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Topic on a Page - Access to Transport

Data Sources:

Access to Transport Supplementary Data

DEFRA:

Rural transport, travel and accessibility statistics

Supporting Information:

HM Government:

Accessible transport

Transport if you're disabled

It's my choice: Safer mobility for an ageing population

NHS England:

NHS England: help with health costs

NHS Evidence:

Access to Transport

Public Health England (PHE):

Local action on health inequalities: Improving access to green spaces

Working Together to Promote Active Travel: A briefing for local authorities

Local Government Association (LGA):

Dementia Friendly Communities: Advice for Councils

Health and Wellbeing and Rural Areas

Alzheimer's Society:

Driving and dementia

Lincolnshire County Council:

Call Connect

Community Transport

Public Transport

United Lincolnshire Hospitals NHS Trust:

Getting to your appointment

Miscellaneous:

ADEPT - Shaping Places for Thriving Communities - Strategic Plan 2017-2020 and beyond

National Infrastructure Assessment July 2018

King's Fund - Improving the public's health

UCL - Transport and Poverty: A review of the evidence

TravelWest essential evidence

Motability

WHO: Making the (Transport, Health and Environment) Link

Linked Topics:

New Topic (Oct-18)

JSNA Topic: Access to Transport

Background

Whether or not people can travel with ease is a fundamental determinant of health and wellbeing as it enables access to services and social participation. A good motorised transport network is required to ensure all of Lincolnshire's residents can easily access employment, education, shops, social support networks, health services and open spaces.

However this topic will focus on factors that may mean an individual, household, or community are particularly vulnerable to barriers associated with accessing and using a car, bus or train, often described as ‘transport disadvantage’, which include:

  • Social isolation
  • Living in rural communities
  • Car dependency and driving cessation
  • Passenger transport knowledge and skills

There are many organisations that commission and provide transport in Lincolnshire, but currently there is little co-ordination between these organisations. Efforts in trying to resolve duplication of services have made limited progress. The impact on transport is often given little consideration when making strategic commissioning decisions.

Public sector organisations in Lincolnshire spend around £41.5 million pounds a year on transport.

This JSNA topic was commissioned in order to:

  • summarise the current situation regarding access to cars and public transport in Lincolnshire
  • improve understanding of existing transport provision in Lincolnshire
  • identify potential improvements
  • ensure that potential transport impact is fully considered in future commissioning decisions

Whilst active travel options (predominantly walking and cycling) support good health outcomes, these are outside the scope of this JSNA topic and instead form part of the Physical Activity topic and associated themes of the JHWS as well as contributing to tackling obesity. Emergency transport (such as ambulances), highly specialist transport (such as some mental health transport) and road traffic accidents are also outside the scope of this topic.

Context

National Strategies, Policies & Guidance

The Department for Transport (DfT) Transport Investment Strategy published in 2017 sets out current Government funding priorities.

Accessible transport - transport should be available for everyone. Buses, coaches, trains and taxis make it easier for people to visit friends, get to the shops or to work. This is beneficial to the economy and means fewer car journeys, which reduces carbon emissions.

Total Transport - nationally the DfT funded a series of ‘Total Transport’ pilots which were intended to explore the potential for localised integration of transport services. Lincolnshire was one of the successful bids. This work continues in Lincolnshire as the Integrated Passenger Transport Commissioning project, involving stakeholders from local authorities and the NHS.

The Inclusive Transport Strategy was published by the DfT in August 2018 and sets out the Government plans to make transport more inclusive and provide better access for disabled people. Legislation ensures that public transport should be accessible for all people, for example passengers in wheelchairs.

Local transport - good local transport helps people get where they need to go quickly and easily. This makes places better to live in and is good for the local economy.

Chapter 3: Community infrastructure that empowers social connections, of the HM Government policy document A connected society: a strategy for tackling loneliness identifies that 'the importance of having access to community space – both buildings and outdoor space- was a frequent theme in responses to government's call for evidence on loneliness'. Also highlighted was the importance of good neighbourhood planning, including transport links, and housing design.

The report 'Promising approaches to reducing loneliness and social isolation in later life' (Age UK and Campaign to end Loneliness, 2015) described transport as an enabler or gateway, along with technology, to accessing services and interventions.

