"I should be eligible for patient transport"

About: Colchester General Hospital / Cardiology East Of England Ambulance Service NHS Trust

(as the patient),

I saw a Surgeon at a Heart hospital in order that I am now on the waiting list for a coronary bypass. I am on 20 pills of medications which were changed today. I have also had 3 stents in 2003 after a corany myocardial infarction, 3 further inserted in 2007 and also a blockage in the heart itself so was on Warfarin. I was in hospital again 3 times before an Angiogram (a repeat of one 2 years before, and ironicly the same time span when Ipswich twice discharged me before I could have one). When said angiogram was a week away I was told, yes I could have transport in but not home - so how would i cope with an overnight bag and uncontrolled angina? I was then told I could have patient transport home, given I had a medical condition. So what did they think I was going for, to play tiddly winks? As a result of 3 further stays an MRI scan was arranged but between my Doctor's Surgery in East Burgholt, Colchester General, I rang thrice, and Bethnal Green, when given the correct number they all said no I have to ring one of the others. Long and short - I never went, having had to get transferred to Papworth. A niece kindly drove me. Today I asked for transport home after being in the Cornary unit and delayed. None available. Changed medication at first, and then I was told by a member of staff on the ward that they didn't provide hospital transport, which having occassionally managed to get some disagreed to the extent a row blew up. I was emphatically told thereafter the matron had made that decision. As for the two I had communication with, one insisted my Mum got taken home when I she had no alternative but to accompany me on my very many hospital trips since my first heart attack in 1997. Earlier the lovely ambulance driver suggested in her opinion having a heartbeat level of 45 might almost certainly entail an overnight stay, however the Doctors said with an adjustment of medications I could go home. If I agreed to take the chance and see how it went. I demanded to see the Matron on duty, who was in a meeting and firstly told if I couldn't get a lift I would have to go to the secondary waiting area, and would not be able to stay were I was, I disagreed especially as I hadn't been imbued with the changed medication. Apparently I was judged to be fully fit today to go home under my own direction via a taxi - how far from my front door the taxi dropped me off is irrelevant except he left me to carry a heavy bag up our steep drive and the staff had asked me if we're got oxygen at home - why that is a decider as to my state of health I'm not sure? I asked if the taxi driver will have a canister of oxygen, or be able to resucitate me if I have a another coronary, after all that stress and pressure - not to mention harrassment. When I demand a duty of care from the Matron, I was told that I should not insult their intelligence, that they had been nursing 38 years, and know all about duty of care. I ventured maybe if proved wrong they would apologise, even help supplement my income support I get as a full time carer out of which £20 for a taxi is a big deal < and not for the first time. This is why I feel I should have been eligible for free patient transport: 1. ‘Ambulance and other Patient Transport Services: Operation, Use and Performance Standards’ [HSG 1991(29)] was published in 1991. This set out guidance for the NHS on the operation, use and performance standards for emergency and urgent ambulances. It also set out criteria for establishing which patients were eligible for nonemergency patient transport services (PTS). 2. The White Paper (‘Our health, our care, our say: a new direction for community services’, January 2006) made a commitment to extend eligibility for the Hospital Travel Costs Scheme (HTCS) and PTS to procedures that were traditionally provided in hospital, but are now available in a community setting. This will mean that people referred by a health care professional for treatment in a primary care setting, and who have a medical need for transport, will also receive access to PTS and HTCS. 3. This extension to PTS, as outlined in this document, is expected to come into force in 2007/08, although Primary Care Trusts (PCTs) can of course amend local eligibility criteria for PTS in line with the White Paper before that date, should they wish to do so. 4. This document therefore updates and replaces the 1991 guidance and applies to both NHS and independent service providers contracted to the NHS. What is PTS? 5. Non-emergency patient transport services, known as PTS, are typified by the nonurgent, planned, transportation of patients with a medical need for transport to and from a premises providing NHS healthcare and between NHS healthcare providers. This can and should encompass a wide range of vehicle types and levels of care consistent with the patients’ medical needs. Who is eligible for PTS? 6. PTS should be seen as part of an integrated programme of care. A non-emergency patient is one who, whilst requiring treatment, which may or may not be of a specialist nature, does not require an immediate or urgent response. 7. Eligible patients should reach healthcare (treatment, outpatient appointment or diagnostic services i.e. procedures that were traditionally provided in hospital, but are now available in a hospital or community setting) in secondary and primary care settings in a reasonable time and in reasonable comfort, without detriment to their medical condition. Similarly, patients should be able to travel home in reasonable comfort without detriment to their medical condition. The distance to be travelled and frequency of travel should also be taken into account, as the medical need for PTS may be 8 affected by these factors. Similarly, what is a “reasonable” journey time will need to be defined locally, as circumstances may vary. 8. Eligible patients are those: - Where the medical condition of the patient is such that they require the skills or support of PTS staff on/after the journey and/or where it would be detrimental to the patient’s condition or recovery if they were to travel by other means. - Where the patient’s medical condition impacts on their mobility to such an extent that they would be unable to access healthcare and/or it would be detrimental to the patient’s condition or recovery to travel by other means. - Recognised as a parent or guardian where children are being conveyed. 9. PTS could also be provided to a patient’s escort or carer where their particular skills and/or support are needed e.g. this might be appropriate for those accompanying a person with a physical or mental incapacity, vulnerable adults or to act as a translator. Discretionary provision such as this would need to be agreed in advance, when transport is booked. 10. A patient’s eligibility for PTS should be determined either by a healthcare professional or by non-clinically qualified staff who are both: - clinically supervised and/or working within locally agreed protocols or guidelines, and - employed by the NHS or working under contract for the NHS
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