Hertfordshire County Council

Health Scrutiny Committee (HSC) Scrutiny of Transport Arrangements

Issues related to the implementation of the Delivering Quality Health Care Strategic Plan

The Herts PCT’s have agreed a strategic plan for the location of services in the county.

The basic principle is to focus specialist activities, such as A&E or maternity, in a smaller number of locations but to provide new services such as Urgent Care Centres around the county.

A basic premise in the plan was the ability of staff, patients, and visitors to travel to the various facilities within an acceptable period of time. Much of the data analysis was directed to such movements with critical assumptions on the use of ambulances, private cars, public transport, and the voluntary sector.

During discussions on the plan it was accepted that there needed to be closer integration between the various transport operators to ensure that the various needs are met. One action has been the re-establishment of the Herts Integrated Transport Project so that the County Council and the PCT’s can cooperate to achieve the Plan’s objectives.

A further issue was the need for better communication with the public to allow them to identify the services that are available for them.

Many of the facilities provided for users are controlled by age/disability/financial criteria that make it difficult to access these services.

It is worth noting that the number of NHS staff movements to and from home or between sites far outweighs those by patients or visitors. The numbers are around 4000 patients, 2000 visitors, and over 30,000 staff trips per day.

While the numbers will be small there are those with no car, no access to public transport, limited by age or disability, and lacking confidence to check out options.

It is this most vulnerable group that need the greatest attention.

The various transport options are commented on below.

Ambulances

Those patients requiring urgent transport have access to ambulances. These are now staffed by qualified paramedics who are capable of stabilising the patient and deciding on the appropriate destination. Time and distance is less critical.

A non urgent ambulance service is provided in particular for people who need transfer between sites. This is governed by the criteria mentioned above.

Private cars

By far the majority of movements will be by private car. The most critical and emotional issue for this group is car parking, both availability and cost.

Public transport

While train services may be possible the majority of movements will be by bus.

Some routes do pass NHS facilities but frequency and reliability may be a constraint.

Given the specialisation of services at single locations there can be a need for one or more changes of bus to reach these destinations.

Also critical is the problem of disabled or elderly people who find it difficult to use buses.

Voluntary services

For those without a car or access to public services a variety of voluntary services are available either by bus or car.

These can provide a door to door service or have disability facilities.

They can be arranged to meet appointment times although the uncertainty of the length of the appointment can cause problems with return trips.

The availability of parking for volunteer drivers and drop off/collect areas is part of the problem mentioned above.

There are several good examples of service from the Lister Shuttle which is centred on the hospital or the Broxbourne Shuttle which is based in the area. These can be booked for specific journeys or times.

A major problem for these organisations is the declining availability of volunteer drivers.

Integration

It is intended that the Integrated Transport Group will bring together the commercial transport operators and the voluntary sector to ensure that the differing needs of users are met, and that duplication is avoided.

Robert Kerr

West Herts LINk Representative

Board MemberRoundabout (SW Herts Community Transport Scheme)

19/12/2008

1