Arriva Transport Solutions Quality Account 2014/15 Company information
Operates 16 NEPTS contracts across the UK
1,187 employees
502 vehicles
22 ambulance bases
11 satellite bases
3 call centres (with planning & control)
2 central staff office sites (excluding registered head office)
160,000 miles travelled each week across all contracts
2.7 million patient journeys completed since 1 July 2012 Where we operate:
1.3 million patient journeys completed in 2014
610,000 calls answered in Rotherham Greater Sheffield 2014 Manchester Chesterfield
2,500 calls answered a day
2,700 bookings made online Nottinghamshire a day
Leicestershire Dudley Birmingham
Gloucestershire Swindon Bath and Wiltshire North East Somerset Homerton
1 Contents
Part One p3-4 Introduction and Statement of Quality p5 Statement of Accuracy
Part Two p6-8 Priorities for 2015/16 p9-10 Statements of Assurance p11-12 What Others Say p13 Data Quality
Part Three p14-17 Review of Quality Performance
P18-24 Review of priorities 2014/15 p25-32 Statements from Clinical Commissioning Groups, Healthwatch and Overview & Scrutiny Committees
2 Introduction and statement of quality by Jonathan May, UK Managing Director, on behalf of the board of directors
am extremely pleased to present Arriva Transport Solutions’ Quality Account for 2014/15. IArriva Transport Solutions is a leading provider of specialist transport solutions for the health and social care sector, delivering services on behalf of the local NHS.
Undertaking 1.4 million patient journeys a year, using a variety of vehicles including seated, stretcher, wheelchair, bariatric ambulances and cars.
Established in 2011, Arriva Transport Solutions (ATSL) has had an exciting journey so far. Following Arriva’s acquisition of Ambuline, a private ambulance provider operating in the Midlands for nearly 30 years, Arriva Transport Solutions has grown into a thriving business, employing over 1,000 people.
The Quality Account aims to provide information about the quality of our services, outline where improvements have been made across the business and demonstrate our commitment to remain accountable to not only those who commission our services, but also to the stakeholders and users of our service.
“Quality is central to our Jonathan May way of working at Arriva
Transport Solutions” incidents from happening in the future. Jonathan May Alongside this, we have strengthened our employee engagement programme. This has included increased Quality is central to our way of working at Arriva training and personal development to enhance the Transport Solutions. We continue to work closely with training levels of our already highly-skilled staff and the Commissioning Quality Leads on all aspects of provide a career development pathway for those who quality and are absolutely committed to delivering an wish to progress. excellent level of service to our patients in a safe and caring environment. Other employee engagement initiatives we have introduced this year include face-to-face engagement The Governance and Quality team has put in place a sessions and the launch of our new staff intranet site. number of measures to improve the quality and The success of our increased employee engagement is format of information received through our incident reflected in the results of our recent staff survey, which management systems. This has given us a far greater saw 89% of our staff say they understand what they understanding of the types of incidents that occur so can do to help deliver excellent service to our patients. that we can mitigate risks and prevent similar Our stakeholder communications and engagement 3 Introduction and statement of quality by Jonathan May, UK Managing Director, on behalf of the board of directors
programme ensures that we balance the needs of from patients that will be used to further improve the all our key stakeholders, without compromising the service we provide for them. needs of one over the other, building mutually beneficial relationships that create value for all We would really value your feedback on this Quality stakeholders. By measuring satisfaction levels and Account. If you have any comments or require any gaining patient feedback from our service users, the more information please contact Director of business can understand and act upon the areas of Governance & Quality, Paul Willetts on improvement that it needs to make and can [email protected] or 0191 520 4226. track the progress of these changes. This year we have increased the amount of patient experience data we have gathered.
We have strengthened our business in all areas this year through the hard work and dedication of our staff and the support of our partners in the healthcare community. We have also strenghthened Jonathan May, UK Managing Director the Patient Experience Team to capture feedback
4 Statement of accuracy by Paul Willetts, Director of Governance and Quality
In preparing our Quality Account, the Director of Governance & Quality has ensured that:
StatementThe performance information of reported accuracy in the Quality Account is reliable and accurate; by Paul Willetts, Director of Governance & Quality There are proper internal controls over the collection and reporting of the measures of performance included in the Quality Account, and Inthese preparing controls our Quality are regularly Account, reviewed the Director to confirmof Governance that they& Quality are has ensuredworking that: effectively in practice
The performance information reported in the Quality Account is reliable and accurate The data underpinning the measures of performance reported in theThere Quality are proper Account internal is robustcontrols andover thereliable, collection conforms and reporting to specified of the measures dataof performance quality standards included inand the prescribed Quality Account, definitions, and these iscontrols subject are toregularly reviewed to confirm that they are working effectively in practice appropriate scrutiny and review; The data underpinning the measures of performance reported in the Quality TheAccount Quality is robust Account and reliable,has been conforms prepared to specified in accordance data quality with standards NHS Paul Willetts guidance.and prescribed definitions, is subject to appropriate scrutiny and review The Quality Account has been prepared in accordance with NHS guidance The Director Of Governance & Quality confirms to the best of his knowledge andThe beliefDirector that Of Governance he has complied & Quality with confirms these to therequirements best of his knowledge in preparing this and belief that he has complied with these requirements in preparing this QualityQuality Account. This This has has been been confirmed confirmed through validationthrough withvalidation the Board. with the Board.
byPaul Paul Willetts, Willetts, Director Director of Governance of Governance & Quality and Quality
5
4 Quality priorities for 2015/16
We have selected our priorities by considering the progress we have made this year. We want to continue our learning and development and have selected priorities based on wishing to increase our momentum and commitment to improve our service and patient experience.
ATSL’s priorities for improvement in 2015/16 are set out below.
Priority 1: Patient safety
Our priority: Introduce Datix and use the learnings from Incident Management information to carry out a review of health and safety risk assessments in place across all areas of our operation.
Why? The activities of our staff and the way they are conducted is fundamental to ensuring the safety of both our staff and the patients we transport.
The new incident management system implemented in 2014/15 has embedded a reporting culture and provided invaluable information which will aid the review of existing safe systems of work. This information also supports the suite of health and safety risk assessments currently in place and the issuing of refreshed guidance to operational staff in the safe performing of key tasks, e.g. transferring patients and assisting patients up the steps to vehicles. We have also seen an increase across the business in high-acuity patients e.g. those requiring wheelchairs and/or stretchers.
The introduction of Datix will strengthen our mechanisms for reporting, recording and analysing incidents.
Who will be responsible? Director of Governance and Quality.
How will this be measured? The production of a new standard suite of health and safety documentation for all operational tasks; The number of staff that have gone through associated training/awareness of revised procedures The number, type and severity of incidents for 2015/2016 to show a positive impact on patient safety harm incidents.
