An independent patient transport provider is to hand back a £63m contract to the NHS, as it was revealed the Care Quality Commission has served six improvement notices on it.
Patient transport services in Sussex will gradually transfer from Coperforma to South Central Ambulance Service Foundation Trust over the next few months, with the trust taking complete control by 1 April.
HSJ understands the company has been in discussion with the Sussex clinical commissioning groups – led by High Weald and Lewes Haven CCG – for some time and the CCGs view it as “standing down” rather than being “stripped” of its contract.
This has allowed the CCGs, which have been criticised for awarding the four year contract to Coperforma in April, to negotiate a phased withdrawal rather than an abrupt end to the service.
Last week Caroline Lucas, MP for Brighton Pavilon, told Parliament that the CCG had told her the form of contract used to commission the service had caused difficulties.
She told the House of Commons: ”When I have talked to staff of the CCG, they have acknowledged that they are using an off-the-peg contract that is not suitable for such a service, and that there have therefore been problems in the system as well as with the company, which is not providing the service that people in our city deserve.”
A CQC report released today shows significant concerns about Coperforma’s oversight of its subcontractors. Areas needing improvement included the timeliness of services, registering a manager with the CQC, and vehicles and equipment being appropriate for safe transport of patients, including those in wheelchairs.
Coperforma provided the booking part of the service through its demand management centre and then uses a range of sub-contractors to transport non-emergency patients to hospital appointments and home after discharge. In the seven months since it took over the contract – for which it was the only bidder – two of the subcontractors have gone into liquidation.
Some staff, who worked for South East Coast Ambulance Service Foundation Trust, the previous provider, have worked for several private ambulance companies since April. In September the CCGs stepped in after a number of staff went unpaid.
However, the biggest concern has been poor performance against the contract, with patients arriving late for appointments or not being picked up from home. Several of the area’s hospitals experienced disruption and in some cases incurred extra costs as staff had to stay late, and patients had to stay overnight or be transported by taxi. East Sussex Healthcare Trust spent £40,000 in one month dealing with such issues.
While performance against key performance indicators has improved recently, the CCGs were thought to be concerned about the long-term stability of the contract – especially given its reliance on a number of small subcontractors.
Professor Edward Baker, CQC deputy chief inspector in the South, said: “The new patient transport service provided by Coperforma got off to an unacceptably poor start. In the first three months, CQC received 52 complaints which raised a number of concerns which included delays in pickups, cancellations without notification, inappropriate vehicles dispatched, vehicles not arriving leading to missed appointments and difficulties in getting through to the control centre. The commissioners were rightly concerned about the implications for patient safety.
“Although they do not provide the vehicles directly – they do have responsibility for managing the service, and ensuring that subcontractors provide a service which is safe, effective and reliable. Our inspection highlighted significant concerns about the provider’s oversight of this service.
“Since the time of the inspection Coperforma has taken steps to work with the local CCG, providing an action plan to address the issues we have raised. The service sourced additional vehicles to manage the operational difficulties and to deal with the variations in demand at peak times. I note that in response to a particular area of concern the provider has set up a dedicated renal team to manage those patients.
“We have seen evidence that since the summer the provider has made significant improvements in performance. Surveys appear to show a much higher degree of patient satisfaction.
“It is essential that people in Sussex have a patient transport service which they can rely on to get them to their hospital appointments safely and on time.
“During this transition period we will continue to monitor the service closely. If we find the required progress is not sustained we will consider using our legal powers to protect the people who use the services.”
Coperforma and the CCG have been approached for comment.
Information provided to HSJ and CQC report
1 November 2016