Greater Glasgow NHS Board

 

ACUTE SERVICES REVIEW – ACCESSIBILITY STUDY

SUMMARY


 

 


1                           Introduction

 

1.1                    This summary presents the key findings from the accessibility study undertaken as part of Greater Glasgow NHS Board’s Acute Services Review.

 

1.2                    The Acute Services Review has considered the provision of acute services, and proposed the consolidation of some hospital services on fewer sites.  One of the issues raised during the consultation process was that of the accessibility of services if offered from fewer locations throughout the city than at present.

 

1.3                    Oscar Faber (now FaberMaunsell) was appointed by the Greater Glasgow Health Board in June 2001 to study the accessibility impact of options being considered within the Acute Services Review.  The results were presented to Greater Glasgow NHS Board in January 2002, and informed the strategic decisions which were taken at this stage on the future shape of Glasgow’s Acute Services. 

 

1.4                    The study involved calculating the average travel times for all patients, and considering all modes of transport to each hospital.  Changes in these average travel times were then calculated on a Glasgow-wide basis.  These travel times were calculated for a number of different relocation options.

 

1.5                    The main aim of the study was to produce a mechanism with which the accessibility of the strategic options contained within the Acute Services Review could be quantified on a comparable and equitable pan-Glasgow basis.  In general, accessibility was quantified using mean weighted travel times.  These considered travel times by both public transport and private travel in proportion to their usage.  It also considered the travel times of patients who would experience change, and those who would not.  Public transport impacts were also considered independently.

 

1.6                    Along with patients, the study considered the accessibility of staff, visitors and blue light ambulance times.  The potential impact of the different options upon each hospital site was also assessed, and recommendations presented for further study.  Subsequent work has focussed on ascertaining the percentage of patients in the South East catchment affected by change in location of services, and this has been presented as an annex to the main report.

 

1.7                    At present, 99.9% of patients experience mean journey times to acute service facilities of under 30 minutes.  None of the proposed options appreciably increased the percentage of patients experiencing mean journey times greater than 30 minutes.

 

1.8                    At present, 99.3% of visitors experience mean journey times under 45 minutes.  None of the proposed options appreciably increase the percentage of visitors experiencing mean journey times greater than 45 minutes.

 

1.9                    At present, 99.8% of staff experience mean journey terms of work of under 45 minutes.  None of the proposed options appreciably changed this percentage.

 

1.10              At present, 97% of the population within the Greater Glasgow NHS Board catchment experience “blue light” ambulance journey times to hospital of under 20 minutes in the am-peak period.  None of the options appreciably impact upon this.

 

1.11              Initial site impact analyses showed that for the key in-patient sites, up to a doubling of existing private car demand and associated parking could be anticipated.  It is recommended that particular emphasis will need to placed upon the improvement of public transport to each hospital’s catchment, and the development of comprehensive travel plans and detailed car park management proposals.

 

1.12              The study recommended that when the final sites for the main in-patient sites were confirmed, there would be a requirement to study the detailed journey time impact for different areas of the community.  This should build upon work already undertaken. 

 

1.13              The analysis found that development of any of the five possible hospital sites as one of three main in-patient site generated additional parking demand and traffic flows.  In most cases this could potentially double existing overall demand, however at the GRI traffic flow and parking increases were more limited due to the existing restraint at this site.  For those sites not considered as main in-patient sites, parking accumulations, and traffic flows would reduce.

 

1.14              It is also recommended that the development of the Southern General would place particular emphasis on ensuring adequate public transport accessibility solutions. 

 

 

 


2                           Study Assumptions

 

2.1                    All assumptions used in the study were based upon those in place at the end of summer 2001, and patient figures based on the April 2000 – April 2001 dataset.  All accident and emergency figures excluded child attendances.  The work does not consider recent work undertaken on the re-modelling of accident and emergency catchments.

 

2.2                    For the North and East of Glasgow, the main options are:

 

(i)                  Main in-patient site at GRI, ACAD at Stobhill site;

(ii)                Main in-patient site at Stobhill, GRI retains specialist in-patients;

(iii)               Stobhill and GRI retain their respective roles

2.3                    For the West of Glasgow all options are for the redevelopment of Gartnavel.

 

2.4                    For the South of Glasgow, the main options are:

 

(i)                  Main in-patient site at Southern General, ACAD at Victoria Infirmary site;

(ii)                Main in-patient site at Cowglen, ACAD at Victoria Infirmary site.

2.5            All travel times and travel costs were based on SPT’s Strathclyde Integrated Transport Model (SITM).

 

 

 

 


3                           Key findings - patients

 

3.1                    It has been found that throughout Glasgow, 60% of patients travel by private car, 10% by taxi, and 10% walk, cycle or use hospital transport.  20% of patients travel by public transport, which is slightly higher than in comparable UK cities.

