Free hospital travel at risk

Andrew Smith MP

Andrew Smith MP

First published in News Witney Gazette: Photograph of the Author by , Health reporter, also covering Kidlington. Call me on 01865 425271

PATIENTS face being refused free transport to hospital appointments and procedures as part of NHS savings.

Managers want to cut pat-ient journeys by up to a third to save up to £325,000 by tightening eligibility criteria of those needing the free travel.

They estimate this would axe up to 34,000 of the less complex journeys. In total they make 107,000 trips a year with an overall cost of £3.77m.

It said non-NHS services, led by volunteers, could step in – but one such county service warned it would struggle to cope, while MPs raised fears about the plan.

A consultation will be held from May 30 to August 8 with any changes taking effect from November 1.

The changes are proposed by Oxfordshire Clinical Commissioning Group (OCCG), which contracts journeys from South Central Ambulance Service.

These are provided by a volunteer driver, minibus or single crew ambulance car and patients fall into eight categories.

About two-thirds of the “walker” and “single crew seated patient” groups – which make up half of the annual journeys – could potentially lose free trips, the OCCG said It has to save up to £6.3m by the end of the financial year and said changes “will reduce the majority” of trips in the groups. “Walkers” are patients who can get in and out of cars and walk unaided, while “single crew patients” are those who need “minimal assistance” and may only manage short distances.

An OCCG report said those patients don’t need help or specialist transport such as a wheelchair capable vehicle.

But it said those whose condition “impacts on their mobility” – like dialysis and eye surgery patients – will be exempt from the proposed cuts.

It said the move is “in line” with other CCGS like Bristol and South Gloucestershire and because there are “a number of free or low cost transport services”.

These include Wantage Independent Advice Centre Volunteer Car Scheme and Cherwell Volunteer Connect Community Transport Scheme.

Pat Chirgwin, manager of Volunteer Link-Up (West Oxon), which has 60 volunteers who are paid expenses for using their own vehicles, criticised the proposals.

She feared some patients will be too infirm to get the group’s help, saying: “We will die trying. But there comes a point where it is going to break.

“We only have a certain amount of capacity, there are only a certain number of hours in the day.”

Oxford East Labour MP Andrew Smith said: “There is clearly a risk with these sort of cuts that a lot of additional inconvenience and cost is put onto really quite vulnerable patients who will find it difficult and expensive to get to medical appointments.”

Wantage MP Ed Vaizey said: “There is often limited if any public transport available in rural areas so it is essential that any changes to current arrangements recognise the particular needs of my constituents.”

Age UK Oxfordshire spokeswoman Rachelle Kennedy said: “We would regret any reductions in patient transport services for vulnerable older people.”

Julia Stackhouse, spokeswoman for OCCG, said: “Plans to review patient transport services are set against the backdrop of the financial challenges facing the local NHS.

“We propose to revisit the eligibility criteria for non-emergency patient transport, protecting the service for the most vulnerable.”

Ambulance service spokeswoman Michelle Archer said it had yet to have talks with OCCG about the plans, for its 48-vehicle fleet.

She said: “Those in need of support will continue to receive transport and those requiring no support during transport will be signposted to alternatives”.

Commissioning group’s top post vacant

THE OCCG’s medical director has taken a secondment, leaving the post vacant.
Oxfordshire Clinical Commissioning Group has yet to comment on whether Dr Mary Keenan will return and how long her secondment will last.
Spokeswoman Julia Stackhouse said: “Dr Keenan has taken up a secondment to Oxford University where she will be undertaking research into how technology can be used to benefit patients. Her post is currently vacant.”
She was appointed when the OCCG was formed on April 1, 2013, under a major national shake-up of the NHS, to involve GPs more.
Chief executive Dr Stephen Richards stepped down in October due to the demands of the job. David Smith takes on the post in June.

