Patient groups welcome additional NHS support to cover cost of hospital travel

Every patient who needs kidney dialysis will benefit from free transport to and from vital hospital appointments, the NHS in England announced today.

New rules will also come into place to make it simpler for other patients to get free transport, including those with long term conditions and mobility problems.

After a full public consultation period, the updated criteria would mean all 21,000 kidney dialysis patients will be eligible for free transport to hospital appointments.

The new offer have been developed in partnership with patient groups and will be used and funded by local health systems when arranging transport services for people in their areas.

A patient or their family will be offered appropriate transport or be able to claim a refund of reasonable travel, when they are referred to hospital or other NHS premises for specialist NHS treatment or diagnostic tests.

New guidance follows an extensive review commissioned by former NHS chief executive Simon Stevens into non-emergency patient transport services, which help people who need regular hospital care but who can’t travel by themselves, to attend important hospital appointments. It includes those who have:

• a medical need for transport, for example because they require oxygen while travelling which needs specialised equipment or support
• a cognitive or sensory impairment that requiring the support of patient transport staff or trained driver
• no other suitable transport option given their wider mobility or medical needs, and treatment or discharge would be missed or severely delayed

Around 11 million patient transport journeys are taken every year in England, covering a combined 140 million miles – roughly the distance of travelling six times around the earth– and accounting for around a fifth of direct NHS transport emissions.

As well as improving the experience of patients who need to make these journeys, the plan will introduce requirements to reduce their environmental cost, supporting the health service’s world-leading ambition to achieve net zero carbon emissions by 2045.

The NHS has worked extensively with patient groups including Age UK, Healthwatch England and Kidney Care UK as part of the review to ensure that the needs of patients have been at the forefront of the proposals.

Professor Stephen Powis, the NHS’s national medical director, said: “The NHS is easing the health and financial costs of long-term conditions.

“Digital, video and phone consultations all have their part to play, but each year patients still need millions of convenient face-to-face appointments with hospitals and GPs. That’s why these new arrangements – developed in partnership with patients’ groups – will make it easier to get convenient NHS care, while easing the financial burden of long-term health conditions and helping reduce the health service’s carbon footprint.”

Imelda Redmond CBE, National Director, Healthwatch England, said: “It’s good to see that NHS England have listened to the experiences of thousands of people with this review and committed to significant improvements to better support them in getting to and from their hospital appointments.

“With the key challenge people told us about being the vague eligibility criteria for travel support, we hope the changes to set more consistent measures that determine entitlement will be particularly welcomed, along with improvements to patient communication and access to additional financial or information support outside of the service.

“People requiring non-emergency hospital transport are often older, disabled or living with a long-term condition, such as patients needing renal dialysis. For them, these services are incredibly important in ensuring that appointments aren’t missed, or that transport issues don’t exacerbate the physical and emotional stress of travelling and receiving medical treatment.

“We look forward to supporting NHSE in implementing the changes and ensuring they work for everyone who relies on hospital transport.”

Fiona Loud, Policy Director of Kidney Care UK, said: “As a member of the NEPTS Review Expert Advisory Group, we are delighted to welcome the universal transport support commitment for all of the 21,000 kidney patients on dialysis, who receive their treatment in hospitals or satellite units.

“For far too long we have heard about the variable and often difficult experiences many individuals have when travelling for their life-sustaining treatment, with transport regularly at the bottom of Kidney Care UK’s annual survey of patient experience.

“These new proposals show a real determination to improve patient care. National data, including waiting times, will be monitored and published, providing a real opportunity to improve the day to day experience for people who have to make over 300 journeys a year to get to and from their life-maintaining treatments.”

Caroline Abrahams, Charity Director at Age UK, said: “Older people have been telling us for some time about how difficult it can be for them to get to and from hospital for clinic appointments and the like, so we were delighted to take part in this NHS England review.

“Non-emergency patient transport has been something of a Cinderella service for far too long, because when it works well it can make the world of difference to an older person who may otherwise find it unbelievably stressful and tiring accessing hospital services when they need them.

“It’s great that NHS England is committing to review the criteria which determine entitlement to hospital transport, and to improving the overall quality of the service too. The proof of the pudding will be in the eating, but we really do hope that the outcomes of this review will make an appreciable difference to many older people, up and down the land.”

“We would also like to thank NHS England for sticking with the review and seeing it through to a successful conclusion, when they have had so much else to focus on over the last fifteen months.”

Among the specific measures announced include:

• A new universal transport support offer for patients travelling to and from renal dialysis.
• Overhauling the Healthcare Travel Costs Scheme to make it easier for people on a low income to claim back journey costs.
• A commitment to 100% zero emissions journeys by 2035, except for ambulance journeys and volunteers driving their own cars.

The review also sets out a path to making greater use of technology to better communicate with patients and coordinate journeys, expanding the role of community transport, and improving accountability, procurement and contracting.

Subject to Parliamentary approval of reforms to the NHS announced by the Government this week, the review also confirms that Integrated Care Systems will be responsible for commissioning and overseeing the quality of patient transport across their areas from April 2022.

Patient transport emits up to 65 kilotonnes of carbon dioxide a year, around 20% of direct NHS transport emissions, and costs the NHS around £460 million each year, around the same amount as radiotherapy.