The Director of Urgent and Emergency Care submits a report that provides an update on the provision of services by Thames Ambulance Services Limited (TASL) to the Leicestershire, Leicester City, and Rutland (LLR) healthcare geography as at August 2018. The Committee is asked to receive the report and comment as it sees fit.
A minute extract of the meeting of the Leicestershire County Council Health Overview and Scrutiny Committee held 28 February 2018 is also attached.
Mike Ryan, Director of Urgent and Emergency Care, West Leicester Clinical Commissioning Group (WLCCG) presented a report that provided an update on the provision of services by Thames Ambulance Services Ltd (TASL). Members heard that TASL had been awarded the LLR Non- Emergency Patient Transport Services contract in June 2017 and began providing the services on 1 October 2017. During the first year, TASL had under-performed against expectations in terms of both performance and quality. Whilst performance had slowly improved, there were still concerns in relation to quality and this was being monitored. There were also concerns as to TASL’s long-term financial sustainability as the organisation were operating at a deficit. An independent review was being carried out to ascertain their overarching long-term viability and the report of that independent review was due out shortly.
Members considered the report and raised comments and queries, which included the following:
· In relation to the procurement exercise, a Member commented that it appeared that the CCG had been aware that TASL had shortcomings but had procured their service anyway. Mr Ryan responded that non- emergency patient transport services were very difficult to procure; they had been aware that there were some shortcomings, but these were considered to be manageable. They had not anticipated that there would be concerns relating to the financial viability of the organisation. The CCG were working closely with TASL and NHS England to ensure appropriate action was being taken to mitigate any risks associated with their financial pressures and have also established contingency plans with other providers.
· Comments were raised that reports on TASL had been brought to the Leicestershire County Council Health Overview and Scrutiny Committee twice, though a representative from TASL had not been present. Concerns relating to TASL’s financial stability had also been raised earlier in the year, and Members were given assurances that the financial issues would be sorted out, but the concerns over financial viability were still there.
· In response to a question, Members heard that the current CQC rating for TASL was that the organisation required improvement.
· Micheal Smith, Healthwatch asked the committee to consider the wider impacts arising from delays with handovers at hospitals and he added that Healthwatch had been working with TASL.
· A Member commented that the concerns relating to performance and quality were not particular to Leicester, Leicestershire and Rutland alone, and she would be interested to hear how the NHS was working with other counties in relation to TASL’s performance, as some patients crossed boundaries to receive services. A question was asked as to how the NHS was managing those patients. The Chair asked for this question to be noted and to be brought back and addressed in a future meeting.
· Concerns were raised at the cost incurred in monitoring TASL and Mr Ryan responded that as it was a new contact, it was expected that they would put in more time in monitoring. He believed that it was value for money. Mr Ryan was also asked as to how the financial concerns affected the contract going forward, as it had been awarded for a five-year term. In relation to those concerns, the committee heard that the TASL were backed by a group of Spanish investors and venture capitalists; they were the premier passenger transport service in Spain and they had tried to get into the UK market for the past few years. The financial backers were concerned that their investment had not reached the break-even stage. However a cost improvement plan had been drawn up which had inspired more confidence and the investors were now talking in the long term rather than the short term.
The Chair drew the discussion to a close and Members agreed the following:
1) that the report be noted, and a further report be brought back in six month’s time and that a representative from TASL comes to the meeting; and
2) that the committee request that the report includes performance data, and information relating to contractual obligations and conditions.