MACS ANNUAL REPORT April 2007 – June 2008

Actions Required to Improve the Mobility of Disabled and Older People in Scotland

An advisory report for Scottish Ministers.

November 2008

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Contents Page 1. Introduction ...............................................................……4 2. Conclusions of the Review of Recent Research..………5 3. The Way forward………………………….…………………..6 3.3.1 Information on People with Reduced Mobility………… 6 3.3.2 The Role of Different Modes……………………………….7 3.3.3 Effective Monitoring and Evaluation……………………….7 3.3.4 Finance……………………………………………………….7 3.3.5 Developing the Necessary Skills…………………………..8 4. Issues Requiring Action.....................................................8 4.1 Gap Analysis ..………………………………………………..8 4.2 Guidance on the Design and Development of Accessible Demand Responsive Transport……………………………11 4.3 Assessing Eligibility………………………………………….14 4.4 Monitoring and Evaluation…………………………………..16 4.5 Terminology…………………………………………………...18 4.6 Defining Levels of Access…………………………………...18 4.7 Developing an Analytical Approach to Investment………..20 4.8 People with Reduced Mobility (PRM)………………………21 4.9 The Relationship between Disability, Age and Poverty.....22 4.10 Concessionary Travel………………………………………..23 4.11 Effective Working with Older and Disabled People……….25 4.12 Developing Cost Benefit Analysis…………………………..26 4.13 Policy into Practice…………………………………………...27 4.14 Access to Ferries……………………………………………..28

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Annexes A. MACS’ Objectives ......................................…………………..29 B. Understanding Accessibility and Mobility..…………………31 C. Main Issues identified in the Review of Recent Research:

Practical Action needed…………………………………………..33 Prioritisation………………………………………………………..35 Future Research…………………………………………………..37

D. List of Meetings and Attendees……………………………….38

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1. Introduction

1.1 MACS believes in a Scotland where anyone with a mobility problem due to some physical, mental or sensory impairment can go when and where everyone else can and have the information and opportunities to do so. 1.2 Transport policy is becoming increasingly complex. A review of recent research commissioned by MACS has shown that:

• the research has still not answered fundamental questions; • there are concerns that the variable needs of disabled people

are not achieving the priority they deserve; and • the variability of barriers to travel for disabled people in

Scotland is not well understood. 1.3 The conclusions of the review are set out in 2 below. A subsequent independently commissioned professional evaluation of the SE website publication ‘How to Plan and Run Flexible Demand Responsive Transport (DRT) Guidance considered that whilst the publication provides a useful introduction to the setting up of a DRT service it is not comprehensive, particularly in relation to the many sensitive and specialist areas of design that make services accessible to older and disabled people. Rather it provides only a brief insight into what is a highly complex process. In addition to the pro-active agenda set out in this report, MACS must continue to liaise with disability organisations, organisations representing older people, with Local Authorities, ATCO, COSLA, SATA, CPT, CTA, PVS, etc. MACS must also be able to make inputs to various draft policy documents, respond to consultation exercises and effectively liaise with DPTAC. MACS needs to produce position papers or discussion papers for wide distribution, setting out the pros and cons on various issues relating to the mobility of older and disabled people, inviting constructive comments which can add to the debate.

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As and when appropriate, MACS will need face to face briefing meetings with relevant Scottish Ministers. Between meetings MACS should provide Ministers with briefings on a range of issues flowing from MACS’ work, or as requested by Ministers. Planners and politicians should be encouraged to shift from discussions which are primarily about modes and begin to learn how to talk about people. People with Reduced Mobility need to be able to make three types of trip, short (very many), medium (much fewer) and long (very few or not at all). Different modes play a different role in providing for these trips and different modes will play a different role in different geographic areas, in urban, peri-urban, rural and island communities. 2. Conclusions of the Review of Recent Research 2.1 Overall the review concluded that:

• Current and planned programmes will not achieve the level of change needed to improve the mobility of disabled people;

• There are some immediate actions needed to ensure that

current investment and funding programmes are more equitable;

• The scale of what needs to be done, and the likely cost, has

not been adequately grasped at any level of government. (Decision makers and funders need to understand that physical access is only one factor affecting accessibility and that it will only have a small impact on mobility unless other significant factors such as confidence, marketing and the availability of appropriate services are also addressed);

• The available research does not provide an adequate basis

for comprehensive and coherent action;

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• It will be important to clarify achievable goals and gain commitment from all partners even if this means that short term aspirations need to be lowered.

