NHS GRAMPIAN

Health and Transport Action Plan

1.0Introduction

1.1 The Health Transport Action Plan (HTAP) for the Grampian Area was commissioned jointly by Nestrans and NHS Grampian in 2007. The following year the HTAP was formally endorsed by the Boards of both organisations and the Local Authority Committees.

1.2The HTAP set out the commitment of a number of key stakeholder groups and agencies towards improving health and reducing inequalities and captured these within three main themes: Promoting Active Travel, Links between Transport and Public Health; and Access to Healthcare.

2.0Aim

2.1This paper will outline the progress of the HTAP during 2011 – 2012 and provide a focus on future direction during 2012 - 2013

3.0Discussion

3.1The HTAP is a key document that provides the direction to the three main themes outlined in 1.2, but has also supported emerging themes in 2010 such as lower emissions; climate change; and how to protect our environment within the context of constrained budgets.

3.2In November 2008 the HTAP, to ensure performance was monitored and supported within a recognised governance structure, was formally adopted as part of the North East of Scotland's Joint Public Sector Group's [NESJPSG] programme of work. The NESJPSG is now known as the Chief Executives' Forum [CEF] and comprises of the Chief Executives of Aberdeen City, Aberdeenshire and Moray Councils, NHS Grampian, Grampian Police and Grampian Fire and Rescue Service.

3.3Nestrans and NHS Grampian originally led the delivery of the action plan, however it was soon recognised that the implementation of the HTAP could only be achieved with the support of other agencies and in May 2009 an HTAP Programme Board was set up including representatives from Nestrans; NHS Grampian; the three local authorities and the Scottish Ambulance Service.

3.4In 2010 it was agreed the HTAP Programme Board was not functioning as a Board and work commenced to set up an HTAP Steering Group with appropriate senior management involvement from participating organisations.

3.5The HTAP Steering Group produced a revised Constitution and this was approved by the CEF in October 2010.

3.6Following the Constitution being formally approved sub groups have also been put in place to deliver on three main themes, with the Programme Manager continuing to deliver on the overall programme of work and in addition the drive to:

  • Reduce inequalities;
  • Support solutions to halt community severance issues and:
  • Investigate future funding options to support HTAP initiatives.

3.7The HTAP continues to support strategic documents such as: Local Strategies in Aberdeen City; Aberdeenshire and The Moray Council areas’; NHS Grampian’s 20/20 Vision; the Scottish Ambulance Service, Service Review; and the University of Aberdeen’s Dot Rural work within their Centre of Transport Research Unit.

3.8Achievements in 2012:

Active Travel

3.8.1The HTAP Steering Group confirmed that "Active Travel" should fit within a new main heading, that of “Active Lifestyle”. This is to take account of the wider need for communities to be encouraged to live a more active lifestyle with the benefits of active travel acknowledged as a main factor in improving people’s health in general.

3.8.2The HTAP had brought about the introduction of a sub group in 2010 to promote active travel and was a multi agency group called "Get About". Get About was introduced to perform promotional activities, however was reviewed in 2012 with regard to performance.

3.8.3During the review it was identified that NHS Grampian should become more actively involved due to the change to "Active Lifestyle" and this is being considered as part of the review.

3.8.4Following the review the sub group will be required to deliver a programme of work for 2013 –2014.

3.8.5This will see a coordinated approach to the health benefits of active travel forming part of an active lifestyle campaign and the sharing of resource.

3.8.6In 2012 two areas were identified as Cycle Demonstration Towns : Peterhead in Aberdeenshire and the area of Greenbrae in AberdeenCity. Work continues to improve cycling facilities in these areas and monitor the increased activity levels.

4.0 NHSG Transport Interchange ARI

4.1January 2010 the Programme Manager was asked to revisit the proposal for an integrated transport system in the grounds of Aberdeen Royal Infirmary in support of promoting more active travel options including cycle facilities, incorporated within a new bus port etc.

4.2A meeting was then held to establish the background to this proposal and a sub group set up to progress the proposed project.

4.3 The sub group agreed the concept was sound, however due to financial

constraints this has meant that two options were to be considered.

  • What could be done to the existing bus port to improve this area; and
  • What will the design of the interchange look like for the future, and subsequent costs involved to inform a longer term strategy.

4.4It should be noted that the proposed long term interchange was not to be bus provision only, but will take in the needs of other modes of active travel such as cycling.

