Patient Transport

I have had considerable experience of patient transport personally and as a carer, including air ambulance from Geneva.
The following is from my comments to the London Health care review2010.
“Another area not mentioned in this consultation but critical to its success is patient transport. This is also a bureaucratic nightmare – small health trusts setting up small contracts when it needs a London wide and probably national and international response.

Which bits of transport issues are really health responsibilities? Is health taking too much responsibility because of history and institutional structural issues?

Very important improvements in health are possible, but health services are only one part – a critical part – in the jigsaw of someone’s life. Are the institutions really supportive or are they elephants fighting and trampling on the people?”

I recommend that Transport for London and London Ambulance Service set up a working group to review this whole area from whole system principles and to ensure a properly joined up service covering for example, Shopmobility, dial a ride, taxis, patient transport, local community transport services, non emergency services, walking and cycling.

Currently a disabled person may have half a dozen different passes and a myriad of contact points.

There are serious issues at nodes like getting to an airport or railway stations.

My personal experience exposed weaknesses in capabilities of moving walking stretcher issues, and weaknesses in design of patient lounges (if they exist!), that assume wrongly that everyone is able to sit. There were issues about communication.
These types of issues I understand to be symptomatic of not having planned this from a whole system strategic level and contracting out too small units of operation, without standard quality control.

It is time to move away from the current disjointed incrementalism to properly designed and managed person centred systems. There may in fact be significant cost savings by taking a London / South East approach to start and then building up a common service structure.

This is a classic transport issue – moving a very fragile object appropriately from one place to another.

Excellent transport is key to an accessible and prosperous London. Organisations like Accessible Portugal and Design for All Austria are taking forward the whole system approach. There is a wealth of experience in Europe to use – I have a paper on Dutch cycling strategy that is superb for example.

They are using clear principles of equality, ecology and economy to enable superb design solutions. Durability.

I would really love to see a revolution in the design of mobility scooters. Disabled people are believed not to cycle. Porsche already has a concept – the Porsche Pegasus wheelchair, and Toyota has various “i” vehicles.

There would be two legacies from this:

properly managed and sustainable series of Shopmobility disability and personal mobility services across London and

properly designed integral vehicles as part of the set of logistical transport solutions for London, that are designed to be used in people’s homes, on buses, trains and planes, around shops, up mountains!

I want the full integration of all patient and community transport and seriously meaning door to door.
I would want to see standardised design solutions that work as a joined up process from someone getting up in the morning moving around their home, crossing the liminal point at the front door, going down the path, transferring to the next transport node and getting to an accessible destination.

Clive Durdle

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