The DfT produces a large amount of statistics. The Department of Environment, Food and Rural Affairs (Defra) publish Rural transport, travel and accessibility statistics.

Local Strategies & Plans

Lincolnshire County Council's 4th Local Transport Plan sets out an integrated transport strategy for the area and outlines proposals for the future, covering public transport and infrastructure (e.g. bus stations, bus lanes, cycle lanes). It is supported by other policies and strategies covering specific transport-related issues or areas.

The Joint Health and Wellbeing Strategy (JHWS) for Lincolnshire 2018 has seven themes:

  • Mental health and emotional wellbeing (children and young people)
  • Carers
  • Obesity
  • Mental health (adults)
  • Dementia
  • Physical activity
  • Housing and health

None of these currently have transport as a specific element of the delivery plans but links need to be made. There are also a number of themes or overarching aspirations for the strategy, one being of particular relevance to transport disadvantage – focus on tackling inequalities and equitable provision of services that support and promote health and wellbeing.

Strategic planning, development management and infrastructure

This topic focuses on people having access to a car or public transport in order to travel. However, requiring people to make unnecessary journeys should be avoided.

Mobile and flexible working reduces the frequency individuals have to travel to places of work. Digital solutions such as video conferencing for GP or Consultant consultations and work meetings reduces costs, wasted time, congestion on the roads and pollution. Greater use of digital health solutions such as online reminders to take medication could reduce the need for a carer visit and the associated journey. Such solutions should not be to the detriment of people interacting with others and leading to social isolation and loneliness. NHS Sustainability and Transformation Partnership (STP) submissions to NHSE and NHS estates strategies (following recommendations from the Naylor Review of NHS estates) have led to reviews of acute services and the accommodation to deliver them. One outcome might be increased co- location of GP practices in 'multi-service practices' (MSPs) serving larger populations but necessitating a longer journey to get to a GP surgery. The same would be true of developing specialisms in certain hospitals; however the benefit of improved care, reduced waiting times, fewer cancelled appointments or operations may well outweigh travelling a longer distance journey. Increasingly, procedures being carried out in MSPs or even in the home instead of acute hospitals will reduce the need for patients to travel as far if at all. Transport is a strand of the STP submission.

It is important to recognise, however, that transport is a significant aspect of enabling people to access services and amenities. The right infrastructure is needed, and locating services so that a high proportion of people could reach them without the need for motorised transport is desirable. This links to public sector estates strategies, in particular the One Public Estate programme.

From a strategic planning perspective, Local Plans covering individual districts or groups of districts across Lincolnshire (Central Lincolnshire, East Lindsey, South Kesteven and South Lincolnshire) have either been adopted or are in development and contain policies appertaining to transport. Housing growth in Lincolnshire is focussed on major centres and larger villages where the majority of services are, to make them more accessible and sustainable. The Housing Infrastructure Group (HIG) in Lincolnshire has a strong focus on transport provision as an enabler of housing growth.

What is the picture in Lincolnshire?

What the data is telling us

Further data and information including maps can be found in the Access to Transport Supporting Data Document.

Cars

Given the rural nature of the county it is unsurprising that Lincolnshire has higher rates of car ownership than other areas. In England car ownership is around 75%, in Lincolnshire it is 82%, although this varies within the county – rural areas have significantly higher ownership rates than urban centres. (Source: ONS/Census 2011)

Car ownership seems to mirror the levels of deprivation in Lincolnshire, going down in areas of high deprivation. North Kesteven has the lowest level of deprivation and the highest level of car ownership. (Source: ONS/Census 2011)

Data is available for Lincolnshire residents with a limiting long- term condition or disability who do not have access to a car or van. 29.5% (18,334) of people whose day-to-day activities are limited a lot due to disability or illness do not have access to a car or van compared to 9.9% (55,544) whose day-to-day activities are not limited. (Source: NOMIS 2018)

Conditions that may preclude people of all ages from driving include:

  • Neurological disorders
  • Cardiovascular disorders
  • Diabetes
  • Psychiatric disorders
  • Drug and alcohol misuse and dependence
  • Visual disorders
  • Renal and respiratory disorders

(Source: Cambridgeshire Insight (JSNA), 2015)

Passenger Transport

Public sector organisations in Lincolnshire spend around £41.5 million pounds a year on transport services:

  • £26M home-to-school transport
  • £1.4M CallConnect*
  • £1.2M social care transport
  • £5.5M NHS non-emergency patient transport
  • £140K Lincoln Dial-A-Ride*
  • £7M bus route support*
  • £5K voluntary car schemes*
  • £100K healthcare travel costs scheme

These figures do not include all the relevant staff costs. Of course, members of the public will also pay a fare when using some of these services (indicated with *).

