Fit for the Future Programme Citizens Jury Travel Times Analysis - - PDF document

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@one_glos

Fit for the Future Programme Citizens’ Jury

Travel Times Analysis 21st January 2020

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Contents

• Introduction to me and what I will be presenting
• Why are travel times relevant to the jury questions?
• What level of car ownership exists in households across Gloucestershire?
• Where do non-car owners tend to live?
• How long will it take to get to the nearest hospital from 6 places in the county?

– By car? – By public transport?

• How do these times change for travel from the 6 places to the furthest hospital?
• Main conclusions for travel times (e.g. where does it make a significant difference
• n whether you go to Cheltenham or Gloucester?)
• Summary of the main points

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Introduction Presenter: Jo Underwood Transformation Programme Director for care in hospital element

• f Fit for the Future

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Why are travel times relevant?

• Public concern about increased difficulty getting to hospitals –

both patients and carers/relatives

• Public concern about safe travel times in an emergency

(=ambulance Trust presentation)

• Legal duty to understand how people might be impacted, and

to take into account in our planning

• Legal duty to understand if impacts would worsen health

inequalities, and to take into account in our planning

• Planning purposes – impact on roads and public transport

routes, impact on the environment

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Why are travel times relevant?

Reminder of scope:  Travelling to hospital for day surgery or overnight admission  Travelling to hospital in an urgent/emergency situation  Outpatient appointments, maternity and children's services, oncology appointments (chemo/radiotherapy)

Reason for going to hospital Approximate % of Gloucestershire residents this affects per annum Approximate adults per day affected* Emergency admission 7% 126 Planned admission 1.2% 21

*These figures are based on services described in the Public Engagement and may increase when details of possible options are developed. 2018/19 activity.

147 patients, plus relatives/carers potentially affected per day 6

Car ownership in Gloucestershire

2011 National Census data:

• 83% of households in Gloucestershire have a car
• 17% of households in Gloucestershire do not have a car (compared with

26% in England)

• In some areas the rate of households with no car is much higher:

– All Saints and Oakley in Cheltenham: 31% – Barton and Tredworth in Gloucester: 40%

• Areas with low car ownership such as those above may be closer to

health facilities such as GP practices and hospitals

• Travel impact analysis will also look at current and potential parking

issues

More than 80% of households have access to a car to travel to hospital

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Where do non-car owners tend to live?

Urban areas: Cheltenham and Gloucester Rural Towns/large villages: Forest of Dean: Cinderford, Lydney, Coleford South Cotswolds: Stroud, Dursley, Stonehouse, Nympsfield, Cirencester North Cotswolds: Moreton-in- Marsh, Stow-on-the-Wold, Bourton-on-the-Water Green areas = lower car

• wnership

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Travelling without a car – what are the options for patients?

• Ambulance (for emergencies)
• Hospital transport (for eligible patients with scheduled dates)
• Community transport
• Public transport

*NB. We do not routinely collect data on how people travel to hospital

Reason for going to hospital Approximate total per day affected Assumption for travel without a car* Estimated people who won’t get there by car/ambulance Emergency admission 126

Higher proportion travel by ambulance – assume 10% do not

13 Planned admission 21

Assume 20%

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17 patients per day needing car/ambulance alternatives

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How will we assess the impact?

1. Develop specific change proposals 2. Use a sample year (e.g. 2018/19) and identify all patients who would have been affected by the proposed changes 3. Model the actual impact for all patients affected, if the change had been implemented at that time 4. Estimate the impact on carers/relatives and other visitors 5. Project the impact forward to account for variations in the sample year (e.g. more patients, new houses) 6. Evaluate the impact and consider whether it is proportionate and/or we can offset it by making other changes. 7. Evaluation will include impact on inequalities, parking and environmental sustainability

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How will we assess the impact?

For now, we have identified 6 places in the county. These were selected by Malcolm Oswald to represent places in Gloucestershire’s geography, both urban and rural. The following slides consider how travel to the furthest hospital might impact residents. Central postcodes are used and analysis is purely indicative.

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Illustrating the impact – 6 places

Parkend – Forest

• f Dean

Upper Slaughter– North Cotswolds Fairford – Cotswolds

Gloucester

Stroud Cheltenham

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How long does it take to drive to the nearest hospital?

6 Places Nearest hospital Drive time to reach nearest hospital by 9am Cheltenham Cheltenham General 6 minutes Fairford (Cotswolds) Cheltenham General 40 minutes Upper Slaughter (N. Cots) Cheltenham General 33 minutes Stroud Gloucestershire Royal 29 minutes Gloucester Gloucestershire Royal 6 minutes Parkend (Forest of Dean) Gloucestershire Royal 49 minutes Source: Google maps, accessed October 2019

Forest of Dean and Cotswolds already have long travel times

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How long does it take to travel to the nearest hospital?

6 Places Nearest hospital Travel time to reach nearest hospital by 9am Cheltenham Cheltenham General 16 minutes Fairford (Cotswolds) Cheltenham General 1 hour 10 minutes Upper Slaughter (N. Cots) Cheltenham General 1 hour 43 minutes Stroud Gloucestershire Royal 35 minutes Gloucester Gloucestershire Royal 10 minutes Parkend (Forest of Dean) Gloucestershire Royal 1 hour 18 minutes Source: Google maps, accessed October 2019

Forest of Dean and Cotswolds already have long travel times 14

How long does it take to travel to the nearest hospital?

