Travelling For Health And Care Services Engagement Report Author: Nicky Ainscough

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If you would like help translating this information into another language, or you would like this information in Braille, large print or audio format, please get in touch with us. Call: 01942 482711 or Email: [email protected] Contents

Section Page

Section 1: Introduction, background and overview 2

Section 2 Results of the survey 5

Section 3: Face to face and other engagement activities 20

Section 4: Patient stories 23

Section 5: Next steps 26

Page 1 Section 1: Introduction, background and overview

------Page- - - -2 Introduction

In February 2020 we launched an engagement project to talk to local people about travelling for health and care services. The issue of travel and transport is something we recognised comes up when we are talking to people about how we can improve services and so we wanted to explore it in more detail.

As we look to make it easier for people to access health and care services over the next few years we wanted to find out how people usually travel across the Borough. We also wanted to understand some of the common issues that people experience and how that can impact on how they access the health and care services they need.

Through this engagement project we aimed to find out:

• The usual method of transport that people use; • The different areas/places people travel to and from; • The general experiences people have had travelling for health and care services; • If people have experienced difficulties when travelling for healthcare and if they require support with getting to appointments; • What is most important to people when travelling for health and care services; • If there are any individuals or groups who experience barriers when travelling.

Some of our activities were cut short in March 2020 to the COVID-19 pandemic. However, using a mixture of online, face-to-face engagement and a survey we had over 558 contacts.

Thank you to everyone who took the time to speak to us or complete a survey.

Page 3 How did we engage with people We produced a survey that was available online and we had conversations with some groups and individuals to talk about their experiences of travelling for health and care services.

Online activities: Face-to-face activities: • We posted regularly about the survey on our • We met with our Borough Engagement social media channels; Group; • We included information about this engagement • We held a session at Pemberton ; work in local newsletters, such as our Shape Your • We attended a Tenant Roadshow in Shevington NHS community newsletter and the Health alongside our colleagues at Wigan Council to talk Champions newsletter; to people and give out the survey. We also took • We included this on our internal newsletters to the opportunity to visit a Bingo Group that was our 60 GP practices and staff; meeting nearby. • We created a page on our website with more • We met with the Lowton and Golborne Traffic information about this work and a link to the Group; survey • We held a session at Orrell Book Cycle to talk to people and give out the survey; Unfortunately due to the COVID-19 our planned face- • We met with our Equality Reference Group to-face engagement activities in March 2020 didn’t go • We visited the following Voluntary Community ahead as planned. Here is what we were able to do in Sector groups: February 2020. – Think Ahead Stroke; – U3A Relaxation and Meditation Group at Leigh Miners; 240 COMPLETED 318 FACE-TO- – Platt Bridge Community Zone. SURVEYS FACE CONTACTS

Page 4 Section 2: Results of the survey

------Page- - - 5- Which part of the Borough do you live in? We asked people to tell us what area of the Borough they live in.

22.1% of A further 2.5% responses came from responses from people living in one of the neighbouring Wigan North areas outside of Wigan Borough, e.g. Billinge, Garswood, Upholland, St Helens & .

20% of responses from 20% of responses Wigan Central from Ince, Hindley, Abram, Platt 7.1% of responses from Bridge Tyldesley, Atherton, Boothstown, Astley

7.5% of responses from South Wigan & Ashton North

10% of responses from Golborne, Ashton & 10.8% of Lowton responses from Leigh Page 6 How do you normally travel?

Their first method of transport Most people said they normally travel by car and the second most popular method of transport was the bus.

CAR BUS TAXI

75.1% travel 17.8% travel 3.3% walk 2.5%travel 0.8%travel 0.4% cycle by car by bus by taxi by train

The second method of transport We asked people to then tell us how they would choose to travel if their preferred method of transport wasn’t available. Some people commented that this would really depend on where they needed to go.

BUS TAXI CAR TRANSPORT SERVICE

45.4% travel 26.5% travel 7.6% travel 3.4% travel 2.1% travel by 0.4% cycle 12.6% walk by bus by taxi by car by train transport service

Page 7 What kind of car do you have?

For those who said they have a car, 61% said it was petrol. 36.9% said the car was diesel. Only 1.6% said they have a hybrid car or 0.5% who said their car is electric.

How far do you travel to work and how? 37.5% of people said this question wasn’t relevant to them. For those that the question was relevant to, a majority said they travelled between 3 – 10 miles.

