IOS Medical Travel and Transport Group
Healthwatch administers and co-chairs this group. It includes representatives of the NHS, Council, Skybus and Healthwatch, and meets every two months to discuss issues as they arise.
Members share information and often problems can be managed by working together. It is not a forum where policies are made or agreed. Organisations are responsible for making their own policies and some may be subject to wider consultation.
Recent discussion included:
reducing the need to travel; local X-ray; treatments on island; post-16 escorts; contingency arrangements for vulnerable patients; access to NHS-commissioned services;' travel warrant criteria and administration; patient information; capacity and flight availability; travel for urgent (non-emergency) treatment.
Other developments in medical travel:
- Funding for high costs of travel from off islands.
Healthwatch initially raised this from feedback. NHS Kernow has accepted that this is a mandatory requirement, and patients may now reclaim the cost of the inter-island leg when travelling to an apointment on the mainland. The funding of off-island travel is included in the new Non-Emergency NHS Funded Patient Transport Policy, although it has been in place since May 2017.
- Non-Emergency NHS Funded Patient Transport Policy, June 2017. You can see the policy here.
NHS Kernow has published the new Non-Emergency NHS Funded Patient Transport Policy (June 2017). Some elements of the policy are explained in more detail in the updated FAQS from the RCHT Patient Transport Service.
The public consultation asked three questions about Isles of Scilly patient travel:
- When a patient is travelling to the mainland from the Isles of Scilly for more than one day should the NHS fund the cost of flights when cheaper boat transport is available?
- Should patients only receive NHS funded flights from the Isles of Scilly to Lands’ End?
- Should patients travelling to the mainland from the Isles of Scilly receive NHS funding for taking the shuttle bus service provided by Skybus for patients travelling from Lands’ End to Penzance?
We are pleased at the outcome regarding the first proposal, in that patients will not be required to travel by boat unless this is their choice.
We have not challenged the outcome regarding the remaining proposals, which is that our travel warrant now takes us as far as Lands End, and patients are responsible for all onward travel costs. The NHS has been looking at ways in which patients might be able to pay the difference to travel to Newquay, for instance, but this has not yet been resolved.
We have challenged some other elements in the policy and have asked NHS Kernow to reconsider or clarify a few things.
We are particularly concerned about exclusions on travel for urgent diagnosis and treatment, where previously patients have been granted a warrant to travel by a scheduled flight to attend the Emergency Department at Treliske or Urgent Treatment Unit at West Cornwall. We have also raised this separately as an urgent issue.
We also have some questions about escort criteria, and the definition of ‘usually resident’ (thinking about seasonal staff).
You can find our full response here and a summary of our questions to NHS Kernow below. We will let you know their response, in due course.
Meanwhile, if you have any questions about your travel, please direct them to the Patient Transport Office when making your booking.
Questions to NHS Kernow regarding IOS patient travel
1) Definition of ‘usually resident’
We request clarification of the qualification for eligibility of seasonal staff, in terms of being usually resident for longer than three months.
2) Exclusion of ‘Treatment through an Emergency Department, Urgent or Primary Care Centres or Minor Injuries Unit….travelling for an X-ray for an undiagnosed fracture or attending for Primary Care Dental Services.’
We request that either:
- Comprehensive facilities for diagnosis and treatment are made available on-island; or
- Referrals for diagnosis and treatment are actioned through the secondary care appointment system; or
- This element of the policy is re-examined with regard to limitations in on-island services and facilities, and the high cost of travel.
3) Exclusion of ‘self-referral’
We request that consideration is given to NHS commissioned services (i.e. talking therapies) where patients are currently encouraged to self-refer (Choose Well).
4) Escort criteria
A need for assistance can relate to co-existing health conditions, frailty or disability; the different stages of the journey, with at least one stage always involving public transport; and the length of time spent away from home. We continue to request that these factors are taken into account when considering applications for an NHS funded escort.
5) Escorts: NHS Kernow local criteria
- Attending a 20 week pregnancy scan; or
- Attending a two week wait appointment, where an initial diagnosis will be discussed.
This is now subject to strict eligibility criteria, i.e. receipt of qualifying benefits or allowances.
We request that this element of the policy is re-examined, on the grounds that making authorisation of an escort dependent on further means testing is inequitable.
6) Previous IOS specific escort scenarios
- Attendance at an emergency non-scheduled pre-natal scan;
- Expectant mothers travelling to give birth;
- Patients attending for Ophthalmology procedures where sight may be temporarily impaired e.g. cataract removal, procedures requiring drops etc.
We request clarification on arrangements for patients in these scenarios, as well as other medical need, e.g. needing someone to collect you from hospital and/or have supervision for 24 hours after discharge from hospital.
7) Exclusion of ‘frequent travellers’
Frequent travellers are defined as those patients who are required to attend hospital:
- At least three times a week for a sustained course of treatment lasting a minimum of six weeks; or,
- At least six times a month for a sustained course of treatment lasting a minimum of three months.
We request clarification that patients will be eligible for NHS funded travel, in accordance with provision for islanders under the Health Care Travel Costs Scheme, when travelling to undertake a course of treatment, as defined above.