Car parking is a clinical quality issue
BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h1312 (Published 14 April 2015) Cite this as: BMJ 2015;350:h1312All rapid responses
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I had great sympathy with David Gilbert's mum's agitation as a consequence of parking issues when attending a hospital appointment.
I wonder how many of my community based colleagues share my pain and frustration when trying to visit patients where parking is restricted to residents only. Twice in the last 4 months I have been ticketed despite displaying my position as a vsiting GP and which house I was in. The first I appealed successfully but was advised the ticket was correctly issued, the second no quarter given. Pay up or go to court. I have been advised that I can have a yearly parking ticket for £15. Is this how we are going to work in partnership with our local councils?
Not much to pay I know but really?
Competing interests: No competing interests
Hospital car parking isn’t just a problem for patients. It is a problem for anyone who has business at the hospital.
How many clinics and operating lists start late because staff can’t find a parking space? How many lives are put at risk because consultants who have to dash from an emergency in one hospital to another are driving around looking for parking while a patient’s condition deteriorates? How many staff cannot journey to work by public transport because it doesn’t run or is unsafe at the time they have to travel, or doesn’t exist at any time of the day or night.? How many people chose to work elsewhere because parking is such a struggle or is unaffordable on a meager NHS income?
But it isn’t realistic to try to solve the problem by creating more on-side parking. Over the last few years much green space on hospital sites has been covered with concrete, removing one of the small psychological reliefs for anyone who visits or works there, and still there is a shortage of parking space.
Providing more parking is only a small part of the answer. Everyone – staff, patients, the community, local government – needs to be involved in working out how to tackle a problem which wastes time and money and increases frustration and prejudices the care that patients receive.
Competing interests: No competing interests
Thank you for this article. It took me back to 20 years ago to my time in a Clinical Audit department, when we were eventually dissuaded from asking about car parking in patient satisfaction questionnaires as there was 'nothing that could be done about it'. The irony is, that hospital has since amalgated all wards and services to a newly built single building with most of the potentially useful entrance access area landscaped into an open air piazza unsuitable for all except the rare hot sunny days that the area in the Midlands receives. Dropping off elderly relatives involves incurring the wrath of the parking attendants keen to point out it is drop off only, leaving your patient sat on a bench outside (weather permitting, see above) while you trek back from the multistorey. Needless to say in 'normal' weather the tiny entrance is clogged with people taking shelter. Shame that nothing can be done about this for the next 20 years plus either.
Competing interests: No competing interests
In my experience it isn't just having to spend that frantic 90 minutes looking for a car park space, it's finding that the only empty space is a long hike away from the hospital entrance - an added stress on an already frail and elderly patient like David's mum.
I would like to solve the problem by providing a comfortable drop-off area just inside the hospital entrance, with a welcoming person to settle in the patient for the long wait for her driver to return to join her. I think a member of the Friends of the Hospital may well be interested in providing that kind of welcome given the hospital could find a few comfortable chairs for them to use. It would be worth asking them anyway.
Competing interests: No competing interests
Have suffered similar problems with car parking & access to hospitals & other health provision both myself and in accompanying others.
Usually if I am having to see a medical professional I am unwell and/or feeling somewhat stressed before I get there - which I think is often forgotten. So not always feeling my best or worried about someone else difficulties in accessing buildings compounds this & I am often not at my best when in the appointment.
I would suggest that planners & providers of services walk through access (literally) in the eyes of the patients, or better still work with patients at the planning stage to really get an appreciation of 'walking in their shoes'. A very different perspective will be revealed that if dealt with can make patients' experiences much less stressful & can optimise any resulting clinical care.
Competing interests: No competing interests
The irony here is that potentially the doctor was also late because they could not find a car parking spot. I'd leave early, and still start my shift frustrated and cross.
3pm starts always used to fill me with dread as parking was impossible. Public transport wasn't an option, as it didn't go to my house, and stopped before my shift finished.
Now I don't have this problem. The walk home fills me with a different sort of dread.
Still, the reprieve of the holidays is always there. For some reason, parking is not a problem in school holidays...
Competing interests: No competing interests
It is not just car parking that is a quality issue.
If, as a consequence of the drive to 7 day working, services will be redesigned, merged and some sites closed, then the wider issue of transport needs to be included in the redesign process. Not everyone has a car and the public transport system may be infrequent or not match appointment times, especially in rural areas. Taxis can be expensive, especially for longer journeys in rural communities.
So it is essential that transport planning, in partnership with local authorities & providers, must be considered from the beginning of the redesign process.
Competing interests: No competing interests
Patients' care includes transportation along with care. Hospitals and consultation suites provide drop and go facilities for patients to cut short the transportation delay for patients. Hospital authorities should adopt specific guidelines and rules for car parking and patient transfer in vehicles .
Competing interests: No competing interests
Thanks all for these thoughtful responses.
I agree with Glenn Stewart that the NHS should do more to promote 'healthier' travel. If that were to have been the case, then perhaps my frail mother and I would have got a parking space! Joking aside, it should be noted that, for some people (including my very frail mother and myself) there was no way we could have got there by any other means.
Having a particular interest in mental health, and starting a role that will include overseeing integration of physical and meantl health well-being, I am particularly interested in the views of Shrikant Srivastava. I wonder how the issue of dispersed community sites can be balanced with 'green' travel policies.
I am really encouraged by having triggered renewed attempts to finding local solutions in Brighton. I hope I can help, Kamal Patel!
Competing interests: No competing interests
Re: Car parking is a clinical quality issue
Thank you for this thoughtful article. I fully agree that car parking at hospitals is both a cost and a quality issue for patients. One possible way forward is to move certain services into the community, where this is appropriate.
We have started providing chemotherapy in our GP surgery, led by the local oncology team. The distance from the (free) car park to the unit is about 30 yards, and patients tell us they find this service easy and convenient.
knut.schroeder@bristol.ac.uk
Competing interests: I'm a Partner at Concord Medical Centre, and we're a member practice of Quality Practice.