6 Quality priorities for 2015/16
Priority 2: Effectiveness
Our priority To review the governance arrangements associated with the use of third party providers, e.g. taxi companies, other transport organisations and volunteer car drivers.
Why? In common with other patient transport providers, all areas of our business use a number of approved providers to assist in the transportation of patients. This includes the use of taxi companies, other private ambulance/transport providers, and community transport services. Additionally ATSL runs a successful volunteer car drivers scheme where volunteers carry out a number of journeys for suitable patients in their own vehicles.
These providers are subject to strict screening by ATSL including ‘duty of care’ inspections. They must also provide evidence of their adherence with all appropriate legal and regulatory requirements. Service level agreements are in place to enable monitoring of quality.
Analysis of information from our incident management system, as well as feedback from patients through our improved complaints, comments and concerns processes, has identified a need to review these arrangements to include further controls and requirements for continuity of quality and patient experience when service is provided by a third party.
Who will be responsible? Director of Governance and Quality.
How will this be measured? A review/development of a suite of standard volunteer car driver documents involving our volunteers, community partners and interested partners e.g. Healthwatch in their production; A review/development of a sub-contractor compliance document to standardise the questions asked of sub-contractors including regular compliance visits. A questionnaire that a third party provider must complete to ensure they meet our standards. This will be enforced through face-to-face visits with each third party provider and the revised Service Level Agreement (SLA); Development of a revised SLA based on feedback through incidents, complaints and performance of third parties.
7 Quality priorities for 2015/16
Priority 3: Patient experience
Our priority To review and develop the patient feedback processes across the business with a view to increasing the qualitative data received on patient experience. We will also continue to increase the number of responses in relation to patients transported (response rate). This will increase our organisation-wide learning and will be used to improve quality within service delivery.
Introduce Datix and use the learnings from contacts with our Patient Experience Team to inform a review of patient experience across all areas of our operation.
Why? Through creation of multiple feedback channels, ATSL is now receiving a large amount of feedback and needs to ensure that it continues to develop its methods of collection and also improves the quality of the information we collect. We need to continue to use this information effectively to improve the care we provide to our patients while also developing new methods of gathering feedback. For example we are holding roadshows within our major acute hospitals to engage with patients face-to-face at their point of care.
The introduction of Datix will strengthen our mechanisms for reporting, recording and analysing comments, compliments and complaints.
Who will be responsible for this? Head of Communications & Engagement and Director of Governance and Quality.
How will this be measured? Increased number of feedback channels and opportunities for patients to give face-to-face feedback; Produce new patient experience survey with revised questions; Patient feedback reports with themes; Complaints reports with themes.
8 Statements of assurance from the board
Review of services
During 2014/15 Arriva Transport Solutions provided Non-Emergency Patient Transport Services in the following areas:
Chesterfield Royal NHS Foundation Trust Birmingham Community Healthcare NHS Trust Homerton University Hospital NHS Trust Dudley Sheffield (PTS & GP urgent transport) Rotherham Leicestershire Nottinghamshire Greater Manchester Bath and North East Somerset Swindon Wiltshire Gloucestershire.
In July 2012, ATSL acquired Ambuline Ltd as a wholly-owned subsidiary and sub-contracts some of its Patient Transport services to Ambuline.
Arriva Transport Solutions has reviewed all the data available on the quality of care in all these areas. The income generated by the NHS services reviewed in 2014/15 represents 100 per cent of the total income generated from the provision of NHS services by ATSL for 2014/15.
Participation in clinical audits
During 2014/15, no national clinical audits and no na- tional confidential enquiries covered NHS services that ATSL provides. During that period ATSL was not eligi- ble to participate in any national clinical audits or any national confidential enquiries of the national clinical audits.
As ATSL was ineligible to participate in any national clinical audits and national confidential enquiries, no data collection was completed during 2014/15, and therefore no cases were submitted for audit or enquiry as a percentage of the number of registered cases re- quired by the terms of the audit or enquiry.
As no national clinical audits covered the services pro- vided by ATSL no reports of national clinical audits were able to be reviewed by the provider in 2014/15 and no actions to improve the quality of healthcare provided could be identified.
9 Statements of assurance from the board
Local audits
ATSL undertakes rolling audits in areas associated with:
Infection Prevention and Control; Health and safety; Care Quality Commission compliance; Information Governance.
Audit schedules are maintained and reviewed monthly by our compliance teams and reported to the Board by the Director of Governance & Quality.
Local audits
Arriva Transport Solutions did not recruit any of its patients receiving NHS services provided or sub-contracted by ATSL in 2014/15 to participate in research approved by a research ethics committee.
Use of the CQUIN payment framework
A proportion of ATSL’s income in 2014/15 was conditional on achieving quality improvement and innovation goals agreed between ATSL and any person or body they entered into a contract, agreement or arrangement with for the provision of NHS services, through the Commissioning for Quality and Innovation payment framework.
The themes included patient notification, mobility and Healthwatch engagement. Also, the early adoption of the Friends & Family Test in Manchester allowed us to embed effective reporting processes within the organisation before the mandatory implementation of the scheme nationwide. Arriva Transport Solutions was successful in achieving all the agreed CQUIN goals.
10 What others say about ATSL
Statements from the CQC
Arriva Transport Solutions is required to register with the Care Quality Commission and its current registration status is for ‘Transport services, triage and medical advice provided remotely’. Arriva Transport Solutions has no conditions to its registration.
The Care Quality Commission has not taken enforcement action against ATSL during 2014/2015.
ATSL has participated in special reviews or investigations by the Care Quality Commission during 2014/2015. During these investigations or reviews the CQC has evaluated the service against specific outcomes listed in the Essential Standards of Quality and Safety. Any non-compliance has been measured by the possible impact on people who use the service, with the following results:
Leicestershire, 17 April 2014 Care and welfare of people who use services - moderate impact Supporting workers - minor impact Assessing and monitoring the quality of service provision - minor impact
Birmingham, 4 August 2014 Cleanliness and infection control - moderate impact Supporting workers - moderate impact Assessing and monitoring the quality of service provision - moderate impact
Leicestershire (revisited), 25 November 2014 Care and welfare of people who use services - minor impact
Areas where there was a compliance action identified during their inspection, we developed and implemented a full action plan to address the areas raised. All have been fully implemented.
Examples of actions taken as a direct result of CQC inspections:
Comprehensive 2015/2016 audit programme New Supervision Policy for Observed Practice, PDR and 1:1 sessions Service Improvement Programme Updated Infection Prevention and control Policies and procedures Improved Maintenance systems Comprehensive Staff engagement programme Re-vamped training programme
Details of CQC inspections can be viewed on their website: www.cqc.org.uk. 11 What others say about ATSL
We received the following comments during CQC inspections in 2014/15:
“We saw that quality issues were cascaded to operational staff. The provider was producing monthly reports which detailed incidents, complaints, audits and information on key performance indicators. This information was shared with staff through noticeboards within their depots. We saw that compliance groups met on a monthly basis to share and learn from incidents that had happened across the wider organisation. We saw minutes from these meetings and saw that learning was shared. We saw that where risk was identified, the provider was responding and taking appropriate actions.” “The provider was able to demonstrate that safeguarding awareness, completion of audits and spot checks were planned throughout the coming year. We also asked to see the training records for the staff and saw that over 99% of staff had attended safeguarding training within the last year.”