3. The Way Forward 3.1 Translating current knowledge from the growing body of published research into practical action requires that decision makers and funders across all sectors understand the complexity of the issues as well as the role they can play and that they take appropriate action. Distilling these very complex issues into deliverable agendas is key to achieving MACS’ vision at 1.1 above and in helping MACS focus the action required to improve the mobility and accessibility of disabled people in Scotland. MACS has identified five key issues which are the root cause of reduced mobility for older and disabled people. Usually approaches concentrate on the symptoms of an inaccessible transport system leaving the problem of the underlying causes unaddressed. These issues are relevant to the design and development of passenger transport in general. Information on People with Reduced Mobility There is a lack of sufficient credible and widely available information which can inform politicians, planners, and operators of the whole spectrum of barriers to movement experienced by older and disabled people. There is very little information which shows what people would do if they were mobile; how often they would go out, what activities and facilities they would like to reach, how long their trips would be, and what would be the patterns of those movements – dispersed or along corridors.

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The Role of Different Modes Information describing the latent demand, the potential patterns of movement, would facilitate the identification of the roles to be played by the various modes of passenger transport in providing a solution. That is, given the “shape” of the suppressed demand, what is the potential for catering for this demand using existing services with improved accessibility? What is the need for introducing new services to cater for parts of this demand? Should the delivery of all services be co-ordinated or independent? What is the relative significance of the different modes? For example, can 85% of the solution to older and disabled people’s mobility problems be provided by routed services, plus 15% by some form of accessible DRT; or vice versa? Effective Monitoring and Evaluation What should be monitored and evaluated so that we can see if developments are actually making a difference, producing the desired results? Are currently funded schemes (e.g. concessionary travel schemes) targeted at older and disabled people, effective? What should the objectives be and what are the desired outcomes in terms of journey frequency and purpose? How many times per week should someone be able to travel, and for what range of activities? Do choices have to be made? Specifically, if an approximate estimate of the total cost implications of a particular proposal cannot be met, can priorities be identified? Will some developments emerge as better value in terms of the potential use i.e. outcomes achieved? Are some types of journey more important than others e.g. local travel versus long distance movements? Finance How can the development of an appropriate passenger transport system be financed? If older and disabled people were able to pay the going rate for the services they need, they would already be provided. So, subsidised services are needed. But are the subsidies

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targeted at the services most needed? Should some services rely on grants or have statutory funding? Should the concessionary travel scheme be radically changed to include Taxicard schemes, accessible DRT services and car schemes? What level of expenditure can be justified by identifying benefits to users and savings to other sectors? How should expenditure be administered, directly from the Scottish Government, through Transport Scotland, through Regional Transport partnerships, or through Local Authorities? Developing the Necessary Skills Key people in central and local government and the transport professions need to acquire an in depth knowledge of the information flowing from 3.3.1 to 3.3.4 above. They need to understand the intricacies and sensitivities involved in designing an integrated system of passenger transport which is appropriate for the needs of older and disabled people. This knowledge needs cascading into the professions through academia and training done by the key transport institutions. 4.0 Issues Requiring Action Having considered the five key areas itemised in 3.0 above, MACS has identified the following 14 specific issues which need taking forward by the SG. 4.1 Gap Analysis At present when measures are taken to improve the mobility of older and disabled people, they are not in the context of a framework that shows a list of things which need to be done, ranked in an order of

