Agenda item

To receive and consider the attached report of the Head of Scrutiny and Member Development.

The report of the Head of Scrutiny and Member Development referred to the Board’s initial discussions regarding their work programme for the 2008/09 Municipal Year and the concern regarding Renal Services, particularly the transport of kidney patients.  Attached to the report were submissions from Leeds Teaching Hospital Trust (LTHT) and the National Kidney Federation.  Also tabled was a paper from the Yorkshire Ambulance Service (YAS).

The Chair introduced the following to the meeting:

• Nigel Gray – Leeds PCT
• Judith Lund – Leeds Teaching Hospitals NHS Trust
• Brian Young – Leeds Teaching Hospitals NHS Trust
• Amanda Dean – Matron for Renal Services , Leeds Teaching Hospitals NHS Trust

The Board was informed of recent changes to the delivery of Renal Services in and across Leeds, including the closure of the Wellcome Wing at Leeds General Infirmary (LGI), movement of services to St James’ Hospital and Seacroft Hospital and the continued development of the live donor renal transplant service.

It was reported that a number of initiatives had been developed regarding the transport of renal patients, however it was acknowledged that a number of problems had been encountered.  LTHT and the PCT would continue to work in partnership with Yorkshire Ambulance Service and the Kidney Patients Association (KPA) in an attempt to solve this.  A standard appointments system had been piloted although this had encountered some problems including some related to transport issues.

In response to Members questions and comments, the following issues were discussed:

• Due to the increase in the number of transplant patients, this should reduce the number of patients needing dialysis and alleviate some of the problems currently encountered.
• There had been a 12% increase in the number of patients requiring transport.  This had contributed to the problems encountered with transporting patients.
• Patients not attending appointments and failing to inform YAS that they would not be attending.
• There had been other bidders for the transport contract.  Yorkshire Ambulance Service had been considered to be the most suitable for the contract by the adjudication panel.  Consultation had taken place with the KPA throughout the process.
• Details of follow up action for patients who had failed to attend appointments.

The Chair introduced the following to the meeting:

·  Sarah Fatchett – Director, Yorkshire Ambulance Service

·  Diane Williams, Assistant Director, Yorkshire Ambulance Service

·  Nicola Greaves, Customer Relations Manager for Renal Services, Yorkshire Ambulance Service

It was reported that under the terms of the transport contract, YAS had a performance target to transport 90% of patients to appointments within 30 minutes.  This target had been met last year, but was currently running at 77%.  A number of service improvement measures had been implemented to improve this and bring the service back up to standard.  A further target of 90% was in place to transport patients home within 45 minutes of their treatment ending.  This was currently running at 90.26%.  Approximately 2% of journeys were cancelled or aborted due to cancelled or missed appointments.

In response to questions and comments regarding the YAS submissions, the following issues were discussed:

• Reasons for aborted journeys included those where there were no response from the patients and where patients had been admitted to hospital or been on holiday without informing the YAS.  Records of times of attendance at patients homes were kept.  Work was taking place with hospitals to improve communications and increase awareness where patients had been admitted to hospital prior to appointments to prevent aborted journeys.
• Some homeward bound journeys had to be cancelled at a late stage due to patients being kept in hospital.
• There had been an increase in the number of patients in and across Leeds who relied on transport from YAS.
• ‘On-line’ booking systems were being trialled.

The Chair welcomed the following to the meeting:

• Lilian Black – Kidney Patients Association (Leeds General Infirmary)
• Paul Taylor – Kidney Patients Association (St James’ Hospital)
• Gloria Black – Renal Services Patient
• Lesley Britton – Chair of St James’ Kidney Patients Association

It was reported that the KPAs represented approximately 1,000 patients and carers across Leeds and they had been involved with all the local recent issues such as the relocation of services and transport arrangements.  It was envisaged that the relocation of services would cause problems and main areas of concern focussed on transport arrangements.  The Board was informed that kidney patients typically had to go for dialysis 3 times per week for 4 hour periods and many patients were completely reliant on the services provided by YAS.

Examples of problems with transporting of patients to and from appointments were given to the Board.  These included the late and missed collection of patients for appointments and patients having to travel on long unnecessary journeys whilst other patients were collected.  Patients had also encountered difficulties in being able to make complaints and representations about poor service.

Further to the Kidney Patients Association concerns, the following issues were discussed:

• The Yorkshire Ambulance Service had a dedicated Renal Planner.  Late changes often had to be made to schedules for transport of patients due to various factors such as patients illness.
• Concern was made that it was not possible to contact YAS by telephone.  It was reported that a dedicated line for contact was to be created and patients would be informed of the details.

The Chair thanked those present for their attendance.

RESOLVED – That the report and information presented be noted.