(Source: Lincolnshire County Council)

Trains

The rail network in Lincolnshire is relatively limited, with only 9 of the 22 largest towns having a rail station. Away from the East Coast Main Line, rail services are generally limited to hourly or less frequent. Whilst there are some meaningful connections between significant destinations (relevant for access to specialist hospitals for example), rail is secondary to bus travel in terms of the contribution it makes to public transport journeys within the county. However, with around 5 million passengers using rail stations in Lincolnshire a year, rail does make a meaningful contribution to the transport network. (Source: Lincolnshire County Council)

Rail fares are complicated with numerous ticket options and few subsidies exist, other than with rail cards or season tickets. For out of county services such as specialist health care appointments a rail fare from Lincoln to Nottingham with an additional tram, bus or taxi journey to one of the two hospitals for example would cost over £20. For a single passenger this is less than motoring and parking costs but doubles if a carer travels on the train as well making a car a more cost effective mode. In either case or using whatever mode of travel it is more than if the appointment had been in Lincoln.

Buses

Lincolnshire is a large county with a relatively sparsely distributed population. The county’s 5,560 miles of road are almost entirely single carriageways, with just 12.4% classified as an A-Road. In order to meet the challenges of Lincolnshire’s geography there are a number of different public transport services ranging from traditional fixed-route buses to more innovative demand-responsive bus services e.g. Call Connect. (Source: Lincolnshire County Council)

Bus passes are available to older people and people with disabilities. The pass allows free travel on buses. Lincolnshire currently goes beyond the national minimum standard and allows residents to travel free before 9.30am.

The bus operator market in Lincolnshire also presents some difficulties. There are many small, family-run businesses that do not have the capacity to take on larger contracts. This also means they do not have sufficient flexibility to make economies of scale which might see fares reduced and, therefore, lower costs to customers which might improve accessibility.

Fixed route services

There are about 260 fixed bus routes across Lincolnshire. The network of InterConnect bus services links together major towns in Lincolnshire (except where rail links exist), supplemented by a series of local bus routes and into-town services.

Some bus routes are run on a purely commercial basis by bus companies; some routes receive financial support from Lincolnshire County Council without which they may not be financially viable. Lincoln city is the only area in the county that can sustain a comprehensive network of commercial routes.

There is a significant reduction in the number of services running in the evenings and on Sundays. For example buses to the villages surrounding Lincoln stop at around 6.30pm.

Timetables are not tailored to services such as outpatient clinic times, supermarket opening hours or cinema screening times. Routes may well serve such destinations but running an additional service for example for a late-night opening will be a commercial decision unless public subsidy is provided.

There is an issue where scheduled service buses are full or children travelling to and from school meaning access to other passengers is reduced, or they would rather not travel with large numbers.

Taxis and private hire vehicles

These are licensed by District Councils, who publish details of all current vehicles (including wheelchair accessibility) on their websites.

Non-Emergency Patient Transport Service

Patients with certain mobility or clinical conditions are entitled to free transport to planned NHS hospital appointments. This is known as Non-Emergency Patient Transport Services (NEPTS).

Lincolnshire West CCG commission NEPTS on behalf of all four of Lincolnshire’s CCGs. The journeys are provided by a private contractor. It costs around £5.5 million per year to complete about 200,000 journeys.

Hospital destinations can be within Lincolnshire or further afield. In addition to the main NEPTS contract, some journeys are provided by volunteer drivers, and some are sub-contracted to other transport operators.

It is the destination (a hospital) and the patient’s medical condition that determine eligibility for this service, not the length of the journey. A patient who qualifies for free transport to hospital will not be given free transport to their GP surgery, even if this is also a significant distance away.

Patients making routine journeys for renal dialysis, wherever located in or out of county, form a significant percentage of NEPTS journeys.

