Hospital Appointments Can Make Greener Travel Harder: Access, Emissions, and Public Transport Solutions

The Conversation examines how the timing and location of hospital appointments influence how people travel, affecting access to care and transport-related emissions within England's NHS. It draws on evidence about concessionary travel, public transport reliability, and variations by health condition. The piece highlights local studies in Southampton and the Isle of Wight and discusses remote consultations, appointment coordination, and transport supports as ways to reduce travel while preserving access to care. Authors: Keyvan Hosseini and Dawn-Marie Walker for The Conversation.

• Early appointments can constrain travel budgets when concessionary passes are not yet valid.
• Unreliable bus services and multi-connection journeys increase patient burden and emissions.
• Remote consultations can substantially cut travel and carbon, but full lifecycle impacts should be considered.
• Coordinating same-day appointments and providing transport support can reduce missed visits and emissions.

Introduction

The Conversation report explores a deceptively simple question with wide implications: how the timing and location of hospital appointments shape travel decisions, access to care, and emissions from transport in England’s National Health Service (NHS). It places the discussion in a climate context, noting that patient and visitor journeys account for more than 40% of transport emissions from the NHS. The article also cites historic and more recent data on public transport access to hospitals, highlighting that in 2019 a substantial share of households could not reach their nearest hospital within 30 minutes by public transport or walking. By weaving together patient experiences, policy reviews, and new research, the piece argues that reducing travel emissions is not simply about telling people to drive less but about rethinking when and where care is provided and how travel is organized around clinical needs.

The travel-health link and access to care

The article emphasizes that the timing of a hospital appointment has consequences beyond scheduling. For older patients, an early appointment can occur before concessionary bus travel is valid, forcing them to pay for journeys that would have been free. When appointments are at specialist centers rather than the closest facility, patients may travel via multiple connections, increasing time, cost, and fatigue. For those who are already unwell, a short clinical encounter can translate into hours of travel, waiting, and a difficult return journey. These experiences underline how transport barriers intersect with health needs, potentially contributing to missed appointments and delayed care.

Environmental impact: emissions from hospital travel

The article cites a 2024 review that linked transport problems, distance, and access to services with missed appointments, stressing the potential for more flexible, patient-centered scheduling to mitigate these issues. It also points to broader NHS emissions data, noting that patient and visitor trips represent a substantial portion of transport emissions. In addition, more recent work shows that healthcare itself generates significant travel; for example, a 2025 study of 6,599 NHS patients in Greater Glasgow found that annual hospital travel varied by health condition and peaked around the year of diagnosis, with cancer patients traveling the furthest among those examined. These findings suggest that emissions reductions require not only changing patient behavior but also altering how and where care is delivered to minimize the need for travel.

Local insights and public perspectives

Southampton and the Isle of Wight were part of a broader program called Cordial (Community responsive digital twins for inequality alleviation and low-carbon mobility) and Ethos (Extreme temperature and health outcomes). These projects collected public accounts of traveling to healthcare and found that indirect and unreliable buses, long walks to bus stops, and journeys requiring several connections were common. Participants also described the cost of repeated hospital visits when household budgets were tight. The conversations echoed similar findings from a study of cancer patients in north-east Scotland, where travel could consume a large part of a day and add financial and physical strain, with fuel costs becoming difficult to manage and transport problems affecting when people sought help.

What can reduce travel and emissions?

The article discusses several measures already proven to cut travel demand and emissions when clinically appropriate. Remote consultations have been shown in a review of 48 studies (encompassing more than 68 million consultations) to markedly reduce travel and emissions when they replace in-person visits, though many studies assess emissions saved primarily through avoided travel rather than the broader environmental footprint of delivering care remotely. Scheduling reforms are also highlighted: coordinating multiple appointments for the same day and aligning appointment times with local public transport and concessionary travel arrangements can shorten journeys. Bringing some services closer to patients could substantially reduce travel while keeping access to care intact.

Transport support and practical options

Transport-support measures such as bus and taxi vouchers, shared transport, and dedicated van services were associated with fewer missed appointments in a body of research, though evidence about their impact on costs or health outcomes remains less definitive. Volunteer-led car services offer another transport option for those unable to use public transport, though their availability can be uneven (weekends and holidays) and may not accommodate wheelchair users. The overarching message is that reducing emissions from healthcare travel requires a combination of lower travel demand and smarter delivery of care, not just individual choices to switch to public transport.

Conclusion

The Conversation argues that to genuinely green healthcare travel, providers must rethink when and where care is offered and consider whether every appointment must be in person. By improving appointment flexibility, coordinating same-day visits, expanding remote options, and enhancing transport support, the NHS and healthcare systems can reduce unnecessary travel while ensuring all patients retain workable pathways to care. The article draws on public input and multiple research streams to illustrate how transport challenges intersect with health needs and climate considerations, and it highlights practical, scalable strategies for making healthcare travel more equitable and low-carbon.

References to Programs and Projects

Public engagement elements featured Cordial, Ethos, and cancer patient studies in the north-east of Scotland, indicating a broader pattern of experiences informing policy directions. The piece emphasizes that while remote care offers significant emissions reductions, a comprehensive approach that includes transport vouchers, coordinated scheduling, and local service delivery is essential for reducing the carbon footprint of healthcare travel.