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
2014
Greater
Manchester
Rotherham
Sheffield
Chesterfield
2,500 calls answered a day
2,700 bookings made online
a day
Nottinghamshire
Dudley
Leicestershire
Birmingham
Gloucestershire
Swindon
Bath and
North East
Somerset
1
Wiltshire
Homerton
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
I
am extremely pleased to present Arriva Transport
Solutions’ Quality Account for 2014/15.
Arriva 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
way of working at Arriva
Transport Solutions”
Jonathan May
incidents from happening in the future.
Jonathan May
Alongside this, we have strengthened our employee
engagement programme. This has included increased
training and personal development to enhance the
training levels of our already highly-skilled staff and
provide a career development pathway for those who
wish to progress.
Quality is central to our way of working at Arriva
Transport Solutions. We continue to work closely with
the Commissioning Quality Leads on all aspects of
quality and are absolutely committed to delivering an
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
sessions and the launch of our new staff intranet site.
The success of our increased employee engagement is
reflected in the results of our recent staff survey, which
saw 89% of our staff say they understand what they
can do to help deliver excellent service to our patients.
Our stakeholder communications and engagement
The Governance and Quality team has put in place a
number of measures to improve the quality and
format of information received through our incident
management systems. This has given us a far greater
understanding of the types of incidents that occur so
that we can mitigate risks and prevent similar
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
all our key stakeholders, without compromising the
needs of one over the other, building mutually
beneficial relationships that create value for all
stakeholders. By measuring satisfaction levels and
gaining patient feedback from our service users, the
business can understand and act upon the areas of
improvement that it needs to make and can
track the progress of these changes. This year we
have increased the amount of patient experience data
we have gathered.
from patients that will be used to further improve the
service we provide for them.
We would really value your feedback on this Quality
Account. If you have any comments or require any
more information please contact Director of
Governance & Quality, Paul Willetts on
willettsp@arriva.co.uk or 0191 520 4226.
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
the Patient Experience Team to capture feedback
Jonathan May, UK Managing Director
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:
The performance information
in the Quality Account is reliable and
Statement
ofreported
accuracy
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
controls
are regularly
reviewed
to confirm
that they
are has
Inthese
preparing
our Quality
Account,
the Director
of Governance
& Quality
ensured
that:
working
effectively in practice
The performance information reported in the Quality Account is reliable and accurate
The data underpinning the measures of performance reported in
the
Quality
Account
is robust
reliable,
conforms
to specified
There
are proper
internal
controls and
over the
collection
and reporting
of the measures
of
performance
included
in
the
Quality
Account,
and
these
controls
areto
regularly
data quality standards and prescribed definitions, is subject
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
Account
is robust
and reliable,
conforms
to specified
data qualitywith
standards
The
Quality
Account
has been
prepared
in accordance
NHS
and prescribed definitions, is subject to appropriate scrutiny and review
guidance.
The Quality Account has been prepared in accordance with NHS guidance
The Director Of Governance & Quality confirms to the best of his knowledge
The belief
Directorthat
Of Governance
& Qualitywith
confirms
to the
best of his knowledge
and
he has complied
these
requirements
in preparing this
and belief that he has complied with these requirements in preparing this
Quality
Account.
This
confirmed
with the Board.
Quality Account.
This
hashas
beenbeen
confirmed
throughthrough
validation validation
with the Board.
Paul Willetts, Director of Governance & Quality
by
Paul Willetts, Director of Governance and Quality
5
Paul Willetts
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 national confidential enquiries covered NHS services that
ATSL provides. During that period ATSL was not eligible 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 required by the terms of the audit or enquiry.
As no national clinical audits covered the services provided 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
team has been extremely helpful
and accommodating during the
recent escalation in the urgent
care system. Our quality lead has
also been very complimentary
about the enthusiastic attitude of
the team to get things right.”
