Payment of Travelling Expenses to Patients Attending Hospitals

Transcription

1 This is an official Northern Trust policy and should not be edited in any way Payment of Travelling Expenses to Patients Attending Hospitals Reference Number: NHSCT/11/385 Target audience: The procedure is intended to be a working guide for members of staff who process requests from patients, escorts and dependants for the reimbursement of the cost of travel to hospital under the Hospital Travel Costs Scheme (HTCS). Sources of advice in relation to this document: Ian Winton, General Manager Finance Liam O Kane, Assistant Director Financial Accounting and Financial Services Replaces (if appropriate): Previous NHSCT Payment of travelling expenses to patients attending hospitals (NHSCT ) Type of Document: Directorate Specific Approved by: Liam O Kane, Assistant Director Financial Accounting and Financial Services Date Approved: 11 January 2011 Date Issued by Policy Unit: 9 March 2011 NHSCT Mission Statement To provide for all, the quality of service we expect for our families, and ourselves.

2 Operational procedure Payment of travelling expenses to patients attending hospitals

3 Northern Health and Social Care Trust Payment of Travelling Expenses to Patients Attending Hospital Contents Introduction..... Purpose or aim of the policy Policy statement Target audience Responsibilities. Legislative compliance. Page 1. Patients entitled to reimbursement of hospital travel costs Patients not automatically entitled to a refund but on low income Patients assessed as eligible for low income help Patients claiming but not yet assessed for low income help Travelling expenses of patients escorts Retrospective claims Other categories included under HTCS special cases War disablement pensioners special arrangements People not eligible for HTCS help Procedures for reimbursing claims Calculation of travel costs Information for patients Sources of advice Review Equality, Human Rights and DDA Alternative formats.. 6

4 Introduction This procedure document relates to requests from patients, escorts and dependants for reimbursement of the cost of travel to hospital under the Hospital Travel Costs Scheme (HTCS). These procedures should be read in conjunction with DHSS&PS circular HSS (SC) 1/2006. (Appendix 1 HSS (SC) 1/2006). Throughout this procedure the patients referred to are: Those who are HPSS hospital in or outpatients but who are not eligible for free health service transport through Patient Care Scheme. Those who are receiving health service treatment at a non-hpss hospital or other clinic whilst under the care of a HPSS hospital consultant. Purpose or aim of the policy The purpose of this operational procedure is to provide detailed guidance on all aspects of the processing of requests from patients, escorts and their dependants for the reimbursement of the cost of travel to hospital under the HTSC. This policy will provide speedy access to relevant sections and provide a source of reference and guidance Policy statement The application of this procedure will assist staff working in the various cash offices to process the requests for reimbursement from patients, escorts and dependants under the HTSC. Target audience The procedure is intended to be a working guide for members of staff who process requests from patients, escorts and dependants for the reimbursement of the cost of travel to hospital under the Hospital Travel Costs Scheme (HTCS). Responsibilities This procedure provides guidance to the staff working in the various cash offices who process claims under the HTCS It is the responsibility of those staff to ensure that all such claims are properly completed and processed in accordance with this procedure Legislative compliance The governing circular is DHSS&PS HSS (SC) 1/2006 (see appendix 1) The Standing Financial Instructions apply at all times and these notes should be read in conjunction with them.

5 1. PATIENTS ENTITLED TO REIMBURSEMENT OF HOSPITAL TRAVEL COSTS 1.1 The following patients are entitled to full reimbursement of travel costs to hospital: Category of Patient (i) Patients who get Income Support (ii) Patients who get Jobseeker s Allowance (Income based) (iii) Patients who get Working Tax Credit (WTC) and/or Child Tax Credit (CTC) and meet the conditions stated on Page 4 of HTCS scheme (iv) Patients who get Pension Credit relating to Guarantee Credit element only (i.e. with or without the Savings Credit element) (v) Patients who are Dependants in a family who currently receive (i ), (ii), (iii) or (iv) (vi) Patients who are in receipt of Income Related Employment & Support Allowance Documentation to be presented for inspection 1. An Award Notice OR 2. Form FF260 or FF260A OR 3. Letter from Social Security Office or Jobs and Benefits office confirming receipt of Income Support for the purpose of refunds for travelling expenses. Letter from Social Security Office or Jobs and Benefits office confirming receipt of Jobseeker s Allowance for the purpose of refunds for travelling expenses. NHS Tax Credit Exemption Certificate showing they are entitled to help with health costs. Award Notice (this contains personal information). Patient may prefer to fold the letter to show only item 5. Evidence of (i), (ii), (iii) or (iv) above should be shown. Award letter Comments Information on Tax Credit arrangements is contained in leaflet HC11 which should be made available to patients Patients in receipt of Savings Credit on its own are not entitled to reimbursement of travel expenses. Need to ensure that all pages of the award letter are produced 1.2 If a patient wishes to claim travelling expenses but has not brought the necessary evidence with them, provided they can supply their national insurance number the staff member dealing with the claim can contact the relevant benefit office to confirm entitlement. The patient should be reminded to Payment of Travelling Expenses to Patients Attending Hospital 11/1/2011 1

