Adrian Davis

Making Travel Plans Work: Evidence from the NHS (in England): 

Making Travel Plans Work: Evidence from the NHS (in England) Dr Adrian Davis Transport and Health Consultant adrian.davis@phonecoop.coop 0117 9245 603

How is the patient? : 

How is the patient?  The majority of NHS Trusts in England have yet to develop travel plans Planning requirement - key to NHS action Some pioneers Many chronic contemplators Modest evidence of support + promotion for travel planning within NHS – low priority vis-à-vis health care and waiting lists Re-organisation 2006-07 ‘Commissioning a patient-led NHS’

Main Diagnosis: 

Main Diagnosis History of laissez-faire approach/free for all Lack of attention to NHS ‘lifestyle’ and corporate citizenship role Inefficient and inequitable use of scarce resources Trust failing to meet NHS policy commitments and so to promote health through transport Yet signs that travel plan work is being assimilated – partly due to planning controls

Examples of Good Practice at Large Acute NHS Sites: 

Examples of Good Practice at Large Acute NHS Sites Oxford Radcliffe Hospitals Nottingham City Hospital Royal Devon and Exeter Hospital

Why do we need a Travel Plan ?: 

Why do we need a Travel Plan ? Because we ought to Health – NHS leading by example Culture change - pressure groups Environment - congestion, emissions Because we have to National Policy - PPG13 & Transport Policy NHS - Estatecode / Estate Strategy Planning permission for development

Why did we need a Travel Plan?: 

Why did we need a Travel Plan? Plan to expand site (+ 1400 staff; 250 beds; 20,000 inpatients; 150,000 outpatients; 50,000 other treatment episodes) 2400 cars chasing 2000 spaces & lack of funds to build permitted new ones (JR Hospital) Everyone says we have a problem…oh and the simple answer is a big new multi-storey car park Without a Travel Plan we would not get planning permission for hospital relocation & development

Travel Plan: strategic objectives: 

Travel Plan: strategic objectives Manage car parking and commuting Improve access for alternative modes Develop and promote alternatives Satisfy Planning Authority - maintain healthcare services with limit of 1680 staff spaces (JRH) & prevent spill-over Parking on-site only for those that need it….. Attractive alternatives to car for the others….

Measures implemented: 

Measures implemented Travel Zone based on level of bus services Better buses & access Permits based on need not status: in theory – End to free unrestricted parking Annual renewal @ £60 parking permit (£90 @ £30K +) Subsidised bus tickets More for Cyclists & Peds. Information and publicity Car share system

What have been the benefits?: 

What have been the benefits? Modal shift 2000 2002 2005 Single occupant car: 58%  54%  52% Car share / passenger: 8%  9%  9% Bus / P&R: 8%  10%  12% Walk: 13%  14%  14% Cycle: 12%  12%  13% Trust granted planning permissions

Underlying Factors for success: 

Underlying Factors for success Widespread acceptance of a problem Recognition that it means life-style shift External force (others are really to blame) Agreement that it’s ‘least worst’ way forward Real alternatives and funding for them Flexibility, adaptability (without giving in) Set an example (do what you preach)

Making it work – information & communication: 

Making it work – information & communication Travel Surveys Management / staff-side working party Staff newsletter, payslips ‘On The Move’ transport news Open meetings (road shows) Email, intranet  don’t be dogmatic or crusading

What has worked… or will: 

What has worked… or will More buses, bigger ticket discounts + tighter parking restrictions + pool cars and bikes Realistic Parking charge (according to income) Parking restrictions + existing buses + discounted tickets + inter-site vehicles Bonus (parking cash out) for choosing alternatives (C £200 p.a.) Transport information, marketing, publicity etc. Cycle routes (safe / traffic free) + secure parking / storage Assisted cycle purchase Car sharing (unless there’s a financial incentive + priority parking) Showers & changing (unless local to work station + secure lockers) BUG, cyclists breakfasts etc unless part of continuing campaign

Nottingham City Hospital: 

Nottingham City Hospital 1997 – 72% by car (alone) 2000 – 55% 1997 – 2% car (share) 2000 – 11% 1997 – 11% by bus 2000 – 19% 1993 – 13% walk/cycle 2000 – 13% Ring fencing of car parking charges Communication programme with staff Investment in cycle infrastructure Car sharing scheme Improved public transport provision and information (inc on site buses) Park and Ride

Slide14: 

Installed additional cycle lockers (now 120) Introduction of Link 4 Free internal bus service - 9 stop points on site: services the 2 major roads on edge of site Introduction of Medilink free bus service - linking with QMC university hospital £19,000 showering facilities upgrade Purchase of LED self illuminating speed signs Introduction of Bicycle Leasing Scheme Introduction of Car Sharing Scheme 4 on site touch screen travel information kiosks Subsidised travel tickets for staff (for use on all buses, trains and tram)

Slide15: 

1996 1800 parking permit holders Concentrating and expanding service onto single site 1997 salary-related parking permits excluding most day-time staff living within city boundary Ring-fenced parking revenue Discounted bus fares and on-site service by 2000 Dedicated Park and Ride Cycle infrastructure improvements 2003 EU Optimum project funding for travel bureau and on-line travel information www.optimum2.org/

Objections to P + R: 

Objections to P + R Staff will leave and work somewhere where they can park We need our cars on site so that we have somewhere to go in lunch hour We will get wet walking to and from the bus – nowhere to put dripping coats “I bet managers will never use it” Cars will be vandalised In the wrong place Buses will be too infrequent, overcrowded, late, take too long, drivers will be rude etc…

Outcomes: 

Outcomes Reduction by 500 in permits issued to staff since 1997/98 - down to 1300 Gradual increase in P+R uptake Since P+R, pay and display car parks always have some capacity Staff parking still over-subscribed More informal car share Car use down from 72% in 1996 to 60% in 2004 Service bus stable at 7% but further 7% now P+R

Travel Plan key elements: 

Travel Plan key elements Financial incentives Financial disincentives Parking restraint Travel Plan Coordinator Emphasis on widening travel plan choice (accessibility) Clear communication strategy (widely distributed and transparent) Board level engagement + working group + travel plan coordinator (not a junior)

Travel Plan Costs to Employers: 

Travel Plan Costs to Employers Example of indicative costs Travel Coordinator Salary + on costs £40K Surveys £5K Publicity and promotions £5-15K Incentives to staff for 100 staff £50K Average annual running cost per employee £47 Annual running cost of surface-level car parking space £300-£500 Source: Department for Transport, 2002 Making Travel Plans Work