4.5In 2011 – 2012 a sub group was formed and work commenced to deliver an improved bus port and approach system. This was officially opened in June 2012 and continues to be monitored.

4.6Early indications are that service providers are encouraged by the flow of services at the bus port and increased service provision is now being developed.

5.0Links between Transport and Health

5.1 A review of this work has identified three key themes to be considered in more depth during 2012 – 2013:

  • To monitor and review the Air Pollution areas within AberdeenCity boundaries;
  • To confirm the position of the Noise Pollution development [postponed in 2011-2012 by the Scottish Government] and
  • To start work on the effects that driving has on people’s health.

5.2Road safety also plays a significant part in this theme and work has commenced to review road safety strategies in the NE Scotland and confirm what is in place to deliver the strategies in a co-ordinated way.

6.0Access to Healthcare

6.1In 2012 it became clear the service review of the Scottish Ambulance Service would have a significant impact on the public trying to access healthcare services who do not have personal transport and who do not meet the clinical needs of their Patient Transport Service.

6.2In addition the work done by the HTAP Programme Manager with patient groups; disability groups and transport providers identified a real need for the public to be better informed about transport choice in their area to support NHS Grampian’s 2020 Vision in getting clinics back to into local communities.

6.3It was clear the general public were confused about transport availability and provision and it was proposed to set up a Transport to Healthcare Information Centre to support lack of provision.

6.4 Work is on track to have a team in place to support such need by 1 October 2012. However, initially only six pilot areas will be tested ahead of rolling out the service across the region in January 2013.

6.5The team will be based at Maryhill Health Centre in Elgin and act as a personal travel plan service for members of the public with transport related issues.

6.6The team will have no transport available to allocate, but act as a conduit between the public and transport providers across the region to support patients getting to their healthcare appointment by transport that suits their needs.

6.7The team will also collate data relevant to transport provision in the area; identify areas of weakness in relation to transport provision; link to NHS Grampian Patient Focused Booking System and streamline current service provision.

6.8It must be noted that the team will act as an advice centre for current transport provision to improve the patient experience and have no transport allocated to the team for deployment. However, in the longer term a fully integrated transport system would be the main aim of the HTAP.

6.9The workstream also has linked in with the Digital Health workstream. If we can assist in patients being attended to in their own home then this reduces the negative impact from the need to travel to Healthcare facilities.

7.0 Shared Delivery Service.

7.1On 1 April 2012 a shared delivery service in three pilot areas commenced between HTAP partners. These areas included Peterhead; Inverurie; and Stonehaven.

7.2The scheme initially only delivered mail bags between the partner agencies in the pilot schemes and saw NHS Grampian act as the main courier service, with the electric vehicles based at council offices thereafter delivering to all the key partner offices.

7.3The benefits of such a service meant:

  • Partner agencies did not all need to have vehicles running to and from main townships at the same time thus reducing the vehicle numbers on our roads;
  • Low carbon vehicles could then be used for local deliveries thus reducing air and noise pollution;
  • Running and maintenance costs to partners could be reduced; and
  • Service provision maintained.

7.4The sub group is now moving towards what other items can be moved in a shared approach such as stationery; cleaning items and such other sundries.

7.5In addition to the above benefits, savings have been made in relation to courier costs and these may be increased as the second phase develops.

8.0 Key Risks

8.1Risk of patients not being able to attend necessary medical/clinical appointments.

8.2Supporting patients to attend to clinical needs and avoiding hospital admissions(s)

8.3The distribution of funding to support travel may need to be reviewed to better support disadvantaged communities.

9.0Conclusions

9.1The setting up of the Transport to Healthcare Information Centre will see a major step forward to support transport provisions to healthcare services and improved patient care as the NHS Grampian 2020 vision delivers its outcomes.

9.2The potential to include transport to social care services in an integrated approach should also be noted and will form stage two of the project.

9.3As the HTAP enters a challenging period of delivery it should also be noted that one of the main benefits it provides to the area is that of improved service provision not only to the public, but to the partnership agencies.

9.4Develop greater linkages with Digital Health with a view to reducing travel where appropriate.

10.0Recommendations

The NHS Grampian Board is asked to:

10.1 Note the programme of the HTAP Steering Group during 2011 – 2012.

10.2Note the current work in development.

10.3Provide guidance and focus for the workstreams moving forward.

Executive Lead

Alan Gray, Director of Finance

Gerry Donald

Head of Property and Asset Development

21 September 2012

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