People Asset Management (PAM)

D Perrin made this Freedom of Information request to East of England Ambulance Service NHS Trust

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

The request was successful.

Dear East of England Ambulance Service NHS Trust,

This Trust outsourced a lot of its occupational services and support to the above named company last year.

Posters provided by that company state that staff can get "Access to physiotherapy within five days" although the reality seems to be that this can take much longer with many staff receiving little more than a telephone call and "advice" and never getting to see a health care professional.

Because of the physical nature of their work, ambulance staff are clearly very susceptible to picking up musculoskeletal injuries including back, neck, knee and shoulder problems.

It should also be noted that this Trust wanted to (and infact did) stop unsocial hours payments to its own emergency staff if they were off work even if they picked up injuries in the course of their duties. That would have meant a reduction for most front-line staff of 25% - something that wouldn't apply to anyone who worked from Monday to Friday and was off with an identical problem.

I'm sure the welfare of your staff would be considered a top priority and with that in mind, can you tell me the following please?

1. When did the contract with PAM start?
2. How many staff have been referred to them with musculoskeletal problems?
3. Of the number referred, how many were actually given "hands on" treatment by a physiotherapist? Please express this also as a percentage.
4. Of those that did actually get proper physiotherapy, what was the shortest wait, the longest wait and the average wait for treatment?
5. How much has the Trust spent to date with PAM and / or what is the value of the contract you have agreed to?
6. How long it will be before this contract can be reviewed and put out to tender with other companies being able to bid?

Yours faithfully,

D Perrin

Dear D Perrin

Thank you for your email dated 10th May 2014 where you requested information regarding the East of England Ambulance Service.

Your request will be dealt with under the Freedom of Information Act 2000 and we will respond to you within twenty working days. Your request has been allocated the following reference: F17959 and I would be grateful if you could quote this reference in any future correspondence with the Trust.

If you have any questions please do not hesitate to contact me.

Yours sincerely

FoI Officer
East of England Ambulance Service NHS Trust

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Dear East of England Ambulance Service NHS Trust

Please supply all of the requested information as the period by which you should have done so has now passed.

Can you also confirm whether or not the Managing Director of PAM, James Murphy, or any other member of that company has tried to have any influence over your response?

Yours sincerely,

D Perrin

Dear D Perrin

Thank you for your email, my apologies for the delay in our responding to you. We are finalising our response and this will be with you as soon as possible.

Kind regards

FoI Officer
East of England Ambulance Service NHS Trust

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Dear East of England Ambulance Service NHS Trust

Thank you for your reply but you have failed to provide the information as required by the FOI Act. This isn't for the Trust to disregard and as such I would like that information now, particularly as my request was made 7 weeks ago.

Yours sincerely,

D Perrin

Dear D Perrin

Further to your email and with my apologies for the delay, please find the Trust's response below. I can confirm that no member of PAM has tried to influence our response.

1. When did the contract with PAM start?
The contract with PAM started on 1 August 2013.

2. How many staff have been referred to them with musculoskeletal problems?
EEAST Musculo Skeletal Appointments i.e. appointments where the clinician set the Clinical Report Reason Level 1 to ‘Musculo Skeletal’: 1121 appointments
Please note: the count of 1121 appointments is where the clinician at the appointment reported the reason code as Musculo Skeletal. This does not necessarily mean the employee was referred with a musculo skeletal complaint and therefore it may not have been appropriate to allocate a physiotherapist for the appointment.

3. Of the number referred, how many were actually given "hands on" treatment by a physiotherapist? Please express this also as a percentage.
Of the 1121 Appointments the clinician providing the appointment was a physiotherapist in: 366 appointments
366 appointments as a percentage of 1121 appointments: 32%
Of the 366 appointments there was a number of service types provided.
• Functional Capacity Assessment 180: 1 appointment
• Functional Capacity Assessment 240: 9 appointments
• Physical Capability Assessment: 22 appointments
• Physio Assessment and Report: 5 appointments
• Physio Paper Case Review: 1 appointment
• Physiotherapy (Treatment): 328 appointments

4. Of those that did actually get proper physiotherapy, what was the shortest wait, the longest wait and the average wait for treatment?
Of the 328 appointments, 290 appointments were the first appointment linked for the referral.
All other appointments were additional to the first appointment per referral.
i.e. for one referral there were multiple appointments.

