NEPTS Commissioning Checklist: 12-Point NHS Procurement Framework
What a quality non-emergency patient transport provider should evidence — aligned to NHS Standard Contract requirements and CQC Key Lines of Enquiry.
What is NEPTS?
Non-Emergency Patient Transport Services (NEPTS) is commissioned by NHS Integrated Care Boards (ICBs) under the NHS Standard Contract and is subject to NHS England's National NEPTS Standards (first published 2007, revised in subsequent guidance frameworks). CQC regulates NEPTS providers under the Ambulance Service regulated activity.
Patient transport is not a low-risk service. Inadequate provision results in missed appointments, delayed discharges, patient deterioration during transport, and significant patient safety incidents. The commissioning decision matters.
The Case for Rigorous Commissioning
NEPTS procurement has historically been dominated by cost. The consequences of under-investment are well documented: high DNA rates, complaints about late or failed pickups, clinical incidents during transport, and poor patient experience for some of the most vulnerable people in the NHS's care.
Rigorous commissioning — using an evidence-based framework — is the primary mechanism available to ICBs to ensure that cost efficiency does not come at the expense of clinical quality and patient safety.
- NEPTS contracts should specify minimum clinical staffing ratios, not just vehicle numbers
- Performance frameworks should include patient experience metrics, not just punctuality
- Clinical governance requirements should be contractually mandated, not discretionary
- Providers should be evaluated on their governance infrastructure before price
NHS Standard Contract Requirements
NEPTS commissioned under the NHS Standard Contract must comply with the following key requirements:
- Service Condition 13:Provider must have a Board-approved Quality Improvement Plan and report quarterly against it
- Service Condition 21:Information governance compliance including DSP Toolkit submission
- Service Condition 27:Duty of Candour — the provider must be open and transparent when things go wrong
- General Condition 9:Provider must comply with CQC registration requirements and notify commissioners of any change in registration status
- General Condition 15:Provider must have appropriate insurance cover and make it available on request
- Particulars — Local standards:ICBs should specify local performance standards including response time windows, cancellation rates, and complaint response timescales
Key Performance Indicators — What Good Looks Like
When setting KPIs for NEPTS contracts, commissioners should consider the following benchmarks:
- On-time pickup rate: ≥95% of journeys with patient ready within the collection window
- Journey completion rate: ≥99.5% — failed journeys must be reported and investigated
- Patient wait at discharge: No patient should wait more than 2 hours post-discharge clearance
- Complaint response time: Acknowledgement within 3 working days, full response within 25 working days
- Serious incident rate: Reported, investigated, and learned from within 72 hours (Serious) / 45 days (full report)
- Patient experience score: ≥85% positive response on validated patient survey instrument
12-Point NEPTS Commissioning Checklist
Score each criterion 0–2: 0 = not evidenced, 1 = partially evidenced, 2 = fully evidenced. A quality provider should score 20 or above.
| # | Criterion | What to Evidence | Score |
|---|---|---|---|
| 1 | CQC Registration | Active registration, Good or Outstanding, no warning notices in last 24 months | — / 2 |
| 2 | Clinical Staffing Model | Written staffing policy specifying minimum crew ratios for each vehicle type | — / 2 |
| 3 | Training Compliance | Mandatory training matrix with ≥95% compliance evidenced (last audit) | — / 2 |
| 4 | Vehicle Maintenance Records | Fleet maintenance schedule, MOT/service records available, safety inspection programme | — / 2 |
| 5 | Safeguarding Policies | Adults and Children safeguarding policies, named safeguarding lead, training records | — / 2 |
| 6 | Information Governance | DSP Toolkit submission (current year), DPA registered, named IG lead, DPA in place | — / 2 |
| 7 | Incident Reporting | STEIS-compliant SI reporting, internal incident log, learning from incidents evidence | — / 2 |
| 8 | Patient Experience | Complaints policy, validated patient survey, quarterly patient experience report | — / 2 |
| 9 | Clinical Governance Framework | Named clinical lead, governance committee, board-level clinical oversight | — / 2 |
| 10 | Equality & Accessibility | Equality Act compliance, accessible vehicles for bariatric/wheelchair/stretcher needs | — / 2 |
| 11 | Business Continuity | BCP document, tested within 12 months, deputy fleet and staffing contingency plan | — / 2 |
| 12 | Performance Reporting | Automated or monthly KPI reporting, commissioner dashboard or report template | — / 2 |
Scoring Interpretation
| Score | Interpretation | Recommended Action |
|---|---|---|
| 20–24 | High-quality provider — evidence complete | Proceed to commercial evaluation |
| 14–19 | Adequate — some gaps to address | Require remediation plan before contract award |
| 8–13 | Significant concerns — material governance gaps | Escalate to commissioner governance — do not proceed without reassurance |
| 0–7 | Unacceptable — major failings evidenced | Do not commission — refer to CQC if regulated activity concerns identified |
Bariatric and Specialist Transport
If commissioning bariatric transport (patients over 25 stone / BMI >40 requiring specialist equipment), ensure the provider can evidence:
- Bariatric-rated vehicles with appropriate stretchers and hoists (minimum 350 kg rated)
- Crew trained in bariatric manual handling (specific to patient transport, not just general MH training)
- Partnership with hospital bariatric teams for complex discharge planning
- Clear escalation pathway for patients whose weight or condition exceeds equipment capacity
High Dependency and HDU Step-Down Transport
High Dependency Unit step-down transport requires enhanced clinical capability. As a minimum, commissioners should require:
- At least one crew member with a current clinical qualification (RGN, paramedic, or emergency care practitioner)
- Appropriate equipment: SpO2, NIBP, ECG, IV access maintenance capability
- Documented clinical risk assessment completed jointly with the referring clinical team
- Direct handover to receiving team with clinical documentation
About Health Connections
Health Connections (Aries Medical Services Ltd) provides NEPTS across England from 9 depots, operating a fleet of 21 patient transport vehicles including bariatric, wheelchair-accessible and HDU-capable configurations. Our patient transport crews are trained to PTS Level 3 and above, with mandatory training compliance tracked monthly via our HealthConnect OS platform.
We provide quarterly commissioner reports as standard, including KPI performance, incident data, patient experience scores and training compliance rates. Our CQC registration is active and current.
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