kent and medway pts key process flows v1.0 dated 27 may 16 · kent and medway pts key process flows...
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Kent and Medway PTS Key Process Flows – V1.0 dated 27 May 16
For all routine updates on Patient Transport please use CLERIC on-line or speak to your relevant G4S point of contact - Please refer to the relationship maps on pages 10 – 15 for further details
For further guidance on our feedback process please refer to Page 20
Methods -
Email - [email protected] – 0800 096 0211
Web - www.km-pts.co.ukIn Person - Speak directly to your G4S on-site team or relevant Area Manager
For further escalation please follow one of the below escalation processes
1. Service Specification Failure Escalation Process – Page 162. Clinical Dispute Process – Page 18
3. Out of Contractual Scope Dispute Escalation - Page 19
To book transport please use our CLERIC on-line booking system via www.KM-PTS.co.uk/NHS or phone 0800 096 0211.
On-line booking is quicker, allow you to track the progress of the crew allocated to the journey and will allow you to provide near live-time updates to patients
For further booking guidance please refer to -
1. Booking process for patients with higher medical needs that basic PTS – Page 3 2. Booking process for people identified with Mental Health needs - Page 5
3. Guidance for Community Healthcare Providers – Page 64. Guidance for London Trusts / Bromley and Bexley CCG’s – Page 8
Please also note that Cardiac, Neo-natal Intensive Care Unit (NICU) and Children’s Acute Transfer Service (CATS) journeys are out of the scope of this contract and should be booked through the relevant Service Providers
Please make sure you have the following details –
Patient details (remembering patient confidentiality rules)Journey details – to/from locations, time of pick up
Details of any concerns
Giving Service Feedback
Escalation
Booking Guidance
Ref & Journey type Required standardNotice required prior to scheduled
arrival/booked ready time
Performance reporting
threshold
1a - Journey booked in advance - Outpatient arrival.
Patients to arrive on time and no more than 75 minutes
prior to their appointment time 0r no more than 60 minutes
if it is the first appointment of the day for that clinic
n/a 95%
1b - Journey booked in advance - Time bound Haematology-
oncology patients that are receiving IV chemotherapy and
children outpatient arrival.
Patient to arrive within 15 minutes of their scheduled
appointment timen/a 95%
1g - Outpatient return journey - All bookings.Return Journey patients to be collected within 60 minutes
of the identified booked ready time
Booking to be made when booking
inward journey85%
2a - Journey booked in advance - Discharge.Patients to be transported within 60 minutes of the
identified booked ready timen/a 95%
2b - Journey booked on the day - Discharges.Patients to be transported within 120 minutes of the
identified booked ready timen/a 90%
2c - Journey booked on the day - Time bound discharge - care
package.
Patients to arrive within 15 minutes of the identified
required arrival time4 hours 95%
2d - Journey booked in advance - Time bound discharge - care
package.
Patients to arrive within 15 minutes of the identified
required arrival timen/a 95%
3a - Journey booked in advance - Transfer of care.Patients to be transported within 60 minutes of the
identified booked ready timen/a 90%
Outpatients
Discharges
Transfers
Kent and Medway KPIs
Standard NEPTS
Renal PTS
Ref & Journey type Required standardPerformance reporting
threshold
1a - Arrival time Patients to arrive on time and no more than 15 minutes prior to
or later than their scheduled appointment 95%
1b - Return journey. Return Journey patients to be collected within 30 minutes of the
identified booked ready time. 95%
1c - On the day bookings and
transfers.
Patients to be collected within 15 minutes of booked ready time
(requires 2 hours’ notice of booked ready time)95%
Section 1 Patient journeys
Page 2
Kent and Medway Intermediate Tier Transport
Does the patient require continuous care or a clinical intervention on the
journey?
Is an appropriately trained escort available -
1. Trained HCP 2. Competent carer
3. Competently trained parent
SECAmb to transfer patient – Call Booking line 0300 200 1067
No
Yes
Yes
Risk assessment by trust clinician required before further analysis can
be undertaken
No
No
No
Yes
This flow is for patients who have higher medical needs than standard PTS transport
No
Yes
No
Has a risk assessment been carried out and documented by a
competent medical clinician?
Is the patient assessed as being at Level 2/3 ?
Is the patient in, or expected to go into, active labour within 12 hours
Is it likely that the patient will need to travel under ‘blue lights ‘
at any point of the journey
Has the patient been declared stable and likely to stay so for the
duration of the journey by a medical clinician?
