Visions Appendix B - HTM07 Parking Policies Appendix C – Together for a Healthier Future Policy Appendix D - Non-Emergency Transport Appendix E - PTS Breakdown Appendix F - PTS Eligibility Criteria Appendix G - PTS Aborted Journeys Appendix H - PTS / NWPALS Cost Summaries Appendix I - Survey Results Appendix J - Transport User Information Workshop Outputs and Healthcare Recommendations Appendix K - Stakeholder List Appendix L - Stakeholder Consultation Appendix M - Booking Patient Discharge Transport Appendix N - Benchmarking Hospitals Appendix O – Assessment of Public Transport Accessibility to Healthcare services in NWE Cumbria. ii Success Regime September 2016 Introduction 1. Introduction 1.1 Success Regime The Success Regime Programme has marked the start of a new way of working to improve local health and care services. It is a national initiative designed to support health and care systems which have faced significant and sustained challenges, including long term difficulties in recruiting permanently to key clinical posts, a history of financial challenges, and the need to improve the quality of services across the area. The Success Regime was announced by the Secretary of State in June 2015 with a launch for stakeholders in Cumbria on 18th September 2015. The programme has focused on delivering a sustainable health and care system fit for the future, with the involvement of patients, local people, clinicians, staff and partners. 1.1.1 Overview of West North East Cumbria Success Regime The programme aims to deliver a sustainable health and care system fit for the future. The local organisations directly involved in West North East Cumbria (WNEC) Success Regime include: • North Cumbria University Hospitals NHS Trust; • Cumbria Partnership NHS Foundation Trust; • NHS Cumbria Clinical Commissioning Group; • Cumbria County Council and Local Authority; • Specialist and support services provided by Newcastle upon Tyne Hospitals NHS Foundation Trust and Northumbria Healthcare NHS Foundation Trusts; • 1st Care Cumbria GP federation; • Carlisle and Borders GP federation ;and • North West Ambulance Service. 1 Success Regime September 2016 Introduction 1.2 Transport Agenda Transport is viewed as a critical enabler to ensure that patients and service users can access healthcare services when needed, and that their families are supported during their care. Transport is particularly important in WNEC as part of the overall healthcare delivery and patient experience. There are a number of key challenges across the WNEC area that highlights the particular importance of transport locally including: • Distance and accessibility from home and between key healthcare sites; • Lack of motorways or strategic road network; • Access to public transport; • Rural settings; and • A ‘Super-ageing’ population. There has been a considerable focus from health professionals on emergency ambulance provision, however the Success Regime Transport & Enabling Group are of the opinion that consideration should be given to transport in its broader sense, with services such as public transport, community transport, transport in the community, patient transport services and car parking policy as much as a priority as paramedic ambulance provision. This report focuses on these broader non-emergency transport provisions. For the purpose of this report, our definition of non-emergency transport and related issues for healthcare is: • Non emergency transport provided/arranged by North West Ambulance Service; • Transport provided/arranged by other NHS Trusts • Transport in the Community (County Council funded) and Voluntary Transport; • Public Transport; and • Car Parking and Car Park Management. Transport is and will continue to be cited by public, patients and staff as an area of high concern in relation to both current and future healthcare services. The visions and principles of the Success Regime Transport & Enabling Group are presented in Appendix A. 2 Success Regime September 2016 Introduction 1.3 Purpose of this Report The overall aim of this transport baseline report is to develop a thorough understanding of how and when patients, public and staff currently reach (and potentially don’t reach) and return from healthcare services using (non-emergency) transport, mapping the statutorily funded, health sector and voluntary transport provision, describing funding flows and agency responsibilities. From developing a thorough understanding of current non emergency transport provision, the baseline report will extract the key challenges and gaps in service provision. Analysis of the data collected will inform the key recommendations that will endeavour to ensure effective and efficient ways of addressing the key issues. 1.4 Structure of the Report The report takes the following structure: Chapter 2 –Context Chapter 3 – Baseline Chapter 4 – Stakeholder Consultation Chapter 5 – Stakeholder Summaries Chapter 6 – Benchmarking and Best Practice Chapter 7 – Key Issues and Challenges Chapter 8 – Next Steps 3 Success Regime September 2016 Context 2. Context 2.1 Setting the Scene (Regional Context) 2.1.1 Introduction This section of the report will detail baseline conditions and area context for the WNEC region. The healthcare system covers a large proportion of one of the most rural and sparsely populated counties in England, with unique geographical and social challenges. 2.1.2 Geography The WNEC Healthcare System represents a combination of districts and health and social care organisations. Its geographical boundary is defined by the four regional districts of Allerdale, Copeland, Carlisle and Eden, with a total population of approximately 327,000 people, around 65% of the total Cumbrian population. The Local Health and Care Economy (LHCE) consists of several health and social care service providers operating directly within this geographical boundary, with main providers as follows: • Cumbria Clinical Commissioning Group (CCG); • Cumbria County Council; • Cumbria Partnership NHS Foundation Trust; • North Cumbria University Hospitals Trust; • North West Ambulance Service; and • Primary Care Independent Contractors. Other peripheral health and social care organisations also deliver some healthcare services to NWE Cumbria residents. These are as follows: • Northumbria Healthcare NHS Foundation Trust; • Newcastle Upon Tyne Hospitals NHS Foundation Trust; • University Hospitals of Morecambe Bay NHS Foundation Trust; and • A small number of private sector providers. 4 Success Regime September 2016 Context The average population density across the WNEC healthcare system is 74 people per km2, compared to a national average of 413 per km2. This density also
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