RURAL COMMUNITIES: A Healthwatch focus on rural isolation and community transport around Bedale
From left, Ian Sandell, Sheila Sandell and Malcolm Bloor from Bedale Community Minibus
As part of our work looking into the issues facing rural communities, Healthwatch North Yorkshire spends a morning with the volunteers and passengers of Bedale Community Minibus – a service which offers a lifeline to local villagers, but one which faces issues including unpredictable demand and difficulty in recruiting volunteers.
Every day, thousands of vehicles zip through the North Yorkshire countryside between our two National Parks – the Moors to the east and Dales to the west – along the A1.
Watching them arrow along the 396-mile route connecting the capitals of England and Scotland, it seems somehow ironic that many of the villages nestling in the shadow of this bustling artery are very firmly in the slow lane when it comes to accessing transport.
People living in the county have told us rural transport is one of the biggest barriers in accessing NHS services, along with difficulty in getting GP appointments and long distances to hospitals. In our highly rural area, many told us they wanted services closer to their homes and better transport support to access more distant services. It was a theme repeated across England’s Healthwatch network as we talked to people about the NHS Long Term Plan – and this month Simon Stevens, the chief executive of the NHS, announced a national review of the links between the NHS and local transport.
Boarding a minibus bound for some of these villages – next to the A1, yet a world away – it is easy to see why this work will be so important.
“Bedale Community Minibus aims to provide affordable transport for elderly and disabled people, local community groups and others in need in the Bedale and surrounding area. It is our wish that those in need, where possible, maintain an independent lifestyle and do not become socially isolated.”
So reads the home page on the website of the organisation, set up in 1992 and an independent Charitable Incorporated Organisation (CIO) since 2014. The mission statement echoes another key issue facing the NHS in England – loneliness and isolation, which the Government says is one of the country’s biggest health challenges with an impact to match smoking or obesity.
It very quickly becomes clear that the Bedale service is a lifeline for people living nearby – in the likes of Carthorpe, Burneston, Leeming, Snape, Kirklington and Exelby – many of whom would struggle to get out of their village without it. Even where there are public transport services, buses run infrequently and bus stops can be hard to access on foot. Getting anywhere by commercial taxi services is prohibitively expensive to elderly people who have to count every penny. But every Wednesday, one of Bedale Community Minibus’s two vehicles is driven right up to the front door of each of the locals signed up for the weekly market run, and a volunteer helps them out of their home and to their seat, bound for Northallerton.
On the day Healthwatch North Yorkshire joins them, numbers are down. Some weeks there can be nine passengers aboard, but today we pick up a third of that. They each pay £5 for the return journey, which gives them a couple of hours’ shopping time before ferrying them back to the comfort of their own homes.
NHS Chief Executive Simon Stevens speaking at the Healthwatch Conference in Birmingham this month
“Today we won’t cover our fuel costs, but that’s our contribution to the community,” says Malcolm Bloor, trustee of Bedale Community Minibus – a non-profit organisation which costs £22,000 a year to run. Fluctuating passenger numbers is the kind of issue that can make it difficult for commercial operators to maintain services in rural areas – and will give those involved in Simon Stevens’ review a headache – but Malcolm says it gives organisations like his a “niche” in which to operate: “We’ve got the only specialised vehicles in the area with hydraulic lifts for wheelchairs.”
Run entirely by volunteers, the organisation has two minibuses, also available to hire by the likes of community organisations, youth clubs and schools to take people to events. They are able to call on a pool of about 17 drivers, but many of them are available for just a day a month, and the timing of the core services – including a similar run to Bedale’s GP surgery every Tuesday – means the drivers are retired or semi-retired. This imposes another restriction: the clock is ticking. Past the age of 70, drivers have to pass a special medical to stay behind the wheel of a minibus. All these factors create an ongoing rota headache for Jenny Gardiner, a volunteer aboard today who helps with administration and passengers.
Ian and Sheila Sandell, from Hunton, are today’s driver and passenger escort respectively. They have a very busy family life with six grandchildren, but Ian can offer up to two days’ service a month. He was recruited to the cause through his interest in using the minibus in his role as a Scout Leader in Bedale. “In these villages, if you don’t drive, you’re stuck. This service makes things more accessible for people,” he tells us.
While Ian keeps his mind on the road, Sheila helps the first of the service users out of her house in Carthorpe. It’s a dedicated service, right down to making sure they have remembered their keys, and volunteers like Ian and Sheila get to know the individual needs of every passenger. Today’s first is armed to the teeth with bags. This is going to be her big weekly shop. Asked what she would do without Bedale Community Minibus, her answer is blunt: “Stay at home!”
“Bedale is expanding considerably and there is a high proportion of elderly people,” says Malcolm, echoing a sentiment expressed earlier by Ian – who backed Malcolm’s view that local health services are not expanding accordingly. Malcolm says in many cases, men had been running the household car – and when widowed, women were left facing loneliness and isolation. “The local surgery receives phonecalls from lonely people simply because they haven’t seen anybody,” he says.