Desktop analysis shows a certain amount of duplication between NEPTS and CallConnect. Approximately 10% of NEPTS journeys could potentially be delivered by the existing CallConnect service. (Source: Integrated Passenger Transport Commissioning project)

Healthcare Travel Costs Scheme

The NHS runs the Healthcare Travel Costs Scheme (HTCS) to help patients who are on low incomes but who do not qualify for NEPTS. Eligible patients can reclaim the costs associated with their journeys to hospital. At least £100,000 a year is spent in Lincolnshire on reimbursing these journeys, a cost paid by the Clinical Commissioning Groups (CCGs). The hospitals do not collect sufficiently detailed data to see if the journeys being reimbursed could have taken place more efficiently or cost effectively. (Source: Lincolnshire West CCG)

How well known about the HTCS is can be questioned and the available data does not identify how many people might be eligible but are not aware of it.

Other issues

Access to services

The Department for Transport (DfT) produce annual statistics on access to a range of services – for example ‘how many people can access a shop within 30 minutes by public transport’. A full report of these is included in the Supporting Data Document. In summary these show that accessing services in Lincolnshire is more difficult than the national average.

For example: The DFT estimate that 97% of households are within 15 minutes of a GP surgery by car, and that 65% of households are within 15 minutes of a GP surgery by walking/public transport. This assumes traffic travels to the speed limits whereas using real-time traffic data taking into account safe speeds for roads, congestion, etc., would provide a more accurate picture. Public transport of course operates to a timetable and infrequent services will lengthen the overall time needed to attend appointments and may not correlate with opening times, clinic times, etc. The data also does not account for demand-responsive transport, a service in Lincolnshire that is obviously specifically designed to improve access to services in a rural county but remains restricted in the operating hours.

Wider impacts of transport

The scope of this JSNA topic is restricted to access to a car and public transport options. There is a wider perspective around environmental costs of transport or not having an effective public transport service i.e. cost of obesity such as on social isolation. Services must not be viewed individually as a lot are cross cutting. Issues that are important and impacted on by choosing to use combustion engine powered cars, bus or train, etc., but will be considered elsewhere in the JSNA in due course include:

  • Air pollution and its effect on illness and premature deaths;
  • Carbon emissions and climate change;
  • Impacts on physical activity (or inactivity) and obesity;
  • Inequalities associated with rurality and the cost of a move to ultra-low emission vehicles (e.g. distances involved between charging points for electric vehicles and the on-the-road price of electric cars);
  • Social costs such as lost work days at work from an inability to travel.

Providing an effective passenger transport network should help minimise the number and length of car journeys to reduce congestion and harmful emissions to the environment. Buses have a lot of potential to improve air quality and reduce traffic congestion, particularly in urban areas. It is, however, important to consider the nature of the fleet of vehicles used in commissioning passenger transport with the aim of low emissions and the infrastructure for them to operate (e.g. dedicated bus lanes, electric vehicle charging).

Trend

Car ownership

DVLA data shows there are increasing numbers of older drivers. More people have, therefore, been familiar with and reliant on using a car for the majority of their lives. It is acknowledged that for the majority of older drivers, driving cessation is a process of self- regulation but the decision to stop driving is less likely to be taken if there are no or limited other options. This is of particular significance given the expected rise in numbers of older people, and those of whom are living at home independently with long term conditions including dementia.

Evidence from the DVLA suggests that fewer young people are learning to drive. The sharing economy also means fewer young people are buying cars, with other options such as car clubs becoming more popular in major cities, but there is no evidence these are operating in Lincoln or across Lincolnshire.

Bus use

Use of buses is declining in Lincolnshire. There were around 13.5 million journeys in 2016/17, a reduction from 16.3 million journeys in 2009/10, approximately a 20% reduction.

The reduction in passenger numbers may be influenced by a number of factors; reduction in evening/weekend services, increasing fares, the rising age of qualification for free bus passes, fears of anti-social behaviour on buses, parking provision that encourages car travel rather than bus travel to town centres, schools and colleges providing their own transport to attract pupils – these may all play a part in this trend.

Approximately 30% of bus passengers use concessionary passes. Older people tend to use buses more and are reluctant to use taxis because of cost.

Gaps

Unfortunately there is no trend data available for use of trains, taxis and voluntary car schemes.

