The Community Transport Association (CTA) welcomes the “Health and wellbeing in rural areas” report published this week, written by the Local Government Association and Public Health England. It shares a range of initiatives describing how health and care interventions have been designed to target those most in need in rural communities. You can find the report here.
The CTA is national charity that leads and supports thousands of other local charities and community groups across the UK that all provide transport services that fulfil a social purpose and community benefit. Community transport is about providing flexible and accessible community-led solutions in response to unmet local transport needs, and often represents the only means of transport for many vulnerable and isolated people.
Many of our members, through demand-responsive services and community buses will contribute to supporting health and well-being of local rural economies through connecting people to businesses and vital public services, carrying passengers between rural locations and providing employment opportunities in rural areas. As such we believe there is potential for community transport to address some of the issues and questions flagged in the report.
Although its not about transport specifically a consistent narrative throughout the document is the impact of transport-related disadvantage, which is more widespread in rural areas than might be commonly perceived. We know from our members’ stories there is a growing group of rural residents who cannot use a private car, for reasons of accessibility and affordability, and don’t have a local bus service available because of withdrawal of services that aren’t commercially viable. This is not just about older people and disabled people. The cost of getting on the road is putting off many younger people from driving, which might influence their decision to live and work in urban areas.
This report champions thinking beyond the traditional ‘medical model’ of health and taking a broader view of interventions to foster better health outcomes, which speaks directly to the work of our members who are both helping people get to appointments in medical setting and helping them stay mentally and physically healthy more generally.
Supporting access to health settings
The involvement of charities providing transport has been a long-standing benefit to the health service and patients. CTA’s own “State of the Sector” research has consistently shown that journeys into health settings are the second largest purpose given for using community transport.
Much of this however will be off the radar of health service commissioners, evidenced by the disconnection between the number of charities helping people to reach health settings and those that are remunerated for the work by those commissioners. CTA’s survey in 2014 found 74 per cent of operators in England worked in health settings but only 24 per cent were remunerated by any local NHS body.
CTA in partnership with the Urban Transport Group will soon be releasing its own report soon which shows how the quality and efficiency of health related transport could be markedly improved through more innovative models of commissioning delivery which build cross-sector partnerships and networks of provision where people are transported in a vehicle and service most appropriate to their own circumstances and needs, with a prominent role for the community sector. Many of the gains to be made from this approach will be felt in rural areas and the examples of good practice we share will focus on predominantly rural counties.
Working beyond the ‘medical model’
Community transport enables people to feel in control of their lives and stay connected to the people and places that are important to them, which has massive benefits for their health and well-being. Through trips to the shops, leisure activities and even (in moderation) the pub they help people to stay independent and reduce the risk of people feeling isolated. Whilst this has a massive benefit for those people it also reduces the likelihood that they will need more costly publicly-funded care which, in the context of rural residents, could be some distance from their home adding further transport disadvantage.
We also know that access to private and public transport is a common labour market barrier for many young people in rural areas. Community transport operators help them through several initiatives like Wheels to Work schemes which help them access to work, training or college through lending them a scooter or bike and providing safety training and equipment.
Have a read and see if anything leaps out at you that would support your conversations with local authorities about problems you can help solve. Don’t forgot to let CTA know what you think of the report and any news of similar initiatives in your local areas.
Look out for our report soon to be published in partnership with the Urban Transport Group, which looks at improving commissioning and provision of health transport in rural and urban settings.