6 submit proof of entitlement with future claims, as each claim must be checked individually. Changes in patient s personal circumstances may affect their entitlement to benefit. 2. PATIENTS NOT AUTOMATICALLY ENTITLED TO A REFUND BUT ON LOW INCOME This assessment of low-income entitlement would be carried out by the local Social Security Office or Jobs and Benefits Office which will issue an entitlement certificate HC2 or HC3 if appropriate after assessment. Patients who may be entitled to help on low-income grounds should be encouraged to read leaflet HC11 and make a claim using form HC1 and a refund claim using form HC5. 3. PATIENTS ASSESSED AS ELIGIBLE FOR LOW INCOME HELP Patients assessed as eligible for low-income help after claiming as in Para. 3 above should be able to produce either of these certificates: (i) Form HC2 which will show: The period of validity (both start and end dates); The period it covers, i.e. one or two parents and the children; That a full refund be given (ii) Form HC3 which will show; The period of validity (both start and end dates); The period it covers, i.e. one or two parents and the children; The amount of travel costs that each patient is expected to meet in any one week (7 days starting midnight Saturday) 4. PATIENTS CLAIMING BUT NOT YET ASSESSED FOR LOW INCOME HELP 4.1 Patients who claim low income entitlement but who have not applied for assessment: These patients should be given a claim form HC1 which they should be advised to complete and send to the Pension Service or their local Social Security Office or Jobs and Benefit Office with a completed form HC Patients who have claimed but not received a certificate: These patients should be given a claim form HC5 which they should be advised to complete and send to the Pension Service or their local Social Security Office or Jobs and Benefit Office. Patients should be advised that the claim for a refund has to be received by the respective office above within 3 months of the date of travel claimed. 4.3 After an assessment has been carried out by the respective office, it will send a completed HC5 to the hospital confirming entitlement. Payment should Payment of Travelling Expenses to Patients Attending Hospital 11/1/2011 2

7 be made by the hospital at the patient s next visit or, if more practical, direct to their home address. 4.4 If the patient does not hold an HC2 or HC3 certificate, the respective office will also send an HC5 form to the hospital stating the date the HC1 claim form was received (ref. Para. 14 of circular attached). 5. TRAVELLING EXPENSES OF PATIENTS ESCORTS Eligible patients are also entitled to claim for the travelling expenses of escorts where this is considered by their GP or consultant to be medically necessary. (See Para. 15 of circular for more details). (Appendix 1) 6. RETROSPECTIVE CLAIMS This refers to patients who wish to make retrospective claims or are unable to produce evidence of entitlement at the time of travel. Such patients should be given an HC5 form so that they may claim a refund from the respective office. For more details, refer to paragraphs 16 and 17 of the attached circular. (Appendix 1) 7. OTHER CATEGORIES INCLUDED UNDER HTCS SPECIAL CASES Children if they are dependants in a family entitled to assistance under the HTCS scheme. Patients attending a hospital for the provision or maintenance of appliances Patients attending for health service treatment at non-hpss establishments (where contractual arrangements exist) See paragraph 18 of the circular attached for further details on the above categories. 8. WAR DISABLEMENT PENSIONERS SPECIAL ARRANGEMENTS The HTCS does not apply to War Disablement Pensioners attending hospital if the treatment is for their pensionable disability. War pensioners attending hospital for reasons other than war disability should be treated under the HTCS arrangements on the same basis as for other patients. 9. PEOPLE NOT ELIGIBLE FOR HTCS HELP The following are not eligible for HTCS help: 1. Patients using HPSS ambulance service. 2. Patients with medical need for ambulance transport. Payment of Travelling Expenses to Patients Attending Hospital 11/1/2011 3

8 3. Patients being transferred between treatment centres. 4. Visitors (including relatives) to patients in hospital. They should be advised to enquire at their local Social Security Office or Jobs and Benefit Office and ask for an application form SF300. See more details relating to each of the above categories in paragraphs 22 to 25 of the circular attached. 10. PROCEDURES FOR REIMBURSING CLAIMS Patients should be informed of their entitlements. All relevant documentation (as shown in paragraph 2. above) must be inspected and travel claims checked before payment can be made. For all claims, form A107 (Appendix 2) Travelling Expenses Claim Form for Hospital Patients should be completed giving the following details: (a) (b) (c) (d) (e) (f) (g) (h) The name, address, date of birth and hospital number of claimant; Verification by a Trust officer that the claimant attended the hospital for the purpose of receiving medical treatment on the date(s) specified; Proof of entitlement to benefit. Bus tickets, train tickets or taxi receipts. (Taxi fares will only be paid if the patient is medically unfit to travel by other means of transport. This MUST be certified by a Medical Officer responsible for the patient) Where the means of transport is a private car, the number of miles travelled in undertaking the journey from home. Where a patient is accompanied by one or two (max.) escorts, a certification by the Medical Officer in charge of the patient that this was medically necessary Signature of Trust officer and date as having inspected the documentary evidence required. Signature of claimant and date. 11. CALCULATION OF TRAVEL COSTS 11.1 Patients who are able to provide the evidence described should be refunded the appropriate cost of travel. Claims up to 50 may be paid from petty cash. Claims exceeding 50 should be submitted to the Trust s payments office for processing Appropriate travel costs should be calculated on the basis of the cheapest form of public transport available to the patient (including any promotional or concessionary fares) Where public transport is used, the cost can be verified by tickets/receipts from the bus/train company or taxi owner. (All taxi receipts should be verified by a telephone call to the taxi company). Payment of Travelling Expenses to Patients Attending Hospital 11/1/2011 4

