FOI 25-582 PNA for Renal Patients

Freedom of Information Request

Reference
FOI 25-582 PNA for Renal Patients
Request Date
15 Dec 2025
Response Date
09 Jan 2026
Information Requested

1. Eligibility Criteria 
Please outline the specific criteria used to assess whether a patient requiring renal dialysis is eligible for nonemergency ambulance transport. In particular, clarity on how the Patient Needs Assessment (PNA) is applied in such cases would be appreciated. 
From your previous FOI response (FOI 25152), I understand that transport eligibility may include circumstances such as: 
 
Requirement for high level of mobility assistance, 
Need for specialised ambulance equipment, 
Dependence on oxygen and inability to self-administer during transit, 
Conditions affecting dignity, communicable disease, post-surgery side effects, and, immunocompromise, or cognitive/sensory impairment. 
 
Could you please confirm if all or some of the above apply specifically to dialysis patients, and whether there are any additional renal dialysis–specific criteria? 
 
2. Application Process 
How is the PNA applied during booking for renal dialysis transport? Please describe the assessment process, including who conducts it (e.g., Scheduled Care Coordinators), and how clinical or mobility needs are evaluated. 
 
3. Examples or Case Studies 
Could you provide anonymised case studies or examples illustrating: 
 
Scenarios when renal dialysis patients were deemed eligible for Scottish Ambulance Service transport 
Scenarios when renal dialysis patients were considered ineligible, and the reasons identified during the PNA. 
 
These examples will help clarify how the eligibility criteria are applied in real-world settings. 
 
4. Policy or Guidance Documents 
If available, please share any policy documents, operational guidance, or flowcharts relating to: 
 
Patient transport eligibility for renal dialysis 
Use of PNA specifically in this patient group. 
 
5. Service Provision & Alternatives 
In instances where patients are deemed ineligible by the Scottish Ambulance Service, could you outline: 
 
What alternative transport options are provided or signposted (e.g., volunteer services, taxi, Healthcare Travel Costs Scheme)? 
Whether the service monitors or evaluates the impact of these alternative arrangements. 

Response

 

Q1 – The Scottish Ambulance Service (SAS) determines eligibility for non‑emergency patient transport using the Patient Needs Assessment (PNA). The PNA is a structured series of question “card sets” within SAS’s booking system, applied on every call to assess clinical and mobility need. 

 

As set out in FOI 25‑152, patients are likely to qualify for Scheduled Care patient transport if one or more of the following apply: 

  • A high level of mobility assistance is required. 
  • Specialised ambulance equipment is needed to mobilise. 
  • Oxygen is required and the patient cannot self‑administer during transport. 
  • A medical condition/disability could compromise dignity or cause public concern on public transport/taxi and there is no appropriate private transport. 
  • A communicable disease makes travel on public/community transport or taxi inadvisable and there is no appropriate private transport. 
  • Post‑surgery side effects may require assistance during the journey (one‑way only). 
  • An HCP has determined the patient is at risk using alternative transport due to being immunocompromised and they do not routinely travel by other means. 
  • A cognitive or sensory impairment requires oversight to travel safely and no escort is travelling. 
  • Dementia or a mental health condition prevents safe independent travel and could present risk to self/others 

 

SAS applies the same PNA‑based clinical and mobility criteria to all scheduled care cohorts; there are no additional renal dialysis–specific eligibility criteria recorded beyond the PNA.  The PNA is applied case‑by‑case to determine need. 

 

Q2 - The Renal Department initially contacts the Scheduled Care Supervisor to discuss resource availability and confirm alignment with departmental capacity. Where availability is agreed, the department is then guided through a standard PNA by a call handler. 

Given the department’s familiarity with the PNA process and detailed knowledge of patient requirements, all patients are deemed eligible at this stage. It is recognised that some patients may improve following a period of treatment; however, they may remain on transport lists until a formal review is completed. Currently, there are no defined timescales for this review. Once a patient is assessed as no longer eligible for transport, they are subsequently removed from the list. 

Q3 – The Freedom of Information Act 2002 does not oblige authorities to create new information in order to answer a FOISA request.  The Scottish Ambulance Service does not hold anonymised case studies or examples illustrating eligible and ineligible outcomes for dialysis patients. 

It is for this reason we have applied section 17 of the Freedom of Information Scotland Act 2002, as information not held. 

 

Q4 - The Scottish Ambulance Service do not hold policy documents, operational guidance, or flowcharts specific to dialysis or to the use of PNA for this patient group. It is for this reason we have applied section 17 of the Freedom of Information Scotland Act 2002, as information not held. 

Please Note: The PNA questions themselves are considered as a flowchart and the outcomes depend upon the responses to questions within those cards.   As set out in FOI 25‑152, the detailed PNA question sets themselves are withheld under section 30(c) FOISA (effective conduct of public affairs), though SAS has published the background description and expected eligibility criteria referenced above.   

Q5 - At initial booking, due to the very high success rate of eligibility for dialysis bookings at the first contact, there is no requirement to signpost to alternative transport providers (e.g., volunteer services, taxis, Healthcare Travel Costs Scheme) at that point. 

The Scottish Ambulance Service do not hold information on monitoring or evaluation of alternative arrangements for dialysis patients who are deemed ineligible at first contact. 

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