NEPT –

Non Emergency Patient Transport

Guildlines

Non-EmergencyPatient Transport – NEPT

Non Emergency Patient Transport to and from Croydon University Hospital is provided byAST Ambulance Service.

In order to provide a quality service for all those patients who are most in need, the Trust implements a strict policy on who is and isn’t eligible for Transport.
Here is a short guide regarding eligibility criteria and how transport will be arranged by the Hospital or GP.

1. Qualifying Criteria

There is one criteria that patients must fit before they are eligible for patient transport patients must:

•Be medically unfit to travel by any other means

2. Who decides whether a patient is medically fit for transport?

Only medical staff, including GPs, can advise on completing the Eligibility Form requesting the use of Non-Emergency Patient Transport. However, it is recognised that in certain circumstances the assessment maybe delegated to another Senior Qualified Clinician or Matron.

If a senior clinician assesses that the patient’s condition has improved or changed to the extent that transport is no longer required, then transport will be withdrawn.

This form is then vetted by the transport booking team who discuss the eligibility with the patient before informing of the decision.

3. When does a patient qualify to have an escort?

Normally designated ambulance transport staff will escort the patient to and from hospital. The Trust welcomes relatives and friends to meet a patient at their point of destination, although they will be unable to accompany the patient on their journey unless the patient satisfies one of the following criteria:

  • Patients less than 16 years of age
  • Escort is required to interpret
  • Escort is required to action medical treatment
  • Patient is confused or has other mental health condition

Again, only designated clinical staff can authorise the use of an escort via the eligibility form.

This form is then vetted by the transport booking team who discuss with the eligibility with the patient before informing of the decision.

4.Questions to be asked when triaging eligibility for patient transport.

Once completed by the Clinician or GP, the Eligibility form is sent electronical to the Transport Assessment and Booking (TAB) team.

From CUH clinic or GP practice the patient is given a Trust Transport Leaflet and invited to contact the TAB team direct to book transport following receipt of their hospital appointment letter.

On contacting the TAB team, the patient will be engaged in conversation with one of the facilitators

Process for assessing patient NEPT eligibility and booking transport

  1. Check point process

a)Patient calls through to the TAB team

b)TAB facilitator asks patient to confirm hospital number or other key identifier

c)Double checks address, contact telephone number (preferably a mobile) etc

d)Double checks appointment time and location

e)TAB facilitator opens the patient electronic Eligibility form

  1. Social assessment

f)TAB facilitator starts social assessment e.g. “how do you get to the shops”

g)Patient has other means of getting around e.g. friend, relative, public transport – then patient is not eligible

h)Patient has no other means of getting to hospital – proceed to medical assessment

i)The ‘assessment notes’ section must be completed

  1. Medical assessment

j)TAB facilitator goes through the medical assessment scoring section with the patient

k)Each answer is highlighted on the form

l)Scores are entered directly onto form and the calculator function is activated

m)If score is 3 or less – patient not eligible for NEPT

n)If score is 4 or more – patient is eligible for NEPT

o)Patient is informed of outcome

p)Patient not eligible - patient is given details of alternative transport options

q)Patient is eligible – proceed to booking stage

  1. Booking of transport

r)TAB Facilitator double checks pick up and collection points

s)Confirms which category of transport the patient needs

t)Establishes whether patient requires escort (which must fall under criteria)

u)Explains to patient that they will need to be ready up to 1.5 hours prior to appointment time

v)Transport is booked

  1. Appeals process

w)TAB Facilitator explains clearly the reasons for non-eligibility

x)Patient is unhappy with outcome of assessment

y)TAB Facilitator explains appeals process

z)Patient needs to write to Trust Transport Manager with supporting evidence e.g. from GP etc.

aa)Trust Transport Manager investigates the claim for appeal (may consult with TAB Team and clinically qualified member of staff)

bb)Writes to patient with outcome

7.Questions that are likely to be asked when triaging eligibility for patient transport.

  • Have you a (or what is your) medical need for an ambulance?
  • How do you get around in your everyday life?
  • How do you normally go and do your shopping?
  • How do you get to the doctors?
  • How mobile are you?
  • Do you need any medical intervention on the journey?
  • Can you manage steps?
  • Are you able to walk onto the ambulance?
  • Are you able to communicate okay?
  • What is your mobility?
  • Are you able to get in and out of a car?
  • As you can get into a car you do not qualify for ambulance transport.

4. Objectives & Responsibilities for Staff.

Staff are encouraged to ensure patients and their relatives make their own transport arrangements. On admission, staff should check with the patient who will be collecting them when they are discharged from hospital. Staff will make a note of the name and telephone number of this relative or carer who will collect the patient.

Note: Staff will be expected to only book transport when a patient has been deemed eligible. Staff are encouraged to always be stringent on use. Staff are not permitted to book more than one medical escort.

5. Cancelling Transport.

If a booked journey needs to be cancelled it is the responsibility of the patient and or Hospital Ward/Department to ensure the TAB/ Transport Department is urgently notified.
6. Reimbursement of Costs

Patients not qualifying for hospital transport may obtain a cash refund for travel to the hospital when travelling by public transport or private care, if they are in receipt of one of the following:

  • Income support
  • Working families tax credit
  • Income-based job seekers allowance

Patients arriving by public transport must bring the receipt/ticket and their proof of benefit with them. They must go to the hospital administration offices to make their claim.

Patient arriving by private car may be able to apply for petrol costs current rate per mile up to the cost of public transport fare. Proof of benefits must also be provided at the time of the claim.

Patients in receipt of mobility allowance, should, except in exceptional circumstances, make their own way to the hospital, using those monies, which are paid specifically ‘to help them get around, which includes attending hospital appointments.

To support this change the eligibility criteria has been revised, based on learning from other acute trusts and the Department of Health guidelines. To view the full guidelines please follow this link

Staff should not book NEPT (Non-Emergency Patient Transport) when its service is not required or when an alternative means of transport is available.

NEPT service should under no circumstances be used to transport patients due to

either their social or economic reasons. Similarly, patients treated in the Accident and

Emergency Department may have an expectation that anambulance will be provided by theTrust, however if the medical condition of such patients does not require them to betransported by an ambulance, then the Trust would be under no obligation to provide transport.

Taxi Service

Taxis may only be ordered on behalf of Trust staff subject to one or more of the following criteria being met:

  • To escort and to transport patients for tests to or from another NHS Hospital, where it is more cost- effective and clinically appropriate to utilise a taxi instead of the Ambulance Service for non- emergency patients transport.
  • A taxi service may be used when the cost of using this service is cheaper for the Trust than using any other appropriate transport arrangement, including private or public vehicle particularly when parking availability and other charges are taken into account.
  • In situations when a patient is discharged from hospital and they do not meet the criteria for NEPT and there is not possible any other form of transport (e.g. relatives or friends) a taxi may be booked.
  • Patient not eligible for NEPT , nursing staff should only consider the use of a taxi vehicle for discharge when a bed is required or it would be inappropriate for the patient to remain in hospital. The patient must be considered ‘fit’ to travel (where possible through a document issued by his/ her consultant) by this mode of transport or where an escort is available to facilitate this.

Please see Trust policy - ..\Taxi Services Policy.pdf

Lesley Cohen - November 2012 v3