Least infirm will be affected by changes

Two out of eight categories of patient – the least infirm – will
be affected by the changes, with most set to lose the right to free journeys.
These “walker” and “single crew seated patient” journeys made up 51,966 of the 107,488 county journeys in 2013/14.
The OCCG has said about a third of these would be protected from changes, meaning up to 34,644 could miss out. Managers have said the changes would “reduce the majority” of the 51,966 journeys.
The criteria was last changed to include patients such as those who need continuous oxygen during their journey and cannot use public transport.
All are assessed by a healthcare professional under four general principles set by the Department of Health.
Free trips are for those who require specialist staff; who could have their access to care, condition or recovery damaged without help or are parents or guardians travelling with children.
Transport can also be for escorts or carers whose skills are needed for those with “communication difficulties” or those with mental health conditions.
If some lose free trips under the changes, OCCG said they can apply for costs under the NHS Healthcare Travel Costs Scheme.
Applicants must be on a low income or receipt of a list of benefits like income support or Jobseeker’s Allowance.

Comments (7)

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9:33am Wed 30 Apr 14

West Oxon Webwatcher says...

The hopitals should consider the provision of more outpatient services at the minor hospitals. I have to attend both JR & Churchill hospitals for outpatient appointments and each 10 minute appointment is a half day trip for me. More outpatients appointments services at Abingdon, and Witney hospitals would cut down on the need for patients to travel.
The hopitals should consider the provision of more outpatient services at the minor hospitals. I have to attend both JR & Churchill hospitals for outpatient appointments and each 10 minute appointment is a half day trip for me. More outpatients appointments services at Abingdon, and Witney hospitals would cut down on the need for patients to travel. West Oxon Webwatcher
  • Score: 10

10:19am Wed 30 Apr 14

Quentin Walker says...

Has OCCG considered a charge, equivalent t the bus fare from a patient's accommodation to the hospital, I wonder.

The patient would be paying a public transport rate and OCCG would gain funding.
Has OCCG considered a charge, equivalent t the bus fare from a patient's accommodation to the hospital, I wonder. The patient would be paying a public transport rate and OCCG would gain funding. Quentin Walker
  • Score: 5

12:24pm Wed 30 Apr 14

King Joke says...

WOWW - spot on. Centralising services saves the NHS money but costs the rest of society. THey're just externalising their costs. 'Cottage hospitals' or poly-clinics in the market towns could do a lot of this stuff.

Quentin - a good idea in principle but it would be complicated by the fact that many patients are OAPs and as such entitled to free travel anyway.
WOWW - spot on. Centralising services saves the NHS money but costs the rest of society. THey're just externalising their costs. 'Cottage hospitals' or poly-clinics in the market towns could do a lot of this stuff. Quentin - a good idea in principle but it would be complicated by the fact that many patients are OAPs and as such entitled to free travel anyway. King Joke
  • Score: 1

12:49pm Wed 30 Apr 14

Gunslinger says...

King Joke wrote:
WOWW - spot on. Centralising services saves the NHS money but costs the rest of society. THey're just externalising their costs. 'Cottage hospitals' or poly-clinics in the market towns could do a lot of this stuff.

Quentin - a good idea in principle but it would be complicated by the fact that many patients are OAPs and as such entitled to free travel anyway.
If they registered these routes as public transport routes, they could claim back for OAP travel.

A more obvious solution is to further develop dial-up services for old and disabled people to get to hospital and other appointments.
[quote][p][bold]King Joke[/bold] wrote: WOWW - spot on. Centralising services saves the NHS money but costs the rest of society. THey're just externalising their costs. 'Cottage hospitals' or poly-clinics in the market towns could do a lot of this stuff. Quentin - a good idea in principle but it would be complicated by the fact that many patients are OAPs and as such entitled to free travel anyway.[/p][/quote]If they registered these routes as public transport routes, they could claim back for OAP travel. A more obvious solution is to further develop dial-up services for old and disabled people to get to hospital and other appointments. Gunslinger
  • Score: -1

12:52pm Wed 30 Apr 14

Andrew:Oxford says...

