It is expected that most people should travel to and from hospital independently by private or public transport, with the help of relatives or friends if necessary

NHS-funded patient transportation is reserved for when it is considered essential to ensuring an individual’s safety, safe mobilisation, condition management or recovery

If patients do not meet the eligibility criteria, transport will not be awarded to ensure limited resources are available for those who really need them

NEPTS caters for those patients where the medical or mobility condition will require the support of NEPTS staff to support them to and from a hospital or clinic for treatment and may be eligible for patient transport

Further, NEPTS caters for patients whose medical condition will require the support of NEPTS staff and/ or it would be detrimental to their diagnosed condition or recovery if they were to travel by any other means

Patients must be reassessed every time they request NEPTS as their condition may have changed. However, individual patient eligibility for those with long-term conditions will be subject to an eligibility review every 3 months (except for patients attending for haemodialysis)Judgement will be made, in line with the eligibility criteria, to assess whether transport is required for both parts of the journey.

Indication

Only patients who meet one of the below reasons will be considered for eligibility for NEPTS:

a) The patient has been referred by a doctor, dentist or ophthalmic practitioner for non-primary care NHS-funded healthcare service appointment – that is, diagnostics or treatment.

b) The patient is being discharged from NHS-funded treatment

Qualifying Criteria

Patients that have been referred for hospital treatment will receive written information about patient transport including the NEPTS booking centre details

The patient is likely to qualify for non-emergency patient transport if they meet one or more of the following criteria:

A. They have a medical need for transport (refer to Section 2: Overarching principle), typically because they:

1. require oxygen and are unable to self-administer this during transit
2. need specialised equipment during the journey
3. need to be closely monitored during the journey
4. need to be transferred to another hospital
5. have a medical condition, have undergone major surgery (such as a transplant) and/or the potential side effects of treatment are likely to require assistance or monitoring during their journey
6. have a medical condition or disability that could compromise their dignity or cause public concern on public transport or in a licensed taxi or private hire vehicle, and do not have access to appropriate private transport
7. have a communicable disease with which travel on public transport or in a taxi is not advised, and do not have access to appropriate private transport
8. have been clinically determined as at risk from using public transport due to being immunocompromised and are unable to make their own way with relatives/friends and/or escorts/carers whether by private transport or a taxi (refer to : Overarching principle)

Repatriation

The commissioner is the main contact to request funding approval by other transport providers for repatriation of Coventry & Warwickshire patients back to the local hospitals, care homes or NHS patient homes within Coventry & Warwickshire borders

The Commissioner will, subject to reasonable pricing, agree to use the local patient transport provider to repatriate service users

There are some instances where the local transport provider will not undertake a journey to repatriate a user back to Coventry and Warwickshire or the cost is prohibitive. In these instances, Coventry & Warwickshire transport Provider will be expected to repatriate patients from other hospitals in England, Wales, Scotland and Northern Ireland

B. They have a cognitive or sensory impairment requiring the oversight of a member of specialist or non-specialist patient transport staff or a suitably trained driver

In accordance with national core standards this is likely to include patients who:

• have dementia or another mental health diagnosed condition that means they are unable to make their own way with relatives/friends and/or escorts/carers whether by private transport, public transport or a taxi (refer to : Overarching principle)
• have a confused state of mind, learning/communication difficulties, hearing loss and/or impaired sight of a severity that they are unable to make their own way with relatives/friends and/or escorts/carers whether by private transport, public transport or a taxi (refer to Section 2: Overarching principle)
• are assessed as being at risk to themselves or others if they travel independently (please note that secure mental health transport for high-risk patients is managed separately from non-emergency patient transport)

C. They have a significant mobility need that means they are unable to make their own way with relatives/friends and/or escorts/carers whether by private transport (including a specially adapted vehicle if appropriate for the journey), public transport or a taxi (refer to : Overarching principle)

This is likely to include patients who:

• need to travel lying down and/or need a stretcher for all or part of the journey
• need specialist bariatric provision
• are unable to self-mobilise
• are wheelchair users. This may include wheelchair users who have no alternative means of transport and cannot transfer in or out of a vehicle without assistance

