15/01/2020 Fit for the Future Programme Citizens’ Jury Travel Times Analysis 21 st January 2020 @one_glos 1 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 on whether you go to Cheltenham or Gloucester?) • Summary of the main points 2 1
15/01/2020 Introduction Presenter: Jo Underwood Transformation Programme Director for care in hospital element of Fit for the Future 3 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 4 2
15/01/2020 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 Approximate % of Gloucestershire Approximate adults hospital residents this affects per annum 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 5 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 6 3
15/01/2020 Where do non-car owners tend to live? Green areas = lower car ownership 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 7 Travelling without a car – what are the options for patients? Reason for going to Approximate Assumption for travel Estimated people hospital total per day without a car* who won’t get there affected by car/ambulance Emergency 126 Higher proportion travel by 13 ambulance – assume 10% do not admission Assume 20% Planned admission 21 4 • 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 17 patients per day needing car/ambulance alternatives 8 4
15/01/2020 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 9 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. 10 5
15/01/2020 Illustrating the impact – 6 places Cheltenham Upper Slaughter– Gloucester North Cotswolds Parkend – Forest of Dean Fairford – Cotswolds Stroud 11 How long does it take to drive to the nearest hospital? Source: Google maps, accessed October 2019 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 Forest of Dean and Cotswolds already have long travel times 12 6
15/01/2020 How long does it take to travel to the nearest hospital? Source: Google maps, accessed October 2019 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 Forest of Dean and Cotswolds already have long travel times 13 How long does it take to travel to the nearest hospital? Source: Google maps, accessed December 2019 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) Poor public transport options for North Cotswolds currently 14 7
15/01/2020 How do these times change for travel from the 6 places to the furthest hospital? @one_glos 15 How long does it take to drive to the furthest hospital? Source: Google maps, accessed December 2019 6 Places Drive time to Furthest Drive time to Increased nearest hospital hospital furthest hospital journey time for 9am by 9am Cheltenham 6 minutes Gloucester 40 minutes 34 minutes Fairford (Cots) 40 minutes Gloucester 55 minutes 15 minutes Upper Slaughter 33 minutes Gloucester 1 hour 27 minutes (N. Cots) 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 16 8
15/01/2020 How long does it take to travel to the furthest hospital? Source: Google maps, accessed December 2019 6 Places Travel time to Furthest Travel time to Increased nearest hospital hospital furthest hospital journey time (9am) (9am) Cheltenham 16 minutes Gloucester 44 minutes 28 minutes Fairford (Cots) 1 hour 10 Gloucester 1h 39 mins 29 minutes minutes Upper Slaughter 1 hour 43 Gloucester 2h 24 mins 41 minutes minutes (N. Cots) Stroud 35 minutes Cheltenham 56 minutes 21 minutes Gloucester 10 minutes Cheltenham 56 minutes 46 minutes Parkend (FoD) 1 hour 18 Cheltenham 2h 1 min 43 minutes minutes Greatest time increase for Gloucester City, Forest of Dean and N. Cots 17 How long does it take to travel to the furthest hospital? Source: Google maps, accessed December 2019 6 Places Travel time to Furthest Travel time to Increased nearest hospital hospital furthest hospital journey time (12pm) (12pm) Cheltenham 16 minutes Gloucester 37 minutes 21 minutes Fairford (Cots) 1 hour 10 minutes Gloucester 1 hour 35 mins 25 minutes Upper Slaughter No buses Gloucester No buses (N. Cots) Stroud 49 minutes (bus) Cheltenham 1 hour (train) 0 mins (bus) 26 minutes (train) 49 mins (bus) 23 mins (train) Gloucester 10 minutes Cheltenham 43 mins 33 mins Parkend (FoD) 1 hour 29 minutes Cheltenham 2 hours 5 mins 36 mins (Bus + Train) Greatest time increase for N. Cots, followed by Forest of Dean and Gloucester City 18 9
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