7.1% travel 44.9% travel 19.4% travel less than 1 mile between 3 – 10 miles 15+ miles

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23.5% travel 5.1% travel between 1 – 3 miles between 11 – 15 miles

For those in employment, how many days a week they travel into work?

When asked how often they travel to and • 7.1% travel 1 day a week • 40.8% travel 5 days a week from work in a normal week, the most • 6.1% travel 2 days a week • 5.1% travel 6 days a week popular answer was 5 days. • 19.4% travel 3 days a week • 3.1% travel 7 days a week • 18.4% travel 4 days a week Page 8 Have you travelled to any of these places in the last 12 months?

We asked people if they had travelled to some well known locations within the last 12 months. The most popular answers were our local town centres of Wigan and Leigh. 10% of people had only travelled to one of these places in the last 12 months and in all these cases it was either Wigan or Leigh Town Centre. A small number 1.6% said they hadn’t been to any of these places in the last 12 months.

83.3% 65% 54.6% Travelled to Travelled to Travelled to Wigan Town Centre Leigh Town Centre City Centre

40% 37.9% 32.9% Travelled to Travelled to the Travelled to Trafford Centre City Centre

17.1% 17.1% 10.4% Travelled to Travelled to Travelled to Preston Bury Page 9 Do you experience any difficulties when it comes to travelling?

20% of respondents said they don’t experience any difficulties when it comes to travelling.

When people said that they do experience difficulties when it comes to travelling, we have themed up the answers. Here are the top 3 in order of popularity.

Issues Unreliability of 2 3 Issues with 1 accessing public transport traffic transport Including trains or congestion Including lack of buses being late or Including the amount disabled seating, lack cancelled or of traffic on the road of level access, lifts overcrowded services and roadworks out of order

Some people also mentioned parking in response to this question. This was being concerned with a lack of parking, particularly disabled spaces, at their destination or concern about the expense of parking.

A smaller number of people mentioned physical and mental health issues that impact on travelling. For example having a condition that means they can’t walk long or stand for long period of time. Some people also mentioned that they can find travelling difficult due to anxiety or panic attacks.

Who supports you to get to and from health services? The majority of people, 60.4% did not require support to get to and from health services. Those who did need help were most often supported by a family member of carer.

Page 10 The last time you used a health or care service, where did you have to go?

Most people said they had travelled somewhere within Wigan Borough the last time they had needed a health or care service. The top 3 in order of popularity:

1 2 Royal Albert 3 Leigh Edward Infirmary or GP practice Infirmary, Thomas Including Linacre Emergency Department Centre

A small number of people, 7%, said that they had travelled outside of the Borough. The following places were listed: • Aintree • St Helens Hospital • Burnley General Hospital • • Hospital • Salford Royal Foundation NHS Trust • Christies • Walton • Kendal • Wythenshawe • Manchester (including Manchester Royal Infirmary) • Walkden

Page 11 How difficult was it to get there?

Difficult Okay Easy 0 1 2 3 4 5 6 7 8 9 10

1.7% 0.9% 3.8% 3.4% 4.7% 15.7% 6.8% 6.8% 13.6% 7.7% 34.5%

Where people said they had travelled somewhere within Wigan Borough, most people rated the journey as okay to easy. A small number of people rated their journey as more difficult but there was no particular trend here or location that this related to.

A smaller number of people rated their journey as difficult and around a half of those were outside of the Borough, specifically: • Walton • Whythenshawe Hospital • Kendal • St Helens Hospital • Manchester Hospitals

When you look at those that rated their journey okay to easy, i.e. 5 or above, just under half had mentioned the use of a car in a previous answer. Most people here said they use a mix of transport methods, particularly when travelling out of the Borough, e.g. mainly use a car but will get a train if travelling into Manchester.

Looking at those who found their journey more difficult, e.g. rating it 4 or under, most people also mentioned a car. Less people in this group mentioned using a mix of transport methods. Page 12 If you received an appointment in a place you hadn’t been before, how would you go about planning your journey?

39% 20% 15% would look Would use a Would online Sat Nav ask friend/family

Other answers included getting a taxi or allowing extra time for the journey. A small number of people said they would contact the service to ask for advice on how best to get there or even request an appointment closer to home somewhere they were familiar with.

If you received an appointment on a weekend, how easy or difficult would you find it to travel?

