Getting to healthcare appointments is more challenging for remote and rural communities with considerable distances to access primary and secondary healthcare services. This is particularly challenging for island populations. Transport is a massive issue. Limited public or community transport, time / cost to travel by car, reliable and affordable access to ferries and planes, inclement weather are all significant factors. Distance from services continues to correlate with use of services and a form of 'inverse care law' operates but with distance from services rather than deprivation being the driver. Travelling for a single specialist intervention maybe understandable but when regular follow-up care or more regular treatment is required this can be particularly challenging. Whilst the Highlands and Islands Patient Travel Scheme (HIPTS) is available it has limitations e.g. HIPTS does not support someone travelling with you. Family support when breaking bad news or during treatment is so important and the lack of it informs patients’ decisions. Recent ferry and air travel disruptions (Calmac, Northfleet and Logan Air) have led to healthcare appointments being cancelled and missed. These challenges are compounded by the volume of visitors (to islands) in the summer months. The cost of living crisis has also contributed to missed appointments. Travel is an important factor in patients deciding to access services. How travel barriers impact on health outcomes and inequalities is an areas requiring further consideration. The ability to transfer sick patients for care in mainland specialist centres is considerably restricted by the availability of the mainland-based aircraft and support team (especially for mental health) as well as the time of day and weather.
It is really hard for people with conditions like Parkinson's that impact mobility to make the journey for specialist care. We know that some people opt out as a result. And Scottish Ambulance Service patient transport services only travel to large acute hospitals, so even where more local clinics are offered, patients can't always get there. The lack of HIPTS funding for someone to accompany the person they support to the mainland is also an issue that's been raised with us.
I agree because it is a challenge for many people to make it from our area to Inverness which is the main centre for healthcare. On our lochside someone can travel 9 miles to reach the only 6-day a week bus service. It departs the nearest stop at 8.10 am and reaches Inverness at approximately 10.20 or 10.30 am. Then there's another trip to reach Raigmore Hospital. The bus home departs at 1710 hours and reaches our nearest stop at approximately 1940 hours. There is then the onward journey. It would be a good thing if the hospital could be aware of postcodes when giving appointments. The alternative is to book the hospital car from Gairloch Community Car Scheme. There is so much demand on this scheme, it is not always possible to use.
This content is created by the open source Your Priorities citizen engagement platform designed by the non profit Citizens Foundation