9 11.4 Where patients travelling by private car, the mileage payable is paid at the Public Transport Rate (PTR) which is currently 24 pence per mile Car parking charges may also be taken into account where they are unavoidable, evidence will be required Concessionary fares are available for many elderly people and for people with disabilities. Patients should be reminded to use cheap day returns and other promotions offered by public transport operators Requests for payments in advance should only be considered where: (i) It is deemed necessary for such a payment to be made; and (ii) The patient is entitled to assistance under HTCS. In these situations, the patient must show evidence of a future appointment, which should be copied to support the payment. The advance should only be given for one future visit at a time. Subsequent evidence is also required to show that the patient did attend the hospital on the date specified. If the attendance for which the payment was made did not occur, the patient should be contacted to arrange reimbursement to the Trust Where staff suspect that a fraudulent claim has been made they must follow the procedures set out in the Trust s Fraud Response Plan. (See Trust Losses procedure) 11.9Costs incurred by overnight stays by patients cannot be met under HTCS. However it would be appropriate to reimburse patients who would otherwise be entitled under the HTCS. Bed and breakfast costs may be reimbursed but not other meal costs. (Appendix 1 Para 34 35) There may be occasions when a patient is escorted to hospital and is admitted as a patient. It is therefore reasonable that where the return journey is claimed that it is paid. This is based on the premise that the escort has to travel home In cases where a private car is used and where it is essential that a patient requires an escort e.g. a child, a blind person etc, then passenger miles where claimed should be paid at the current passenger rate: 5 pence per passenger mile. See para 15 of Appendix INFORMATION FOR PATIENTS Notices about HTCS should be displayed in all patient areas (Appendix 3 Notice to patients). Leaflet HC11 summarises the arrangements set out above and should be made freely available in appropriate hospital departments or clinics as well as in the community. The hospital should keep a supply of the following forms: Payment of Travelling Expenses to Patients Attending Hospital 11/1/2011 5

10 Form HC1 - for patients who wish to claim for help with health costs on the grounds of low income from the appropriate office i.e. Pension Service, local Security Office or Jobs and Benefits office. (See paragraphs 3 & 5). Form HC5 - for retrospective claims (see paragraphs 3 & 7) 13. Advice 13.1 If you require further advice or assistance, please contact one of the following members of Trust staff (where possible, please use the tie line, by prefixing the extension number with 7631). Name address Telephone number Rhonda Hilditch rhonda.hilditch@northerntrust.hscni.net Evelyn Stephens evelyn.stephens@northerntrust.hscni.net Ann Johnston Ann.Johnston@northerntrust.hscni.net Debbie.mcmordie Debbie.mcmordie@northerntrust.hscni.net Review 14.1 This procedure will be kept under review, and its operation and effectiveness will be examined in two years time and revised if appropriate. 15 Equality, Human Rights and DDA This policy has been drawn up and reviewed in the light of Section 75 of the Northern Ireland Act (1998) which requires the Trust to have due regard to the need to promote equality of opportunity. It has been screened to identify any adverse impact on the 9 equality categories and no significant differential impacts were identified, therefore, an Equality Impact Assessment is not required. 16 Alternative formats This document can be made available on request on disc, larger font, Braille, audio-cassette and in other minority languages to meet the needs of those who are not fluent in English. Payment of Travelling Expenses to Patients Attending Hospital 11/1/2011 6

11 Payment of Travelling Expenses to Patients Attending Hospital Listing of Appendices Appendix 1 - HSS (SC) Hospital Travel Cost Scheme Appendix 2 - Travel Expenses Claim form for Hospital Patients Appendix 3 - Notice to Patients Information to patients claiming travel expenses

12 (Page 1 of 19) The hospital travel costs scheme (HTCS) - update January 2006 Contents Introduction 2 Patients entitled to reimbursement of hospital travel costs 3 Patients not automatically entitled to a refund but on low income 5 Patients assessed as eligible for low-income relief and holding a current entitlement certificate 6 Patients claiming but not yet assessed for low income relief 7 Travelling expenses of patients' escorts 8 Retrospective claims 8 Other categories included under HTCS - special cases 9 War disablement pensioners - special arrangements 10 People not eligible for HTCS help 11 Procedures for reimbursing claims 12 General 12 Calculation of travel costs 12 Concessionary fares schemes 13 Payment arrangements 13 Payments in advance 13 Fraudulent claims 14 Overnight stay costs 14 Information to patients 15 Contractual and financial arrangements 15 Contacts 16 Frequently asked questions 17