“The complaints policy is clear and
comprehensive with processes,
responsibilities, time frames and
expectations clearly laid out. It
shows a great step forward and
will encourage people to feel
more confident about raising
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
identified from the analysis this year:
Theme:
Patient slips, trips or falls where the ATSL crew was
present.
Theme:
Vehicle incidents*.
Action:
• Detailed analysis of the types of vehicle incidents;
• Installation of Masternaut technology into vehicles
with real time analysis of the driver’s technique;
• Increased awareness and monitoring by managers of
vehicle incidents, especially where the ATSL driver
was at fault;
• Additional driving skills training scheduled in
mandatory training for 2015/2016 focussing on
reversing and manoeuvring.
*Our vehicles travel on average 160,000 miles every week.
Action:
Staff received additional manual handling
training during mandatory training. Additional
manual handling/patient handling training is planned
for 2015/2016 with a focus on reducing falls.
Theme:
Staff injuries. Mostly lifting and handling injuries and
either shoulder or lower back injuries.
Action:
Staff received additional manual handling
training during mandatory training. Additional
manual handling/patient handling training is planned
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
Journeys
92943
94145
93578
99901
99588
107872
112675
101917
101560
105825
99655
107010
1216669
Incidents
resulting in
physical harm
4
8
11
5
5
7
9
8
9
11
8
1
83
Incidents
resulting in
physical harm
as a % of
journeys
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%
Incidents
categorised
as serious*
2
Incidents
categorised
as serious* as a
% of journeys
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%
1
1
0
0
1
1
*categorised using the NHS Serious Incident Management Framework.
16
0
3
0
0
1
11
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
our incident management systems to ensure a robust
and consistent process for the reporting, recording
and investigation of incidents through the revised
framework. Quality and Operational meetings allow
for these to be reviewed, discussed and actioned
formally on a regular basis.
through NHS commissioner quality groups.
What we achieved
Why we chose this as a priority
The process of identifying, recording, reporting,
investigating, and learning from incidents was in need
of review and a consistent application of the process
across all areas of our service.
This went hand in hand with an awareness campaign
to ensure a culture of awareness and responsibility
was cultivated and as a result the number of
incidents/near misses reported has increased.
This is welcomed as it enables better analysis of
themes and trends.
Who was responsible for this?
Director of Governance and Quality.
How did we measure this?
The number and type of incidents were monitored
and detailed analysis of reports produced through
our internal compliance group structure and scrutiny
18
A revised incident management process was rolled
out acrossall contracts during 2014. The incident
management policy was revised with a focus on
encouraging staff to report incidents, introducing
a method of recording and promoting a
culture of learning from incidents to improve
patient safety.
A series of online training sessions were held with
all managers and team leaders to introduce the
incident management process. 49 managers and
supervisors attended these sessions during April
and May 2014. The details of the new process
were then cascaded to all staff.
All areas of our operation saw an increase in
reported incidents during 2014/2015. Further
evidence of this is detailed in the ‘Incidents’
section on Page 13. This increase is further
analysed later in this report, however it is
consistent with the awareness activities and the
development of an enhanced culture for reporting
incidents.
Review of priorities 2014/15
We recognise that the reporting of incidents is one
stage in the process of developing quality
improvements. Local managers have been held
responsible for conducting investigations into every
reported incident. This not only includes actual
occurrences, but also ‘near-miss’ reports. Where
appropriate senior managers have also been
involvedin investigating incidents along with
support from the Compliance Team. These
investigations are focused on preventing
re-occurrences and encourages the full involvement
of staff and where possible patients.
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
A full time support officer was appointed during
2014/2015 with a focus on logging and tracking
incidents.
Two Compliance Managers have attended root
cause analysis training during 2014/2015 to
provide additional expertise and knowledge to
support serious or complex investigations.
A full analysis of all data from 2014/2015 to
identify annual trends, themes and learning
opportunities is being developed.
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.
This has had a direct impact on staff morale as well
as capability and in turn improved the quality of care
provided to our patients.
these courses, as well as in-house training, all new
staff received externally accredited qualifications in
Infection Control and Essential First Aid.
