An 83-year-old man who has had two heart attacks and been treated for three types of cancer was forced to drive himself on a four-hour round trip for medical tests in west Wales after being refused non-emergency transport. Charles Swift, from Borth, Ceredigion, was referred to Withybush Hospital in Haverfordwest, 70 miles away, for tests on his heart in August.
Swift said when he rang hospital taxis he was asked if he could walk, climb stairs and owned a car. When he replied yes to all three, he said he was told: "You'll have to use that then." He said: "I don't understand. What's the difference if you've got a car or not? I'm 83. It's not a good journey to do. It was tiring." He also said: "I can't understand why pensioners have to run about in their own car."
Hywel Dda University Health Board's website says patients travelling to and from hospital are normally expected to organise their own transport. Where that is not possible, some patients may be eligible for free non-emergency transport provided by the Welsh Ambulance Service, with criteria including receiving regular dialysis or cancer treatment, needing a stretcher or oxygen, or needing to travel in their own wheelchair. Public transport is not a realistic option, as trains from Borth to Haverfordwest take a minimum of three and a half hours each way.
On another occasion, Swift was told on a Friday afternoon that his hospital transport for an appointment the following Monday had been cancelled, leading him to cancel the appointment. When he received hospital transport for a subsequent appointment, he said it was "very pleasant, no problem at all".
Mark Harris, WAST's assistant director of operations, said the transport would not have been refused if the service had more information. "We've changed our processes now, and we've put some training out to our call taking team, so when Mr Swift rings again, he'll get a different answer," he said. Harris said demand for transport and the distances travelled were increasing, placing a strain on resources. "We are seeing an increase in the volume of journeys we have to cancel where the demand exceeds our available resource," he said, adding that the service was in the middle of a significant improvement programme.
Ceredigion councillor Hugh Hughes met Swift shortly after his first appointment, when the health board wanted him to return for a second one. "He was distraught. He didn't know how he was going to manage it. He was absolutely exhausted after the first experience," Hughes said. He said services appeared to be migrating further south from Bronglais Hospital, and called for the health board and ambulance service to work together, saying people were "falling through the net and are not getting the transport they need".
Community transport service Dolen Teifi, based in Llandysul, has 42 vehicles and 160 volunteer drivers covering Ceredigion and Carmarthenshire. Manager Rod Bowen said drivers make about 50 journeys to hospital appointments each week, and the ambulance service's capacity “has been stretched”. Bowen said the charity, which charges an average of 57p a mile to partly cover costs, had taken 145 calls in the past two months when hospital transport had been cancelled the day before an appointment, and was able to help in about a third of cases. “We've seen a huge increase of people having to travel past their main hospital door to a hospital that could be anything up to 40 to 50 miles away,” Bowen said, adding that older patients were “not really comfortable” driving to hospitals in unfamiliar areas.
Andrew Carruthers, chief operating officer at Hywel Dda health board, said the board covered a large rural area and was "aware of the challenges that some of our patients face especially when they have to travel longer distances to access specialist treatment". He said it worked closely with WAST and would raise concerns to see how "transport options available for our patients" could be improved.
Analysis
Why This Matters
- The case shows how eligibility rules for non-emergency patient transport can leave elderly patients with serious health conditions facing long, tiring drives they are not comfortable with.
- Rural patients in Ceredigion are increasingly being sent to hospitals far from their local one, making reliable transport essential for them to attend appointments at all.
- The ambulance service itself acknowledges demand is outstripping capacity, so refused bookings and cancellations could continue unless its improvement programme works.
Background
Hywel Dda University Health Board covers a large rural area in west Wales, with services spread across hospitals including Withybush in Haverfordwest and Bronglais in Aberystwyth. Travelling between them by car or train takes hours, and the area's community transport charities have been filling gaps left by the non-emergency ambulance service.
Key Perspectives
- Charles Swift: says pensioners should not have to drive themselves long distances to hospital appointments, and questions why owning a car should disqualify him from transport.