CCG feedback Healthwatch feedback
“The Arriva Transport Solutions “The complaints policy is clear and team has been extremely helpful comprehensive with processes, and accommodating during the responsibilities, time frames and recent escalation in the urgent expectations clearly laid out. It care system. Our quality lead has shows a great step forward and also been very complimentary will encourage people to feel about the enthusiastic attitude of more confident about raising the team to get things right.” concerns.”
Gloucestershire CCG Alice Tligui, Chief Officer
12 Information governance
Data quality
Our Business Information and Systems team provide monthly data quality reports to help managers monitor and improve reporting and data quality within their teams. This identifies data completeness against minimum data sets (MDS) which are specified within each service area along with appropriate levels of completeness (%). Data Quality Improvement Plans are developed where appropriate. Data is handled in accordance with strict information security controls.
NHS number and general medical practice validity information
ATSL did not submit records during 2014/15 to the Secondary Uses service for inclusion in the Hospital Episode Statistics which are included in the latest published data.
Information governance toolkit attainment levels
Arriva Transport Solutions achieved Level 2 on the NHS Information Governance toolkit Assessment Report and was graded satisfactory.
As a non-emergency patient transport provider this is the level we are required to attain for NHS England contracts.
Clinical coding error rate
ATSL was not subject to the Payment by Results clinical coding audit during 2014/15 by the Audit Commission.
13 Review of quality performance
The review of quality performance contained within this year’s quality account represents statistics pertaining to the organisation as a whole.
We are committed to present the information in an agreed manner that is clear and meaningful to the reader.
Health and Safety
Arriva Transport Solutions recognises and accepts its responsibilities under the Health & Safety at Work Act 1974, applicable regulations and all other relevant legislation to undertake all reasonable steps to protect the health, safety and welfare of staff, patients and members of the public.
The UK Managing Director assumes overall responsibility for health and safety and delegates to each operational Head of Service, the administration and implementation of all policies and procedures within their area of responsibility.
Arriva Transport Solutions will ensure that: Health & safety issues and considerations are adequately resourced An appropriate organisational structure is established that supports a safety culture and management of risk throughout the business operations with full engagement of employees A systematic approach is employed to the identification of risk and the implementation of suitable and sufficient control measures to manage and minimise those risks It provides adequate arrangements for local and organisational learning from all incidents, accidents and near misses identified within the business.
Arriva Transport Solutions requires its employees to: Take all reasonable steps to protect their own safety and the safety of others who may be affected by their acts or omissions Co-operate fully with management in all aspects of health & safety policy and procedure, this shall include all employees, volunteers and salaried staff To follow all work instructions, safety rules and regulations as directed by Arriva Transport Solutions Not to interfere with any equipment provided for the health, safety or welfare of themselves or others Undertake any health & safety training provided as appropriate for their role.
14 Patient safety - incidents
An ‘incident’ is an event or circumstance which results in unnecessary damage, loss or harm to a patient, staff member, visitor or member of the public. Staff are encouraged to report all incidents, whether major or minor.
Incidents are investigated to resolve the immediate issues and recorded/reported through our internal processes to the Quality Team. The identified themes and trends are reviewed and discussed at internal compliance group forums where further learnings can be made to influence necessary changes in policies and/ or procedures.
ATSL also complies with the requirements under the NHS Serious Incident Management Framework. During the first part of 2014, a revised incident management framework was implemented across ATSL, which included a revised policy as well as supporting documentation and a range of reporting forms. Prior to implementation this was subject to internal and external consultation. All incidents are now consistently logged across all business areas and reported through the production of a monthly summary for each contract area.
Through understanding more about the types of incidents that occur and the trends surrounding them, we can better plan and risk-assess our service to minimise such events. We openly and regularly share all information gathered with our NHS stakeholders through operational meetings, for example transport working groups and tripartite meetings. At senior level this takes place with quality and compliance, typically with the CCG, with all actions recorded and monitored.
Last year we said we wanted to increase the numbers of incidents reported internally. In 2013/14 we had 267 internal incidents reported compared to 970 at the end of year 2014/15. This indicates that our staff are more confident in reporting incidents and near misses. It also provides us with significant data to analyse and use across the business to improve service delivery. It is worth noting that the majority of incidents reported do not relate to patient safety.
The implementation of a revised incident management system has allowed us to analyse in more detail incidents that are more directly related to the safety of our patients. It has been identified through our partnership working and discussion of incident reporting that further analysis, paticularly on timeliness and the impact on patients’ wellbeing, is important. The introduction of Datix will allow us to monitor this in 2015/16 and report on our findings and actions in next year’s Quality Account.
Below is a summary of the three top themes Theme: identified from the analysis this year: Patient slips, trips or falls where the ATSL crew was present. Theme: Vehicle incidents*. Action: Staff received additional manual handling Action: training during mandatory training. Additional • Detailed analysis of the types of vehicle incidents; manual handling/patient handling training is planned • Installation of Masternaut technology into vehicles for 2015/2016 with a focus on reducing falls. with real time analysis of the driver’s technique; • Increased awareness and monitoring by managers of Theme: vehicle incidents, especially where the ATSL driver Staff injuries. Mostly lifting and handling injuries and was at fault; either shoulder or lower back injuries. • Additional driving skills training scheduled in mandatory training for 2015/2016 focussing on Action: reversing and manoeuvring. Staff received additional manual handling training during mandatory training. Additional manual handling/patient handling training is planned *Our vehicles travel on average 160,000 miles every week. for 2015/2016 with a focus on reducing falls. 15 Patient safety - incidents
We report on all incidents on a regular basis to our contract leads. Following feedback on our Quality Account last year, and through our involvement with CCG quality leads in the areas in which we operate, the table below provides details of incidents involving patient or staff safety.
2014/15 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Total Patient 92943 94145 93578 99901 99588 107872 112675 101917 101560 105825 99655 107010 1216669 Journeys Incidents 4 8 11 5 5 7 9 8 9 11 8 1 83 resulting in physical harm Incidents 0.0043% 0.0085% 0.0118% 0.0050% 0.0050% 0.0065% 0.0080% 0.0078% 0.0089% 0.0104% 0.0080% 0.0009% 0.0068% resulting in physical harm as a % of journeys Incidents 2 1 1 0 0 1 1 0 3 0 0 1 11 categorised as serious* Incidents 0.0022% 0.0011% 0.0011% 0.0000% 0.0000% 0.0009% 0.0009% 0.0000% 0.0030% 0.0000% 0.0000% 0.0009% 0.0009% categorised as serious* as a % of journeys
*categorised using the NHS Serious Incident Management Framework.
