Transport to Health

Work with Scottish Government Health colleagues to ensure disabled people are equipped with the information and services they need to ensure that they are able to travel safely to medical / health appointments

We know that poor access to transport has a disproportionate effect on people in low incomes, disabled people, older people and people with ongoing health and social care needs.

The 2019 ‘Scottish Household Survey’ showed that 60.3% of all respondents believed that access for hospital outpatients was “very or fairly convenient”, which was the lowest score of all services surveyed. The satisfaction level varied significantly depending on the income of the respondent - dropping to 54% for those with a net household income of up to £15,000 per annum. During 2019 the Mobility and Access Committee for Scotland (MACS) undertook research to explore the transport barriers faced by disabled people and older people when accessing health and social care appointments and facilities.

This work was undertaken to explore offerings in the 32 Local Authority areas, gather insights, find out about initiatives that worked well, and to gain a better understanding of the issues and barriers facing disabled and older people when accessing these essential services. This research and evidence gathering involved a Transport to Health and Social Care roundtable discussion, hosted by MACS with assistance from Transport Scotland, and independently facilitated by the Scottish Government.

This event brought together around 40 stakeholders, including individual disabled people, Disabled People’s Organisations (DPOs), Community Transport Association (CTA), Transport Scotland (TS), Regional Transport Partnerships (RTPs), representatives from NHS Boards, Access Panels and Local Authorities (LAs).

It was followed up by a second Roundtable event in March 2020, that looked at prioritising the recommendations from MACS phase one work and earlier roundtable. These recommendations reflected the National Audit Office Report of 2011 on Transport to Health and Social care, which identified similar failings of transport provision and made similar recommendations that had not been progressed to date. 

MACS recommended that transport should be integral to care plans and that organisations need their requirements to be better joined with NHS Boards, Local Authorities and the Scottish Ambulance Service (SAS). MACS also recommended that the CTA should be recognised as a key partner in the planning and care pathway due to the key role they play in this sector.

The MACS Report on Transport to Health and Social Care is a summary of the findings of this work, including 9 key issues clustered around five themes.

Additionally an extensive evidence gathering exercise to capture the voices of disabled people was undertaken by Disability Equality Scotland asking the question “Have you had problems booking, or getting transport to medical/healthcare appointments?  They received 848 responses with 98% (829 respondents) stating Yes and 2% (19 respondents) stating No. 

Overall their membership felt that more had to be done to shake up the planning and organisation of patient transport as it plays such an important part in ensuring patients receive the treatment and consultations that they require. The research showed that some patients chose not to travel to appointments at all, citing that the process was too stressful or too costly, while others prepared for them but on many occasions had to cancel due to the transport not arriving at the correct time, or not at all. This in turn has an impact on NHS resources and waiting times and creates real challenges for patients in accessing the right care at the right time.

Again it is worth noting that good practice exists across the country including to meet the demand for the newly developed Clinical Assessment Centres an alternative Patient Transport Service was quickly established to support patients without access to their own transport. This new service was created collaboratively between the Scottish Government, NHS National Services Scotland and Transport Scotland, with the support of the Scottish Ambulance Service and incorporated offers of support from external organisations including Arnold Clark, who provided 120 minibuses at no cost and NorthLink Ferries put processes in place early in the Covid-19 pandemic to allow passengers travelling for hospital appointments to remain on their vessels for up to 3 hours after arrival.

We have also seen many good cross organisational initiatives during the pandemic, some of which improved transport access to medical facilities and the CTA provided free transport to medical facilities and for vaccinations. These initiatives cannot be lost as we move out of the pandemic.  

Key actions for 2021-2022

In order to fulfil this objective Transport Scotland will:

• Ensure that patient’s needs inform our approach to this activity and ensure transport initiatives continue to operate to good effect as lockdown restrictions ease and our NHS and transport services recover from COVID-19.
• Work with partners to ensure we do not lose good practice initiatives from the pandemic that helped people get to essential medical appointments and travel for vaccinations.
• Participate in workshops led by SG Health colleagues and MACS to explore how Transport to Health recommendations can be taken forward.
• These Workshops will help identify the membership and remit of a Transport to Health Working Group, whose role will be to work towards the implementation of MACS recommendations from their 2019 report.