13 (Page 2 of 19) Introduction 1. For some patients, travel to hospital can present difficulties - for example, because of the cost, the length or complexity of the journey, or the lack of access to private or public transport. This chapter is primarily concerned with the financial help which is available under the Hospital Travel Costs Scheme (HTCS), to those patients who do not have a medical need for ambulance transport and who cannot meet the cost of travel to hospital. The scheme operates under the provisions of the Health and Personal Social Services Travelling Expenses and Remission of Charges Regulations (Northern Ireland) Throughout this guidance the patients referred to are: those who are HPSS hospital in or out-patients but who are not eligible for free Health Service transport through Patient Care Scheme (PCS); or those who are receiving HS treatment at a non-hpss hospital or other clinic whilst under the care of a HPSS hospital consultant. 3. Throughout this guidance the terms 'hospital' or 'provider unit' refer to: units managed by a Health & Social Services Trust, or a private unit used by the HPSS, e.g. diagnostic and treatment centres that are being created unless the context specifically indicates otherwise. 4. Hospitals should hold copies of: forms HC1 and HC5, and leaflet HC11

14 (Page 3 of 19) that are referred to in this guidance. Further supplies of the forms and leaflets can be obtained from Social Security Office or Jobs and Benefit offices and the Benefit Shop, Castle Court, Royal Avenue, Belfast, telephone number: , Mon Fri between the hours of 9am 5pm; or from the Pension Service if you are aged over 60, telephone number: or text phone: Patients entitled to reimbursement of hospital travel costs Patients in receipt of Income Support, Jobseeker s Allowance (Income-based), Pension Credit (Guarantee Credit), Working Tax Credit and/or Child Tax Credit. 5. Under the HTCS, the following patients (and, where considered medically necessary, their escort) are automatically entitled to full reimbursement of travel costs to hospital. Income Support Patients who get Income Support should be able to present either an award notice or form FF260 or FF260A covering the day they attend the hospital. Or they should ask their local Social Security Office or Jobs and Benefit office for a letter confirming receipt of Income Support for the purpose of refunds for travelling expenses and Health Service charges. Jobseeker s Allowance (Income-based) Patients who get Jobseeker s Allowance (Income-based) are not likely to have evidence and they should ask their local Social Security Office or Jobs and Benefit office for a letter confirming receipt of this benefit for the purpose of refunds for travelling expenses and Health Service charges.

15 (Page 4 of 19) Tax Credits Patients who get Working Tax Credit (WTC) or Child Tax Credit (CTC). Patients are entitled to a refund if they meet the following conditions: their income is 15,050 or less this is the amount shown on the Tax Credit award; and they get WTC and CTC, or they get WTC with a disability element shown on the award, or they get CTC and are not eligible for WTC. They will be sent a NHS Tax Credit Exemption Certificate showing they are entitled to help with health costs. Information about the new Tax Credit arrangements is in leaflet HC11, order from Belfast Benefits Shop on This leaflet should be made available to patients. Pension Credit Pension Credit consists of two elements Guarantee Credit and Savings Credit. Guarantee Credit (paid on its own or with Savings Credit) entitles the recipient and their partner to a full reimbursement of Hospital Travel Costs.

16 (Page 5 of 19) Pension Credit Customers will have to produce an award notice. Please note that the award notice includes personal information and if the patient would prefer not to show this, they could fold up the letter just to show item 5. Those in receipt of Savings Credit on its own are not entitled under the Hospital Travel Cost Scheme. Although they may be entitled to full or partial help under the HS Low Income Scheme and as such should be advised to complete a HC1 form, available by calling Dependants Patients, who are dependants in a family that gets Income Support, Jobseeker s Allowance (Income-based), Pension Credit Guarantee Credit, Working Tax Credit or Child Tax Credit, should be able to present the evidence of entitlement outlined above. Patients not automatically entitled to a refund but on low income 6. Other patients (and, where considered medically necessary, their escort) may be eligible for full or partial reimbursement under the HTCS on the basis of low income. The assessment of low income entitlement to refund of travel costs, and to exemption from a range of HS charges, is carried out by the local Social Security Office or Jobs and Benefits office which will issue a certificate, if appropriate after assessment. Patients who may be entitled to help on low income grounds should be encouraged to read leaflet HC11 and to make a Low Income Scheme claim using form HC1 and a refund claim using form HC5. Leaflet HC11and forms HC1 and HC5 are available from the Benefit Shop, Belfast, on and from hospitals. HC11 is also available online at

