The death of a Brighton patient who missed an appointment for a scan days earlier has prompted fresh questions for the non-emergency ambulance contractor Coperforma.
Campaign group Sussex Defend the NHS that the man, who was in his eighties, died at the weekend, adding: “The family are understandably furious and are left wondering whether the outcome would have been different if the ambulance had taken him to the hospital as booked.”
Coperforma said that an investigation into what happened was now under way. Details of the pensioner’s case were being shared as local health chiefs and Coperforma met MPs at Westminster.
The clinical commissioning groups (CCGs) have given Coperforma until mid July to improve its performance in providing the patient transport service.
The company is currently missing too many appointments and turning up late for others. Although it provides a non-emergency ambulance service, patients are said to be at risk if, for example, they are on dialysis.
The Labour MP for Hove, Peter Kyle, praised the GMB union for speaking up on behalf of staff and patients and for raising safety concerns.
Simon Kirby, the Conservative MP for Brighton Kemptown, said that he had received many complaints from constituents about the service since Coperforma took over the contact in April.
He said: “Sussex MPs were very concerned as, two months on, constituents were still contacting them about missing operations, hospital appointments and waiting for hours in hospital reception areas to return home due to patient transport problems.
“CCG senior managers told MPs that they have been working closely with Coperforma to establish the cause of the problems since taking over patient transport for Sussex in April.
“They are currently awaiting the results of an independent report to investigate the handover problems.
“However, they also recognise that urgent action is needed and have already agreed an improvement plan with Coperforma which is being reviewed on a weekly basis.
“The CCG has demanded that Coperforma reaches their target of ensuring that 95 per cent of patients are transported to and from appointments on time by the end of June.
“They are also already consulting with all Sussex CCGs and providers on possible alternative plans should Coperforma not reach this target.
“I am pleased that the CCGs and Coperforma agreed to this meeting with Sussex MPs which was very productive. I am looking forward to seeing an improvement to the service and to meeting again at the beginning of July.”
The company itself said: “Coperforma welcomed the opportunity to meet with Sussex MPs and CCGs to provide insight into the patient transport service it is delivering and to share information on the progress that is being made.
“While stretching targets have been set which need to be met by early July, Coperforma is confident of meeting those targets and is investing in additional resources at its own expense including further vehicles and crews that will deliver up to 84 extra shifts in June and July to meet the uplift in demand that the company is experiencing.
“Coperforma looks forward to continuing its collaboration with the CCGs to monitor that improvement and to providing all data required and requested.
“Coperforma thanks the MPs and the CCGs for a positive and supportive meeting that will enable more information to be shared with patients and constituents.
“An investigation is under way into the precise circumstances surrounding the transport service experienced by this patient and his family.
“A report will be sent direct to the family once that is complete. Coperforma extends its sympathy to the family at this very sad time.”
Sussex Defend the NHS said: “The patient concerned suffered from a respiratory illness and was struggling to breathe.
“His son said that when the transport failed to arrive for his hospital scan appointment, his dad phoned his GP who visited immediately.
“The doctor was furious that the service hadn’t turned up and contacted them there and then to find out what was happening.
“The patient did not get to hospital for the scan and a few days later an emergency ambulance had to be called to take him to hospital where he was treated.
“Sadly, his condition had deteriorated by this time beyond the point of recovery.
“The family made a complaint to Coperforma, the private company who run the patient transport service.
“They were told that the driver who didn’t turn up ‘had walked out’ and had ‘let the company down’.
“The family also told us that their dad’s carer had written in visit notes, after the missed appointment, that her client was in a terrible state and extremely distressed because his transport hadn’t arrived for the CT scan.
“The family now know their dad was very ill so the outcome might well have been the same.
“However, if he had made that planned appointment he would have received medical care and what turned out to be his last few days would have been more comfortable.”
Val Knight, from Sussex Defend the NHS and a neighbour of the patient, said that she had been watching out for him in recent weeks.
She said: “This makes me so angry. The distress caused to an elderly, disabled person and the suffering in their final days is utterly unacceptable.
“And we are all left wondering if the outcome would have been different if he had been taken for the scan he was booked in for.
“Those who commissioned this company are still just talking about what to do.
“Until they get rid of Coperforma and go back to Secamb (South East Coast Ambulance Service), who used to run the service reliably, this can happen again and again.
“I want our health and social care services run for the public who pay for it, not for faceless profiteers.”
Coperforma are now using private ambulance firms from all over the country to fill in the gaps in its abiity to collect patients. It means a wide variety of vehicles are in use and patients do not know if the one that turns up will be suitable for their needs.
This was rarely, if ever, a problem with SECAMB.
Lovely new drivers are being taken on by Coperforma, trained by a Crawley taxi firm and some are used to the West Sussex patch but have no familiarity with Brighton & Hove roads and hospital interiors. This is a major issue for accessing the RSCH which is simultaneously undergoing redevelopment while still being in use!