Today’s first passenger is armed to the teeth with bags. This is going to be her big weekly shop. Asked what she would do without Bedale Community Minibus, her answer is blunt: “Stay at home!”
Glebe House Surgery works closely with Bedale Community Minibus for the Tuesday service, which also runs from door to door at a cost of £5. The surgery identifies people with appointments booked for that day who will need transport, and supplies the service with a list. Today’s first passenger on the market run says the set-up is “ideal”. She has a series of appointments booked for the next few Tuesdays, and says it is a relief to know she can get to them. She says she had spent £20 on a taxi getting to the surgery when she had an appointment on a Friday.
Malcolm says: “Some people move to this area from elsewhere to be near their children, but they get forgotten. People can get on the A1, use the railway system. But these young people are not available to take elderly people to appointments unless they take time off work.
“The GP surgery is running itself into the ground. There’s a big problem getting appointments because of the overload,” he adds.
After picking up the next two passengers in Leeming – where there is a shop, albeit a long walk from many homes – we wind our way into Northallerton, where arrangements are made for pick-up locations in a couple of hours. One says she has access to a bus service running from Monday to Saturday, but it would leave her with five hours to fill in the town before the return journey, as well as a lengthy walk to the bus stop. And no help with her bags, unlike on the minibus.
While Bedale Community Minibus is happy to operate in this “niche” and has declined opportunities to run commercial services, Malcolm sees a lot of wasted potential. The other minibus is newer – partly funded with £8,582 from the Co-op Community Fund last year – with more modern specifications including front and rear cameras and armrests for passenger seats. However, both vehicles often sit idle all weekend when they could easily be put to use – but for a shortage of drivers.
“We could do more if we could get more volunteers,” he says “Some people can only give up a day a month. Those who are volunteering are getting on, getting towards 70. We have people asking to go and visit gardens, WIs and so on in the summer, but it’s hard to get drivers to give up a whole day.”
He says he has tried to secure meetings with local employers to discuss promoting the possibility of volunteering to employees approaching retirement, but his efforts have met with little success.
The minibus service works with Broadacres, a Northallerton-based not-for-profit housing association, which identifies residents who would benefit from a community outing. For £2 or £3 a head, they might be taken to an afternoon tea or a Christmas show – “to get them out of the house”. But availability of such services is limited by the availability of drivers.
Malcolm also says he feels frustrated by what he perceives as a lack of funding available for transport in the budget for events. North Yorkshire County Council, via its Stronger Communities programme, puts on a range of community events – however, while “the organisers are able to obtain funding to hold events, a lot of elderly are unable to attend due lack of transport”, he says.
In our What Would North Yorkshire Do? report, long distances to access hospital services was also a concern, and in this part of the world the future of services at the Friarage in Northallerton is under consultation. Urgent temporary changes to services were introduced in March amid concerns over a shortage of medical cover, and the emergency department is in line to be replaced with an Urgent Treatment Centre.
Malcolm, 79, this summer spent four weeks at the James Cook University Hospital in Middlesbrough with a foot problem. When he was eventually transferred to the Friarage, he says he spent a day in the Clinical Decisions Unit before being discharged with no means of getting home, adding that his local surgery apparently received no information relating to his future treatment from the hospital for five days. “Communication isn’t happening,” he says.
For Ian and Sheila, a key change has already been made at the Friarage – the downgrade of maternity services from consultant-led to midwife-led in 2014. They say none of their six grandchildren were born at the Friarage – grandson Noah was due to be delivered there, but amid the floods of 2012, his parents were told the unit was full and they would have to go to James Cook. Their efforts to beat the flood water made headlines at the time – you can read a Daily Mail article from 2012 here.
Despite assurances otherwise from the local hospital trust, there remains a genuine concern in the community that the perceived “running-down of services” at the Friarage is a “foregone conclusion”, says Ian, who feels the changes echo the decline of the military hospital in Catterick where he used to work. “It might take 10 years.”
Considering concerns over the potential loss of services at local hospitals and the time taken to reach more distant facilities, a roadblock that left the team at Bedale Community Minibus baffled highlights the size of the task in providing the transport people need to access health and social care services, and suggests there will be no easy “one-size-fits-all” approach.
A weekly Thursday service was launched in April to take villagers to visit family members or friends at James Cook for £7.50 return – leaving Bedale at 1pm and leaving Middlesbrough shortly after 4pm. It was a service volunteers thought would be welcomed – but it was cancelled in August after three months with no passengers.
However, Malcolm says the team are happy to focus their efforts on where they are needed in their “niche”, which includes offering MiDAS (Minibus Driver Awareness Scheme) training alongside the bread and butter of taking their regulars – “like a little family” – to market: “They’re happy to know somebody’s going to do something for them.”
Oak House, 35 North End, Bedale, North Yorkshire. DL8 1AQ
Telephone: 01677 425329
Office hours are Monday to Friday 9.30am until noon
Charity Registration Number 1158623