This related to 100% compliance.
Who was responsible for this?
All existing operational staff also receive
mandatory training every year in core topics
and this was delivered across all of our areas in
2014/2015. During this more than 400 staff (over
50 per cent of the operational workforce) were
enrolled onto a BTEC customer care course to
further enhance our employees’ skills.
Human Resources Director.
How we measured this
Training and completion records for staff were reviewed by HR managers through the year to monitor
progress and detailed analysis of reports produced
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
managers. 63 supervisors/team leaders are
undergoing a BTEC in supervision and more than
41 managers attended a series of management
courses throughout 2014/2015.
What we achieved
In order for our staff to deliver a quality service
we know it is essential to provide them with the
right level of training and development in order for
them to carry out their role.
During 2014/2015 we have made a significant
investment in our training offered to all levels of
staff, from operational staff to supervisors and
managers.
We also took the opportunity in 2014/2015 to
review our training plans. This led to the formation
of a national training steering group, which reports
directly to the board of directors on the strategy
for the development of training across the
business. A significant outcome has been the
development of a new induction package which is
due to be rolled out in the first part of 2015/2016.
We welcomed more than169 new members of
staff during 2014/2015 and our training team
delivered 32 two-week induction courses. During
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.
How was this measured?
Response rate of patient surveys.
Feedback trends, positive and negative areas.
What we achieved
This year’s patient feedback programme was
developed to increase the amount of feedback
gathered. This was done through increasing channels
of communication, improving signposting and
increasing the number of responses we receive for our
patient feedback survey.
The following methods were used to capture feedback:
Patient survey
- Postcards with freepost capability – given out
by drivers and within hospital discharge lounges
(these are barcoded to identify which area they
have been distributed in)
- Online survey
- Utilisation of tablet devices to target specific
groups of patients
Public and patient events/forums
Patient feedback app
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.
Theme:
Feedback from 2013/14 led to direct action being
taken to improve patient satisfaction in 2014/15
in the following areas:
Patients queried the use of and service delivered by
third party providers.
Action:
Theme:
Service level agreements are in place to monitor the
care and quality delivered by third party providers.
Providers are also subject to strict screening,
including ‘duty of care’ inspections. Analysis of
information from our incident management system
as well as patient feedback identified the need for us
to review arrangements and ensure continuity in the
quality of care when a service is provided by a third
party. Therefore this forms our main priority under
effectiveness this year.
Some patients found their journey was bumpy and
commented on levels of noise inside vehicles.
Action:
Analysis of patients’ feedback revealed a number of
causes for the bumpiness. In some instances the level
of dissatisfaction was due to road conditions but in
other cases we were able to take action.
By re-assessing patients’ mobility, the type of vehicle
they are assigned and where they are seated on it
resulted in reduced levels of discomfort during
journeys.
Theme:
Some patients were confused about whether an
escort can travel with them.
We encouraged this practice with staff through team
meetings to remind them to ensure they offer patients
a choice of seat where possible, escalate any
comments provided by patients regarding their
comfort to control, and to check regularly during the
journey that the patient is comfortable.
Action:
We have introduced a suite of patient information
materials to ensure patients have a greater
understanding of the service we provide.
Some of the confusion over escort eligibility resulted
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
improvements to our Complaints policy and
processes.
The complaints process has been extensively
improved, driven forward by the Patient Experience
Manager as a result of extensive studies. Several
proposals were looked into with recommendations
for a new inclusive complaints software and new
in-house team being approved.
Why we chose this as a priority
Learning from our complaints is imperative to improve
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
Healthwatch bodies, Commissioning bodies and
local Patient Experience groups. The main theme
from the policy is around encouraging patient
feedback by opening up the methods of contact
and taking actions and learnings following
investigations from complaints.
Who was responsible for this?
Director of Governance & Quality.
How was this measured?
Number and type of complaints monitored via a
complaints dashboard
Triangulated with patient survey information
Identify and monitor trends through compliance
forums to identify areas and actions to improve
service quality.
