The NHS patient transport system isn’t working. So what can we do about it?

Some ambulances at St Thomas’ Hospital, London. Image: Getty.

The hallmark of an effective transport service is one which gets people to where they need to be at the time they expect. The more timely the service, the more people like it.

To make this possible transport operators need accurate information. They need to know how many people they will transport and when. In this ideal ecosystem, this would mean that transport can be matched to need, and passengers would have a reliable service.

In hospital transport, where people are often being taken to appointments, timeliness is particularly important. Clinical Commissioning Groups (CCGs) commission non-emergency patient transport for patients who have a medical need for transport between NHS healthcare providers. This is provided by a mix of in house services, private providers, and community transport operators.

You might only be familiar with patient transport from the news stories which focus on where it doesn’t work, where patients are waiting for transport, or they have to use transport which is unsuitable for their needs. Across the country, patients who rely on these services are greeted with changing eligibility criteria, variable services, and long waiting times. If they can’t use this transport at all getting to hospital can be expensive, stressful, and inconvenient.

Everyone should be able to get in and out of medical appointments in a way which supports good health. But at the moment, this experience is by no means universal.

Planning effective patient transport within the NHS is incredibly difficult. There is poor data collection and use of travel data, commissioning does not support continuous improvement, and demand is often unpredictable. It’s impossible to improve services where operators do not know what they are tendering for, where the commissioning body does not enable improvements, and where patients have no effective mechanisms to hold anyone to account.


For patients who need recurrent treatments such as dialysis or chemotherapy, transport is a significant part of their lives. Staff across the NHS work every day to ensure these patients receive the greatest level of care, but the patient transport environment does not currently reflect their commitment.

In community transport we hear about this a lot. Our members provide hospital transport, often without pay, to ensure people in their communities can get to where they need to be. There are lessons we can learn from their approach to personalisation and accessibility that can transform health transport.

We need to create a culture of innovation which encompasses innovative commissioning practices. It’s necessary to look at how community transport, and communities more widely, can play a greater role in the commissioning, provision, and evaluation, of hospital transport. CCGs also need to share and collect more meaningful data.

These aren’t abstract travel problems which are impossible to resolve. It’s time to learn the lessons from our local communities on how we can make our hospital transport better.

You Can Read CTA’s New Report: Innovations in Health Transport here.

The CTA is the national body for the providers of community transport. You can follow its work at @CTAUK1 and on its blog.

 
 
 
 

These maps of petition signatories show which bits of the country are most enthusiastic about scrapping Brexit

The Scottish bit. Image: UK Parliament.

As anyone in the UK who has been near an internet connection today will no doubt know, there’s a petition on Parliament’s website doing the rounds. It rejects Theresa May’s claim – inevitably, and tediously, repeated again last night – that Brexit is the will of the people, and calls on the government to end the current crisis by revoking Article 50. At time of writing it’s had 1,068,554 signatures, but by the time you read this it will definitely have had quite a lot more.

It is depressingly unlikely to do what it sets out to do, of course: the Prime Minister is not in listening mode, and Leader of the House Andrea Leadsom has already been seen snarking that as soon as it gets 17.4m votes, the same number that voted Leave in 2016, the government will be sure to give it due care and attention.

So let’s not worry about whether or not the petition will be successful and instead look at some maps.

This one shows the proportion of voters in each constituency who have so far signed the petition: darker colours means higher percentages. The darkest constituencies tend to be smaller, because they’re urban areas with a higher population density. (As with all the maps in this piece, they come via Unboxed, who work with the Parliament petitions team.)

And it’s clear the petition is most popular in, well, exactly the sort of constituencies that voted for Remain three years ago: Cambridge (5.1 per cent), Bristol West (5.6 per cent), Brighton Pavilion (5.7 per cent) and so on. Hilariously, Jeremy Corbyn’s Islington North is also at 5.1 per cent, the highest in London, despite its MP clearly having remarkably little interest in revoking article 50.

By the same token, the sort of constituencies that aren’t signing this thing are – sit down, this may come as a shock – the sort of places that tended to vote Leave in 2016. Staying with the London area, the constituencies of the Essex fringe (Ilford South, Hornchurch & Upminster, Romford) are struggling to break 1 per cent, and some (Dagenham & Rainham) have yet to manage half that. You can see similar figures out west by Heathrow.

And you can see the same pattern in the rest of the country too: urban and university constituencies signing in droves, suburban and town ones not bothering. The only surprise here is that rural ones generally seem to be somewhere in between.

The blue bit means my mouse was hovering over that constituency when I did the screenshot, but I can’t be arsed to redo.

One odd exception to this pattern is the West Midlands, where even in the urban core nobody seems that bothered. No idea, frankly, but interesting, in its way:

Late last year another Brexit-based petition took off, this one in favour of No Deal. It’s still going, at time of writing, albeit only a third the size of the Revoke Article 50 one and growing much more slowly.

So how does that look on the map? Like this:

Unsurprisingly, it’s a bit of an inversion of the new one: No Deal is most popular in suburban and rural constituencies, while urban and university seats don’t much fancy it. You can see that most clearly by zooming in on London again:

Those outer east London constituencies in which people don’t want to revoke Article 50? They are, comparatively speaking, mad for No Deal Brexit.

The word “comparatively” is important here: far fewer people have signed the No Deal one, so even in those Brexit-y Essex fringe constituencies, the actual number of people signing it is pretty similar the number saying Revoke. But nonetheless, what these two maps suggest to me is that the new political geography revealed by the referendum is still largely with us.


In the 20 minutes it’s taken me to write this, the number of signatures on the Revoke Article 50 has risen to 1,088,822, by the way. Will of the people my arse.

Jonn Elledge is the editor of CityMetric. He is on Twitter as @jonnelledge and on Facebook as JonnElledgeWrites.

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