Making the journey to healthcare fairer

We recently carried out a public consultation to understand the barriers and challenges for people travelling to health care appointments in our region. In this blog, Sandra Lavergne tells us what we learned through this consultation.

Making the journey to healthcare fairer: what we learned and what happens next 

Reaching a healthcare appointment should be simple. For many people across South East Scotland, it is anything but. Long bus journeys, indirect routes, unreliable services and the stress of coordinating travel all add up. And these challenges are often felt most by people who do not drive, people living in rural areas and those with mobility or health conditions. 

That is why, working with NHS Boards across the Borders, Fife, Forth Valley and Lothian, we carried out a major public consultation in late 2025. We wanted to build a clear, region wide picture of how people currently travel to healthcare appointments, the barriers they face and what needs to change. This work now sits at the heart of our Transport to Health Case for Change and our ongoing work in regional transport to health delivery. 

Why we asked 

Regional Transport Partnerships need to work closely with Health Boards to improve access to healthcare. Before setting objectives or designing solutions, we needed to understand the real experiences of people travelling to appointments. More than 1,500 people across all eight council areas in our region took part, representing a mix of rural, suburban and urban areas. Respondents included many older adults, unpaid carers and people living with long term health conditions. These groups are more likely to face barriers getting to and from health care appointments and rely on public or community transport. 

What people told us 

A consistent picture emerged across the region. 

Getting to primary care, such as GP surgeries and pharmacies, tends to be relatively manageable because these services are located close to communities. But if people need to travel to hospital or specialist care, things get significantly harder. 

Several findings stood out: 

• Public transport journeys to hospital are often two to four times longer than the equivalent car trip. Journeys regularly involve multiple changes, extended waiting and long walks between stops. 

• One third of respondents told us they had missed or delayed an appointment because of transport. In NHS Fife the figure rises to over 40 percent. 

• People without access to a car face the greatest challenges. They are more likely to live in areas with infrequent services and longer travel times. 

• Accessibility barriers are common. These include long distances to bus stops, difficulties boarding vehicles, uneven pavements and limited availability of wheelchair accessible taxis. 

• Parking pressures add stress for those who do drive. Many people told us they aim to arrive early because finding a space is so unpredictable. 

• Cost is a barrier for some people, especially those who rely on taxis for part of their journey or who need to travel long distances for specialist care. 

• Information is not always easy to find. Many people rely on Google Maps, personal knowledge or patient letters because transport information is not consistently provided in one place. 

Beyond these practical issues, people described the emotional impact. Anxiety about missing appointments, fatigue caused by long journeys and the pressure on unpaid carers came through strongly. Missed outpatient appointments are estimated to cost the NHS millions each year in our region. More importantly, they affect people’s health and wellbeing. 

What happens next 

The consultation findings are helping us to shape the next stage of work. We are now developing objectives that focus on reducing journey times and complexity, improving access for people without a car, addressing accessibility barriers and strengthening community and demand responsive transport. These objectives will guide the options that we explore with our programme board and stakeholders. 

We will also look at opportunities such as better alignment between appointment times and public transport, and clearer travel information. Improving coordination across NHS Boards, local authorities, community transport operators and bus and rail providers will be essential. 

Thank you 

If you took part in our consultation – thank you. Your insight is vital. The development of our Regional Transport to Health Strategy will continue throughout 2026, and we will share updates as the work progresses.