- Welsh Ambulance Services Trust (Mark Harris): says the transport would not have been refused with more information, and it has changed its processes and trained call handlers, while acknowledging demand increasingly exceeds available resources.
- Ceredigion councillor Hugh Hughes: says services are migrating further south from Bronglais Hospital and people are "falling through the net and are not getting the transport they need".
- Dolen Teifi (Rod Bowen): says the ambulance service's capacity "has been stretched" and the charity is filling gaps, with a growing number of people travelling past their main hospital to appointments 40 to 50 miles away.
- Hywel Dda University Health Board (Andrew Carruthers): says it is aware of the challenges of longer travel for specialist treatment and will work with WAST to improve transport options.
What to Watch
- Whether Swift's next transport request is handled differently under WAST's changed process and training.
- Whether WAST's improvement programme reduces the number of day-before cancellations.
- Whether discussions between the health board and ambulance service produce changes to eligibility criteria and transport options for rural patients.
Checked
12 claims in this story checked against 1 source: 12 supported.
Show each claim
- SupportedThe 83-year-old patient had to drive four hours for a hospital appointment.BBC Wales: “An 83-year-old recovering cancer patient who has suffered two heart attacks was forced to drive himself on a four-hour round trip for medical tests.”
- SupportedThe Welsh Ambulance Service changed its call-handling processes after Swift was told to use his own car.BBC Wales: “"We've changed our processes now, and we've put some training out to our call taking team, so when Mr Swift rings again, he'll get a different answer," he said.”
- SupportedSwift was 83, had suffered two heart attacks and had been treated for three types of cancer.BBC Wales: “Swift, who has been treated for three types of cancer and has had two heart attacks”
- SupportedSwift was referred in August to Withybush Hospital, 70 miles away, for heart tests.BBC Wales: “Charles Swift was referred to Withybush Hospital in Haverfordwest, Pembrokeshire, for tests on his heart in August - he lives in Borth, Ceredigion - which is 70 miles away.”
- SupportedAfter Swift said he could walk, climb stairs and owned a car, the call handler told him, “You'll have to use that then.”BBC Wales: “When he replied yes to all three, he said he was told: "You'll have to use that then.”
- SupportedSwift said, “I don't understand. What's the difference if you've got a car or not? I'm 83. It's not a good journey to do. It was tiring.”BBC Wales: “"I don't understand. What's the difference if you've got a car or not? I'm 83. It's not a good journey to do. It was tiring."”
- SupportedThe health board says patients are normally expected to arrange their own transport, while some may qualify for free non-emergency transport under eligibility criteria.BBC Wales: “Hywel Dda University Health Board's website says patients travelling to and from hospital are normally expected to organise their own transport. When that is not possible, some patients could be eligible for non-emergency patient transport provided by the Welsh Ambulance Service, but must meet eligibility criteria.”
- SupportedTrains from Borth to Haverfordwest take at least three and a half hours each way.BBC Wales: “Public transport is not a realistic option as trains from Borth to Haverfordwest take a minimum of three-and-a-half hours in each direction.”
- SupportedSwift's transport for a Monday appointment was cancelled on the preceding Friday, so he cancelled the appointment.BBC Wales: “On another occasion, Swift was told on a Friday afternoon that his hospital transport for an appointment in Haverfordwest on the Monday had been cancelled, leading him to cancel the appointment.”
- SupportedHarris said the transport would not have been refused if the service had more information.BBC Wales: “According to Mark Harris, WAST's assistant director of operations, the transport would not have been refused if the service had more information.”
- SupportedDolen Teifi had 42 vehicles and 160 volunteer drivers covering Ceredigion and Carmarthenshire.BBC Wales: “Dolen Teifi - a community transport service based in Llandysul - has 42 vehicles and 160 volunteer drivers covering Ceredigion and Carmarthenshire.”
- SupportedDolen Teifi received 145 calls in the past two months about transport cancelled the day before an appointment and could help in about a third of cases.BBC Wales: “Bowen said the charity had taken 145 calls in the past two months when hospital transport had been cancelled the day before an appointment, and it was able to help in about a third of cases.”