6 Places Nearest hospital Travel time to reach nearest hospital by 12pm Friday Cheltenham

Cheltenham General

16 minutes Fairford (Cotswolds)

Cheltenham General

1 hour 10 minutes

(leave 9.50am, 2 buses, arrive 11am)

Upper Slaughter (N. Cots)

Cheltenham General

No buses Stroud

Gloucestershire Royal

49 minutes (bus) or 26 minutes (train) Gloucester

Gloucestershire Royal

10 minutes Parkend (Forest of Dean)

Gloucestershire Royal

1 hour 29 minutes

(leave 9.53am, 1 bus, 1 train, arrive 11.22am)

Source: Google maps, accessed December 2019

Poor public transport options for North Cotswolds currently

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@one_glos

How do these times change for travel from the 6 places to the furthest hospital?

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How long does it take to drive to the furthest hospital?

Source: Google maps, accessed December 2019 6 Places Drive time to nearest hospital for 9am Furthest hospital Drive time to furthest hospital by 9am Increased journey time Cheltenham 6 minutes Gloucester 40 minutes 34 minutes Fairford (Cots) 40 minutes Gloucester 55 minutes 15 minutes Upper Slaughter (N. Cots) 33 minutes Gloucester 1 hour 27 minutes Stroud 29 minutes Cheltenham 40 minutes 11 minutes Gloucester 6 minutes Cheltenham 55 minutes 49 minutes Parkend (FoD) 49 minutes Cheltenham 1h 25 minutes 36 minutes

Greatest time increase for Gloucester residents, followed by Forest of Dean

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How long does it take to travel to the furthest hospital?

Source: Google maps, accessed December 2019 6 Places Travel time to nearest hospital (9am) Furthest hospital Travel time to furthest hospital (9am) Increased journey time Cheltenham 16 minutes Gloucester 44 minutes 28 minutes Fairford (Cots) 1 hour 10 minutes Gloucester 1h 39 mins 29 minutes Upper Slaughter (N. Cots) 1 hour 43 minutes Gloucester 2h 24 mins 41 minutes Stroud 35 minutes Cheltenham 56 minutes 21 minutes Gloucester 10 minutes Cheltenham 56 minutes 46 minutes Parkend (FoD) 1 hour 18 minutes Cheltenham 2h 1 min 43 minutes

Greatest time increase for Gloucester City, Forest of Dean and N. Cots 18

How long does it take to travel to the furthest hospital?

Source: Google maps, accessed December 2019 6 Places Travel time to nearest hospital (12pm) Furthest hospital Travel time to furthest hospital (12pm) Increased journey time Cheltenham 16 minutes Gloucester 37 minutes 21 minutes Fairford (Cots) 1 hour 10 minutes Gloucester 1 hour 35 mins 25 minutes Upper Slaughter (N. Cots) No buses Gloucester No buses Stroud 49 minutes (bus) 26 minutes (train) Cheltenham 1 hour (train) 49 mins (bus) 0 mins (bus) 23 mins (train) Gloucester 10 minutes Cheltenham 43 mins 33 mins Parkend (FoD) 1 hour 29 minutes Cheltenham 2 hours 5 mins (Bus + Train) 36 mins

Greatest time increase for N. Cots, followed by Forest of Dean and Gloucester City

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The ’99’ Service

• Public transport analysis does not include the ’99’ which

shuttles between Cheltenham General and Gloucester Royal

• The public can use this as well as staff
• It operates Monday to Friday from 6.20am (first bus) to 7pm

(last bus), every half an hour

• Journey time – 30 minutes
• Some public transport times might be shorter if you travel

your nearest hospital then change to the 99

• There are currently no overcrowding issues on the 99 service

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Illustrating the impact – 6 places

Parkend – Forest

• f Dean

Upper Slaughter– North Cotswolds Fairford – Cotswolds

Greater potential increased journey time for people in Gloucester City,

• N. Cotswolds and the Forest of Dean

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Main conclusions

• 147 patients a day might be impacted, of which 17 a day might

need an alternative mode of transport to car/ambulance

• In addition, patient’s relatives, carers and friends will be impacted
• Some patients will be eligible for community/patient transport
• Forest of Dean and Cotswolds experience longest travel times for

existing services

• In some areas, e.g. North Cotswolds, there are no public transport
• ptions during the daytime for existing services
• If any services were moved to the more distant hospital, residents
• f the City of Gloucester, Forest of Dean and North Cotswolds

would experience a greater adverse impact

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@one_glos

Appendices

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What’s important to know about Image-guided interventional surgery?

• The majority of patients are treated in Cheltenham General

(interventional cardiology, vascular and radiology)

• This service consists of both emergency and planned care:

Reason for going to hospital Approximate % of Gloucestershire residents this affects per annum Approximate adults per day affected Emergency admission (IGIS) 0.4% 8* Planned admission (IGIS) 0.7% 17 *These patients are included in the 126 daily emergency admissions

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What’s important to know about general surgery?

• Services are currently offered on both sites, with the

exception of planned Upper Gastrointestinal Surgery which is centralised on the Gloucestershire Royal site

• This service consists of both emergency and planned care:

Reason for going to hospital Approximate % of Gloucestershire residents this affects per annum Approximate adults per day affected Emergency admission 0.9% 16* Planned admission 0.4% 11 *These patients are included in the 126 daily emergency admissions

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What’s important to know about emergency and acute medicine?

• Services are currently offered on both sites
• This service consists entirely of emergency care:

Reason for going to hospital Approximate % of Gloucestershire residents this affects per annum Approximate adults per day affected Emergency admission 7% 126* *This includes the 8 emergency image-guided surgery and 16 emergency general surgery patients per day