Coperforma need to provide internal maps for its drivers so they have SOME idea on arrival of how the RSCH works. This week the Eastern Road frontage was blocked off, meaning the Barry Building front entrance was inaccessible and access to X-ray and MRI, etc. had to be via A&E to the Barry Bldg. My driver had to find a chair and work out how to get through the labyrinthine corridors and change floors twice in lifts to then wheel me through backwards, while I manoeuvred my walking aid in front of me from the chair (like a train). By the end of the day my young driver must have aged somewhat frankly! It is hard on them too.
Going home, a two-man crew in a proper patient carrier took me home more appropriately…but I was the sole patient in both cases in vehicles that should have carried more patients as well.
The CCG commissioning process was just plain negligent. Heads should have been rolling by now! It is really scary wondering if Transport is going to turn up or not and hospitals are juggling appointments to try to work around issues. Its a mess.
Valerie Paynter is quite right, neighbours of mine have recently been transported the The Sussex County by a private amblance from Somerset – this is just bad managment and it has been going on for far to long caseing distress, inconvenience and now a fatality-it is not good enough and thoose responsible for this shamles need to be held to account. Well done to Sussex defend the NHS for taking this up-it is a quite disgraceful situatiom
Before this tender went to market, the CCG advertised a request for information (RFI) this was to obtain information from the NEPTS sector and an understanding from them of how the service should be offered for tender. My solution was to either separate the contracted activity into CCG areas or to tender all of the activity for companies to bid.
The CCG was not prepared to listen to this, and chose to tender the contract as a managed service provider, not allowing the winning company to supply any of its own vehicles and staff. This model narrowed the bidders down to very few operators, which excluded many NEPTS organisations, including Secamb.
Although I cannot be 100% certain of this, only four companies were interested in bidding, one being Secamb. Two companies pulled out due to the affordability cap (this is where a company carries out an analysis on the contracted activity and calculates the cost through their operating model) in this case they could not meet this. One didn’t get through the first stage of the procurement process, which meant Coperforma were the only company that could go forward and possibly win the tender.
Although the CCG KPIs were unrealistic, Coperforma were able to sell the CCG an operating model which would not only save the CCG money, it would supply a first class service, which would meet or exceed their KPIs. This model was based solely on a computerised system that can plan and despatch vehicles with no human intervention. The system is also based primarily on operating taxis for single journey occupancy. This way of planning and controlling ambulances is flawed as vehicles need to be fully loaded to gain maximum efficiencies and occupancy. It is also further flawed as the only way to do this is by local knowledge and a proven and tested operating system. This is further validated as many patients are reporting that there is only themselves traveling in a vehicle at any one time and many have been standing around, minimising their productivity and increasing the cost of the service.
The computerised system used by Coperforma has never been operated on this level, in fact Coperforma have never operated a contract on this scale. They claim to be operating in other areas across the UK, where? The only service they operated was in Hampshire with a maximum of 10 vehicles and were primarily used for discharges where single journey occupancy normally takes place, if you’re inefficient. This work has now been consumed by South Central Ambulance Service.
Many NEPTS contracts operate unsatisfactory, but my predictions were that this (Coperforma’s) operating model would be the most dangerous, especially on this scale. Contiued…….
Coperforma will never be able to provide a service which meets the patient’s expectations, no matter how much money is invested into the service. They simply cannot operate at this level. This is not just my opinion; it is a proven fact as they have had two months to put it right. They can blame as much on others as they want, which was witnessed at the beginning, with the patient data being incorrect. It certainly doesn’t take long to address the journey activity, cleanse the data or seek additional funding required to provide the service. The problem is that they have no idea what is really needed, as they do not have the experience to correct it. Even if they do have a month to put it right their workforce will deteriorate due to patients complaining and letting people down. With this being the case they will not be able to recruit quickly enough and get the skill set needed to put it right.
As an organisation they must be losing an obscene amount of money, as they cannot be operating within their budgets set up at the beginning. In my opinion, this is just the brink of the iceberg, as it will continue to deteriorate and Coperforma will probably just walk away, leaving it worse than what it is now.
The CCG need to get a grip before Coperforma turn their backs and amicably put this back out to tender. They also must ensure that they are either in talks with Secamb or another provider as a contingency (rescue package) capable of taking it over if they do walk away. My fear is would anybody want it as it could tarnish their organisation and have Secamb still got the people and skillsets in their organisation as a majority of them would of either been transferred into Coperforma and possibly left or consumed within their A & E service.
This procurement has been flawed from the very beginning, even where there was a debacle taking place before the contract started with the ex NHS (Secamb) staff not knowing if they had jobs and Coperforma advertising for volunteers on the 31st of March on their website. How on earth can they correct it now?
For the CCGs trying to save money on patient transport the cost of this service has now far exceeded the predicted savings, which now ‘could’ include a person’s life – priceless! How long will it continue is anybody’s guess!