Yes
No
Yes
Yes
G4S to confirm level of crews based on following criteria
(see next page)
Trust to provide appropriately
trained escort or alternative PTS
provider
No
Page 3
Kent and Medway – Minimum Level of Transport to be booked
Page 4
PTS Level 0PTS Level 0 +
Escort
Intermediate Tier
CrewIntermediate Tier Crew + Escort
Venflon - no fluids
Urine catheter
low rate O2 below 28%
Subcutaneous Syringe driver
FracturesWill require risk assessment
from clinician prior to
patient being moved
High rate O2 above 28% over 4Ltrs
Intravenous Syringe pump
Basic ECG monitoring
Chest drain
IV running
Tracheal Suction
Oro pharyngeal suction required
Minimum level of transport to be booked
Remarks
Patients with mental health needs booking process
Is the booker aware of the patients mental
health history?
Has the patient been risk assessed by a clinician?
Is the patient at risk of absconding or self harm?
Will the patient be under the influence of drugs or alcohol at the
time of being collected?
Is a medical escort (i.e nurse / HCA / Doctor) travelling with the
patient?
Will the patient travel under medication /
sedation?
Yes
Yes
No
Will the patient travel with medication / sedation?
No
Is the medical escort fully aware of the patients condition, fully briefed and competent to deal with the patient?
Does the patient self-medicate?
Yes
No
Yes
No
Yes
No
Yes
Yes
Yes
No
NoRequirement to review patients history before
continuing with booking
Trust to provide fully briefed and competent escort or provide own
transport.
Requirement for patient to be assessed before continuing
with booking No
Yes
This flow chart is to support patients with a mental health condition that may put themselves, or G4S staff at risk, during a journey or who may require additional support
G4S Move PatientG4S move patient
with Trust provided escort
Page 5
Community Healthcare Setting
Journeys in scope
· Kent and Medway registered patients going to, or from, NHS funded medical treatment outside of any Primary Care appointments. This includes -
· Patients going to a step down bed in a hospice / care homes
· End of life journeys
· Patients in receipt of continuing healthcare funding
Please note that the actual Point of Care is less relevant than the treatment being provided
Journeys NOT in scope
· Patients going to, or coming from, a primary care appointment
· Patients going to, or coming from, care homes / hospices for non-clinical treatment
· Patients going to, or coming from, care homes / hospices for medical treatment not funded by the NHS
· Patients undergoing private treatment
· Patients that are not registered with a Kent or Medway GP
Page 6
Adding a PoC should not delay transport and therefore this process should be completed within 24 hours.
Should the PoC not be already in our CLERIC booking system then the booking will need to be taken over phone by our booking centre
This process flow for adding locations to the agreed PoC list
PoC not available on on-line booking system
HCP required to call booking call centre to book appointment
Is the appointment an on-the-day journey?
G4S Call centre will complete booking and allocate as pending until PoC is
confirmed
G4S to speak to relevant CCG & CSU to confirm if PoC is a commissioned
secondary care service
Was CCG / CSU contactable
G4S Move PatientAnd review with
CCG / CSU as soon as possible
Was PoC confirmed
G4S move patientAnd PoC added to
approved list
Yes
No
G4S to speak to relevant CCG to confirm if PoC is a commissioned
secondary care service
No
Yes
Yes
No
G4S advises requesting party that transport is not available and
signposts to other travel options
HCP / Patient phones booking line
Adding new Points of Care (PoC)
Page 7
Guidance for London Trusts
Definition of a Kent and Medway Patients
Patients who reside in Kent and Medway and are registered with a Kent, Medway GP
Patients who reside in Kent and Medway and are not registered with a GP
Patients who do not reside in Kent and Medway but are registered with a GP within Kent and Medway
Patients who do not have a registered address or GP and wish to be transported to an address within Kent or
Medway where they are considered “usually resident” following the “who pays” NHS guidance
This will mean that patients will be registered under one of the following CCG’s
Dartford Gravesham and Swanley Ashford
Canterbury & Coastal Swale
Medway
South Kent Coast Thanet
West Kent
Booking Guidance
If patients are booking their own transport they will be required to book via our booking line - 0800 096 0211
If HCPs are booking then they will also be able to book via our on-line booking portal - www.KM-PTS.co.uk/NHS
There will be the requirement to make patients ready after outpatient appointments, this can be done via the above
contact details
Our higher clinical needs booking process should be used to provide guidance if the clinical condition of the patient can
be supported by G4S trained crews.
