We would like to highlight our research, kindly funded by a second-degree student grant from the British Association of Oral & Maxillofacial Surgeons, modelling patient transport services for patients commuting to our Head and Neck Multidisciplinary Team (MDT) clinic.
MDT clinics require a large group of patients commuting to a central specialist centre to receive input from multiple clinicians. Within the NHS, approximately 5% of total emissions originate from patient road transport to appointments. The NHS “Delivering a ‘Net Zero’ National Health Service” document highlights that altering patients’ travel into hospital could save 461 kilo-tonnes of CO 2 equivalent every year. Creating a dedicated patient transport service for our Head & Neck MDT would allow us to reduce patient emissions and contribute towards a net zero NHS.
We performed a retrospective review of patients attending our tertiary centre’s MDT between October 2024 and December 2024. We utilised Python and Googlemaps to create matrices containing travel data for journeys between each patient. We then used a nearest neighbour algorithm to generate a list of patients for each week of the MDT who could commute by a patient transport service. Patients were chosen to limit the total distance travelled, whilst limiting the increase in journey time. We modelled collecting three, four and five patients to allow space for relatives also attending the MDT. The patient transport bus had an optimal pickup route calculated by OpenRouteService and we performed simple descriptive analysis of our findings.
Over ten weeks of our MDT, 299 patients were reviewed. The mean age of patients was 65.4 ± 11.5 years, 69.6% were male and 30.4% were female. For a single week of the MDT, the mean one-way travel distance of every patient commuting privately by car was 535.9 ± 88.7 km, or approximately 0.18 tonnes of CO 2 equivalent. By modelling a patient transport bus which collected three, four and five patients, we were able to save a mean of 12.7 km, 25.0 km and 33.3 km ( Fig. 1 ) travelled and reduce the mean journey carbon emissions of the patients in the transport by 18.9%, 27.1% and 33.1% respectively. This would increase the average journey time for the patient collected first by a maximum of 5.9, 14.9 and 21.6 minutes respectively ( Fig. 1 ). However, we have not modelled increased time for a stationary bus whilst a patient is being picked up. Furthermore, in 60% of cases two patients on the transport would be seen by the same consultant, requiring an additional delay to patients before the transport could perform the return journey. This must be balanced with patient time saved by not having to find a parking space at hospital, however.