 

3.2                    At present 99.9% of patients experience mean journey times to acute service facilities of under 30 minutes.  None of the proposed options appreciably increase the percentage of patients experiencing mean journey times greater than 30 minutes. 

 

3.3                    Table 3.1 presents the results of the accessibility analysis for each of the main options.  This details the percentage of patient attendances experiencing mean journey time savings, and also the percentage of patients experiencing mean journey time increases greater than 5 minutes.

 

                 Table 3.1 – Patient Accessibility Comparison

Main Inpatient Site

% of all patient attendances experiencing mean journey time savings

% of all patient attendances experiencing mean journey time increases greater than 5 minutes

GRI, Gartnavel, Southern General.

60%

1.4%

GRI, Gartnavel, Cowglen

65%

4.6%

Stobhill, Gartnavel, Southern General

48%

1.2%

Stobhill, Gartnavel, Cowglen

54%

4.6%

GRI+Stobhill, Gartnavel, Southern General

69%

0.6%

GRI+Stobhill, Gartnavel, Cowglen

74%

3.9%

 

3.4                    The options with four inpatient sites, as opposed to three, maximise journey time savings.  Of the options with three in-patient sites, the combinations of GRI, Gartnavel and Cowglen, and GRI, Gartnavel and Southern General maximise mean journey time savings. 

 

3.5                    The options which include the Southern General minimise the percentage of patients experiencing mean journey time increases greater than 5 minutes.

 

3.6                    Figures 3.1 to 3.18 within the main body of the report show GIS journey time thematics.  It must be stressed that the GIS plots display mean travel times to hospital facilities, taking into account the travel times of patients affected by the proposals and those unaffected.

 

3.7                    Overall, it was found that the most favourable scenario is that which features in-patient services being provided at Stobhill, GRI, Gartnavel and Cowglen.  The most favourable scenario feature three in-patient sites is the combination of GRI, Gartnavel and Cowglen.


4                           key findings – visitors

 

4.1                    It has been found that throughout Glasgow, between 62% and 78% of visitors use private cars.  Public transport use varies between 12% and 24%.  Taxi use is on average 5%.  These results show slightly higher public transport use than in comparable UK cities.

 

4.2                    At present 99.3% of visitors experience mean journey times under 45 minutes.  None of the proposed options appreciably increase the percentage of visitors experiencing mean journey times greater than 45 minutes. 

 

4.3                    Table 4.1 presents the results of the accessibility analysis for each of the main options.  This details the percentage of visitors experiencing mean journey time savings, and also the percentage of visitors experiencing mean journey time increases greater than 5 minutes.

 

                 Table 4.1 –Visitor Accessibility Comparison

Main Inpatient Site

% of all visitors attendances experiencing mean journey time savings

% of all visitors attendances experiencing mean journey time increases greater than 5 minutes

GRI, Gartnavel, Southern General.

21%

13%

GRI, Gartnavel, Cowglen

13%

7%

Stobhill, Gartnavel, Southern General

17%

34%

Stobhill, Gartnavel, Cowglen

10%

16%

GRI+Stobhill, Gartnavel, Southern General

20%

13%

GRI+Stobhill, Gartnavel, Cowglen

12%

7%

 

4.4                    Options which maximise journey time savings are those which include GRI and Southern General. 

 

4.5                    Options which minimise mean journey time increases greater than 5 minutes are those options which combine GRI, Gartnavel and Cowglen.

 

4.6                    Figures 4.1 to 4.18 within the main body of the report show GIS journey time thematics.  It must be stressed that the GIS plots display mean travel times to hospital facilities, taking into account the travel times of patients affected by the proposals and those unaffected.

 

4.7                    Overall, it was found that scenarios featuring in-patient services at GRI, Gartnavel and Southern General are considered to be the most accessibility overall for visitors.

 

 

 

 


5                           key findings – staff

 

5.1                    It was found that the average percentage of car use for staff was 71%; public transport use averaged 19%; taxi use averaged 1% and other modes (walk, cycle, motorcycle) 9%.

 

5.2                    At present, 99.8% of staff within the GGHB catchment experienced mean journey times to work of under 45 minutes.  None of the scenarios appreciably changed this percentage.

 

5.3                    Table 5.1 presents the results of the accessibility analysis for each of the main options.  This details the percentage of staff experiencing mean journey time savings, and also the percentage of staff experiencing mean journey time increases greater than 5 minutes.

 

                 Table 5.1 –Staff Accessibility Comparison

Main Inpatient Site

% of all staff attendances experiencing mean journey time savings

% of all staff attendances experiencing mean journey time increases greater than 5 minutes

GRI, Gartnavel, Southern General.