17 (Page 6 of 19) 7. Patients who might not consider that they are on a low income should be encouraged to make a claim if they have to travel frequently or over long distances. Unless they have savings in excess of the limit of 8,000 ( 12,000 if aged 60 and over), they will be sent a certificate showing how much if anything they have to pay for their travel per week. They will be entitled to a refund of anything in excess of the amount shown on the certificate. A certificate is usually valid for 12 months. 8. Patients assessed as eligible for low income help and holding a current entitlement certificate 8. Those assessed as eligible for help on low-income grounds will receive a certificate from the Pension Service or their local Social Security Office or Jobs and Benefit office. Patients claiming low income entitlement should be able to produce either of these certificates. 9. Form HC2 will show: the period of validity (both start and end dates); the people it covers, i.e. one or two parents and the children; that a full refund should be given. 10. Form HC3 will show: the period of validity (both start and end dates);

18 (Page 7 of 19) the people it covers, i.e. one or two parents and the children; the amount of travel costs that each patient is expected to meet in any one week (7 days starting midnight Saturday). 11. Any costs incurred in any one week, over and above the amount should be refunded. Patients who have been assessed but who are unable to produce form HC2 or HC3 should be advised to complete HC5 to claim a refund. Patients claiming but not yet assessed for low income help 12. Patients who claim low income entitlement but who have not applied for assessment should be given a claim form HC1 which they should be advised to complete and send to the Pension Service or their local Social Security Office or Jobs and Benefit office, with a completed form HC Patients who have claimed but not received a certificate should be given refund claim form HC5 that they should send to the Pension Service or their local Social Security Office or Jobs and Benefit office. Patients are asked to include their hospital number, the department attended and the full name, address and phone number of the hospital, details of the dates on which they attended and fares paid. Patients should be advised that the claim for a refund has to be received by the Pension Service or their local Social Security Office or Jobs and Benefit office or other office shown on the HC5, within 3 months of the date of travel that they paid. 14. The Pension Service or their local Social Security Office or Jobs and Benefit office will carry out the assessment and if the patient is entitled to a refund for journeys already made, a completed form HC5, confirming entitlement, and information on who should pay the patient will be sent to the hospital. In such cases, the hospital should make the payment at the patient's next visit, or for

19 (Page 8 of 19) those who will not be visiting again within a reasonable period (say, within four weeks), direct to their home address. If the patient does not already hold an HC2 or HC3, the Pension Service or their local Social Security Office or Jobs and Benefit office will also if entitled send out one of these starting from the date the HC1 claim form was received. Entitlement to certificates is based on the date of claim; entitlement to refunds is based on the date of travel. If the patient s circumstances have changed between the date of travel and the date of claim, the amount of the refund could be different from what the certificate says they have to contribute. Travelling expenses of patients' escorts 15. Under the HTCS, eligible patients are also entitled to claim for the travelling expenses of escorts where this is considered by their GP or consultant to be medically necessary. Payments for the travelling expenses of escorts under the scheme should be considered as part of the patient s travel costs and solely on the basis of the patient's entitlement and not on that of the escort. Under the provisions of the HTCS, references to an escort can be taken to mean two escorts where this is considered medically necessary. Retrospective claims 16. Patients may claim help with travel costs up to 3 months after the date of travel. All the conditions applying to patients who claim at the time of travel apply equally in such cases and only Income Support, Jobseeker s Allowance (Income based), Pension Credit Guarantee Credit, Working Tax Credit and/or Child Tax Credit or Low Income Scheme eligibility that cover the date of travel can be taken into account. 17. Where patients wish to make retrospective claims for travel expenses or are unable to produce evidence of entitlement at the time of travel, they should be

20 (Page 9 of 19) given a form HC5 so that they may claim a refund. The completed HC5 must be received by the relevant office within 3 months of the date of travel for which reimbursement is being claimed. The relevant office is shown on the HC5 and is: the patient's Social Security Office or Jobs and Benefit office, in the case of Income Support and Jobseeker s Allowance (Income-based) recipients; the Pension Service, in the case of Pension Credit recipients; the Prescription Pricing Authority for Working Tax Credit and Child Tax Credit recipients. The Prescription Pricing Authority will issue NHS Tax Credit Exemption Certificates when they receive information from the Inland Revenue. This will be sent monthly so there could be a delay in confirming entitlement. The Inland Revenue will not confirm entitlement. The Prescription Pricing Authority s address is Prescription Pricing Authority PO Box 1011 Newcastle Upon Tyne NE99 2ZP If no response is received from the Prescription Pricing Authority after 10 days, the patient should contact them, on ; or the Pension Service or their local Social Security Office or Jobs and Benefit office - in the case of those who are entitled to help under the Low Income Scheme. Other categories included under HTCS - special cases

21 (Page 10 of 19) 18. The following categories of Health Service patients are included under the HTCS arrangements (in some cases for reasons other than their ability to pay): Children - assistance is available to children if they are dependants in a family which is entitled to assistance under the HTCS scheme (see eligibility criteria above); Health Service patients attending a hospital or centre for the provision or maintenance of appliances (e.g. artificial limbs, wheelchairs etc) should be assessed for HTCS help on the same terms as any other HPSS hospital patients; Patients attending for Health Service treatment at non-hpss establishments (e.g. those with contractual arrangements with a HPSS Trust or HPSS Board to provide treatment for Health Service patients) - help is on exactly the same basis as if the patient had attended an HPSS establishment, but HPSS Trusts or referring units will need to make arrangements to pay these patients direct. War disablement pensioners - special arrangements 19. There are special arrangements that apply to War Disablement Pensioners attending hospital for medical treatment for their pensionable disability. These arrangements include payment of travelling expenses, subsistence and loss of earnings allowances. The HTCS does not apply in such cases. 20. Any war pensioner enquiring about expenses for attending for medical treatment should be advised to contact the Veterans Agency Norcross, Blackpool FY5 3TA, stating that he/she is a war pensioner and giving his/her full name and address and, if possible, his/her war pension number.