Key Inequalities

There are a number of barriers to accessing transport that mean certain sections of the community are most likely to be adversely affected. These were included within a Governmental Social Exclusion Unit report, which identified five main barriers in accessing services:

  1. The availability and physical accessibility of transport
  2. Cost of transport
  3. Services and activities located in inaccessible places
  4. Safety and security
  5. Travel horizons - willingness to travel long journey times or distances, or knowing about and/or trusting transport services.

(Source: Lucas, K. Making the Connections, 2003)

Data from the Office for National Statistics (ONS) suggests that over the last decade the costs of bus and rail travel have increased at a much greater rate than costs of car travel, and much above the rate of increase in the cost of living.

The effects of road traffic also disproportionately impact on socially excluded areas and individuals through pedestrian accidents, air pollution, noise and the effect on local communities of busy roads cutting through residential areas or being between these and open spaces. (Source: Cambridgeshire Insight (JSNA), 2015)

Accidents

Road Safety Analysis Ltd has produced work on the link between deprivation and road safety. Although national research by RoSPA indicates higher rates of casualties in areas of higher deprivation this link has not been identified in Lincolnshire.

It cannot be corroborated but there are believed to be issues in remote areas, often also those that are more deprived, around young, inexperienced drivers travelling to colleges early in the morning or late evening being involved in accidents.

Please refer to the JSNA Road Traffic Collisions topic for further details on numbers and trends. The extent to which an increase in use of passenger transport can be shown to reduce accidents is not known; however, there is an assumption less car journeys would lead to fewer accidents.

Access to education and employment

Jobseekers often find lack of transport is a barrier to training or getting a job, attending the Job Centre and interviews. In-work or training, those on lower incomes will find it more difficult to fund transport to where their activity is located. Young people particularly may often have to travel long distances. In general there is no limit on distance someone would have to travel to accept a job. For most benefit claimants there is a limit on travel time of 90 minutes, but the Department of Work and Pensions would take each case on its merits to decide what is reasonable, taking factors such as caring responsibilities in to account. There can be sanctions on benefits if a job offer is refused. There are, however, some schemes that offer discounted travel on public transport to jobseekers.

LCC organises and funds home-to-school transport for pupils who meet the eligibility criteria. The DfT journey time statistics have data on access to primary, secondary and post-16 education.

Access to social, cultural and sporting activities and open spaces

More people without a car find seeing friends and family or getting to amenities such as leisure centres and libraries difficult because of transport problems. Larger areas of open green space are often difficult to get to by public transport. Such barriers tend to mean people will remain at home with the potential to lead to loneliness and social isolation and a lack of physical activity.

Current Activity & Services

Bus passes

English National Concessionary Travel Scheme (ENCTS) passes allow older people or people with disabilities to travel for free on any bus within Lincolnshire (including CallConnect). Not all people who are eligible for a pass have one, and the take-up rates vary considerably across Lincolnshire. This may be unexpected given that most people in Lincolnshire have access to CallConnect service, where you can also travel for free with an ENCTS pass. Work is going on to look at links between ENCTS take up and different categorised groups of older people.

Independent travel trainers teach young people to build confidence to travel on their own; whether that is on foot, by cycle or using public transport. A travel trainer works with the young person until they can manage to travel on their own safely. The service is available to those young people, aged 14 to 25 years old, are attending school or college and using Lincolnshire County Council funded transport - for example school bus or taxi and is funded from the Council's school transport budget. Travelling on their own is important if young people want to be able to live away from their family home and be part of their community. It can also give them more choice; for example when looking at finding a job. It might be possible to increase the number and scope of travel training with further funding.

City of Lincoln Council is encouraging people not to own or use a car. It has set up a task group to look at multi provision response to accessing services and the city centre.

North Kesteven's strategic partnership has a Better Transport group.

CallConnect

To supplement the fixed-route bus services Lincolnshire County Council provide CallConnect – this is a fleet of demand-responsive minibuses that fill in the gaps in the fixed route network. Door-to- door journeys can be booked in advance.

