Improving the quality of non-emergency patient transportation

The Yorkshire Ambulance Service NHS Trust provides both Accident & Emergency (A&E) and non-urgent Patient Transport Services (PTS) to a population of five million people across Yorkshire.

However the Trust was at risk of incurring a significant financial loss, and Service Commissioners were also expressing disappointment over the effectiveness & performance of PTS.

As a result, the Trust approached Unipart in early 2012 seeking our help in developing a solution that would improve their PTS while also reducing costs and protecting a significant income risk.

Our experience in our own company has shown that a high level of employee engagement is central to ensuring that any new way of working is sustained.

As a first stage, their South Yorkshire region was chosen as a pilot area to identify scope for improvement and test new ways of working.

Working closely with front line staff

In order to deeply understand the underlying causes behind the poor patient experience and the increasing costs, our expert practitioners worked closely with the Trust’s staff at every level. As part of this, they spent weeks with the ambulance drivers helping them with the service they deliver and talking to them on a one to one basis, to understand their frustrations.

While the Trust knew that they had blockages and areas that were unproductive, the Unipart team helped them see what was really happening by mapping out the different problems and quantifying their impact.

The results of this in-depth exploration revealed significant opportunities for improvement:

• Up to a quarter of all patient journeys did not take place as planned.
• Vehicles were unproductive for half of their available hours.
• 20% of the vehicles could be out of service at any one time.
• Transport capacity was not aligned to demand, resulting in increased reliance on external contractors to deliver the service.
• Of the many processes in place, less than a third really added value to the patient.
• Staff engagement levels were low, with communication seen as a one way only.

Progressing from the pilot phase

All this data was then fed back, not only to the Executive team but to employees, at all levels, of the organisation. These results were also shared in detail with the service commissioners to gain their support in delivering the improvements identified. All parties were then involved in redesigning the future of the Service.

Using their knowledge of The Unipart Way, our expert practitioners began the process by designing a framework that would deliver a much improved future state. Their next stage was to engage with people at all levels, in order to unlock the staff’s own ideas on how these changes could be achieved.

Throughout the project, our team progressively transferred their knowledge, in order to build the capability of the Trust’s own staff to find their own solutions and sustain continuous improvement.

The following results have emerged in the pilot area:

• The high levels of engagement, across the Trust, in the design of the new processes has meant that the staff themselves now own the contractual KPI’s with all improving between 10% to 35%
• The patient experience has benefited as a result, with an additional 23,180 patients getting dropped off for their appointment and picked up afterwards on time when compared to the same period last year
• The service improvements have also been recognised by the Commissioner who has asked the Trust to tender for additional patient transport activity
• In excess of £600,000 of income at risk has been protected in 2012/13
• Developed solutions from the programme have been planned to roll out across the 4 localities of YAS PTS to deliver £2.5 million cost reduction benefits in 2013/14
• YAS PTS now have a developed team of capable transformation practitioners to continue to develop and lead further improvements