22 (Page 11 of 19) 21. War Pensioners attending hospital for reasons other than their accepted war disability should be treated under the HTCS arrangements on the same terms as for other patients. People not eligible for HTCS help 22. The HTCS arrangements do not apply to patients for whom HPSS ambulance service transport is arranged, patients being transferred between treatment centres, visitors to patients in hospital, or private patients. The arrangements or other help available in these cases are outlined below. 23. Patients with medical need for ambulance transport. Trusts are responsible for providing ambulance transport for those patients considered by a doctor, dentist or midwife to have a medical need for such transport. 24. Patients being transferred between treatment centres. The cost of transferring patients from one hospital to another, or to a clinic or nursing home, whilst their treatment remains the responsibility of an HPSS hospital consultant should be regarded as part of treatment costs. The travel costs of patients who are sent home either as part of their treatment or to meet a hospital's convenience should also be regarded as part of treatment costs. Patients who take leave from hospital at their own request cannot be helped with their travel costs. 25. Visitors to patients in hospital. Help for visitors to patients in hospital is not available under the HTCS. Recipients of qualifying benefits visiting someone in hospital may be able to obtain some help in the form of a Community Care Grant from the Social Fund. They should be advised to enquire at their local Social Security Office or Jobs and Benefit office, and to ask for an application form SF 300.

23 (Page 12 of 19) Procedures for reimbursing claims General 26. Provider units should have adequate arrangements for: informing all HS patients of their entitlements; checking the appropriate travel costs; and refunding patients the travel costs to which they are entitled. 27. Inpatients or outpatients should be able to obtain travel cost refunds at any time of the day or night. This applies particularly to those discharged from hospital or sent home from an Accident and Emergency Unit during out-of-office hours. Provider units might wish to consider giving an identified postholder responsibility for ensuring that patients have access to funds whenever they are required. All clinic and ward staff should be made aware of and be familiar with local arrangements. Calculation of travel costs 28. Appropriate travel costs should be calculated on the basis of the cheapest form of public transport available to the patient (including any promotional or concessionary fares). Patients travelling by private car may claim the lesser of: the estimated cost of fuel actually used, or the equivalent public transport cost.

24 (Page 13 of 19) 29. Car parking charges (including those at a hospital) must also be reimbursed where they are unavoidable, although not penalties incurred through illegal parking. In a few cases, where there is no alternative (for example, in cases where patients have restricted mobility, or public transport is not available for all or part of the journey), patients may have to use a taxi or volunteer car service for the whole or part of their journey. In such exceptional cases these costs must be reimbursed in full. In cases where health service transport is made available at a charge to patients, the charge must be reimbursed to those eligible under the HTCS. The rates and amounts at which a hospital sets their refund levels are left to their own discretion. Rates may vary from one hospital or HS clinic to another and any dispute as to exactly how much is to be refunded is between the patient and the hospital. Concessionary fares schemes 30. Concessionary fares are available for many elderly people and for people with disabilities. Provider units may wish to encourage patients to use or apply for concessionary fares wherever possible; similarly, they should remind patients to use cheap day return and other promotions offered by public transport operators. Payment arrangements 31. Patients who are able to provide the evidence described should be refunded the appropriate cost of travel immediately and in cash. Payments in advance

25 (Page 14 of 19) 32. The Pension Service or local Social Security Office or Jobs and Benefit offices are not responsible for assisting patients with payments in advance to meet travel costs. It is the legal responsibility of provider units to make such payments where necessary and they should have arrangements for dealing with such requests. In these cases, provider units will need to satisfy themselves that the patient is entitled to assistance under the HTCS. Fraudulent claims 33. Hospital staff administering the HTCS should ensure that controls for the payment of travel costs are strictly adhered to, thus reducing the risk of fraud occurring. Where staff suspect a fraudulent claim has been made they must follow the procedures set out in their organisation s Fraud Response Plan. Overnight stay costs 34. For some patients an overnight stay away from home is unavoidable, either because of the time of day or the length of travel. Where it is not reasonable for a patient (or an escort who is considered medically necessary to accompany the patient) to return home, an overnight stay should be arranged unless the patient is able to make their own arrangements. The benefits of encouraging parents to stay overnight with their children in hospital are now generally accepted and most Children's Departments have facilities for them to sleep on the ward. No charge should be made for these facilities. 35. For patients who cannot meet the cost of an overnight stay, costs so incurred cannot be met under the HTCS, but should be regarded as a part of treatment costs or met from non-exchequer funds. As a guide, it would seem appropriate for such costs to be met where the patient is otherwise entitled to reimbursement under the HTCS, and paid in proportion to that entitlement. Bed, or bed and breakfast costs, may be included, but not other meal costs.