Of the 290 appointments where the employee received physiotherapy treatment the waiting times between referral and the appointment convenient for the employee are as follows:
Shortest Waiting Time: 0 days (Appointment on the same day as the referral)
Longest Waiting Time: 52 days
Average: 20 days
Note: these numbers of days are the counts between the referral date and the date convenient for the employee to attend an appointment

5. How much has the Trust spent to date with PAM and / or what is the value of the contract you have agreed to?
The contract is based on the prevailing budget and there is a year-end adjustment facility to return unspent budget, or reimburse additional volume. It is worth £2.081M.

6. How long it will be before this contract can be reviewed and put out to tender with other companies being able to bid?
The contract was let from 1st August 2013 to 31st July 2016, but with an option to extend for a further 2 years.

I am obliged to advise you that if you are dissatisfied with the Trust’s response to your request you have a right to complain to the Trust and should set out your concerns to the Freedom of Information Officer, EEAST, Hospital Approach, Broomfield, Chelmsford, Essex, CM1 7WS or by email to [East of England Ambulance Service NHS Trust request email]. If you remain dissatisfied following this, you have a right under Section 50 of the FOIA to seek a determination from the Information Commissioner on whether the Act has been properly applied by the Trust. For more information, please see www.ico.gov.uk.

Please do not hesitate to contact me should you require any further information.

Kind regards

FoI Officer
East of England Ambulance Service NHS Trust

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Dear East of England Ambulance Service NHS Trust

Sorry but your response to point 3 is far from clear.

Please tell me exactly how many members of staff out of the 1121 actually received "hands on" physiotherapy (and again as a percentage).

I also don't understand what the following means:
Functional Capacity Assessment 180: 1 appointment
Functional Capacity Assessment 240: 9 appointments

Assessments as I'm sure you appreciate aren't treatment

Please clarify these points without further delay

Yours sincerely,

D Perrin

Dear D Perrin

Thank you for your email dated 1st July 2014, please find the Trust's clarification below.

There have been 1121 appointments reported by the clinicians as Musculo - Skeletal. The total number of physiotherapy appointments recorded as Musculo - Skeletal was 366. 177 staff out of the 1121 received one or more of the 366 physio appointments. As a percentage (177/1121) the figure is 16%.

The ‘180’ or ‘240’ reference is to do with the time taken to do the FCA (functional capacity assessment). So this is just a reference to minutes.

An FCA ‘functional capacity assessment’ is conducted by the physiotherapist on the individuals subjective job demands, encompassing objective physiotherapy movement analysis. Therefore making recommendations for return to work, movement capabilities and treatment. This is carried out in the work environment.

Kind regards

FoI Officer
East of England Ambulance Service NHS Trust

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Dear East of England Ambulance Service NHS Trust

Thank you for providing clarification around these figures.

Essentially it seems the service is to pay over £2million and entrust the health and welfare of its staff to a company who let less than 1 in 5 actually see a physiotherapist.
The vast majority seem to be offered an assessment, diagnosis and "treatment" based purely on a telephone call. That is truly shocking.
I can't imagine GPs or hospitals routinely offering that sort of "service" to their patients so why do you think it's appropriate to allow PAM to do it? Clearly it must be cheaper for PAM to work that way but hopefully that should not be the main consideration for the Trust.

I also note that on average, it take 4 times longer than PAM claimed for those staff who actually get to see a physiotherapist to have their first treatment. If I'm not mistake, it might have been me who had to wait the 54 days you mention.

I too was instructed by PAM to undertake an FCA which lasted just under 4 hours.
Having been given the recommendations by the person they employed to do it, PAM basically ignored those. They also cancelled appointments, refused at times to sanction more physiotherapy despite it being recommended and sent out misleading information about other appointments.
One of their lead physiotherapists also agreed a "phased return to work" plan that would have had me trying to carry a responder bag weighing 35kg up and down stairs every 30 minutes. As these normally only weigh between 10 - 12 kg, that advice was not only impractical, it was dangerous in the extreme.

I did write to the charming Mr Murphy about these issues but he didn't appear interested. He did however express his full support "specifically" for the lead physiotherapist who agreed to the return to work plan - quite worrying really. Not that I ever got to see her let alone have a chat on the phone.

I have asked the Unison Chair and Secretary to raise these issues as a matter of urgency, particularly as this Trust does discipline some staff who are off sick. As previously stated, there may well again be a severe financial penalty for front-line staff if they are off sick.
Clearly the delays highlighted and the frequent use of just telephone calls won't help at all, particularly if the "diagnosis" and "treatments" suggested prove to be wrong.

I shall also ask them to contact other regions to see if they are experiencing similar issues if they employ PAM.

Hopefully this Trust will consider using another health "provider" at the very earliest opportunity.

Yours sincerely,

D Perrin