Our escalation and complaints processes are highlighted in this pack and will be the same for K&M patients travelling in
and out of the London Trusts
Bromley and Bexley CCG’s
Bromley and Bexley Patients who have appointments within Kent and Medway Trusts will be eligible to apply for the
service. For guidance this includes the following Trusts / Hospital sites –
Dartford and Gravesham Trust
Medway Foundation Trust
East Kent Hospitals University Foundation Trust
Maidstone and Tunbridge Wells NHS Trust
Medway NHS Foundation Trust
Medway Community Healthcare (MCH)
Kent and Medway Partnership Trust (KMPT)
Kent Community Health NHS Foundation Trust
Page 8
Maidstone and
Tunbridge Wells Trust
Medway Foundation Trust
Kent Community
Health Trust
East Kent Hospitals
University Trust
Kent and Medway Partnership Trust
Area Manager –
West
Area Manager – East
Area Manager - South East London
Renal Area Manager
EKHUFT (Renal)
Kings Trust (Renal)
GSST (Renal)
Dartford and
Gravesham Hospital Trust
London Trust (Outpatients and
Discharges)
Medway
Community Healthcare
Lot 1 – K&M General PTS
Lot 2 – Renal PTS
Lot 3 – DGHT General PTS
G4S Management Trust / Point of Care Relationship Owners
Individual Points of Care List to Follow
Trust Senior Relationship Owner
Point of Care Breakdown
Page 9
1. Operational Relationship Map – Kent and Medway Acute Sites (0800 to 1900)
Ward Staff
Site Controller
QEQM - phone numberK&C – phone number
William Harvey – phone numberMedway Maritime - phone number
Maidstone – phone numberTunbridge Wells - phone number
G4S Day Control
Site Operations Team Ops and Control Manager
On Call Director Assistant Site Director
G4S Area Manager East / West Kent
email Ops and Control Manager
Service Delivery Manager
MFT - phone number / emailQEQM – phone number / email
K&C – phone number / emailWilliam Harvey – phone number / email
MTW – phone number / email
Trust Management
Level 1
Level 3
Level 2
Page 10
2. Operational Relationship Map – Community / Mental Health Points of Care (0800 to 1900)
Ward / Clinical / Support Staff
G4S Day Controlphone number
Appropriate Manager
Appropriate Senior Manager
G4S Area Manager East / West Kent
emailOps and Control Manager
Ops and Control Manager
Service Delivery Manager
MTW – phone number / emailQEQM – phone number / email
K&C – phone number / emailWilliam Harvey – phone number / email
MFT - phone number / email
Trust Management
Level 1
Level 3
Level 2
Page 11
3. Operational Relationship Map – Renal (0800 to 1900)
Ward Staff
Site Controller
Tunbridge - Phone NumberDartford – Phone Number
K&C – Phone Number
G4S Day Control
Site Operations Team Ops and Control Manager
On Call Director Assistant Site Director
Renal Area Manageremail
Trust Management
Level 1
Level 3
Level 2
Page 12
Operational Relationship Map – DGT (0800 to 1900)
Ward Staff
Site Controller
DVH Site Controller Phone Number
G4S Day Control
Site Operations Team Ops and Control Manager
On Call Director Assistant Site Director
DGT SDMPhone Number / Email
Trust Management
DVH Area ManagerTom Maidman
Ops and Control Manager
Level 1
Level 3
Level 2
Page 13
Operational Relationship Map – London Trusts (Discharges and Outpatient Appointments)(0800 to 1900)
Ward Staff G4S Day Controlphone number
Appropriate On-site Manager
Appropriate Senior Manager
G4S Area Manager West Ops and Control Manager
Trust Management
Level 1
Level 3
Level 2
Page 14
Operational Relationship Map – Out of Hours (1900 – 0800)
Ward Staff Out of Hours Control
0800 0960211
Appropriate Duty Manager Duty Senior Manager
Duty SDM / TL
Out of Hours Control0800 0960211
Trust Management
Level 1 / 2
Level 3
Page 15
Escalation Process – Failure to meet Service Specifications
Are G4S in breech of the defined KPI Service Standards?
Has the situation been resolved to an acceptable level for the
patient / HCP?
G4S to ensure patient is informed about new collection time. KPI Failure logged for trend analysis and review
Review of resources undertaken by G4S in consultation with
Patient / HCP
Yes
No
Patient informed that issue is still being resolved
Has the situation been resolved to an acceptable level for the
patient / HCP?
G4S to ensure patient is informed about new collection time. KPI failure recorded for trend analysis and review
Yes
Level 1 Escalation
Level 2 EscalationG4S management review of
resources undertaken
No
Patient informed that issue is still being resolved
Has the situation been resolved to an acceptable level for the
patient / HCP?
G4S to ensure patient is informed about new collection time. KPI failure recorded for trend analysis and review
Yes
Level 3 Escalation
G4S senior management review of resources
undertaken
No
Able to request below additional
resources from control –
1. Cross allocation from other K&M Lots
2. G4S Central Team
3. Support from other G4S Contracts
Able to review resources allocated to Lot
Able to authorise -
1. Staff Overtime
2. 3rd
Party / Sub-contractors
Patient prioritised as HIGH PRIORITY and transported via trust organised 3rd Party
Issue raised to Ops Director to consider invoking BCP
SI raised to CCG within 24 hours
Will delay in journey put patients safety or clinical condition at serious risk?