D. They are travelling to or returning from in-centre haemodialysis, in which case specialist transport, non-specialist transport or reimbursement costs for private travel will be made available. This will be following a shared decision-making process to consider the appropriate requirements for the patient

E. A safeguarding concern has been raised by any relevant professional involved in a patient’s life, in relation to the patient travelling independently

This may mean that the patient requires the oversight of a suitably trained driver or other member of patient transport staff

F. They have wider mobility or medical needs that have resulted in treatment or discharge being missed or severely delayed

An authorised eligibility assessor within the NEPTS booking centre will provide a judgement on whether any other transport is suitable or available

Exceptional circumstances will be considered by the clinician for inpatient discharge arrangements, these reasons will need to be documented and supported by an audit programme

The transport options that should be exhausted before NEPTS is provided include:

• the patient’s own transport – for example, the person does not have a car or would not be able to drive for medical reasons, including the side effects of treatment
• a relative, friend or carer who could assist – for example, using their own vehicle to take the patient or escorting them on public transport or in a taxi
• patient booking their own taxi, including a mobility or assisted taxi public transport, including community transport, where the public transport journey is not unreasonably complex or long
• transport that people are entitled to as part of funded social care provision or a social security benefit

If patients are deemed to be eligible for NEPTS under criteria F, appropriate NEPTS transport (including non-specialist) may be made available. Non-specialist transport may include community transport and support from volunteers (refer to Section : Wider support).

Escorts and carers

Patients are able to travel with their relatives/friends and/or escorts/carers when (refer to Section: Overarching principle):

• they are under 16 years of age and are required to travel with an escort or carer
• they need an escort or carer’s particular skills and/or support
• they cannot be left alone, or their condition means that they need the support of someone who knows them well
• they are under the care of the patient who is eligible for NEPTS, cannot be left alone, do not require the support of the NEPTS ambulance care assistant when travelling, and no alternative care is available at that time

Location of appointment

People referred by a healthcare professional for non-primary care NHS-funded healthcare services, and who are deemed eligible under the criteria above, will be offered access to NEPTS regardless of the geographical location of treatment

This may include transport to non-hospital settings such as community facilities and community diagnostic hubs

NEPTS do not provide transport to primary care services but may be used for healthcare treatment delivered in primary care settings

Wider support for non-eligible patients

Healthcare Travel Costs Scheme (HTCS)

It should be made clear that NEPTS will not be provided for social or financial reasons. For those patients who do not have a medical need for ambulance transport but may require help in meeting the cost of travel to and from their care, information should be provided for the Healthcare Travel Costs Scheme (HTCS).

When receiving enquiries, NEPTS eligibility assessors and/or services provided by transport co-ordination hubs should consider providing people with information about the HTCS

People who are eligible for the HTCS include those who are in receipt of a qualifying benefit and those who qualify for the Low-Income Scheme or under other specified criteria

Further information can be found at: Help with Healthcare Travel Costs Scheme

Providing information and assistance

Local systems should encourage patients to make an independent journey where possible. If the patient does not meet the eligibility criteria then NEPTS services should provide signposting to other known services including:

• Local authority websites detailing alternative community transport services
• Public transport, including bus routes
• Voluntary sector transport provision
• Private hire/ taxi services

Other sources of support

Patients may be entitled to wider transport support from other public bodies. This includes the Disability Living Allowance (DLA) mobility component or equivalent

In these instances, patients are unlikely to be also entitled to funding from the HTCS, and NEPTS would only be available if transport options usually funded by the patient’s DLA are not appropriate

Support from social care or local transport schemes may also be available and should be considered when signposting patients to alternative options.

Local authority cost of living and benefits advice:

Coventry: https://www.coventry.gov.uk/costofliving

Warwickshire: https://www.warwickshire.gov.uk/managing-money-debt/benefits-welfare/2

Appeals

It is expected that the request for NEPTS must be declined and the patient sign-posted to alternative services if the patient does not meet the eligibility criteria and there are no other exceptional circumstances. Any appeal against the refusal to award NEPTS will be dealt with informally by the PTS provider, and if a satisfactory agreement cannot be reached it should be escalated to the ICB Complaints Team by the provider