58%

3%

GRI, Gartnavel, Cowglen

71%

2%

Stobhill, Gartnavel, Southern General

72%

1%

Stobhill, Gartnavel, Cowglen

81%

1%

GRI+Stobhill, Gartnavel, Southern General

59%

1%

GRI+Stobhill, Gartnavel, Cowglen

71%

1%

 

5.4                    Options which maximise journey time savings for staff are those which combine Cowglen with Stobhill.

 

5.5                    Options which minimise mean journey time increases greater than 5 minutes are those options which include Stobhill.

 

5.6                    Figures 5.1 to 5.18 within the main body of the report show GIS journey time thematics.  It must be stressed that the GIS plots display mean travel times to hospital facilities, taking into account the travel times of patients affected by the proposals and those unaffected.

 

5.7                    Overall, it was found that the most accessible scenarios for staff were those that combined Stobhill, Gartnavel and Cowglen.

 

 

 

 

 


6                           key findings – ambulance response times

 

6.1                    The accessibility study considered that part of the ambulance journey between the patient and the hospital.  That part of the journey between the ambulance base and the patient would not be affected by the options within the acute services review.

 

6.2                    At present, 99.9% of the population in the GGHB catchment experience “blue light” ambulance journey times to hospital of under 30 minutes in the off peak period.  None of the options appreciably impact upon this.

 

6.3                    For each combination of accident and emergency units, the percentage of GGHB population within 20 minutes journey time in the am peak, off peak and pm peak is provided in Table 6.1.

 

                 Table 6.1 – Blue Light Ambulance Patient to Hospital Journey Time

Accident and Emergency Sites

% of GGHB population within 20 minute journey time – AM Peak

% of GGHB population within 20 minute journey time – Off Peak

% of GGHB population within 20 minute journey time – PM Peak

GRI, Southern General

95%

99%

96%

GRI, Gartnavel, Cowglen

97%

99%

98%

Stobhill, Southern General

95%

99%

96%

Stobhill, Gartnavel, Cowglen

99%

99%

99%

 

6.4                    The combination of three accident and emergency sites provides a slight advantage in terms of journey time from patient to hospital, compared to those tested with two accident and emergency sites.

 

6.5                    Figures 6.1 to 6.5 within the main body of the report show GIS journey time thematics. 

 

 


7                           Site Impact assessment

 

7.1                    Parking

 

7.1.1               Table 7.1 presents the existing on-site “marked out” parking capacity at each hospital, together with maximum accumulations and the time at which maximum accumulation occurred.  Table 7.1 also shows the existing extend of on-street parking at each hospital.

 

Table 7.1 – Existing On-Site Parking Availability and Accumulation and On-Street Accumulation

Hospital

Marked On-Site Capacity

Maximum On-Site Vehicle Accumulation

% On-Site Vehicles Exceeding Parking Capacity

On-Site Parking Survey Period

Estimated Extent of On-Street Parking (Vehicles)

GRI

480

611

27%

1200 - 1300 hours

475

Stobhill

1011

914

-11%

1400 - 1500 hours

0

Western

520

582

12%

1400 - 1500 hours

625

Gartnavel

540

787

46%

1000 - 1100 hours

0

Victoria

207

267

29%

1200 - 1300 hours

325

SGH

1183

1392

18%

1300 - 1400 hours

0

 

7.1.2               Table 7.1 highlights that the maximum vehicle accumulations recorded at each hospital on the day of the survey exceeded the on-site parking capacity.  Gartnavel clearly experiences the highest levels of vehicle accumulation exceeding car park capacity, at 46%.  By contrast, the Western experiences the lowest number of vehicles exceeding capacity, at 12%. 

 

7.1.3               As Table 7.1 shows, the area surrounding the Western Infirmary currently suffers the highest incidence of on-street car parking, followed by GRI.  The area surrounding Victoria Infirmary, also experiences on-street parking, with an estimated 325 on-street parkers.

 

7.2                    Public Transport and Roads

 

7.2.1               Public transport links within Glasgow have historically been focussed on radial routes into the centre.  Accrodingly, services from South-East to South West are limited, and this is a factor in the scenarios reviewed .  It is strongly recommended that a travel plan committing to work with Strathclyde Passenger Transport to improve these links be adopted.

 

7.2.2               The establishment of large out of town faciltities often leads to an improvement of public transport services to the area, as demonstrated by the recent increase of bus links to the Braehead development.

 

7.2.3               For motorists, the planned extension of the M74 motorway should improve access by car from the East to West of the city, and faciltitate access to the Glasgow Royal Infirmary and the Southern General sites from areas such as the Gorbals and Cambuslang.

 

7.3                    Glasgow Royal Infirmary

 

7.3.1               Analysis has shown that the Glasgow Royal will continue to experience a high proportion of public transport trips. 