Yes
No
Page 16
Escalation Process – Failure to meet Service Specifications
Priority 1 Patients - to reach level 3 escalation within 1 hour
· Renal Patients · Haematology-oncology patients that are receiving IV chemotherapy· Transport of Children· End of Life Transfers · The discharge of patients home where a time bound care package is required
Priority 2 Patients - to reach level 3 escalation within 2 hours
· Discharges· Transfers for care · Transport of patients requiring admission to an inpatient mental health unit
Priority 3 Patients - to reach level 3 escalation within 4 hours
· Outpatient appointments
Page 17
Clinical Dispute Process
Following the G4S booking process the patient journey has been identified as not being a level 0 / level 1 patient, therefore not in-scope for G4S.
In order to avoid delays in patient transport this process should be completed within 1 hour of the booking being
made
Has the situation been resolved and the appropriate Service
Provider Identified?
Appropriate Service Provider moves patient
Case reviewed by Clinical Manager for any lessons learnt
SECAmb to contact G4S to conduct an internal review the clinical
booking process
Yes
Level 1 Escalation
Has SECAmb already rejected the journey
because of the patients clinical status ?
Yes
Signpost to SECAmb booking line - 0300 200
1067
G4S Site Controllers / Day Control will not be able
to make clinical decision but will review against the
agreed guidelines
No
No
Has the situation been resolved and the appropriate Service
Provider Identified?
Appropriate Service Provider moves patient
Case reviewed by Clinical Manager for any lessons learnt
Review the clinical status of the patient conducted between –
G4S SDM G4S Clinical Governance Manager
Trust Clinician
SECAmb EOC – 01622 740400
Yes
Decision to be agreed on which service provider is
responsible for the clinical needs of the patient.
This should not factor in available resources
No
Level 2 Escalation
SECAmb move patient as default
CCG informed and review of decision undertaken at next contract performance meeting
Page 18
Escalation Process – Journey Out of Contractual Scope
Patient journey has been identified as being outside of the agreed Service Specification
Eligibility Review to be undertaken –
G4S Call Centre Manager HCP / Patient
Was it because the patient was not going to, or coming from, NHS funded medical
treatment*
Yes
G4S Move PatientReview undertaken and
any training gaps identified
Patient / HCP sign posted to alternative providers
Was it due to patient failing eligibility?
Did Review change decision?
Yes
Yes
No
No
YesRefer to Adding points of
care flow diagram (Page 7)
No
Was it because the patient was not a Kent and
Medway Patient
* - Excludes Primary Care
^ - G4S will ensure that reasonable attempts have been made to contact the relevant CCG for authorisation
Yes
Was it because the patient is an out of area
repatriation?
Patient / HCP signposted to alternative provider
No
Yes
Patient / HCP signposted to
alternative provider
Can the patient be moved with out impacting the core
service? No
Yes
G4S to seek authorisation from paying CCG
Has patients CCG agreed to pay for journey?
Yes
G4S Move Patient
No
Patient / HCP signposted to
alternative provider
Was the relevant CCG contactable?^
No
K&M CCG underwrite journeyG4S move Patient
Yes
Is it a Discharge Journey?
Patient / HCP signposted to
alternative provider
No
Yes
Page 19
Patients / HCP want to provide feedback directly to G4S
Initial Investigation carried out within 10 working days
Details captured in
Info-Exchange
G4S Complaints Team informed and allocate
feedback as – Complaint Concern
Compliment
Email – [email protected]
Phone – 0800 960 211
Written - Kent and Medway PTS Contract, Swift House, 18
Hoffmanns Way, Chelmsford, Essex, CM1 1GU
Via Web – www.km-pts.co.uk
No YesIs the feedback a formal complaint?
Feedback presented to patient / HCP
Relevant SDM / Area Manager
Informed
Is the incident a safeguarding or SUI? Yes
SUI / safeguarding
process instigated
No
Investigation undertaken Trust
PALS team and CQC informed
Info-Exchange assigns the
investigating Officer
1. Patient Updated 2. Incident closed
3. Root Cause Analysis conducted
Patients / HCP updated every 5 days
Are PALS team happy with outcome Yes
No
Initial Investigation carried out within 7 working days
Details captured in
Info-Exchange
Info-Exchange informs the
relevant SDM
Local Investigation Undertaken
Feedback Process
Is the feedback a concern?
Yes
Is the feedback a compliment?
Yes
No
Details captured in
Info-Exchange
Relevant Crews and SDM informed
Reviewed for best practice and
circulated internally
Longer Term trend and root cause analysis
conducted
Page 20