Transport to health

A vital link for equitable healthcare access

For many across Scotland, the National Health Service is a source of national pride – offering care from cradle to grave, regardless of individual circumstances. Yet, in practice, access to healthcare is not always equal. People living in rural communities, deprived areas, or those without reliable or affordable transport options often face serious barriers in reaching essential services. For too many, a simple hospital visit can mean unaffordable taxi fares, exhausting journeys with multiple transfers, or worse – missed appointments altogether.

At SEStran, we recognise that equitable access to healthcare doesn’t start at the clinic door. It begins with the journey. When people cannot physically reach their GP, hospital, or specialist appointment, health outcomes decline, and NHS resources are wasted. Missed appointments cost the system and compromise individual wellbeing.

Our commitment to improving transport to health stems from our recognition of the importance of these challenges. The journey began over seven years ago when one of our team members, working with the Community Transport Association, saw first hand how local transport operators were already improving health outcomes despite being chronically underfunded. Since then, we’ve seen the impact of accessible, sustainable transport on public health grow clearer and more urgent.

To help us better understand transport to health issues, we’ve carried out a literature review to provide an overview of the evidence and policy context in the SEStran region. The review will feed into the intended development of a SEStran Transport to Health Strategy Case for Change in 2025/26.

Read our Transport to Health Literature Review.

Building collaboration across sectors

The connection between transport and healthcare is now formally recognised in Scottish policy. The MACS Report: Transport to Health and Social Care (2019), along with the Transport (Scotland) Act 2019, placed new responsibilities on health boards and regional transport partnerships to work together to address transport to health challenges. This was further reinforced by the draft Transport to Health Delivery Plan, developed jointly by the Primary Health Directorate and Transport Scotland, which sets out a framework for collaborative action.

In response, we have been leading the way in developing meaningful partnerships across sectors. We’ve launched a dedicated Transport to Health Learning Network, bringing together all four regional health boards – Forth Valley, Fife, Lothian and Borders – alongside the Scottish Ambulance Service and NHS Scotland Assure. Meeting every 6–8 weeks, this group shares insights, explores new ideas, and hears from external voices, all with the goal of delivering practical solutions.

Most recently, we co-hosted a landmark event with Public Health Scotland, welcoming nearly 40 stakeholders across health and transport. This collaborative space gave us renewed optimism – demonstrating that the challenges, while complex, are far from insurmountable when we work together.

Looking ahead: a strategy for change

In the year ahead, we are committed to building on this momentum. Our business plan includes a full review of existing literature and practice on transport to health. This research will inform the development of a dedicated transport to health strategy, designed to reduce barriers, improve health outcomes, and ensure access to care is not determined by postcode or income.