26 (Page 15 of 19) Information for patients 36. Provider units should ensure that information about the HTCS is available to patients. In particular, notices about the HTCS should be displayed in all patient areas. Leaflet HC11 summarises the arrangements set out above and should be made freely available in appropriate hospital departments or clinics, as well as in the community. This is available free from or at Provider units should ensure that details of the local arrangements for payments under the HTCS are displayed prominently in patient areas. 37. For all patients, provider units should ensure that they provide details of the HTCS and of local transport and concessionary fare arrangements with appointment or admission letters. Ideally those who may be able to claim low income entitlement should receive the information early enough to be able to apply to the Pension Service or their local Social Security Office or Jobs and Benefit office for an assessment in advance. They should be advised to use the claim form HC1 which should be held by hospitals and can be obtained from the Pension Service or any local Social Security Office or Jobs and Benefit office. Contractual and financial arrangements 38. Provider units are responsible for administering the HTCS and for making payments to patients. HPSS Trusts are responsible for reimbursing provider units for the payments made under the Scheme to all patients who are resident in their districts. Arrangements should be made for provider units to claim reimbursement from HPSS Trusts at periodic intervals (for example, at the end of each quarter). The 16 procedures for processing such claims (including any attendant documentation) should be agreed locally.

27 (Page 16 of 19) 39. GP practices are not funded for the HTCS. Provider units should reclaim the cost of any payments for directly referred patients from the relevant HPSS Trust. 40. Where patients are referred to a non-hpss hospital (private, voluntary or Ministry of Defence) by an HPSS consultant or HPSS Trust consultant: the referring unit should pay any HTCS costs that are claimed by the patient and seek reimbursement from the relevant HPSS Trust, or the HPSS Trust should arrange to make these payments direct. Contacts For further general scheme and entitlement advice please contact the Benefit Shop on

28 (Page 17 of 19) Frequently asked Questions Q. The NHS have given me the choice of receiving treatment in another country as the waiting list there is shorter, can I claim under the HTCS? A. Yes, providing you are in receipt of one of the qualifying benefits or have been awarded either a HC2 or HC3 certificate. You can claim under the HTCS for travel costs incurred in getting from your home to the port. Your local HPSS Trust will be responsible for the other transport costs. Q. I used to be able to claim under HTCS for my visits to the physiotherapist, but she has moved from the hospital to a community care and treatment centre. Can I still claim? A. You can only claim under HTCS if you are in receipt of one of the qualifying benefits, HC2 or HC3 certificate and you are under the care of an HPSS consultant. Q. Can I claim under the HTCS for a visit for to the dentist? A. No, you must be either attending a hospital or HPSS organisation under the care of a HPSS consultant. Q. Will I be able to claim under HTCS if in the future I choose to attend a Diagnostic and Treatment Centre? A. Yes, providing you are in receipt of one of the qualifying benefits or have been awarded either a HC2 or HC3 certificate. Contact your local HPSS Trust for further details. Q. I am a HPSS patient attending a non-hpss hospital, can I still claim under the HTCS? A. Yes, providing you are in receipt of one of the qualifying benefits or have been awarded either a HC2 or HC3 certificate. Contact your local HPSS for further details.

29 (Page 18 of 19) Q. My husband is in hospital, can I claim under the HTCS for my visits? A. Unfortunately the HTCS does not apply to visitors. Q. My premature baby is still in hospital, I need to visit every day to feed him. Can I claim under the HTCS? A. Whilst the HTCS does not apply to visitors, the hospital should be asked if it has alternative arrangements in place for situations such as a mother visiting a child/baby. Q. I live in a rural area, if I was to use public transport I would not get to the hospital in time for my appointment. Can I get a taxi and claim back the cost through the HTCS? A. Yes, providing you are in receipt of one of the qualifying benefits or have been awarded either a HC2 or HC3 certificate and there is no other suitable means of transport. Q. I have chosen to take an outpatient's appointment at a hospital in a neighbouring city, I intend to use the train to get there, my wife will be coming with me. Can I claim under the HTCS for her train fare as well as my own? A. Yes, you can claim under the HTCS providing you are in receipt of one of the qualifying benefits or have been awarded either a HC2 or HC3 certificate. However you will only be able to claim the cost of your wife's fares if you have a medical need (approved by a medical practitioner) for an escort. Q. I have recently claimed a reimbursement under HTCS, I travelled in my own car and I was only reimbursed at a rate of 15p per mile. Is this correct? A. Just as fuel costs vary throughout the country, fuel reimbursement rates will vary and actual rates will be determined by the local trust.

