East Lancashire is one of five areas in the North West to formally adopt eligibility criteria for patient transport services (PTS) from October 4.
It comes ahead of North West Ambulance Service NHS Trust’s lead commissioner NHS Blackpool taking overall responsibility for PTS in the region from April 2011, when all PTS providers will be expected to work to a national standard framework.
Although the Department of Health’s revised criteria for non-emergency patient transport has been in place since 2007, it has not been officially adopted by healthcare professionals until now.
Under the criteria, patients are eligible for PTS if:
- Their medical condition needs the skills or support of PTS staff on/after the journey
- It would be detrimental to their condition/recovery if they were to travel by other means
- Their medical condition affects their mobility to such an extent that they would be unable to access healthcare or it would be detrimental/hinder recovery to travel by other means
- They are a parent/guardian travelling with children.
There are no changes planned to the way patient transport is booked, with most patients continuing to book via the patient choice centre, but those healthcare providers who currently make the bookings will now be expected to apply the eligibility criteria.
They will have to ask screening questions that are designed to ensure that only those who genuinely need transport receive it.
The new booking system will apply to patients who have never used the patient transport services before or who have not done so in the last three months.
PCTs/commissioners are responsible for ensuring the new system is rolled out across all providers so that the criteria is consistently applied. It will be tested first across the five ‘early adopter’ sites and then the rest of the region will come on board in early 2011. The pilot sites are:
- NHS East Lancashire (including Blackburn with Darwen)
- NHS Bolton
- NHS Heywood, Middleton & Rochdale
- NHS Cumbria
- NHS Central and Eastern Cheshire
Patient assessment
Patients will first be assessed through a web based pre-assessment tool (or over the telephone) by the healthcare professional responsible for the patient’s appointment , to establish if they are eligible for transport or need to make their own arrangements for travel to, from or between hospitals. Healthcare professionals, or patients if they book themselves, must make sure they have the patients’ NHS number.
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Pre eligibility assessment questions (pre screening questions)
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Is the patient able to use their own transport to attend the hospital/clinic?
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If yes, advise the patient they should use their own vehicle to attend their appointment
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Is the patient able to use public transport to attend the hospital/clinic? (i.e. train, bus, taxi)
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If yes but patient unsure of how to attend appointment provide contact details for traveline.
If yes but patient unable to afford own transport provide information on HTCS eligibility
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Could the patient make their own way to the appointment if it was at an alternative date/time?
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Provide patient with contact number for booking centre and ask them to rearrange their appointment for a time convenient for them
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Does the patient have friends or family who could take them to the hospital or clinic?
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If yes, ask if the patient is able to go with friends/family to attend their appointment
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If they are put forward from stage one they will then go through to stage two, assessment against the eligibility criteria, to see if they are eligible for transport. The eligibility criteria assessment questions are as follows;
- Is the patient partially sighted or blind?
- Does the patient suffer from severe mental difficulties?
- Will the patient need medical treatment (including oxygen) en route?
- Is the patient attending for treatment likely to cause severe physical side effects? e.g. for renal dialysis or oncology treatment?
All patients who answer yes to any of the above questions will be eligible for patient transport.
If they answer no to any of the above questions they may still be eligible for patient transport depending on their level of mobility.
They will then be assessed from a mobility perspective and the patient will be taken through a second series of questions
- At this time, how does the patient normally travel to do their shopping or other general outings?
- At this time, can the patient make general trips out and about, either alone or with friends or relatives?
- At this time, how does the patient move about their own home?
- At this time, how far can the patient move from their normal sitting position or in their wheelchair by themselves?
- At this time, can the patient negotiate steps by themselves and if so, how many?
The answers to these questions will be scored and eligibility for transport will depend upon the score reached.
If any patient is not eligible for transport they will be offered alternative options, for example, local services, transport links or routes for financial support if needed.
Patients that are not happy with the outcome can discuss this with the local PALS team.