 

7.3.2               If the GRI were selected as main in-patient site, this would see the demand for on-street parking increase.  Other scenarios would see either the extent of on-street parking being maintained, or reduce.  No changes are anticipated relating to traffic flows to and from the site itself.

 

7.3.3               The provision of new car park at GRI, and the potential extension of on-street parking controls will however cause a change in the present location and extent of on-street parking.  The adoption of travel plan for the hospital would seem particularly appropriate, to promote attractive and viable opportunities for staff, patients and visitors to use non-car modes.

 

7.3.4               On-site and on-street daily parking demand surveys indicate that the existing Glasgow Royal parking demand exceeds capacity.  Scenarios which maintain Glasgow Royal as the main site in the North and East, with Stobhill as ACAD increase overall parking demand by up to 160 vehicles compared to the existing situation.

 

7.4                    Stobhill

 

7.4.1               The development of Stobhill as the main inpatient site for the North and East, could generate a doubling of existing car parking demand if restraint measures were not applied.  Similar increases in peak traffic flow would also be anticipated.  Other scenarios see either the maintenance of existing traffic demand, or an overall reduction.

 

7.4.2               The accommodation of a large increase in on-site parking, and increase traffic flows onto the surrounding road network may not be desirable, and planning policy would encourage the reduction of parking provision to an operational minimum.  The adoption of a travel plan aimed at improving public transport accessibility, and managing car parking demand would be strongly recommended. 

 

7.4.3               If developed as a main in-patient site, the main challenges for public transport accessibility would be in linking with the east Glasgow catchment, and encouraging bus services to enter the site itself.  There may be advantages in targeted subsidised bus services to areas such as Easterhouse.

 

7.4.4               At Stobhill, scenarios which result in Glasgow Royal operating as a specialist site and Stobhill as a District Hospital in the North and East, increase maximum parking accumulations beyond that currently experienced by up to 818 vehicles compared to the existing situation.  All other scenarios reduce the overall demand.

 

7.5                    Gartnavel

 

7.5.1               Gartnavel is located to the west of Glasgow city centre and is linked to the city centre and wider catchment by a very good public transport network.  It is also located on a primary road into the city centre.  All the proposed scenarios would potentially result in very high increases in vehicle accumulation and traffic flow through the hospital.  Given Gartnavel’s current lack of on-street parking provision and over-capacity in terms of on-site car parking, a two fold increase in vehicle accumulation and vehicle flows may present particular problems in terms of accommodating large additional numbers of cars, and also in terms of the adjoining road network.

 

7.5.2               In this case, development of a travel plan and an increased awareness and development of the extensive public transport network surrounding the hospital would be recommended.

 

7.5.3               At Gartnavel, an increase in parking demand of between 800 and 925 spaces would be experienced as a result of all scenarios.  It is thus considered that the redevelopment of Gartnavel would place pressure on all available site space.

 

7.6                    Southern General

 

7.6.1               The proposed scenarios would potentially result in double the number of vehicles at the hospital.  While The Southern General has good links with Glasgow City Centre, more attention may be required to ensure public transport accessibility is provided from the south east of the city.    Attention should be focused on ensuring adequate non-car accessibility to staff, patients and visitors, as well as private car modes.

 

7.6.2               Improvements in public transport accessibility could be achieved by encouraging changes to existing commercial bus services; in particular providing direct links to key interchange points in the city centre such as Glasgow Central Station.

 

7.6.3               Additional subsidised services linking those communities particularly disadvantaged by the proposed alteration in service delivery in the south east of Glasgow should also be considered; especially if these can also link to key public transport nodes in the south of the city.

 

7.6.4               At the Southern General, all scenarios increase parking demand by 870 spaces.

 

7.7                    Victoria

 

7.7.1               The Victoria Infirmary is located in the south of Glasgow within the heart of an urban area, and is well served by public transport.  It suffers from limited on-site parking capacity, and as a consequence there is substantial amount of on-street parking.  All scenarios see a reduction of traffic demand.  It is anticipated that this would reduce the extent of on-street parking associated with the hospital, but would have little overall impact on the on-site parking accumulations and traffic flows.

 

7.7.2               At Victoria Infirmary, all scenarios reduce overall parking demand.  This would ultimately reduce the extent of on-street parking surrounding the hospital, but not on-site parking demand.

 

7.8                    Cowglen

 

7.8.1               It is anticipated that if Cowglen were developed, substantial changes in the local bus service network would be precipitated.  Whilst it is considered that linkages to from the south west of the city through Cowglen, to the City Centre could be easily achieved, more attention may be required to ensure public transport accessibility is provided from the south east of the city. 

 

7.8.2               This may require additional subsidised bus services linking areas of particular public transport demand, such as Castlemilk, through Shawlands.

 

7.8.3               In order to meet parking demand at Cowglen, parking provision of up to 2,260 spaces would be required.