Heart attack patient, 83, had to drive four hours for hospital appointment

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.

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.

He made inquiries about getting non-emergency transport but was refused by a call handler from the Welsh Ambulance Services Trust (WAST) when he told them he owned a car.

"I can't understand why pensioners have to run about in their own car," he said.

WAST said it was not always able to meet the increasing demand for transport, and changes were underway to improve the service.

Swift, who has been treated for three types of cancer and has had two heart attacks, 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.

"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."

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.

When he got hospital transport for a subsequent appointment, he said it was "very pleasant, no problem at all".

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.

This includes 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 in each direction.

Councillors in Ceredigion have made calls for better hospital transport systems in rural areas.

One of them, Hugh Hughes, met Swift shortly after his first appointment when the health board wanted him to go back for a second one.

He said: "He was distraught. He didn't know how he was going to manage it. He was absolutely exhausted after the first experience."

After Swift's initial request for transport, the ambulance service reviewed his phone call.

According to Mark Harris, WAST's assistant director of operations, 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 the demand for transport and the distances travelled to appointments were increasing, placing a strain on resources, which could lead to the cancellation of transport.

"We are seeing an increase in the volume of journeys we have to cancel where the demand exceeds our available resource," he said. "So we will get occasions where we have more work than we can fit on our vehicles within a day [and] we're in the middle of a significant improvement programme now to address that."

The councillors and voluntary organisations involved in patient transport have said that, even when a patient gets transport, bookings are frequently cancelled the day before the appointment.

Hughes said: "We've got a very good hospital in Bronglais just on our doorstep yet many of the services seem to be migrating further south.

"We've got to accept there will be occasions where you have to travel. But this seems to be becoming far more prevalent."

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.

"We've been able to fill that gap, and it's quite an important gap to fill because basically that means the person can actually get to the hospital for their appointment," he added.

"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 also said longer journeys for appointments were more common and older patients were "not really comfortable" driving to hospitals in unfamiliar areas.

Hughes said the health board and the ambulance service needed to work together as people were "falling through the net and are not getting the transport they need".

Andrew Carruthers, chief operating officer at Hywel Dda health board, said the board covered a large rural area and it was "aware of the challenges that some of our patients face especially when they have to travel longer distances to access specialist treatment."

He added it worked closely with WAST, and it would raise concerns to see how "transport options available for our patients" could be improved.