From March 2014 monthly standalone reports
have been created for each contract area. The
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
of PTS
Journeys
2014/15
92943
94145
93578
99901
99588
107872
112675
101917
101560
105825
99655
107010
1216669
Contacts
recorded
2014/15
162
258
270
247
152
202
237
181
140
119
184
240
2392
Incidents
2014/15
as a 5 of
journeys
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%
23
Review
of priorities
2014/15
Our priorities
2013/14
Priority
3: 3:
Patient
experience
Priority
Patient
experience
(Part
2)
(Part 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:
our
patient
feedback
including
complaints
of contacts
relating to key themes identified in patient
feedback including complaints information we have, been able to
Build a wider understanding of the PTS service that ATSL
information
been able
to identifyand
that there
feedback:
identify that we
therehave,
were common
misconceptions
provides
aremisunderstandings
common misconceptions
and
misunderstandings
Booking
process
about the patient transport service.
Ensure patients
and other stakeholders understand the key
This included
access,transport
service specification,
booking
process and
fundamentals of the PTS specification, the commissioned
about
the patient
service. This
included
Eligibility
eligibility.
service and
the contract
access,
service specification, booking process and
Incorrect
booking
– resulting in cancelled or
Work in collaboration with patients (groups, forum and
eligibility.
aborted journeys
representative groups) to increase public and patient
Information
and access.
understanding and awareness about the PTS service
In response to this a targeted campaign has begun
Ensure that patients are signposted correctly to provide
which aims to:
The following
feedback items have already been distributed in
Build a wider understanding of the PTS service that the majority
Build networks
to increase our existing communications and
of areas:
ATSL provides
engagement
channels.leaflet
Patient
information
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
relating to key themes identified in patient feedback:
commissioned service and the contract
FAQs
Booking process
Work in collaboration with patients (groups, forum
Contract
Eligibility summary
and representative groups) to increase public and
Incorrectcopy
booking
Website
and– resulting
images 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
of areas:
provide feedback
partnership
with the NHS
Patient information
leafletand wider stakeholders e.g.
Build networks to increase our existing communiHealthwatch.
Patient reminder card
cations and engagement channels.
NHS staff information flyer
FAQscontinue to develop our action plans with
We shall
Contract summary
patient
feedback at the forefront of our decision
Website copy and images
making. We will maintain our current patient
engagement
methods
and look
into new
methods
of
Patients have directly
influenced
the content
of these
materials
interaction.
through reading groups and forums and our partnership with the
NHS and wider stakeholders e.g. Healthwatch.
Theme:
queried
use ofplans
andwith
service
We shall Patients
continue to
develop the
our action
patient
feedback at
forefront
our decision making.
delivered
bythe
third
partyofproviders.
We will maintain
our current
patientthe
engagement
and
Action:
We worked
to reduce
numbermethods
of patients
look
into
new
methods
of
interaction.
being transported by third party providers and
strengthened our Service Level Agreement. We have
Theme: Use and quality of taxis and third party providers.
also
encouraged
more
Voluntary
Car
drivers
Action:
Worked to
reduce
the number
of Service
patients being
which
gain
positive
feedback
from
patients.
transported by third party providers and strengthened our
Service Level Agreement. We have also encouraged more VCS
drivers which
gainwould
positive like
feedback
from
patients.
Theme:
Patients
better
communication,
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
and
call-ahead
initiative
patients
areforaware
initiative
to ensure
patientsto
areensure
aware and
prepared
their
and
prepared
for
their
transport.
Patients
have
also
transport. This reduces pick up waiting times and aborted
journeys
to patients
being ready.
Patients have
also
been
givendue
leaflets
andnot
telephone
numbers
to call
been require
given leaflets
telephone
numbers to
call if their
they
if they
any and
further
information
about
require any further information about their transport.
transport.
24
20
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 info@healthwatchstockport.co.uk, 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.
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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
arrivatransportsolutions@arriva.co.uk or call 0845 600 1209.
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