16 Effectiveness
Arriva Transport Solutions recognises the need to provide effective training to all its employees prior to beginning work in the healthcare environment and throughout the course of their employment.
As part of our induction programme, new employees are inducted into the Company over a period of two weeks where specific developmental training is undertaken. Every new Patient Transport Service (PTS) Care Assistant will be provided with a mentor to enable them to be supported as they become accustomed to working within Arriva Transport Solutions.
All PTS employees are provided with annual mandatory training to ensure their skills are current and they are competent to undertake all aspects of their role. In addition, periodic reviews are used to identify training needs, which are then formulated into an employee’s personal development plan (PDP).
In order to enhance each employee’s personal contribution to the business, it may be appropriate for some individuals to undertake extracurricular Developmental Training and/or Further Education.This will be determined following recruitment or their 1-2-1 objective meeting which may result in a personal development plan being produced.
17 Review of priorities 2014/15
Priority 1: Patient safety
In 2013/14 we cited patient safety as our first priority. Adverse incidents have the potential to affect the safety of our staff, patients and all those we come into contact with. Through understanding more about the types of incidents that occur and the trends surrounding them, we can better plan and mitigate risks to avoid such events occurring and therefore improve the quality of service delivered. This involves effective reporting, full analysis of the type of incidents that occur and identifying the trends surrounding them. Our priority was To improve the quality and format of information received through our incident management systems to enable better and more consistent analysis of themes and trends To use the data analysis to influence decision-making on policies and processes in order to mitigate risks.
We achieved this by implementing improvements to through NHS commissioner quality groups. our incident management systems to ensure a robust and consistent process for the reporting, recording What we achieved and investigation of incidents through the revised A revised incident management process was rolled framework. Quality and Operational meetings allow out acrossall contracts during 2014. The incident for these to be reviewed, discussed and actioned management policy was revised with a focus on formally on a regular basis. encouraging staff to report incidents, introducing a method of recording and promoting a Why we chose this as a priority culture of learning from incidents to improve The process of identifying, recording, reporting, patient safety. investigating, and learning from incidents was in need of review and a consistent application of the process A series of online training sessions were held with across all areas of our service. all managers and team leaders to introduce the This went hand in hand with an awareness campaign incident management process. 49 managers and to ensure a culture of awareness and responsibility supervisors attended these sessions during April was cultivated and as a result the number of and May 2014. The details of the new process incidents/near misses reported has increased. were then cascaded to all staff. This is welcomed as it enables better analysis of themes and trends. All areas of our operation saw an increase in Who was responsible for this? reported incidents during 2014/2015. Further Director of Governance and Quality. evidence of this is detailed in the ‘Incidents’ section on Page 13. This increase is further How did we measure this? analysed later in this report, however it is The number and type of incidents were monitored consistent with the awareness activities and the and detailed analysis of reports produced through development of an enhanced culture for reporting our internal compliance group structure and scrutiny incidents. 18 Review of priorities 2014/15
We recognise that the reporting of incidents is one A full time support officer was appointed during stage in the process of developing quality 2014/2015 with a focus on logging and tracking improvements. Local managers have been held incidents. responsible for conducting investigations into every reported incident. This not only includes actual Two Compliance Managers have attended root occurrences, but also ‘near-miss’ reports. Where cause analysis training during 2014/2015 to appropriate senior managers have also been provide additional expertise and knowledge to involvedin investigating incidents along with support serious or complex investigations. support from the Compliance Team. These investigations are focused on preventing A full analysis of all data from 2014/2015 to re-occurrences and encourages the full involvement identify annual trends, themes and learning of staff and where possible patients. opportunities is being developed.
Incident data and reports have been discussed internally and externally regularly throughout 2014/2015. Internal compliance groups have met monthly in most areas and incidents are a regular agenda item in order to both monitor the incident process within each area but also to promote shared learning. Monthly incident reports are also shared with commissioners in each contract area and root cause analysis reports following serious incidents are shared with the relevant Clinical Commissioning Group.
19 Review of priorities 2014/15
Priority 2: Effectiveness
Our staff are pivotal to delivering a quality service and we must ensure we provide them with the right training essential to develop and maintain their skills in the delivery of patient transport services. Staff training is essential to delivering an effective service and to enhance the patient experience.
Our priority was To enhance our staff training programme to include: BTEC Level 2 Customer Services to all frontline ambulance staff VRQ level 2 in Transporting Patients by Road which includes the qualification Ambulance Driving Non-Emergency VRQ Level 2 in Infection Control.
Why we chose this as a priority This has significantly improved the training levels of our already highly-skilled staff and provided a career development pathway for staff to progress. these courses, as well as in-house training, all new This has had a direct impact on staff morale as well staff received externally accredited qualifications in as capability and in turn improved the quality of care Infection Control and Essential First Aid. provided to our patients. This related to 100% compliance.
Who was responsible for this? All existing operational staff also receive Human Resources Director. mandatory training every year in core topics and this was delivered across all of our areas in How we measured this 2014/2015. During this more than 400 staff (over Training and completion records for staff were re- 50 per cent of the operational workforce) were viewed by HR managers through the year to monitor enrolled onto a BTEC customer care course to progress and detailed analysis of reports produced further enhance our employees’ skills. through our internal compliance group structure and scrutiny through NHS commissioner quality groups. In additional to operational staff we have invested heavily in training for our supervisors and What we achieved managers. 63 supervisors/team leaders are In order for our staff to deliver a quality service undergoing a BTEC in supervision and more than we know it is essential to provide them with the 41 managers attended a series of management right level of training and development in order for courses throughout 2014/2015. them to carry out their role. During 2014/2015 we have made a significant We also took the opportunity in 2014/2015 to investment in our training offered to all levels of review our training plans. This led to the formation staff, from operational staff to supervisors and of a national training steering group, which reports managers. directly to the board of directors on the strategy for the development of training across the We welcomed more than169 new members of business. A significant outcome has been the staff during 2014/2015 and our training team development of a new induction package which is delivered 32 two-week induction courses. During due to be rolled out in the first part of 2015/2016. 20 Review of priorities 2014/15
Priority 3: Patient experience (Part 1)
ATSL recognises that patient feedback is vital. We aim to deliver a caring, quality service that meets the needs of our patients and stakeholders and contributes to a positive patient experience throughout their health journey. We have introduced a new role of ‘Patient Experience Manager’ with an objective to improve the processes used to capture, review and report feedback that can be used to drive improvements to the patient’s experience.
Our priority was To increase the amount of patient feedback we gather.
Why we chose this as a priority Gaining more feedback from the users of our service will enable a better representation of data for us to focus improvements on the areas that matter the most to patients.
