Rurality and Accessibility

Devon is the third largest county in the country; however, it is also one of the most sparsely populated with a population density well below national and regional averages. The rural nature of the area is what attracts many residents and tourists alike to Devon, however it makes planning and delivery of services to meet population needs a complex issue.

Rurality can create problems of accessibility. This can affect all parts of the population, and is a particular problem for people who rely on public transport and with the increasing cost of fuel this is beginning to affect even more people. The distance people have to travel to access services has a profound effect on whether people will actively choose to access services. This distance decay effect has an impact on people accessing health services from rural areas in comparison with urban areas.

Access to broadband internet services can also be challenging in rural areas. A project is currently underway across Devon and Somerset to extend coverage to rural areas and details about availability and coverage can be found

 Box 2, Transport to Health Services, Perceptions and ExperiencesOne in five people said the transport they use is either not convenient, or prompt or affordable. Nearly two thirds of respondents did not know it was possible to get help with travel costs, or did not know how to make a claim.

Patient Transport Service drivers are widely praised for goodwill and courtesy. The Single Point of Contact (SPOC) scheme is seen as a model of good practice. But punctuality is a problem, and one provider in particular has been the cause of numerous complaints.

“They manage to undertake a very patient/people focus task which is highly improbable, yet make it all look and feel very professional and relaxed. I have nothing but high praise for the entire team.”

Bus services feature long journeys, complicated timetables and lack of connections. Early morning appointments are difficult to get to by bus, journeys are long, and evening appointments are hard to get home from. People with bus passes may not be able to use them on early buses.

“If one travels before 9.30 Monday-Friday one cannot use their bus pass, often the bus times do not tie in and one often misses the connections.”

Travelling distance matters. The further away a service, the harder it is to get there if you are reliant on public transport, and the harder it is for friends and relatives to visit or offer practical support.

“Hospitals do not consider distance and time taken to get to appointments, often early morning when no bus is available.”

Parking is difficult for some car drivers, with inadequacy of spaces, and long walking distances from car park to building. But the Park and Ride scheme for the Royal Devon and Exeter hospital was praised for convenience and accessibility.

“Not everyone for example receives benefits, so hospital car parking fees on top of travelling costs can be very expensive, for cancer patients.”

Cost is a concern – particularly when bus users have to go by taxi instead. The possibility, in some cases, to reclaim travel costs, is not well known.

“Not everyone for example receives benefits, so hospital car parking fees on top of travelling costs can be very expensive, for cancer patients.”


Healthwatch Devon, ‘Transport to Health Services’ Report, October 2014