46.2% 37.2% 16.6% would find it would find it would find it more the same easier difficult

Those who said they would find it easier mostly travelled by car whilst those who would find it more difficult were more likely to use public transport. Where people said it would be easier for them, the top 3 most popular reasons where: 1. because there would be less traffic and congestion, 2. because they work during the week and have more free time at the weekend, and, 3. they could ask for help from friends or family at the weekend. Where people said it would be more difficult for them some of the comments were around public transport services being less frequent on a weekend, particularly on a Sunday. Page 13 In the last 12 months, have you had to travel further than you would have liked to access a health or care service?

67.4% 29.7% 2.9% said said said no yes Not sure

For those that answered yes, they felt that they had travelled further than they would have liked, there wasn’t a particular trend around the service they went to. However, quite a few people who answered yes here mentioned going somewhere outside of the Borough, e.g. Salford Royal for spinal or neurological specialist or into Manchester to see an eye specialist.

When it comes to travelling for a health or care service, what is most important to you?

48.8% 27.6% 12.3% 6.9% 4.4% said the time of said that there said the distance said the cost (e.g. said that it was the day I have to will be a parking I have to travel parking, fuel, on a bus route travel space ticket) Page 14 We presented people with a number of scenarios where they would need to access health and care services. For each scenario we asked them to rate whether it would be more important that the services is close to home or whether they get treated by a specialist.

If you were really poorly and needed specialist treatment, what would be most important to you?

It’s close They are I am treated to home equally important by a specialist 1 0 1 2 3 4 5 6 7 8 9 10

5.1% 3.1% 1.3% 0.4% 0% 25.3% 3.1% 2.1% 3.8% 3.4% 52.3%

Only a small number of people said that it was most important to them that the service was closer to home. More than half the people who responded to the survey felt it was more important they get treated by a specialist then the service being closer to home. A quarter of respondents placed equal importance on both factors.

Page 15 If you were referred to hospital and needed to have an outpatient appointment and maybe surgery, what would be most important to you?

It’s close They are I am treated to home equally important by a specialist 2 0 1 2 3 4 5 6 7 8 9 10

5.8% 3.8% 2.1% 0.4% 1.7% 30.1% 2.5% 3.3% 3.8% 4.2% 42.3%

As with the question above, a much smaller number of people said that it was most important to them that the service was close to home. The majority of people said that it was more important to them that they get treated by a specialist, with a high number rating the two factors of equal importance.

If you needed ongoing treatment for a health problem, what would be most important to you?

It’s close They are I am treated 3 to home equally important by a specialist 0 1 2 3 4 5 6 7 8 9 10

11.1% 8.5% 3.8% 7.7% 2.1% 36.2% 3% 1.3% 0.4% 2.1% 23.8%

The majority of people said that both factors were equally important, but in this particular scenario more people said that that the service being closer to home was important compared to the other two scenarios. Page 16 Do you know where the following places are and would you be confident getting to them?

We listed a number of locations where health services are based within Wigan Borough. We asked people if they knew where they were and if they would be confident to get there.

Royal Albert Edward Leigh Infirmary Thomas Linacre Leigh Walk in Infirmary 88.8% know where it is. Centre Centre 94.2% know where it is. 75% are confident to 85% know where it is. 74.2% know where it is. 81.7% are confident to get there. 76.7% are confident to 60.4% are confident to get there.1 get there. get there.

Boston House Platt Bridge Health Atherleigh Park Claire House Health Centre Centre 42.9% know where it is. Hospital 72.1% know where it is. 55% know where it is. 39.2% are confident to 40% know where it is. 60.4% are confident to 50.4% are confident to get there. 37.5% are confident to get there. get there. get there.

Chandler House Ashton Health Atherton Health 38.3% know where it is. Centre Centre 36.7% are confident to 32.5% know where it is. 20.8% know where it is. get there. 35.4% are confident to 27.5% are confident to get there. get there.

Page 17 Do you know where the following places are and would you be confident getting to them?

We listed a number of places located outside of Wigan Borough where we know people sometimes travel to across health and care services. Again, we asked people if they knew where it was and if they would be confident to get there.

Salford Royal Royal Trafford General The Christie Hospital Hospital Hospital Hospital 52.9% know where it is. 45.4% know where it is. 14.6% know where it is. 32.9% know where it is. 42.5% are confident to 41.3% are confident to 18.3% are confident to 28.8% are confident to get there. get there. get there. get there.