Who was responsible for this? Head of Communications & Engagement. The following methods were used to capture feed- back: How was this measured? Patient survey Response rate of patient surveys. - Postcards with freepost capability – given out Feedback trends, positive and negative areas. by drivers and within hospital discharge lounges (these are barcoded to identify which area they What we achieved have been distributed in) This year’s patient feedback programme was - Online survey developed to increase the amount of feedback - Utilisation of tablet devices to target specific gathered. This was done through increasing channels groups of patients of communication, improving signposting and Public and patient events/forums increasing the number of responses we receive for our Patient feedback app patient feedback survey. Engagement with patient representative groups.
Information from patients was recorded and analysed on a regular basis. This enabled the organisation to understand how it is performing from a patient perspective. This information is reported to commissioners and used to help shape the development of services with the involvement of patients and their relatives.
We recognise the importance of gaining feedback from the users of the service and reviewing improvements/changes that can be made to service delivery as a result of this feedback. 21 Review of priorities 2014/15
Priority 3: Patient experience (Part 1)
Patient Experience Survey Our aim in 2014/15 was to increase the response rate for our Patient Experience Survey.
In 2013/14, the response rate of those patients invited to complete the survey was 11%. In 2014/15 the response rate increased to15%.
Overall more than 2,500 patients took part in the survey with satisfaction levels increasing in all areas.
Feedback from 2013/14 led to direct action being Theme: taken to improve patient satisfaction in 2014/15 Patients queried the use of and service delivered by in the following areas: third party providers. Action: Theme: Service level agreements are in place to monitor the Some patients found their journey was bumpy and care and quality delivered by third party providers. commented on levels of noise inside vehicles. Providers are also subject to strict screening, Action: including ‘duty of care’ inspections. Analysis of Analysis of patients’ feedback revealed a number of information from our incident management system causes for the bumpiness. In some instances the level as well as patient feedback identified the need for us of dissatisfaction was due to road conditions but in to review arrangements and ensure continuity in the other cases we were able to take action. quality of care when a service is provided by a third party. Therefore this forms our main priority under By re-assessing patients’ mobility, the type of vehicle effectiveness this year. they are assigned and where they are seated on it resulted in reduced levels of discomfort during Theme: journeys. Some patients were confused about whether an escort can travel with them. We encouraged this practice with staff through team Action: meetings to remind them to ensure they offer patients We have introduced a suite of patient information a choice of seat where possible, escalate any materials to ensure patients have a greater comments provided by patients regarding their understanding of the service we provide. comfort to control, and to check regularly during the Some of the confusion over escort eligibility resulted journey that the patient is comfortable. from incorrect details being entered at the time of booking. As a result we have offered training to NHS colleagues who book transport and discussed ways we can improve the information we provide. 22 Review of priorities 2014/15
Priority 3: Patient experience (Part 2)
Our priority was What we achieved To improve patient experience by implementing The complaints process has been extensively improvements to our Complaints policy and improved, driven forward by the Patient Experience processes. Manager as a result of extensive studies. Several proposals were looked into with recommendations Why we chose this as a priority for a new inclusive complaints software and new Learning from our complaints is imperative to improve in-house team being approved. our patient experience. Improvements to the process will ensure easier identification of themes and trends. The complaints policy has been extensively rewritten with the policy circulated to UK-wide Who was responsible for this? Healthwatch bodies, Commissioning bodies and Director of Governance & Quality. local Patient Experience groups. The main theme from the policy is around encouraging patient How was this measured? feedback by opening up the methods of contact Number and type of complaints monitored via a and taking actions and learnings following complaints dashboard investigations from complaints. Triangulated with patient survey information Identify and monitor trends through compliance From March 2014 monthly standalone reports forums to identify areas and actions to improve have been created for each contract area. The service quality. data was discussed internally and externally each month, from compliance meetings to Quality Groups with commissioners.
The reports also included data from the patient surveys that were completed during set periods through the year. Other feedback initiatives were also included, such as the patient feedback app and direct contact with patients at events and forums.
2014/15 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Total Total no 92943 94145 93578 99901 99588 107872 112675 101917 101560 105825 99655 107010 1216669 of PTS Journeys 2014/15 Contacts 162 258 270 247 152 202 237 181 140 119 184 240 2392 recorded 2014/15 Incidents 0.1743% 0.2740% 0.2885% 0.2472% 0.1526% 0.1873% 0.2103% 0.1776% 0.1378% 0.1124% 0.1846% 0.2243% 0.1966% 2014/15 as a 5 of journeys 23 ReviewOur priorities of priorities 2013/14 2014/15
PriorityPriority 3: 3:Patient Patient experience experience (Part(Part 2) 2)
Arriva Transport Solutions has, through the analysis of We shall measure this campaign through the analysis Arriva Transport Solutions has, through the analysis of our patient In response to this a targeted campaign has begun which aims to: ourfeedback patient including feedback complaints including information complaints we have, been able to of contactsBuild a widerrelating understanding to key themes of the PTSidentified service that in ATSLpatient informationidentify that wethere have, were commonbeen able misconceptions to identify and that there feedback:provides aremisunderstandings common misconceptions about the patient and transport misunderstandings service. BookingEnsure patients process and other stakeholders understand the key aboutThis included the patient access, transport service specification, service. This booking included process and Eligibilityfundamentals of the PTS specification, the commissioned access,eligibility. service specification, booking process and Incorrectservice and booking the contract – resulting in cancelled or eligibility. abortedWork in journeys collaboration with patients (groups, forum and representative groups) to increase public and patient Information and access. In response to this a targeted campaign has begun understanding and awareness about the PTS service Ensure that patients are signposted correctly to provide which aims to: The followingfeedback items have already been distributed in Build a wider understanding of the PTS service that the majorityBuild networks of areas: to increase our existing communications and ATSL provides Patientengagement information channels. leaflet Ensure patients and other stakeholders understand Patient reminder card We shall measure this campaign through the analysis of contacts the key fundamentals of the PTS specification, the NHS staff information flyer commissioned service and the contract relating to key themes identified in patient feedback: FAQsBooking process Work in collaboration with patients (groups, forum ContractEligibility summary and representative groups) to increase public and WebsiteIncorrect copy booking and – resultingimages in cancelled or aborted journeys patient understanding and awareness about the Information and access. PTS service Patients have directly influenced the content of these The following items have already been distributed in the majority Ensure that patients are signposted correctly to materials through reading groups and forums and our provide feedback of areas: partnershipPatient information with the NHSleaflet and wider stakeholders e.g. Build networks to increase our existing communi- Healthwatch.Patient reminder card cations and engagement channels. NHS staff information flyer We shallFAQs continue to develop our action plans with patientContract feedback summary at the forefront of our decision Website copy and images making. We will maintain our current patient engagementPatients have directlymethods influenced and look the content into new of these methods materials of interaction.through reading groups and forums and our partnership with the NHS and wider stakeholders e.g. Healthwatch.
