Scottish Government

Development Department Research Programme
Research Findings No.148/2002

Transport Impacts of Major Health Care Developments

FaberMaunsell

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Main Findings

There are three important areas to consider in suggesting recommendations for future consideration:

• The potential and need for PPP or PFI exercises to take on board transport issues - staff, patient and visitor access to the development - as a key element in the initial bid and costing process.
• The key role played by transport testing as part of the site selection process. Each site should be tested against the others to ensure that all of the appropriate parameters, including transport are objectively considered.
• Green Travel issues should be enshrined in agreements between the developer and planning authority made under Section 75 of the Town and Country Planning (Scotland) Act 1997 with penalties/actions available for failure to meet mode share targets which are derived from comprehensive travel planning.

It is considered that the most efficient mechanism to ensure that transport testing and travel planning, which is socially and environmentally sustainable, is within National Planning Policy Guideline 17, Transport and Planning. The necessary processes within PPP or PFI to ensure transport is accorded appropriate consideration require detailed contemplation.

Key Issues

A series of key issues have arisen as a result of the exercise. These issues are listed and commented upon below.

• Consultation is essential for the success of the location/ relocation process. By consulting all concerned and affected by the development it is possible to gain support for the project, provided consultation is carried out correctly. Every possible measure should be taken to ensure that all communities affected by the development are consulted. Consultation could be via the community council, community action groups, local councillors, public meetings and the Local Authority itself.

In relation to the NRIE, it is clear from internal documentation that consultation was fairly widespread, though a recurring theme arising from the interview surveys was an apparent lack of such consultation. In this regard, the issue may be one of the quality of consultation undertaken.

• Due to the apparent lack of communication between the PPP and bus operators in the case of the NRIE, it is stressed that a 'partnership' should be set up between the PPP/developer, Local Authority and bus operators at an early stage. This would help to ensure that the appropriate infrastructure is in place to allow access by all modes to the facility. This partnership could identify staff, patient and visitor travel patterns and set targets to improve the modal shift.

It should be noted that it is good practice in any case in relation to major development to engage in dialogue with transport service providers at an early stage of the process. This is reinforced within the Institution of Highways and Transportation 'Guidelines for Traffic Impact Analysis _ 1994' and the recently published Guide to Transport Assessment for Development Proposals in Scotland (The Scottish Executive, 2002).

• Transport issues should be developed as part of the PPP or PFI. This ensures that the funds are allocated in time to make sure that adequate transport facilities are in place to encourage modal shift away from driving alone. At present PPP's are able to side step the issue of transport due to lack of funding. It then falls on Local Authorities and bus operators to produce the funding for the provision of public transport.
• The transport and environmental assessments produced as a result of the development should be efficient in dealing with all the issues relating to transportation. Various parties have a valid interest in the outcome of these documents, therefore they should be made available as and when required.

This point is extracted from a recurring interview theme and reflects feelings on the lack of consultation. Typically, Transport and Environmental Assessments are available for viewing at Council offices as part of the planning process. In the case of major healthcare facilities, which are community based in any case, there is an argument to say that the community should be included in the process to a greater degree than normal and should be given reasonable access to documents informing the decision making process.

• Transport testing should be a key part of the site selection process. Each site should be tested against the others to ensure that all of the appropriate parameters are taken into account.

As evidenced by the experience in the Public Local Inquiry into the relocation of Midlothian Hospital, detailed examination and scrutiny of the site selection process can be a positive exercise. Issues of site selection can, of course, be confidential, nevertheless, a 'sequential test' exercise for the transport issues is worthy of consideration.

The Planning Application for the NRIE was granted subject to a Section 69 (of the Local Government (Scotland) Act 1973) Agreement. This allows the local authority to enter into contracts with 3rd parties. The key differences between Section 69 and Section 75 agreements are explored in detail in The Use and Effectiveness of Planning Agreements (The Scottish Executive, 2001).

The Section 69 agreement as framed has very little 'teeth'. Most measures rely on encouragement etc. rather than actual implementation.

Recommendations

• PPP or PFI must fully consider the transport issues associated with the development being considered.
• Site selection must include transport testing.
• Section 75 agreements should become the accepted mechanism to enshrine Green Travel issues.

NPPG 17 should consider an additional paragraph that singularly considers hospitals. This would recognise the careful consideration required for hospital developments and the need for them to be located where they are well served by public transport, and that the preparation of Green Travel options, which provide a high level of social and environmental sustainability, requires to be enshrined in enforceable planning agreements.

Evidence from a recent hospital construction on a greenfield site in England, which used the legislative equivalent Section 75 agreement (Section 106) illustrates the financial component of such agreements to ensure that health care facilities appropriately consider their travel and transport impacts. The health trust concerned is funding 6 million of highway improvements and providing financial support for between 5 and 10 years for bus services.

Research Methods

A literature review considered secondary sources dealing with hospital relocation and a paucity of documented evidence was revealed. The documented information lodged in support of or as a requirement of the planning application was also reviewed. Additional local authority and Scottish Executive strategy, policy and historical documentation connected to health care facility location, transport and planning, illustrated the site selection process.

Structured interviews were undertaken with some 40 key personnel within relevant stakeholder organisations relating to their views on the previous consultations and past and present policies towards the relocation, as well as how the relocation caters for different modes of transport. Interviews were split between face to face and post, where requested, postal interviewees received a personal interview.

In addition, modal surveys were undertaken at the Edinburgh City Centre hospital location prior to the relocation. These surveys have recorded the travel patterns of visitors, patients and staff to identify a historical pattern of mode share useful for future comparative purposes. Traffic counts were also undertaken to establish traffic movements to and from the City Centre site.