Agenda item

Ian Ayres (Accountable Officer, NHS West Kent CCG) and Dean Souter (Control and Planning Manager, NSL Care Services) were in attendance for this item.

(1)       The Chairman welcomed the guests of the Committee and asked them to introduce the item. Mr Ayres began by updating the Committee on developments following the January meeting. At the beginning of the year, the contract was significantly underperforming. The contract had since been reset and stabilised and the six key targets were on a trajectory to be achieved by June. An independent monthly performance report had been introduced; figures from the February report were beginning to show improvement with day-to-day variation narrowing. By early June, the CCG would know if a recovery had been achieved. 

(2)      Members of the Committee then proceeded to ask a series of questions and make a number of comments. A Member enquired about the additional costs to the contract.  Mr Ayres explained that there were three components to the additional costs. The first, £100,000 was a financial settlement for additional costs incurred between July and December. Both the commissioner and provider were found to be culpable. The second, £600,000 was to cover the costs of additional staff being transferred to the provider which had not been disclosed to bidders. The third, £1.6 million per annum, resulted from the re-basing of the contract. Mr Ayres noted that with these additional costs, NSL would have still won the contract. He reported that from June there were would be no further recovery plans; if performance was not turned around, the CCG would l seriously reflect on the future of the contract.

(3)      A Member raised concerns about the quality of service provided by NSL. Mr Ayres explained that two key learning points had arisen from the tendering process.  Firstly the contracting team should have included a manager with knowledge of running a Patient Transport Service to evaluate the quality of the bid.  Secondly the CCG should have better understood the balance between quality and price. NSL scored significantly higher on quality and value for money. Mr Ayres accepted that this was a failure of the commissioners to show due diligence. Mr Souter reported that NSL successfully ran services in Shropshire, Herefordshire and the East Midlands. These areas recognised NSL as quality service provider. In response to the increased patient activity, NSL had invested in 75 new staff and 15 new vehicles in Kent to improve quality. He stated that NSL committed to continuing to provide an improved service for the people of Kent.

(4)      A question was asked about the recovery plan and the target to meet ‘most’ Key Performance Indicators (KPI) by Easter. Mr Ayres reported that there were 20 KPI; he understood that 15 -16 KPI had been met. The six critical targets were due to be met by June:

1.    Delivering a renal patient to an appointment

2.    Collecting a renal patient from an appointment

3.    Delivering an outpatient to an appointment

4.    Collecting an outpatient from an appointment

5.    Collecting a discharge patient within three hours

6.    Collecting a discharged patient within two hours

(5)       Mr Ayres explained that the CCG was provided with weekly unvalidated data; he would be able to provide validated data to the Committee in April. There was a delay in receiving validated data due to contractors and volunteers of NSL submitting records manually rather than on electronic handsets which were used by NSL staff. There had been a reduction in the number of extreme events but this had not impacted on contract performance.

(6)       A number of questions were asked about performance management and terminating the contract. Mr Ayres reported that the CCG were deeply concerned about the performance of the contract. A final decision would be taken in June by the Commissioners using May’s data. The CCG was working with senior managers from the acute hospital trusts on what the new arrangements would look like if the contract was terminated. If necessary there would be a managed transition to the new arrangements. Mr Ayres stressed that the money for overperfoming contracts came from contingencies rather than reducing care in a different service. He welcomed the opportunity to develop joint working with the Council and to become involved with the recent Select Committee on Commissioning.

(7)       A Member raised a concern about the amount of time taken to transfer a patient from a hospital to a secure unit. Mr Ayres encouraged the Member to raise a complaint.

(8)      RESOLVED that Mr Ayres and Mr Souter be thanked for their attendance and contributions to the meeting along with their answers to the Committee’s questions, and that a written update be submitted to the Committee in July.