Theme:We shall Patientscontinue to queried develop theour actionuse of plans and with service patient deliveredfeedback atby the third forefront party of providers. our decision making. Action:We will maintainWe worked our current to reduce patient the engagement number methods of patients and beinglook into transported new methods by ofthird interaction. party providers and strengthened our Service Level Agreement. We have Theme: Use and quality of taxis and third party providers. alsoAction: encouraged Worked tomore reduce Voluntary the number Car of Servicepatients beingdrivers whichtransported gain positive by third partyfeedback providers from and patients. strengthened our Service Level Agreement. We have also encouraged more VCS Theme:drivers whichPatients gain would positive likefeedback better from communication, patients. particularly when delays occur.. Theme: Communication. Action: We have introduced a text message service Action: We have trialled a text message service and call ahead andinitiative call-ahead to ensure initiative patients to are ensure aware andpatients prepared are for aware their andtransport. prepared This for reduces their pick transport. up waiting Patients times and have aborted also beenjourneys given due leaflets to patients and not telephone being ready. numbers Patients have to callalso if theybeen requiregiven leaflets any andfurther telephone information numbers toabout call if theirthey transport.require any further information about their transport. 2420 Statements
We would like to thank our colleagues from Healthwatch, Clinical Commissioning Groups and Local Authorities for reviewing our Quality Account for 2014/15. In the production of this year’s Quality Account we have taken into account the feedback we received and have incorporated, wherever possible, the comments provided on this year’s account.
The visual style has been changed, including some language used and further explanation of terms to deliver a document that can be easily read by a member of the public. We have strengthened the information provided for our priorities and the details on the way we shall measure them. An introduction has also been added to the priorities section, detailing how we utilise our feedback and reporting mechanisms to highlight areas of focus forming the basis of this year’s priorities. Further information on our internal and external incident and feedback reporting programmes to give background on how we work with our local NHS community to deliver effective change and share best practice.
We have been unable to include region specific information this year and will carefully consider this for next year’s account.
Thank you again to all who have taken the time to comment, please find statements below.
NHS Blackpool Clinical Commissioning Group (CCG)
NHS Blackpool Clinical Commissioning Group (CCG) manages the Greater Manchester (GM) contract on behalf of the commissioning body (NHS Tameside and Glossop CCG), and the other eleven CCGs in GM, and as such welcomes the opportunity to review the 2014-15 Arriva Transport Solutions Ltd (ATSL) Quality Account. This statement is made by NHS Blackpool CCG on behalf of the twelve GM CCGs.
While ATSL is only required to produce one Quality Account covering all contracts, in future it would be beneficial for contract specific data to be included. This would make the Quality Accounts more meaningful to service users at a local level.
Performance concerns were raised with ATSL in 2013/14 in relation to achievement of some quality standards within the contract. An improvement plan was produced and monitored, which resulted in significant improvement and the query notice was removed in September 2014. Commissioners acknowledge all of the work undertaken by ATSL in achieving and maintaining the improvements in performance.
We acknowledge the work undertaken to review the incident management process and to increase the reporting of incidents in 2014-15 which is a positive indicator of a risk aware culture. As part of the quality reporting by ATSL, the Commissioning Quality Group receives information on the incidents and measures being taken to reduce further occurrences.
The Commissioners monitored the Commissioning Quality for Innovation (CQUIN) scheme throughout 2014-15 and the indicators were achieved. We were pleased that ATSL achieved the early implementation of the Friends and Family Test which demonstrates their commitment to innovation and to help Commissioners understand patient feedback .We look forward to working with ATSL in 2015-16 to promote mental health awareness, improve patient experience and identify actions to improve waiting times performance.
Throughout 2014-15 Arriva worked with Healthwatch organisations in GM to build upon the engagement commenced in 2013-14; ensure that Healthwatch understand the key fundamentals of the PTS specification, the commissioned service and the contract; increase public and patient understanding and awareness about 25 Statements
the PTS service; and increase patient feedback. It was pleasing that ATSL involved its stakeholders during the review of the complaints process and the patient information leaflets and now prepares a quarterly newsletter for key stakeholders.
Commissioners continue to closely monitor complaint levels and themes of complaints to ensure that where common themes are identified ATSL are implementing actions and lessons learned to shape the development of the service. ATSL received an average of approximately 0.15% contacts (comments, compliments and complaints) as a percentage of their activity. The main themes of complaints and patient experience feedback in GM are timeliness, in particular the length of time to be prepared before an appointment and the wait to return home from hospital, and communication. As a result ATSL have implemented a call ahead and text message service to improve the patient experience.
During 2014-15 ATSL has worked with individual CCGs and Acute Trusts and participated in tripartite meetings. They have also worked with the GM CCGs collectively, and this relationship will continue to develop during 2015/16 as ATSL attend the GM Area Ambulance Commissioning Group.
Bath and North East Somerset, Gloucestershire, Swindon, and Wiltshire Clinical Commissioning Groups (CCG)
Bath and North East Somerset, Gloucestershire, Swindon and Wiltshire Clinical Commissioning Groups (CCGs) are joint commissioners of patient transport services from Arriva. This statement is provided jointly by the four CCGs (referred to as ‘the Commissioners’) who have reviewed the Arriva Quality Accounts for 2014/2015. The CCGs reviewed the Account in light of key intelligence indicators and the assurances sought and given in the monthly integrated Quality and Performance meetings attended by Arriva and the joint Commissioners. This evidence is triangulated with data from other information sources, including patient complaints made directly to the CCGs. Insofar as the Commissioners have been able to verify the factual details; the Commissioners confirm that the Quality Account appears to be accurate and fairly interpreted.
The Commissioners fully supports Arriva’s commitment to ensure quality is central to its service provision. The CCGs have responded to this Quality Account under the three domains of effectiveness, patient experience and safety.
Effectiveness A skilled workforce is key to providing a safe and effective service. The Commissioners support Arriva’s robust induction and mandatory training programme which includes safeguarding and infection control training which has been attended by all staff during 2014-15. The CCGs welcome Arriva’s stated priority of enhancing governance arrangements for services provided by a third party through the ongoing analysis of incident and patient feedback data to ensure continuity of quality and patient experience. The Commissioners would like to see Arriva further develop this during 2015/16 by including the effectiveness of service delivery via the provision of a review of the key performance indicators linked to quality and how this can be supported via collaborative working with other organisations, including Healthwatch.
Patient Experience Arriva has set out a number of feedback mechanisms aimed at collating patient experience feedback. 26 Statements
The Commissioners are pleased to note an increased response rate and level of reported patient satisfaction. Patient experience has been a focus of the regular Quality and Performance meetings with Arriva due to historically high numbers of complaints. Although there has been a downward trend in complaints during 2014/15, challenges around unacceptable waiting times remains a consistent theme. It is the view of the Commissioners that the account would be enhanced if it included an evaluation of patient experience and safety indicators linked to timeliness of collection and arrival (inbound and outbound). The Commissioners will continue to work with Arriva during 2015/16 to improve performance and patient experience and will look to support this further via the use of a Commissioning for Quality and Innovation (CQUIN) scheme.