Whythenshawe Manchester Royal Liverpool and Wrightington Hospital Children’s Hospital Broadgreen Hospital 26.3% know where it is. 25.4% know where it is. 20.8% know where it is. 80.8% know where it is. 24.2% are confident to 24.2% are confident to 20.9% are confident to 72.5% are confident to get there. get there. get there. get there.

Page 18 Equality Monitoring Information

At the end of the survey, we asked people to complete an equality monitoring form.

Age Sex Ethnicity Sexual Orientation

Under 18: 0.5% Female: 69.5% White/British: 99.5% Bisexual: 1.4% 18 – 24: 0.9% Male: 30% European: 0.5% Gay: 1.4% 25 – 34: 8.1% Prefer not to say: 0.5% Lesbian: 1.4% 35 – 44: 12.2% Straight: 93.5% In a relationship 45 – 54: 14.5% Same sex I was born Prefer not to say: 2.3% 55 – 64: 20.8% Yes: 66.8% 65 – 74: 24.9% Yes:98.2% No: 31.8% 75+: 18.1% No: 0.9% Religion Prefer not to say: 1.4% Prefer not to say:0.9% Christian: 86.4% In school, college or Don’t want to tell you: 7% Long Term Condition Do you work Atheist: 5.5% or Disability Yes: 35 Humanist: 0.5% Yes: 4.5% No: 62.7 Pagan: 0.5% No: 95% Yes: 44.8% Prefer not to say: 2.3 Prefer not to say: 0.5% No: 54.3% Prefer not to say: 0.9% I look after someone who Serving in army, navy, or I was serving in army, is unable to look after air force Retired navy, or air force themselves?

Yes: 0% Yes: 51.3% Yes: 4.9% Yes: 22.8% No: 99.5% No: 48.2% No: 94.6% No: 75.4% Prefer not to say: 0.5% Prefer not to say: 0.5% Prefer not to say: 0.5% I don’t want to tell you: 1.8%

Page 19 Section 3: Face-to-face engagement and other activities

------Page- - - 20- U3A group meeting at Leigh Miners

Feedback: • Ring and Ride isn’t really a suitable solution for transport unless • Blue Badge holders can find it very difficult to park. A lot of you have the appointment booked far in advance. Can only ring town centres have put double yellow lines down. There isn’t once a week to book journeys for the following week. Wouldn’t enough parking at my practice (Wigan Road), it is chaos and be suitable for short notice and they’ll also only go a certain mile causes issues with residents. radius. • In live in Wigan Borough but was hospitalised in Bolton • Rang an ambulance for someone with a head injury and the Hospital. When discharged I was asked to go back to Bolton Ambulance Service told me it would be a 4 hour wait so I ended Hospital to get my dressings changed every day for 2 weeks. up taking them in the car. I had to pay for a taxi. I think this should have been available closer to home. • I missed an appointment at Wrightington Services due to having no transport to travel there from Leigh Pemberton Surgery, Sherwood Drive and being informed I was not eligible for patient transport service. • Some people don’t know that Greater Manchester Transport Feedback: issue bus passes or £120 a year taxi vouchers if people • This is my practice. I live very close by it’s easy to get to; prefer. Wheelchair taxis cost more money. • I’ve had to travel here today from Standish for a diabetic eye • Found it immensely difficult having to travel with husband to appointment I would normally go Thomas Linacre Centre for. I Christies for treatment. Started getting Patient Transport came in the car and set off early as I wasn’t sure where I was which meant leaving at 8am and getting home between 6- going. Not sure why I couldn’t go to Thomas Linacre Centre. 7pm. Ended up using our savings to pay for taxis instead as it • Waiting for appointment for Service here in was too difficult. Pemberton, there is a long wait, but don’t want to travel to Ince • I use buses and trains to get to different places, but when I or anywhere like that so waiting. need to go to Salford Royal I write the whole day off. • I live in Atherton and usually have to go into Bolton or Leigh Town Centre to get connecting buses. There is 1 bus through Atherton to Bolton or Leigh and it is really unreliable, which can make you miss connections.

