Archived: Coperforma Demand Management Centre

Updated 1 November 2016

Prior to 1 April 2016, the booking element of the Sussex Patient Transport Service (PTS) was provided by the Patient Transport Bureau, and managed by a local Clinical Commissioning Group (CCG). The transport function was delivered by another local NHS ambulance trust.

In 2014, the previous NHS ambulance trust decided not to continue with the PTS contract beyond the scheduled end date of 31 March 2015. However, a one-year extension was agreed with the ambulance trust to continue delivering the service until 31 March 2016, to allow the CCG to undertake a review of the local NHS PTS and how it could be improved for patients. Subsequently, a new specification was developed, informed by widespread public, user, staff and clinical engagement. The contract was opened for interest and the bidding process commenced.

Following the procurement process, Coperforma Limited was awarded a four year contract (with an option to extend by a further year) to operate as the Managed Service Provider of PTS across Sussex from 1st April 2016. Coperforma Limited was also managing patient transport services for the NHS in London and Hampshire, prior to the Sussex contract.

The mobilisation and transition of the contract from the previous NHS ambulance trust to Coperforma Limited had identified a number of concerns, which had directly affected the delivery, and performance of this contract. These included issues with data quality, workforce and transport provision, and information technology. Coperforma Limited and the CCG acknowledged that the overall standard of the service since its launch on 1 April 2016 had not been acceptable and had issued public apology to all affected.

In response to these concerns, the CCG and Coperforma Limited jointly developed an action plan to address the current issues and to monitor the performance of this contract. The CCG and Coperforma Limited held weekly meetings, where progress of the action plan was monitored. At the time of the inspection, the CCG were working closely with Coperforma Limited and providing necessary on-going support to ensure the requirements of the contract were being met.

Furthermore, the CCG had commissioned an enquiry into the transition and mobilisation of the PTS contract from the previous NHS ambulance trust to Coperforma. An independent organisation was commissioned to carry out this review.

Between April to July 2016 the Care Quality Commission (CQC) received 52 complaints, directly from patients, relatives, the service staff and hospital staff. These complaints 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. Furthermore, the CCG had shared their concerns with the Commission about the poor performance of this contract and the impact this had on patient safety.

In response to these concerns, we carried out an unannounced comprehensive inspection. This inspection was to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to look at the overall quality of the service.

Updated 1 November 2016

Coperforma Demand Management Centre is an independent organisation, which manages patient transport service (PTS) for patients who meet the eligibility criteria within the areas of Hampshire, London and Sussex. Coperforma manages patient transport service between patient’s homes and hospital. The service does not have a fleet of vehicles, but operates by managing the required transport and subcontracts the transportation of patients to a number of transport service providers.

We undertook an unannounced comprehensive inspection of the Coperforma Demand Management Centre at Andover on 12 and 13 July 2016. We inspected against the following key questions: are services safe, effective, caring, responsive and well-led?

We do not currently rate independent ambulance providers; therefore, ratings were not applied.

Our key findings were as follows:

• The service had a system in place for reporting and recording incidents. However, learning and action points from incidents and complaints were not disseminated to staff. Systems and processes were not always reliable and appropriate to keep patients safe.

• Vehicles and equipment used by transport providers were not always safe and appropriate.

• Comprehensive quality assurance checks had been performed on all transport providers, to ensure they met the necessary requirements in a number of areas.

• Patient transport service was managed, in line with the current standards and legislation. Staff had the skills to carry out their roles effectively, and in line with best practice.

• Some services were planned and delivered in a way that met the needs of local population. However, due to the patient transport not being reliable and timely some patients could not access services, for assessment, diagnosis or treatment when they needed to. The service had developed and introduced a number of initiatives to improve access.

• The service did not have a robust system for handling, managing and monitoring complaints and concerns.

• We observed patients were treated with respect and kindness during all interactions with staff. Staff explained the care and treatment they needed to provide appropriately for each patient so they understood. Patients received information in a way that they could understand.

• Vision and strategy had not been developed. The service did not always proactively engage all staff, to ensure that the voices of all staff were heard and acted on. Performance issues were being reviewed, and joint work with other organisations had commenced to address these concerns.

• The provider did not demonstrate they fully understood their legal requirements with regard to the Health and Social Care Act 2008. They had not assessed the two centres in Sussex against the Commission's "What is a location" criteria to identify whether they needed to follow the Commission's legal requirements to add the locations to the provider’s registration.

• The service was looking for ways to develop, improve and sustain the service and had introduced a number of IT interventions improve care for patients.

There were areas of poor practice where the location needs to make improvements.

Importantly, the location must:

• Ensure a robust system is in place for handling, managing and monitoring complaints and concerns.

• Ensure robust systems are in place to assess, monitor and improve the quality and safety of the services provided.

• Ensure the vehicles and equipment used by contracted services is appropriate for safe transportationof patients, including wheelchair users

• Ensure patients receive timely transport services so they can access the health services they need from other providers.

• Ensure there is learning from incidents and the learning and changes to practice are shared across all staff.

• Ensure transport provider staff always have essential information about patient’s needs so care is delivered safely and risks to patients are minimised.

• Ensure systems and processes are in place to implement the statutory obligations of Duty of Candour.

• Ensure a vision and strategy for the service developed and to ensure this is embedded across the organisation.

• Ensure a manager for the regulated activity is registered with the Commission.

• Ensure the provider and registered persons understand their legal requirements with regard to the Health and Social Care Act 2008. This must include a review of all centres against the Commission's "what is a location" criteria and where necessary follow the Commission's legal requirements to add the locations to the provider's registration.

• Ensure the Commission is notified of safeguarding incidents and incidents affecting the running of the service.

In addition the location should:

• To proactively engage and involve all staff to ensure voices are heard and acted on.

• To ensure a system is place to monitor and review staff training needs.

• Ensure all staff are trained in Duty of Candour.

• Continue to develop and embed the service delivery specialist role in the local hospitals.

• Ensure the ‘Simultaneous Translation Service’ or any similar system is implemented so translation services are always available.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Updated 1 November 2016

We do not currently rate independent ambulance providers, and therefore ratings were not applied.