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significance in terms of producing the desired outcome. Usually success is being judged in terms of outputs rather than outcomes. There is a need to develop a simple tool that will reveal the nature of latent demand amongst people with reduced mobility. Usually PRM have been asked hypothetical questions that they can not easily relate to, or do not really relate to the movements they would make, if they did not have mobility problems. For example, “Where would you like to go?” “What improvements would you like to see to public transport?” “What problems do you have using buses?” Some of these are closed questions focussed on existing public transport. They are very hard to answer for someone who doesn’t use public transport or uses it very little. Respondents may not be aware of the possibility of flexible, accessible door to door services that could be available as part of a concessionary travel scheme. So people talk of “A trip to the Trossachs” “…to Anstruther for a fish supper”. Most have no idea that an independent life may be possible with an appropriate passenger transport system. Even organisations representing older and disabled people often focus on access to the routed network of buses and trains; because that is the agenda they are used to having to respond to. An approach has been used informally that has produced more reliable results. This approach needs developing more formally and making available to all who have to “consult” with older and disabled people and have a role in providing services for them. While asking PRM, especially older people, hypothetical questions produces unreliable results, asking questions about what they actually do, usually produces reliable factual responses. It is possible to start with data from national travel surveys or the latest travel diary analysis. From these it is possible, for the mobile population, to establish the average frequency of travel, modes used, and the journey purposes. There is also outcome data available from some of the major accessible DRT systems in the UK, which shows, for PRM users, journey purpose, by frequency, by distance and by age. So, rather than asking about the intermediary good, the transport mode, one can ask about the activity or facility linked with the journey purpose. For example, do they visit friends, how often, when did they

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stop and why? Do they go to “the Bingo”, do their own shopping, and so on. One could do this with a sample of people pre-identified as PRM and then compare the results with national averages, or, one could sample the population of an area and find people with differing levels of mobility. Rather than using overall averages, one would have to disaggregate by age, gender and socio economic group. Then one could benchmark the activity patterns of PRM against those of mobile peers. In this way one could reveal the gap between someone who is mobile and someone with reduced mobility due to disability. Trips to some facilities would be focussed on specific locations such as shopping centres, health facilities (dentist, chiropodist, optician, etc) and may lend themselves to routing, or at least semi fixed routing opportunities. Other trips, social visiting for example, would probably be dispersed and in the older population would most probably be local trips within the community, needing door to door services. This gap analysis would give some approximation of the scale of unmet need if one applied the principle of equality of mobility, or a practical definition of social inclusion. It would also reveal the relevance of different modes in being able to provide for the unmet needs. Gap analysis should be done regularly as part of a longitudinal monitoring to see if the gap is being closed by the combined effect of all measures being taken to improve the mobility of older and disabled people. The relative contribution of each initiative should be identified by monitoring and evaluation of the outcomes in relation to the objectives of that particular initiative. A specification to progress this work was drawn up by MACS to be financed from MACS’ research budget. This work was held back due to the expected abolition of MACS.

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4.2 Guidance on the Design and Development of Accessible Demand Responsive Transport Following consideration of the results of the study MACS commissioned on the available guidance on DRT, plus evaluation by MACS Members with expertise in this area, a series of discrete sections were identified on which MACS intended to develop more detailed guidance. Existing guidance provides no more than an overview of the general approach to DRT. It does not give guidance on how to develop, bottom up, a system that will effectively mobilise PRM through an optimised system at the lowest unit cost. There are many sensitive considerations to be made in all areas of design from vehicle specifications and livery to complex procedures of dispatching and the associated functions of ensuring security for passengers in any eventuality. Repeated studies since the late 1970s have shown that the most significant development needed to solve the travel needs of PRM is DRT. The latest being the SG’s Improved Public Transport for Disabled People and the Report of the SG’s Equal Opportunities Committee. Where DRT systems exist, and the operators have maintained a research and development capability, demand has continually exceeded the ability to expand the services. This is in contrast to the demand on fixed routed systems whish have been made accessible. DRT is extremely complex; it’s form and capability depending on its capacity in relation to its market. It has to be developed through stages in order to reach a final objective of fully integrated accessible passenger transport that effectively provides for the travel needs of PRM. Many approaches to DRT can not be further developed. Development has to be positive and incremental. Once available people may make radical changes in their life, to their support system. One can not withdraw a service to vulnerable people simply because the approach to the design and development was not thorough in the first place.

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Requirements for DRT Guidance

• DRT the basics. What is DRT, defining DRT, how it works and fits in to overall transport provision. • Planning and the strategic context. Context, vision, aim, objectives, strategy, business plan, implementation plan, pilot/s, development plan, (stage by stage or “big bang”) market development, risks. • Service markets A. Current and future target groups (older and disabled people, socially excluded groups, the general public), data sources, demographics, population density, consultation, mapping. • Service markets B. The scale of need and potential demand, the nature of demand (origins, destinations, times of travel, personal, environmental and trip related barriers to movement), initial demand, probable changes over time, modal shift. • Integration A. Integration with wider planning policy, integration with wider public transport networks, integration with other DRT services, co-ordination with bespoke closed door services. • Integration B. Liaison with other operators (CT, commercial rail/bus/taxi, statutory sector – education, health, social work), co-ordination with other mobility services (shopmobility, travel training, bus buddies, advice lines, etc), integration with economic and social policy and strategy. • Catchments and Route Design. Local topography, “pick-up” catchment boundaries, operating boundaries, times of operation, entirely demand responsive or semi fixed route, notional route/s (many to many, many to few, many to one, one to one), journey planning, access to and use of maps. • Operating parameters and Procedures A. Operational models (for regular and/or occasional demand, for groups and/or individuals, catchments by days of the week, service type by time of day, etc), policy documents (manual of procedures, health and safety, equal opportunities, vulnerable

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adults/children, etc), service standards, setting and applying eligibility criteria. • Operating Parameters and Procedures B. Passenger registration, bookings, passenger trips, scheduling (real time and pre-scheduling), achieving multiple occupancy, passenger assistance, interchange, companions, luggage, complaints, managing service abuse, security, risk assessment, forms, accessibility (of all aspects of service provision). • Promotion and Marketing. Marketing strategy, branding, logo, public launch, use of media/channel choice (TV, radio, leaflets/posters, events, community outlets and networking, newsletter, etc), understanding the DRT concept, raising expectations and awareness. • Premises. Location/s, booking/dispatch centres per capita and/or per number of vehicles, vehicle parking/garaging, office and equipment requirements, leasehold/freehold. • Telematics A. Hardware, networking, booking software, fleet management software, base to vehicle and base to base communications. • Telematics B. Smartcards, geographical information systems (GIS), scheduling tools, navigation and journey planning tools, vehicle tracking, web sit, e-mail and text bookings, data interrogation and reports. • Management. In house and/or external operation, legal structure and its implications for service provision, constitution, membership, management structure, meetings, partnership working, administration, data protection, insurances. • Vehicles. Number, type/s, specification, lease/purchase, procurement, build management, operator licensing, insurance, maintenance, environmental considerations, optimising vehicle utilisation. • Staff. Staff requirements, skills, staff structure, induction, training, appraisal, employment procedures, job descriptions and staff specification, staff handbook, checks (CRB, driving license), terms and conditions, payroll, rosters/shifts, use of volunteers. • Finance.

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Commercial/contracted/subsidised/grant funded, fare/charging structure/s, user side subsidies (concessionary travel pass, hospital fares scheme, direct payments, mobility allowance, etc), provider side subsidies (BSOG, loans, etc), funding sources, costs, cash flow and P & L, full cost recovery, VAT and taxation, sustainability. • Monitoring and Evaluation A. Baseline data, quantitative and qualitative data requirements (operational, management, development and promotional requirements), use of passenger and expert support forums. • Monitoring and Evaluation B. Supplementary surveys, development of KPIs, setting of efficiency and effectiveness targets, cross sector benefits, data interrogation, reports. • Interdependence. Between all of the above.

This work had been specified, put out to tender, and a consultant appointed. A Consultancy was found that had a staff member who had been part of the national team funded by the DTp and Metropolitan Counties, to develop accessible DRT after the International Year for Disabled People. This represented a unique opportunity to tap into this knowledge at minimal cost compared with having to go through the same learning exercise again. The work was then put on hold as the SG did not think it necessary and MACS was being wound down. 4.3 Assessing Eligibility MACS commissioned a study to review current UK practice. MACS had been part of the Working Group on Concessions prior to the set up of the new National Free Travel scheme and the move of the administration from Local Authorities to Transport Scotland. This working group found that while 17% of the population of disabled people were under retirement age, only 4% of concessionary passes were held by people below retirement age. Clearly, there was a problem with eligibility procedures. These statistics show that the current procedure is flawed and is a barrier to achieving the Scottish Government’s goals of equity and social inclusion.

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The study concluded that:

• New assessment approaches for concessionary travel are needed to ensure better value for money, improved targeting of concessionary fares, and to ensure that concessionary fares policy complements wider transport policy.

• Government policy identifies that disabled people are best able to identify their own needs including through self-assessment. Adoption of self assessment is currently fostering improved management and customer focus amongst health and social services practitioners. Self-assessment for concessionary travel eligibility could help to foster similar skills development amongst transport professionals.

MACS has submitted a proposal to the SG for a study to assess alternative methods of assessing eligibility for concessionary travel based on more equitable methods of self assessment rather than the present approach which uses medical assessment. By guiding PRM through self assessment procedures (asking people about their limitations to movement) assessors would be able to gain a much greater understanding of barriers to movement and subsequently be able to analyse how a wide range of personal, environmental and trip related barriers can be designed out of services or their affects negated. This does not happen with the current assessment procedure, and, some people are being refused. Reliance on proxy measures such as DLA is not building up expertise in the transport professions in terms of gaining knowledge and insight into the factors that are barriers to movement. The present system is overly concerned with preventing fraud. There is not an equal emphasis on making sure that everyone with a genuine mobility problem is found and mobilised. Procedures that would produce zero abuse are counter productive as they would have to be so exhaustive that they would become a barrier in themselves and in effect, be abusive of the most vulnerable. A focus on the medical model of disability because of anxieties about potential fraud does not advance equality if it acts as a barrier to people accessing the scheme.

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The proposed project is to monitor and evaluate, in consultation with health professionals, users, carers, transport operators and planners, whether self-assessment is a viable alternative method of assessing eligibility for concessionary travel and to assess whether self-assessment:

• Makes use of concessions more effectively and efficiently than the current system

• Ensures that the “right” people are more likely to get what they need from the concession more often and in a way that is better for society

• Is quicker and cheaper to administer • Is a better experience for the user • Is better for the professionals • Has an effect on the level of abuse • Is perceived as fairer

This project has been put on hold due to the winding down of MACS prior to the proposed abolition of MACS in June 2008. The work is still valid and should be progressed. 4.4 Monitoring and Evaluation There needs to be a shift in emphasis, throughout the passenger transport industry, from measuring outputs (number of low floor buses, the extent of the route network, etc) to monitoring outcomes (who is travelling, how often, and to what?). Many services are described as “accessible”, but in many cases accessibility refers to physical modifications, not to the service being comprehensively designed to remove all barriers to movement. Subsequently monitoring of use can be very poor. In general passenger transport operations monitor only the total number of trips made. When accessible services are developed, there needs to be specific market objectives set. Accessibility improvements to fixed route

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services may simply be geared to attracting additional people with disabilities who can get to and from bus stops and need to access work, education and city centre shopping. DRT services may have a much wider objective of mobilising all People with Reduced Mobility (PRM) in a given area who find it difficult or impossible to use conventional services for some or all trips, providing transport to a wider range of activities and facilities. Essential monitoring information should include: Age Gender Frequency of use Time of day of travel Journey purpose Trip length Monitoring should examine: Whether the whole spectrum of PRM are being attracted to use the service, or if take up is skewed, attracting some users but still deterring others. Whether it is possible to reach a representative range of facilities and activities, or if use is skewed towards a limited range of journey purposes. The distribution of journey making by frequency of travel. Is demand still suppressed by limited supply or other factors? Evaluation should be against specific market objectives. Information relating to the benefits of use, either subjective or objective, should be recorded.

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4.5 Terminology Currently there is no meaningful professional terminology in common use. People struggle to communicate often using meaningless or ambiguous terms. Frequently terms are used that actually mean the opposite of what the speaker/writer intends. This situation is indicative of the concepts behind the words. People are showing that they still have very limited knowledge of the spectrum of barriers to movement and the developments in passenger transport needed to remove them. The terms are anachronistic and stigmatising. Examples include: Disability access Fully accessible Disabled parking Disabled access Disabled toilet Disabled badge holder Disabled transport Tail lift Equally the link between impairment which results in a disability leading in turn to a functional handicap is not widely understood. Hence many people still refer to “the disabled” rather than people with disabilities. More meaningful professional terminology needs to be developed and promoted in transportation education, through Universities and the professional transport institutes. Such a development would be significant in promoting communication and understanding. It is relevant across government and could be led by the Equality Unit. 4.6 Defining Levels of Access At present there is no unambiguous system for describing the level of access of passenger transport services. Sometimes they are described as “low floor” but many people need other features. Some are described as “wheelchair accessible” but that has not meant accessible to all 400 or so types of wheelchair in use. Services have

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been commonly referred to as “fully accessible” which should mean accessible to 100% of PRM. However, they are not. The lack of a meaningful description of the level of access has led to confusion and difficulties. There has been example of people turning up for “fully accessible” bus services only to find that they can not board the bus or have not been allowed on through company policy. There are examples of disabled people setting off on longer journeys requiring interchange and ending up stranded having successfully boarded the first bus but unable to board the second although both have been described as accessible. Many aspects of service design have an effect on accessibility, staff attitudes, marketing, cost, service image etc. but there is a specific need to develop a system that adequately describes the level of access. If access features can be accurately described, disabled people can then make their own judgement as to whether they can use the service. The problem is due in part, to operators and planners having little knowledge of the wide spectrum of impairments and the resulting range of mobility challenges presented by the transport system. Some PRM:

• Can not travel on some buses and trains due to motion problems associated with the suspension characteristics, being jolted by standees, or engine judder at bus stops and while stationary in traffic e.g. people with certain “invisible” heart conditions.

• Need level access; a ramp to some people is more of a barrier than low riser steps. Inclined surfaces are extremely painful and insecure to people with knee, ankle or hip impairments. Some people with sensory impairments can not position themselves on a sloping surface. Some semi-ambulant people can not negotiate any step e.g. those with lower limb deformity.

• Need adjustable seating to give extra space due to rigid knee joints.

• Need to travel in very large wheelchairs or in a semi-prone position in a long wheelchair, perhaps with oxygen cylinders.

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• Can not balance, but can not sit due to a rigid spine. • Need to travel in a travelling bed. • Prefer to travel in privacy due to gross facial disfigurement. • With little warning, need to empty their bladder very rapidly and

frequently. • Increasingly prefer to use scooters rather than powered

wheelchairs. • Can not travel medium to long distances due to severe fatigue

brought on by the stress and effort of travelling plus the vibrations and noise.

• Etc, etc. Continuing uncertainty in relation to the level of access is acting as a barrier to travel. There is a potentially dangerous situation should someone become stranded part way through a journey and not be able to find help. MACS has worked with the CPT to analyse some aspects of this problem. MACS therefore, recommend that an accurate and simple method of describing levels of physical accessibility should be devised. 4.7 Developing an Analytical Approach to Investment At present services and associated infrastructure are being made more accessible through legislative requirements and pressure from campaigning groups. There are demands to make, for example, the whole rail network “fully accessible”. Given the range of mobility problems PRM have, and the range of “walking aids” used or chairs, scooters and beds used for travel, it is not possible to make rail services or stations accessible to 100% of PRM. Using rail as an example, as a mode it accounts for approximately 2% of the journeys made by the travelling public. The bulk of demand is in and out of major cities as commuting traffic. Given the age profile of PRM, plus the identified major need for dispersed local travel, the potential total increase in demand for rail services once made accessible will be relatively small. In sparsely populated rural areas, increases in demand will be particularly small. Major expenditure of both capital and revenue would be needed to make such a rural

