As the nation awaited the announcement of the next Prime Minister this week, the Department for Transport (DfT) – quietly and without fanfare – released its review of the 37 Total Transport pilot projects which begun in 2015. The information on which the review is based was collected back in April 2017 and - reportedly by popular demand - the findings have now been made public. The reasons for sitting on the report for so long are unclear. Whilst results have been modest, Total Transport, as DfT recognise, is and always will be a ‘slow burn’ with ways of working taking time to bed-in and produce tangible results in terms of savings and improvements in passenger experience. That the process takes time is something we have made clear since we first coined the phrase ‘Total Transport’ in our 2011 report of the same name to describe a task that many local authorities have attempted over the years with varying success. The task being to work across public policy divides to deliver better outcomes for communities and taxpayers through the sharing of transport resources (e.g. vehicles, scheduling/booking systems, budgets) and expertise. In doing so, the idea is to remove unnecessary duplication; design complementary networks; utilise what would otherwise be vehicle downtime; reduce administration costs; and ultimately deliver savings and a better passenger experience. We followed our Total Transport report with an event the following year for local authorities and their partners to share their experiences of working on these kinds of approaches with one another. The key learning points that arose from that event seven years ago echo many of those included in the DfT’s review this week. Back in 2012, our delegates told us that Total Transport projects may have a long-term strategic vision in mind, but usually start small to build trust and buy-in from would-be partners. DfT’s review also found no easy ‘one size fits all’ solution and that constructive local engagement took time, as did realisation of bigger savings. At our event, delegates pointed out the central importance of knowing your stakeholders and putting in at least six months of preparatory work in order to build trust and relationships. Even then, as the DfT pilots found, people come and go and too often this means that engagement is severed and relationship building must start again from scratch. Our delegates expressed particular frustration with getting the health sector on board. Similarly, DfT note in their review that many participants saw integration with NHS non-emergency patient transport (NEPT) fleets as representing ‘the biggest prize for better integration’ but also ‘the most difficult to unlock’. Indeed, difficulties in engaging with the health sector, not least finding and keeping hold of the right person to speak to, is described by DfT as ‘perhaps the single most significant barrier to the adoption of Total Transport’. This certainly chimes with what we have heard over the years in respect of Total Transport and more widely for other areas of potential collaboration with the health sector. Whilst the situation has improved considerably for collaboration with public health (having moved under the umbrella of local authorities), the NHS more widely frequently feels like an unknowable and impenetrable entity. This is something we have sought to address in numerous ways from roundtables bringing stakeholders from health and transport together to companion guides for the two sectors to help them understand one another. In 2017, we worked with the Community Transport Association to specifically explore the potential of Total Transport for NEPT, estimating that the NHS could save some £74.5 million per year if more efficient patient transport could prevent just 10% of missed appointments. More recently, we have written to the Chief Executive of the NHS suggesting the need for an independent government review to examine the efficiency and effectiveness of NEPT and potential reforms. Our letter also calls for a health and transport champion in each region charged with making the connections between health and transport and bringing leadership on the issue. A key recommendation from DfT’s review is that ‘more work is needed to involve the NHS in Total Transport and unlock the substantial opportunities for joint working which remain untapped.’ It goes so far as to say that local engagement alone may not be enough and that ‘some degree of coercion might be appropriate to encourage organisations to participate that have so far declined to do so.’ We certainly agree that some form of push at the highest level is required, hence our decision to write directly to the NHS Chief Executive highlighting what we believe to be huge potential for more joined up thinking and working between our two sectors. We will also be making the case to the new Government in the coming months. It is telling that despite the difficulties encountered, the majority of Total Transport pilots are continuing in some form, using their own resources. Local authorities and their partners would not do this if they could not see the potential of Total Transport and what is, necessarily, a ‘softly, softly’ approach. Like the release of the DfT’s review, the results will come slowly and without fanfare but that does not mean they will not be worth celebrating.

Rebecca Fuller is Assistant Director at the Urban Transport Group (Image: North West Ambulance Service)