Transport to health
Accessibility to health services by public transport from rural areas in South Gloucestershire is often poor, with for example up to 13.5% of the population having to travel for over 60 minutes by public transport during peak times to their nearest secondary care provider. There is therefore a recognised gap in the transport offer from rural areas.
In recognition of this and to respond to a Department for Transport bidding opportunity, South Gloucestershire Council developed a proposal to establish the capacity of community transport operators to aid the NHS in transporting patients and visitors from the rural areas to health facilities to complement the patient transport services and to investigate the potential for NHS appointment making processes to be revised to aid the facilitation of enhanced patient transport. The proposal was successful in receiving £150,000 from the Total Transport Fund in March 2015.
The project has been delivered in two stages. Stage one, undertaken during 2015 and 2016, involved a review to establish a baseline of current detailed issues. As part of this, a survey programme was undertaken to collect baseline data. This involved surveying the public at key healthcare facilities (e.g. GP surgeries, healthcare centres, minor injury units and hospitals). The survey programme ran from mid-Nov 2015 for approximately three months to obtain public views on accessing these facilities.
In addition to the survey programme the first year of the study has focussed on a desktop review of data sets available from the Clinical Commissioning Group (CCG), NHS, South Gloucestershire Council and external community representative groups. This included reviews of outpatients, GP locations, a review of the existing community transport provision, neighbourhood development plans, parish and town plans, local transport plans, census data etc.
In stage two consultation continued with transport operators such as community transport, voluntary transport, taxi operators, passenger transport services and stakeholder groups. Stage two concluded in March 2017 with the delivery of a comprehensive feasibility study.
In June 2018 the Department of Transport issued their feasibility report. Key findings from reports submitted by the 37 participants are as follows:
- There is no ‘one size fits all’ and the specific local circumstances need to be understood. Working across local authority boundaries can help with delivering services and reducing overheads.
In South Gloucestershire, community transport providers do work across boundaries, providing journeys to healthcare facilities in neighbouring authority areas. E.g. Southmead Hospital, Gloucester Royal Hospital and Royal United Hospital Bath.
- The final product needs to be acceptable to its customers. Wide scale consultation with users can deliver a better outcome, identify potential issues, and ensure that changes are accepted.
Research carried out in South Gloucestershire as part of the Total Transport project involved consultation with healthcare providers, service users, community transport operators and other stakeholders. The proposals developed during the project followed on from data gathered as a result of the initial consultations and follow up consultations, where the solutions were presented for feedback.
- More work is needed to involve the NHS in Total Transport and unlock the substantial opportunities for joint working which remain untapped. Some areas found that the different ways in which NHS bodies and local authorities work acted as a barrier to integration. One untested suggestion for remedying this was to embed local authority transport professionals in CCGs. Another proposal was to devolve responsibility for non-emergency health sector transport to local authorities.
In South Gloucestershire the Clinical Commissioning Group were involved in the Total Transport project and in developing the proposed solutions.