30 (Page 19 of 19) Q. I have an outpatient's appointment at the hospital, my GP has arranged a hospital car to take me to the hospital and take me home. I have had a bad experience of using the hospital car in the past. So I have cancelled it for this time, I propose to use a taxi instead. Can I claim under the HTCS? A. If hospital transport has been offered to you on the basis of your medical need, you are unable to claim under the HTCS, though previous dissatisfaction should be taken-up with the hospital concerned.

31 Appendix 2 (Page 1 of 2) TRAVELLING EXPENSES CLAIM FORM FOR HOSPITAL PATIENTS (Before completing this form claimants should read the information overleaf) Hospital: Department: Patients Name: Address: Date: Hospital No: Date of Birth: Name of Escort: (If required for medical reasons or in the case of a child) I confirm an escort is necessary Signed: (Medical Officer) I confirm a taxi is medically necessary Signed: (Medical Officer) (Taxi receipt must be submitted) PROOF OF ENTITLEMENT TO BENEFIT MUST BE SUBMITTED WITH THIS CLAIM Details of entitlement National Insurance Number: (Tick as appropriate Jobseekers (IB) Pension Credit Income Support and quote number Prescription Pricing Authority Tax Dates: No where applicable) Credit NHS Exemption Certificate: : HC2 / HC3* Certificate: * In the case of HC3 Certificate please quote the amount of contribution the claimant must make I confirm the above patient attended this hospital for the purpose of medical treatment as an INPATIENT / OUT- PATIENT (delete where necessary) on the following dates: (EXPENSES MUST BE CLAIMED WITHIN 3 MONTHS OF THE TRAVEL DATE) Day Month Year Day Month Year Day Month Year Day Month Year Certified: Grade: Date: (Please note Certifying officer must delete unused columns when signing) FOR FINANCE USE ONLY Train fare (Tickets must be provided) Bus fare (Tickets must be provided) Private car Return Per mile Order Book/Certificate seen: Return Tickets seen: OR Checked with DHSSPS: Claim checked by: Date: I hereby declare that in attending Hospital on the above date(s) I necessarily incurred travelling expenses amounting to and I acknowledge receipt of this sum refunded to me by Northern Health & Social Care Trust. Signed: (Claimant) Date:

32 INFORMATION TO PATIENTS CLAIMING TRAVEL EXPENSES Appendix 2 (Page 2 of 2) Patients can get help with their travel costs to hospital for NHS treatment if he/she is under the care of a hospital consultant and if he/she or their partner is entitle to any of the following benefits: Income Support Guarantee Pension Credit Income Based Jobseekers Allowance Hold an NHS Tax Credit Exemption Certificate Hold a DHSSPS HC2 or HC3 Certificate How to Claim Patient Travel Claims must be submitted within 3 months of the travel date. Complete a patient s travel claim form at the Ward/Dept you are attending. The claim form must be certified by a member of Trust staff as proof of attendance. Take your completed claim form together with tickets/receipts and proof of entitlement to one of the above benefits (Benefit Book / Valid Certificate) to the hospital Cash Office for payment. Postal claims should be forwarded to the Trust Central Cash Office. Please ensure your national insurance number, type of benefit, tickets/receipts and a copy of your proof of benefit is included with your claim. N.B. Taxi fares will only be refunded if the patient is medically unfit to travel by any other means of transport. This MUST be approved by the doctor you are attending at hospital or via a letter from your G.P. Unless the forgoing conditions are adhered to payment will not be made. Please note Information provided on this form may be available to other departments / agencies for the purpose of detecting crime / fraud. Signed: Director of Finance If you require any further details regarding patients travel claims please contact the Central Cash Office Telephone:

33 Appendix 3 INFORMATION TO PATIENTS CLAIMING TRAVEL EXPENSES Patients can get help with their travel costs to hospital for NHS treatment if he/she is under the care of a hospital consultant and he/she or their partner are entitled to any of the following benefits: Income Support Guarantee Pension Credit Income Based Jobseekers Allowance Hold an NHS Tax Credit Exemption Certificate Hold a DHSSPS HC2 or HC3 Certificate How to Claim Patient travel claims must be submitted within 3 months of the travel date. Complete a patient s travel claim form at the Ward/Dept you are attending. The claim form must be certified by a member of trust staff as proof of attendance. Take your completed claim form together with tickets/receipts and proof of entitlement to one of the above benefits (Benefit Book /Valid Certificate) to the hospital Cash office for payment. Postal claims should be forwarded to the Trust Central Cash Office. Please ensure your national insurance number, type of benefit, tickets/receipts and a copy of your proof of benefit is included with your claim. N.B. Taxi fares will only be refunded if the patient is medically unfit to travel by any other means of transport. This MUST be approved by the doctor you are attending at hospital or via a letter from your G.P. Unless the forgoing conditions are adhered to payment will not be made. Please Note Information provided on the Patients Travel Claim Forms may be made available to other departments/agencies for the purposes of detecting crime/fraud. If you require any further details regarding patients travel claims please contact the Central Cash Office Telephone: