NHS Appointment Timing Raises Patient Travel Emissions by Limiting Public Transit Options

A 2025 Greater Glasgow study of 6,599 patients showed annual hospital travel peaking at diagnosis and highest for cancer cases, with distances varying by condition. Combined with 2019 Department for Transport data indicating two-thirds of English households cannot reach hospitals in 30 minutes by public transport or walking, these patterns reveal how fixed appointment systems amplify car dependence. Southampton and Isle of Wight Cordial project interviews highlighted patients adding buffer time for unreliable buses, paying fares before pass activation, and facing shelterless stops during extreme weather.

Transportation barriers compound inequities for those with multimorbidity. The 2024 review of missed appointments linked distance and access issues to non-attendance, while northeast Scotland cancer patient data showed day-long journeys imposing financial and physical costs. These observational findings indicate that rigid timing, rather than patient preference, drives emissions; flexible scheduling could shift modes without requiring individual behavior change.

Next steps require interventional trials testing staggered or virtual options against emission and attendance outcomes, alongside integration of real-time transport data into booking systems. Evidence quality remains limited by reliance on cross-sectional surveys and discontinued national statistics, leaving causal impacts of policy changes untested.