Page 21 Lowton & Golborne Traffic Group Equality Reference Group

We were contacted by this local community group who asked to Feedback: make us aware of some specific issues relating to Lowton & • A couple of members had experiences or knew people with Golborne, particularly around availability of public transport, poor experiences of the Patient Transport Service and felt this which impacts on how people from that area travel. should be a service that we look to improve. • It can be difficult to get to Leigh Infirmary if you travel by bus. Feedback: One member had an experience of being able to get into • Predominant means of transport for people living in the area Leigh Town Centre but then finding there was no bus to get to is car or taxi; Leigh Infirmary and it is quite a walk from the Town Centre. • If people live close to where they are going for an • Wheelchair spaces on buses can be really limited, sometimes appointment they can walk or cycle if possible. Hazards you have to let a bus go past and wait for the next one if there include poor pavements, weather, traffic and traffic pollution; isn’t space. This all adds to the stress and anxiety of getting to • Train stations are not well located for patients in this part of and from appointments. the Borough. There is often a need to drive or get a bus to the • There needs to be understanding within health services to be train station. more flexible with some patients who find it particularly difficult • There are few bus routes servicing the local area. There are to travel around. For example, someone with a sight problem parts of Lowton not serviced by a bus. may need that appointment in the day to avoid travelling when it’s dark. • They are concerned there is serious traffic congestion in this area. At peak periods this can impact on pollution and fuel • When travelling to some places outside of the Borough, e.g. consumption. There is concern in the local area that this Salford Royal or Whythenshawe Hospital, you have to almost problem will get much worse as there are lots of housing give up a full day just for a half hour appointment as the developments being built. transport links aren’t great. This is a real issue for some people. • They are concerned that traffic in the area is exceeding the capacity of the roads to cope with it and they feel there needs • Lack of blue badge spaces at services, particularly the to be investment in hospital is an issue some people experience. • There is concern that emergency vehicles, including ambulances, are impacted by the traffic congestion in the local area.

Page 22 Section 4: Patient stories

------Page- - - 23- Kathy’s story…

“I left at 7:30 am from Standish and arrived at Leigh 9:30 am. My appointment was 9:15 am so I was a little stressed out by the time I got there, all this due to traffic. I was seen after a 30 minute wait. I also had to arrange for my sister to mind my twin Granddaughter's and would need to do the same again in January.

Tests were ordered and they wanted to do a camera but I was reluctant due to poor experiences in the past, with the sedation not working. I told the Consultant this and that the last time I came home with two black eyes. I opted for a barium X-Ray which was a doable experience. I already have an appointment to go back for the results on the 8th January, but if there is nothing found, or just a change in medication this could be done via my GP and would save time for me and the Consultant.

This has happened to me recently when a bowel surgeon did a colonoscopy and made a diagnosis from that and a CT scan. The results were sent to my GP and no follow up appointment was given.

I wish I could have seen the Consultant at Wigan as it is closer to me, but I presumed that as I needed a FastTrack appointment I was given the nearest date. It would be good if the appointment team could provide the option of where to see a Consultant if at all possible”.

Page 24 Ann’s story…

“I went for my annual Retinopathy appointment in October 2019 at Sherwood Drive Clinic , a ten minute walk from my home.

I was called for another appointment for a Slit LampBiomicrospy Clinic Appointment at 9am in Bolton. As I would have been traveling by public transport and having other health problems Rheumatoid Arthritis being one of them. This was not feasible for me and I would have had to be on my way for at least 8 o’clock, so I left a message on the answer machine.

I then got an appointment for 2 pm at an Opticians in Golborne. On public transport this is at least an hour or more away. My concern with this appointment was on the letter it said it was not suitable for wheelchair users. The message I left said I had Rheumatoid Arthritis. They never rang me to check if I was a wheelchair user.. I left another message left on answer machine.

I then got a appointment for Bolton , which I accepted so by the end of February I was finally getting my appointment.

At no time did anyone contact me to speak to me in person. This service appears to be by telephone and messages.

When I attended the clinic everyone was complaining. A man from Bolton had been sent to Bury, someone from Bury was in Bolton and several people from Wigan in Bolton.

What happened to services near to our homes?” Page 25 Section 5: Next Steps

------Page- - - 26- Next steps & Contact Details

• This report will be published online and we will share it with our local patient groups / engagement membership. • We will review these results with some of our patient groups. Our Equality Reference Group will review the equality impact assessment.

If you have any questions or if you would like the report in a different format please don’t hesitate to contact us:

Call: 01942 482711

Email: [email protected]

Website: www.wiganboroughccg.nhs.uk

Facebook: Wigan Borough CCG

Twitter: @wiganboroughccg

Post: FREEPOST RTRA-BXKR-CTTT, Shape Your NHS, Wigan Borough CCG, Wigan Life Centre, College Avenue, Wigan, WN1 1NJ

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