CallConnect covers the majority of the county (the area around Lincoln is not covered because there are many fixed-route buses operating in that area, as well as Lincoln Area Dial-A-Ride). The service is designed to provide a bus service in rural areas where fixed-route services are not commercially viable. Typically each bus covers an area surrounding a market town – the idea being that residents can use the bus to access the services they need within that town, or to connect from that town into the wider fixed-route bus network.

CallConnect provides short, local journeys. It would not be possible to travel, say, from Holton-le-Clay to Stamford on a CallConnect bus. The CallConnect service is available 7am-7pm Monday to Friday, 7.30am- 6.30pm Saturday. Journeys can be booked a week in advance. Users must be registered to book a journey, but registration is free and any Lincolnshire resident is eligible to register. ENCTS passes can be used to travel for free on a CallConnect bus, as on fixed-route buses.

Calls and bookings are handled by a dedicated team within Lincolnshire County Council. CallConnect provides approximately 300,000 journeys per year. The registration rates for CallConnect vary across the county. Again this is perhaps surprising as it is free to register, and it is free to travel on a CC bus using an ENCTS pass. (Source: CallConnect)

Community Transport

Lincoln Dial-A-Ride

Within Lincoln, provision for over 65 year olds/people with disabilities is enhanced by Lincoln Area Dial-A-Ride. This is a demand- responsive service covering an area approximately 6 miles in radius from the centre of Lincoln.

Dial-A-Ride is financially supported by Lincolnshire County Council, City Of Lincoln Council, North Kesteven Council and West Lindsey District Council and undertakes about 20,000 journeys a year. (Source: Dial-A-Ride)

Voluntary Car Schemes

There are around 20 Voluntary Car Schemes across Lincolnshire. These are schemes where volunteer drivers take passengers to and from appointments. The drivers are paid a mileage rate, usually 45p a mile, by the passengers. This will usually include the mileage from the driver’s home to pick up the passenger.

Schemes vary as to what journeys they will undertake. Some schemes are linked with a GP surgery and will only transport patients registered with that practice to medical appointments (some of which can be far afield). Other schemes may be linked with parishes and will transport any parish residents for social appointments.

Approximately 100,000 journeys a year are completed (the majority of these will be return journeys, so they can be thought of as 50,000 bookings). Anecdotal evidence suggests the majority of these are to health appointments. (Source: Lincolnshire County Council)

Home-To-School transport

Lincolnshire County Council determines whether children are eligible for free school transport using a combination of national and local policies. Lincolnshire County Council then commissions transport for children who are granted free school transport. In some cases this is buying tickets on existing bus routes, in other cases it is commissioning bespoke routes from the transport operator market.

Most children are transported relatively short distances on standard vehicles. Small numbers of children require more specialist vehicles and travel longer distances. 20,000 children are transported to school for free every day in Lincolnshire. This number has been reasonably stable over a number of years. (Source: Lincolnshire County Council)

Post-16 transport

Students continuing in education after the age of 16 are not entitled to free school transport. LCC offer discounted transport, generally to a student’s nearest post-16 provider. The annual cost for this transport is £590 per pupil. The numbers of students making use of this service is declining. Some post-16 institutions provide their own, often free, transport, which can duplicate public transport services. (The same may be true of independent schools in Lincolnshire). (Source: Lincolnshire County Council)

Wheels2Work Lincolnshire

Wheels 2 Work is a social enterprise organisation working in partnership with Lincolnshire County Council and Build-a-Future training centre to offer an affordable transport solution for individuals struggling to get to work, college or apprenticeships. It provides affordable scooter training and hire to get people on the road.

Unmet Needs & Gaps

It is difficult to know how much of a household’s income is spent on transport in Lincolnshire.

National 2017 data from the Office for National Statistics suggests that in urban areas around 13% of weekly expenditure is on transport. For households in rural areas this rises to 16.5%

There is seen to be a disconnection between development management planning and transport that needs resolving to ensure transport is thought of as part of the planning process at an early stage. Historically, there have been a number of examples where a new housing development or medical facilities have been completed and there is then a request made for it to be put on a bus route.

Developers provide funding towards a range of infrastructure requirements (e.g. schools and road improvements) through Section 106 agreements in planning legislation or 'developer contributions'. The need for such infrastructure must be as a result of the development(s) in an area. The current system does not allow more than five contributions from different developments to be pooled towards any single piece of infrastructure.