Safety Arriva have successfully increased the number of incidents reported by the organisation during 2014/15 which is important as it enables an organisation to learn about why safety incidents happen within their own service, and what they can do to keep their patients safe from avoidable harm. The Commissioners are working with Arriva to ensure the themes and learning from incidents are identified and embedded throughout the organisation. Commissioners acknowledge the work undertaken by Arriva to improve performance against key performance indicators, as well as their commitment to continuously improve services. Going forward into 2015/16, the CCGs would welcome further information on the patient safety outcomes of unacceptable waiting times and transport delays and how this is reflected in the incident reporting process.
The Commissioners look forward to working with Arriva during 2015/16 on the identified quality priorities.
Healthwatch Bath and North East Somerset, Gloucestershire, Swindon, and Wiltshire
This statement is provided on behalf of the local Healthwatch organisations in Bath and North East Somerset, Gloucestershire, Swindon, and Wiltshire. The role of the Healthwatch service is to promote the voice of patients and the wider public in health and social care services. We welcome the opportunity to comment on Arriva Transport Solutions (ATSL) Quality Account 2014/15.
General Company Information There are some concerns relating to the increase in the number of patient journeys since 2012 and any subsequent impact on quality that this may have particularly if this means more sub-contracted services are required. However, we note the efforts made by ATSL to maintain the quality of sub-contracted services by committing to a review of governance arrangements. We will monitor the situation over the coming year.
We support the three quality priorities as identified in the Quality Account.
Patient Safety: We welcome the increased focus on using the information gleaned from the new and improved incident management system, to learn and mitigate risks for patients and staff. In addition, we can see that staff appear to be more confident to report incidents as reflected by the increase in the number of reported incidents over the past year. We are pleased with this development and hope that this will impact positively on patient care over the coming year.
Clinical effectiveness The inclusion of the service user’s voice in the development of improved quality monitoring is welcomed and we would like to see this continue over the coming year. It is hoped that the increased investment in training will impact on experience of patients who use the ATSL service. We will continue to monitor this situation. 27 Statements
We would like to see some further measure of clinical effectiveness in terms of the effects on the quality of practice and the quality and continuity of care of sub-contractor provision. In addition, we would welcome further clarification regarding: • The proportion and actual numbers of journeys provided by sub-contractors • The actual number of sub contracted companies • The number of volunteer providers
It would be beneficial to know more about how ATSL evaluates the effectiveness of their training as well as explaining in more detail how it is delivered.
Patient Experience It is reassuring to see evidence of how feedback from service users has influenced the service over the past year. We note the intention of ATSL to continue to further include the user’s voice through the development of more methods through which service users can have a say. However, we would welcome more evidence of how previous learning has been shared across the organisation particularly where trials have been introduced. In addition, we would welcome further evidence of how quality improvements within service delivery are to be measured and the extent to which improvements have been made.
Communication regarding referral to the service and signposting for those not eligible still seems to be an area that causes concern and although we recognise the work ATSL have done to address this matter, we look forward to working with ATSL to improve the situation. One area that we would welcome further consideration on is the work with NHS Staff in terms of effective booking of the return journey and communication to the patient, which we have also received direct feedback on and directly affects the patient experience.
It would be helpful to see a regional breakdown of quality performance so that we could develop a sense of how well our respective areas were performing and any areas of concern of which we should be aware.
Statements of assurance from the board and the CQC We would appreciate the inclusion of the CQUIN schemes and agreed goals for ATSL as an appendix rather than requiring the reader to email ATSL. In addition, the comments received during the CQC inspections in 2014/15 would be more meaningful if there was an explanation of the outcomes listed in the results table. It is also felt that the use of selected comments from the CQC inspections has little value without further context or explanation.
We recognise and welcome the work that ATSL has undertaken to engage with local Healthwatch and to review the feedback to improve the quality of the service. Local Healthwatch will continue to monitor the service carefully throughout 2015/16 by listening to local people who use the service and sharing this important information with ATSL so that it can continue to improve the service.
Healthwatch Bolton
Healthwatch Bolton welcome the opportunity to comment on the Quality Account for 2014/15.
We are pleased to see that Arriva Transport Solution have made progress against the priorities set for the year. We are especially pleased to see that patient experience is recognised as a key priority for 2015/16. In this respect, however, we would have liked to see some analysis of complaints information included within the Quality Account. 28 Statements
We hope that in future years we will have the opportunity to engage in the quality accounts process earlier in order that we might have more opportunity to share the intelligence that we gather from patients and ensure that patients opinions are taken into account in the quality review process.
Alice Tligui, Chief Officer on behalf of Healthwatch Bolton
Healthwatch Stockport
Healthwatch is the new independent consumer champion created to gather and represent the views of the public, patients, relatives and carers. Healthwatch plays a role at both national and local level and makes sure that the views of the public and people who use services are taken into account.
Healthwatch Stockport is a membership organisation run by volunteers with an interest in health & social care. They are supported by a team of staff to offer help to members carrying out activity on behalf of the organisation.
Healthwatch Stockport has, amongst others, the following responsibilities; • Promote and support local people to be involved in monitoring, commissioning and provision of local care services • Obtain local people’s views about their needs for and experience of local care services • Tell agencies involved in the commissioning, provision and scrutiny of care services about these views • Produce reports and make recommendations about how local health and care services could or should be improved
Introduction Healthwatch Stockport thanks Arriva Transport Solutions for providing the opportunity to comment on this Annual Quality Account. We recognise that Quality Account reports are a useful tool in ensuring that NHS healthcare providers are accountable to patients and the public about the quality of service they provide. We fully support these reports as a means for providers to review their services in an open and honest manner, acknowledging where services are working well and where there is room for improvement.
We share the aspiration of making the NHS more patient-focussed and placing the patient’s experience at the heart of health and social care. An essential part of this is making sure the collective voice of the people of Stockport is heard and given due regard, particularly when decisions are being made about quality of care and changes to service delivery and provision. Our wish is therefore that Healthwatch Stockport works with its partners in the health and social care sector to engage patients and service users effectively and to ensure that their views are listened to and acted upon.
At times, we have had difficulties in our communication with Arriva Transport Solutions, and, although disappointing, this has improved over the past year. We hope to develop this working relationship to make sure that the voice and experience of patients and the public is heard throughout the provision of services, as required within legislation.
The Quality Account Healthwatch Stockport is aware of many issues that patients have raised with us across Greater Manchester about the service they have received from Arriva Transport Solutions. We are pleased to see that the Governance and Quality team has put in place a number of measures to improve the quality and format of information received through their incident management systems (Introduction and statement of quality) and 29 Statements we hope that this will directly translate to an improvement in the experiences of patients.
