Uber-style model blamed for unacceptable performance by non-emergency ambulance firm

Health chiefs wanted to run the non-emergency ambulance service along the lines of Uber, with drivers standing by their mobile phones as bookings came in.

But the contract was given to a provider that was out of its depth using technology that hasn’t always worked, with a lack of signal leaving drivers sitting idle.

The handover of the contract was rushed because Coperforma – the new operator – wasn’t ready and the clinical commissioning groups (CCGs) turned down an offer of help from the existing ambulance service.

But patients were being made late for appointments and missing them in some cases, putting their health at risk and adding to costs when savings were being sought.

The commissioning of the service – which affects patients in Brighton and Hove and across Sussex – was “one of the worst pieces of commissioning ever”, said a senior health leader.

Shambles

“It’s just a shambles, really!” he said, adding: “They wanted an Uber model but staff are sitting by their mobile phones waiting for a call when too often they don’t even have a signal.”

Neither the CCGs nor Coperforma checked whether phone signals were strong enough and consistent enough throughout the area, which includes rural swathes of Sussex as well as Brighton and Hove.

The health chief said: “It’s just not been thought through. Our staff are wonderful and this really is a concern for them. It places them in an invidious position. They just want the best for patients.

“But this wasn’t an organisation that was equipped to take on this contract. Coperforma do this type of work but on a much smaller level.

“We bent over backwards to help them. We offered the CCGs an extension if the mobilisation plans were not going to plan and this was rejected by them.”

The senior health leader, who is close to the key decision-makers at the South East Coast Ambulance Service (Secamb), said that health commissioners had tried to draw up a contract that would split the way the service was provided.

Some staff would take bookings and then allocate them to drivers who would be on standby.

The way the contract was drawn up placed staff at risk of losing their jobs as part of a savings drive. A number of those who were re-employed faced losing their employment rights when the new contractor took over, also helping make the contract cheaper to run.

Pressure

When this came to light, Secamb – the previous provider – and other reputable ambulance operators pulled out, leaving just Coperforma in the race. This should have prompted a rethink by the commissioners, the health chief said.

He accepted that the CCGs – like other public sector organisations – were under pressure to bring costs down. But he said that the concerns raised by reputable organisations should have prompted the CCGs to rethink the way that the contract was supposed to operate.

The contract for non-emergency ambulances – also known as the patient transport service – has also been criticised by the GMB union and is the subject of a report to Brighton and Hove City Council.

Members of the council’s Health Overview and Scrutiny Committee will hear from witnesses about the debacle this afternoon (Wednesday 25 May) at Portslade Town Hall. The meeting starts at 4pm and is open to the public.

The witnesses include officials from the High Weald Lewes Havens Clinical Commissioning Group (CCG). The CCG represented all seven Sussex CCCGs in procuring the contract as the lead commissioner.

The report to councillors says: “Unfortunately, since (Friday) 1 April 2016 when Coperforma assumed responsibility for the patient transport service there have been unacceptable levels of performance, with many patients experiencing severe delays or not receiving services at all.

“High Weald Lewes Havens Clinical Commissioning Group has commissioned an independent inquiry into the Patient Transport Service (PTS) in Sussex … and has asked for a draft final report to be available for review by mid-June.

“The investigation will examine the transition and mobilisation of the PTS contract from Secamb to Coperforma, and is supported by all three organisations (CCGs, Coperforma and Secamb).

Disruption

“In determining what, if any, further scrutiny of this issue is required, members may wish to bear in mind the level of disruption caused to patients in this instance and also the potential for Sussex CCGs to use learning from these events to improve subsequent contracting.”

The health chief said:  “Everyone wants the best for patients. They’re doing a fraction of the journeys that we did.

“The worry everyone’s got is that the CCGs will just cave in and give Coperforma more money.

“After the MSK (muscoskeletal) contract and the way that was handled, it looks like the commissioners are really struggling with this.”

Secamb’s acting chief executive Geraint Davies is expected to spell out his views on the way the contract was commissioned this afternoon.

And it is believed that he will be joined by a fellow director, Terry Parkin, a non-executive who was previously the Brighton and Hove City Council’s director of children’s services.

Representatives from the CCGs and Coperforma are also expected to attend and answer questions.

The report to councillors says that each CCG – including Brighton and Hove CCG – is responsible for the performance of the contract in its area.

It is due to be discussed at Portslade Town Hall this afternoon. The meeting starts at 4pm and is open to the public.