It is possible for funding to go towards the production of travel plans or even subsidising new bus routes for a period of time. There are, however, numerous possible requirements and limited possible funding before it would be unviable to develop the site and so transport is often a low priority. Development of smaller sites means the funding pot is not big enough to enable funding for public transport provision to be applied for.

Other LCC policies do not allow for transport to be used as effectively as it potentially could be. For example, people who fund their care themselves or those with personal care budgets can and do use the CallConnect service. However, Adult Social Care do not allow their funded clients to share transport with other users for safeguarding reasons, and therefore have to pay for taxis and other transport. This could be reviewed to see if the concerns can be overcome with the right assessments in place.

Bus and train services are less frequent in the evenings, finishing quite early and even less frequent or non-existent in some areas on Sundays. Moves to improve services such as extended GP hours, 7 days a week services will be hampered if there is a lack of public transport at these times.

Local Views & Insights

There is little evidence relating to the views of the public influencing the future public transport service.

The importance of good transport links is often advocated by Lincolnshire residents. Passenger transport users often cite the complexity in planning journeys, the length of time involved and the expense in making journeys as barriers to access.

Consultation on Lincolnshire County Council budget decisions
In 2016 the County Council consulted residents on a range of proposals to reduce expenditure. Some of the outcomes were clear in that maintaining a good road network was prioritised. Pothole filling and road repairs, winter gritting and road safety work including school crossing patrols were the three areas where most survey respondents felt spending should be maintained. Roughly half the respondents thought rural bus subsidies should remain at current levels whereas there was more support to reduce expenditure on school transport for children over 16 (not including special educational needs).

Healthwatch Lincolnshire conducted patient engagement on missed GP appointments in 2014 and their report is available. Of the potential reasons for a missed appointment the fewest respondents (6.1%) cited 'transport problems' as the issue. Future demographic changes and a changing landscape of surgery sizes and locations could impact on this. There is an example where a GP practice closed and patients were transferred to alternative practices where they had to change buses to make the journey by public transport. Similar research relating to hospital appointments might be useful.

Feedback from parents on school transport is available.

The Lincolnshire Youth Council has identified cost of transport as one of its priorities.

Risks of not doing something

If no action is taken, then access to transport in Lincolnshire will remain as it is now. The main risks are:

  1. Current transport-related inequalities will remain and adversely affect more vulnerable people's health and wellbeing, for example mental health through loneliness and social isolation.
  2. Use of public transport will continue to decline. Opportunities to reduce pollution and congestion will be missed. Declining use will affect the commercial viability of services which, without public subsidy, could then disappear.
  3. Separate organisations will continue investing in services with a degree of duplication, such as NEPT.
  4. New services will be commissioned without sufficient consideration of transport impacts.
  5. Voluntary organisations will continue to work in an uncoordinated way.

It is difficult to quantify the financial cost of not doing something.

What is coming on the horizon?

There are many changes coming – some sooner than others – that need to be factored in:

Demographic changes

Lincolnshire’s population is growing and is getting older, with a consequent increase in demand on health and social care services. There are fewer young people learning to drive and fewer young people owning vehicles. There are plans for 100,000 new homes in Greater Lincolnshire by 2040.

NHS service redesign

The Lincolnshire STP may lead to significant redesign of NHS services in Lincolnshire, altering the distribution of access points for healthcare services. Neighbourhood teams and GP federations may lead to patients travelling to different destinations than they have historically done. There may be a bigger shift of activity to primary care. There may be a redistribution of secondary care activity into a wider number of more localised settings. The NEPT service is also due to be re-commissioned in 2022.

Technology changes

IT is evolving at a rapid rate, and the public’s expectation of technology changes along with it. It already seems archaic that Lincolnshire residents need to buy separate tickets on bus journeys with different operators rather than simply tapping a smart card that works all the details out in the background. As rural broadband rolls out across Lincolnshire more and more people will shop on the internet and receive home deliveries rather than going out to the shops, and socialising online rather than in person is easier than ever. Potential to use telehealth such as Skype consultations could improve access to services without requiring significant new transport solutions.

There are seismic technology changes on the horizon. Mobility as a Service (MaaS) seems likely to become more commonplace in the short term. Greener vehicles are already here and their market share will grow. In the medium term Connected Autonomous Vehicles will become increasingly viable. Significant levels of ‘digital deprivation’ mean that Lincolnshire may not be well-placed to benefit from these changes.