Healthwatch Stockport note that the Arriva Transport Solutions’ Information Governance Assessment Report overall score for 2014/15 was 66% and graded satisfactory (Statements of assurance from the board). We would ask what action is to be taken to improve this score.
Although it is positive that satisfaction levels of comfort, care and communication have all improved in 2014/15 compared to the 2013/14 figure - an increase of 4% overall (Priority 3: Patient experience (Part 1)), we are aware that under Priority 3: Patient experience (Part 2), the rate of response against the number of journeys made was only 0.2%. In addition, 84% of the breakdown of contacts made to Arriva Transport Solutions, by type, were complaints.
In a service designed to take people with no other means of getting to a health appointment, it is essential that the patient arrives in good time, and to be collected before the department closes. Healthwatch Stockport support the work being done to tackle long pick up waiting times and aborted journeys due to patients not being ready (Priority 3: Patient experience (Part 2)).
During 20014/15, Healthwatch Stockport carried out three Enter & View visits of Arriva Transport Solutions at Stepping Hill Hospital. The aim of the visits was to further inform Healthwatch Stockport about the service, give Healthwatch Stockport the opportunity to see the service in action and speak to patients after they had been in the ambulance or were waiting for transport home both from and to Stepping Hill Hospital. Enter & View representatives also spoke to staff and patients in the setting where the services were used as well as asking about the booking system. Recommendations were made to Arriva Transport Solutions, Stepping Hill Hospital and Stockport Clinical Commissioning Group (CCG) relating to the experiences shared by the patients spoken to on the day, in particular communication with patients, waiting times and lack of information leading to the hospital choosing to use other providers of patient transport.
Healthwatch Stockport is pleased to see that Arriva Transport Solutions are tackling the issues leading to the use of other providers (Priority 3: Patient experience (Part 2)) trialling a text message service and call ahead initiative to ensure patients are aware and prepared for their transport. However, more work is needed in this area for those within access to text message services.
Patient safety incidents, reported by staff, rose dramatically to 907 in 2014/15, apparently due to training on reporting, but the actual number causing physical harm was 83 which includes 11 serious incidents (Patient safety - incidents). We hope that Arriva Transport Solutions are able to learn from the incident reports to help improve services. Healthwatch Stockport is pleased to see many references to planned improvements in 2015/6 including training; compliance monitoring; volunteer drivers and documentation.
Conclusion Healthwatch Stockport thank Arriva Transport Solutions for the opportunity to comment on this document and request consistency in reporting next year to enable a direct comparison of the information.
If members of the public have any queries or questions or concerns resulting from this report or annex, Healthwatch Stockport can be contacted by e-mail at [email protected], telephone on 0161 974 0753 or you can visit our website at www.healthwatchstockport.co.uk.
30 Statements
Healthwatch Leciestershire (HWL)
Overview Healthwatch Leicestershire (HWL) acknowledge the receipt of the Arriva Transport Solutions draft Quality Account (QA) 2014/15 and for the opportunity to comment.
We welcome the priorities for improvement as set out in the account and note that you have a named Director responsible for the oversight and implementation of the majority of priorities. HWL is pleased to see a drive to improve and focus on the overarching structure of Governance and that your number one priority is to improve patient safety quality and reduce harm.
We particularly welcome the recognition to improve service user feedback and the introduction of a new complaints system which we hope will provide a better analysis of complaints and themes.
The strengthening of the Patient experience team, led by the Head of Communications and Engagement is very welcome along with reported improvements in satisfaction rates, however as yet HWL have received only anecdotal evidence, no actual figures or evidence has been offered or provided.
It is anticipated that through this development there will be a real drive to work locally and engage effectively with local Healthwatch to capture people’s real experiences across our locality.
HWL has engaged with the public over 2014 - 2015 and passed on to Arriva the evidence gathered. In summary the public view appears to be that the non-emergency patient transport service is poor and needs improving. Examples given included transport that was not suitable for wheelchairs, a lack of concern from staff, having to wait hours after their appointments to be taken home and public meetings being not being held in the evening when people can attend. We are aware that Arriva Transport Solutions Ltd have been working on these issues and have made changes to their vehicle fleet and have conducted training within the hospitals around booking return transport for patients being discharged.
Working locally with stakeholders and Healthwatch is a key to success in this area and we feel this is currently an area of weakness and in need of improvement. An example being that we have endeavoured to engage with Arriva and to date we have been unsuccessful in organising regular meetings during which we would expect to discuss this agenda and to form good future working relationships.
The priority of Clinical effectiveness captures the need for increased training and learning experiences across the organisation, particularly the need for regular training, the ‘duty of care’ inspections, stricter guidelines and checks on subcontractors by a new compliance document and the revised feedback in this area of complaints and the monitoring of incidents.
Due to the nature of your business we note that there is no opportunity for Arriva to participate in Clinical Audit and it is hoped that Arriva will challenge and strive to seek opportunities and partnerships to enable this to happen as a tool to monitor and evaluate your service.
HWL feels this is a fair Quality Account and represents the service at this time and the need for growth and continuing improvement. It is disappointing that the Quality Account covers all 13 Arriva Non-Emergency Transport areas and there is no localisation. HWL feels that this is detrimental to the service and stakeholders as the demonstration of quality, service provision will reflect diverse experiences across the country and may give widely differing results HWL would like to see this reflected in the 2015/16 Quality account. 31 Statements
We note that you intend to measure outcomes and effectiveness across all your priorities in a number of ways and look forward to the outcomes of these being a success in 2015/16.
Rick Moore Chair of Healthwatch Leicestershire
Healthwatch Sheffield
Healthwatch Sheffield is grateful for the opportunity to comment on this Quality Account. We note a clear and readable style has been employed and commend ATSL for taking this approach. We are particularly pleased to see patient experience as one of the three priorities for the forthcoming year, and look forward to seeing the results of offering improved opportunities for people to feed back.
We would like to point out in relation to page 9 “What others say about ATSL” that we conducted a review of non-emergency patient transport in Sheffield in this period which included people transported by Arriva, and are therefore disappointed that this is not taken into consideration. While we support the quote from another local Healthwatch about the complaints policy, we would like to point out that we did share our own recommendations with ATSL and we direct readers to our website: http://www.healthwatchsheffield.co.uk/ sites/default/files/moving_forward_-_a_report_into_patient_transport_report_healthwatch_sheffield.pdf where they can read our full findings.
We note with some concern that the Information Governance assessment score was a ‘satisfactory’ 66%. We would have liked to see some additional information included detailing how ATSL intends to improve upon this figure in 2015/16.
We thank ATSL for offering the opportunity to comment on this Quality Account and look forward to working with them in 2015/16.
If you would like to provide feedback or request further information on the Quality Account, please email [email protected] or call 0845 600 1209. 32