King Joke wrote:
WOWW - spot on. Centralising services saves the NHS money but costs the rest of society. THey're just externalising their costs. 'Cottage hospitals' or poly-clinics in the market towns could do a lot of this stuff.

Quentin - a good idea in principle but it would be complicated by the fact that many patients are OAPs and as such entitled to free travel anyway.
It's not just about savings costs though. Isn't it also about making best use of consultant time?

Spending 2 hours of consultant time on a return trip to Banbury, potentially longer if the consultant has to take a bus to the P&R site first, is probably around 8-12 patient appointments. Once a week through the year and suddenly you hit 400-500 appointments lost.
[quote][p][bold]King Joke[/bold] wrote: WOWW - spot on. Centralising services saves the NHS money but costs the rest of society. THey're just externalising their costs. 'Cottage hospitals' or poly-clinics in the market towns could do a lot of this stuff. Quentin - a good idea in principle but it would be complicated by the fact that many patients are OAPs and as such entitled to free travel anyway.[/p][/quote]It's not just about savings costs though. Isn't it also about making best use of consultant time? Spending 2 hours of consultant time on a return trip to Banbury, potentially longer if the consultant has to take a bus to the P&R site first, is probably around 8-12 patient appointments. Once a week through the year and suddenly you hit 400-500 appointments lost. Andrew:Oxford
  • Score: -1

1:05pm Wed 30 Apr 14

King Joke says...

Time is money, so there is a cost too.

That said, having to work in Banbury vice Oxford for a day a week shouldn't be a problem, plenty of other professions have to move to serve their customers. Modern technology and hot-desking mean you no longer need to be tied to the same building five days a week, so the consultant wouldn't have to go the JR first then the Horton, s/he could go straight to the Horton and be based there for the day.
Time is money, so there is a cost too. That said, having to work in Banbury vice Oxford for a day a week shouldn't be a problem, plenty of other professions have to move to serve their customers. Modern technology and hot-desking mean you no longer need to be tied to the same building five days a week, so the consultant wouldn't have to go the JR first then the Horton, s/he could go straight to the Horton and be based there for the day. King Joke
  • Score: 0

1:48pm Wed 30 Apr 14

WitneyGreen says...

West Oxon Webwatcher wrote:
The hopitals should consider the provision of more outpatient services at the minor hospitals. I have to attend both JR & Churchill hospitals for outpatient appointments and each 10 minute appointment is a half day trip for me. More outpatients appointments services at Abingdon, and Witney hospitals would cut down on the need for patients to travel.
Exactly this. I've spent seven half days taking trips to the Churchill and the JR over the last six months, and on each occasion my actual appointment was no more than 15 minutes long. Had I been able to go to the Witney Community Hospital for my appointments, the 15 minute visit would have taken half an hour, including travel. It seems silly to have people drive, bus, taxi, or take booked ambulances from outlying locations like Wantage, Witney, Chippy, Wallingford etc. when there are facilities in those towns already.
[quote][p][bold]West Oxon Webwatcher[/bold] wrote: The hopitals should consider the provision of more outpatient services at the minor hospitals. I have to attend both JR & Churchill hospitals for outpatient appointments and each 10 minute appointment is a half day trip for me. More outpatients appointments services at Abingdon, and Witney hospitals would cut down on the need for patients to travel.[/p][/quote]Exactly this. I've spent seven half days taking trips to the Churchill and the JR over the last six months, and on each occasion my actual appointment was no more than 15 minutes long. Had I been able to go to the Witney Community Hospital for my appointments, the 15 minute visit would have taken half an hour, including travel. It seems silly to have people drive, bus, taxi, or take booked ambulances from outlying locations like Wantage, Witney, Chippy, Wallingford etc. when there are facilities in those towns already. WitneyGreen
  • Score: 2

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