Lincolnshire County Council is to commission a Transport Focus Passenger Survey in autumn 2018.

Legislative changes

The Bus Services Bill has created some uncertainty in the public transport market, with greater powers being given to Local Authorities to franchise services. There are also some additions to this Bill which are being discussed in relation to real-time information and minimum levels of technology availability on board (such as Wi-Fi and timetable screens). Additional requirements may have an impact on ticket pricing.

What should we be doing next?

Further research into certain aspects of transport and its effect on health and wellbeing would be beneficial. The fundamental question is: do we need better transport services, or could residents make better use of the services that currently exist?

The answer is: both.

And is access about something different to transport?

Yes, especially in terms of IT / digital solutions, although these may take longer to implement and become the standard use for all age groups and demographics.

Improved use of existing services

Both hard data and softer intelligence support the view that more use could be made of existing public transport services.

  • It is important to improve the perception of public transport to encourage more people to make use of it. Reversing the decline in passenger numbers is important. A big modal shift towards public transport helps make public transport better – for example, less congestion on roads means buses can travel faster.
  • Understand better the barriers to use of public transport. It would help to establish a county focus group on transport under an appropriate facilitation mechanism, with participants drawn from across other partnership boards.
  • LCC to write a new passenger transport strategy including nudges towards people making better use of passenger transport. There is a need for a clear, strategic plan for Lincolnshire to integrate passenger transport provision.
  • Bus operators to improve reliability and fare transparency.
  • Making clear and relevant transport information about local transport options easily available and at appropriate times, such as when health appointments are booked.
  • Local Authorities to develop policies that encourage public transport travel to town centres, rather than private car travel. This will also positively impact air quality and traffic congestion.
  • Targeted publicity on the CallConnect service, which is not widely understood and therefore underutilised.
  • Targeted publicity on ENCTS passes and usage.
  • Catch-up technologically on buses – electronic ticket machines, cross-operator smart ticketing, better Real-Time Passenger Information/apps for passengers. (It should be noted that some operators have already invested in and made progress on this).
  • Some investment has taken place on bus priority measures (e.g. improved bus lanes in Skegness, traffic signal priority for late running buses at certain junctions in Lincoln) but this needs to go further to encourage a shift towards bus travel.
  • Incentives to encourage modal shift to using public transport and more environmentally friendly transport, working on 'driving' the right culture in terms of choices in transport with on-going campaigns.
  • Facilitate multi-mode transport – making it easier to get bikes on buses or trains in sufficient number so that the bulk of a 'long' journey can be completed on public transport with a cycle ride at either or both ends.
  • Better publicity on Voluntary Car Schemes.
  • Support for developing additional Voluntary Car Schemes.
  • Greater support for people wishing to be volunteer drivers.
  • Look at the potential to make better use of taxis that are already being commissioned for pupil school transport, etc.

Building better services

There would be benefits to making the following changes:

  • Ensuring that all organisations procuring transport are working jointly when reimagining their transport offer to ensure a system-level perspective on health and transport planning.
  • Remove duplication in services and use the savings to enhance the transport offer in other areas. LCC are currently hosting the ‘Integrated Passenger Transport Commissioning’ project which is starting to identify existing duplication services and suggest some ways forward.
  • Remove internal organisational barriers to making better use of transport (for example LCC Adult Social Care procedures requiring use of taxis rather than CallConnect).
  • Raise the profile of transport in decision-making and ensure that all public sector organisations take due regard of the information in this JSNA Topic when commissioning any new services.
  • Embed a ‘Transport Impact Assessment’ on all new projects and decisions.
  • Ensure that transport is better considered by LCC and Local Planning Authorities. Consideration should be given to developers funding additional bus provision for a period of time following the building of new housing estates.
  • Encourage transport operators to shift their fleet towards greener vehicles.
  • Undertake research to quantify the wider costs of transport- related issues, such as missed health appointments, the costs of poor air quality and so on.
  • Incentivising modal shift towards environmentally-friendly transport with ongoing campaigns to encourage changes in transport choices.

 

If you need to contact us about this topic, please email JSNA@lincolnshire.gov.uk