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NHS: Transport Services

Volume 711: debated on Tuesday 2 June 2009

Question

Asked By

To ask Her Majesty’s Government whether the guidance issued to Primary Care Trusts in August 2007 on the commissioning of ambulance and patient transport services is being monitored.

My Lords, all patients are eligible for free non-emergency patient transport services if they have a medical need for transport. Primary care trusts are responsible for ensuring that there is provision through patient transport services; it is the strategic health authorities’ role to oversee that PCTs are properly fulfilling their commissioning role, including the commissioning of patient transport services. At present, the guidance issued to primary care trusts is not being monitored centrally.

My Lords, I thank the Minister for her response. In her reply to my proposed amendment to the Health Bill, she said that good practice in this area to achieve more effective user-focused transport services should involve multi-agency working. In the light of today’s admission by the National Health Service that some kidney patients are suffering as a result of the unacceptable quality of patient transport, does she now accept that a duty should be imposed on primary care trusts to co-ordinate the transport services that they provide with the public transport provided by, or on behalf of, local transport authorities?

My Lords, I thank the noble Baroness for the Question, as I know that she is tackling and attempting to remedy the problem as she sees it—and I agree that there are problems. We remain clear that a multi-agency approach is essential; she is absolutely right on that. She is also right to point to the announcement today about the provision of transport for people who use dialysis. Indeed, it was the Department of Health that asked the Information Centre to take up this audit and to help us better to understand and improve transport for kidney patients. Today’s audit shows that the majority of kidney patients get to treatment within half an hour and are satisfied with the service that they receive. However, that is not all of them. We want to ensure that all kidney care patients have the same quality of service.

On the more general question of patient transport services, we expect that the world-class commissioning assessment will be used by the CQC, as the new regulator, as part of the evidence in assessing PCTs’ commissioning ability. That will include patient transport services. Each PCT will be under scrutiny and there will be patient feedback about the effectiveness of the services.

My Lords, what support are the Government giving to air ambulance services, which play an increasingly important part in some of our rural communities? I declare an interest as a supporter of the Northumberland air ambulance, which is largely supported by charitable funds. That service is particularly important for people who live on the Holy Island of Lindisfarne, which is cut off by the tide for several hours each day.

My Lords, as the noble Lord will be aware, we regard air ambulance services as a very important, integrated part of our emergency services. We provide financial support to air ambulance services for the staffing that they use. However, given the nature of those services, we have always felt that it was better that they should be organised locally, because need for them is sporadic. There is no proposal to do this centrally and, indeed, I do not think that we would want it to be done centrally.

My Lords, is the Minister aware that the car park at the spinal unit of Stoke Mandeville Hospital has been built over? Even if patients have their own cars, there is nowhere to park their vehicles.

My Lords, the Minister will know that, in these days of polyclinics and specialist hospitals that patients now attend, often much further from their home than previously, this issue is crucial. The paper Eligibility Criteria for Patient Transport Services says grandly on page 9 that the cost of patient transport services,

“remains within the scope of Payment by Results as an integral part of the relevant tariffs”.

Can she elucidate that sentence a little? Does “results” mean “patient satisfaction”, as she indicated? Will she also acknowledge that, unless a target is attached to a service in the National Health Service, it tends to wither on the vine?

My Lords, it does indeed mean that patient satisfaction will be judged when the tariffs are under consideration. I suggest to the noble Baroness that the design, commissioning and running of transport services must be done at a local level for obvious reasons—you need the input of local patient groups and individuals. It is therefore not the Government’s job to do that. Our job is to try to set the framework, which we did, and to do what we can to make sure that these matters are audited and regulated in a suitable fashion.

My Lords, has my noble friend given any thought to whether aspects of the public service could make a contribution? Is there the possibility of developing some kind of integrated transport system within the public sector?

My Lords, my noble friend points to exactly the issue that our guidance set out: multi-agency working will lead to more effective and user-focused—if noble Lords will pardon that expression—transport services. The north-west has produced Providing Transport in Partnership, which is guidance for health agencies and local authorities. It provides advice to local authorities and the NHS on the benefits of integrating their transport services across their different needs and making the best of the transport available for health, education and social services.