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station accessible to all PRM. But the additional income from use by PRM would be low, too low to cover the cost of the changes. Greater knowledge of the potential patterns of movements of PRM were they able to travel, revealed through gap analysis, would allow a more analytical evaluation of how to maximise outcomes with the revenue and capital expenditure available. In effect, a business case should be evaluated to identify what improvements can be made. If there was a gap between the cost of modifications and projected income, either an alternative solution could be identified e.g. an accessible on demand bus service, or an overt and informed decision could be made to support the modifications from the public purse. We feel that this approach will result, for a given budget, in more outcomes (people travelling) than one based just on the principles of equality or campaigning. 4.8 People with Reduced Mobility (PRM) There is a need to develop guidance on the nature, scale and composition of the population of PRM. Twenty seven years on from IYDP (International Year of Disabled People) there is still no easily accessible paper that informs Central Government, Local Authorities, the Voluntary Sector and transport operators, of the nature of barriers to movement which are either personal, environmental or trip related, and how to “design out” barriers in infrastructure and services. The majority of people with a disability are over retirement age, but they do not see themselves as “disabled” and usually do not belong to disability organisations. Hence it is more productive to refer to People with Reduced Mobility (PRM), a non-stigmatising all encompassing term coming from the ECMT Working Group on transport for older and disabled people. Organisations for older people and people with disabilities could participate in this development. It should not be a list of disabilities, but a paper identifying and explaining the nature of barriers to movement.

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This paper could be made available on MAC’S web site. It should be dynamic, never finished. There should be a request for readers to send in information on barriers that have not yet been identified. 4.9 The Relationship between Disability, Age and Poverty Limited incomes result in hard choices. For many older PRM there is a choice in winter “between heating and eating”. Figures frequently used to describe the combined spending power of the population of older and disabled people are misleading. They are used to encourage operators to make expensive adjustments to service provision in the expectation of significant increases in income from fares. The figure commonly quoted is of total income, not of disposable income, or of the amount of income left after all necessary expenditure on, for example, accommodation, heating, lighting, food and clothing. At present many accessible transport services have to charge a fare, even if users have concessionary bus passes. The effect is to rapidly change patterns of use. Many short distance local journeys are stopped. It should be noted that PRM may make up to 60% of their journeys to participate in some form of social activity. Social trips are the first to be stopped when PRM are charged a fare. Next, PRM stop making trips that they can get other people to do on their behalf such as shopping trips. Trip making becomes concentrated on medical and quasi medical trips and average trip distance increases. In Finland, as demand for flexible DRT services increased, charging was used as an effective tool to depress demand. Producing significant income from fares is counterproductive and can easily defeat the objective of finding and mobilising as many PRM as possible. This has been done as benefits accruing to other sectors have not been assessed. Although as many as 80% of disabled people are over retirement age and approximately 50% over 75, there should be more recognition that most older people with a disability do not regard themselves as “disabled people”. Hence initiatives which have tried to involve people with disabilities have often been able to involve only younger disabled

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people, people who are more comfortable with the term “disabled” and happy to belong to an organisation of people with disabilities. A significant example was the development of the DRC’s Transport Code of practice, when the major organisations representing older people did not want to participate. The needs of the “silent majority” therefore, frequently go unrepresented and are misunderstood. To be more inclusive both MACS and the SG need to adopt a less stigmatising approach, referring to People with Reduced Mobility, or at least to Older and Disabled People with Mobility Problems. The aim should be to connect with all people whose mobility is adversely affected by a physical, mental or sensory impairment. A discussion paper on the relationship between disability, age and poverty would be a useful briefing paper to have on MACS’ web site. It would need regular updating with current statistical information. 4.10 Concessionary Travel The majority of journeys that people make are short distance. There is a rapid drop off in trip frequency with increasing distance. Some medium distance trips between adjacent communities are made simply because local routed bus services go to large shopping centres. So some PRM who can access routed buses are making these trips because there is no alternative. Some surveys of concessionary travel have shown that up to 70% of pass holder’s trips are ostensibly to shopping destinations. This is not typical of journeys made where more choice of destination is possible and should be interpreted as constrained demand. OPCS data show that people with disabilities have a limited ability to walk for any distance. The number of people able to walk drops off exponentially with an increase in distance. It should be understood that if people can walk a certain distance, they will be willing to walk only half that distance from their home as they need to be sure that they can return to a safe environment. This has major implications for the demand for routed services and distances from the home to a bus

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stop, and from bus stop to a final destination. Waiting at bus stops is more fatiguing than walking and therefore further reduces walking distances. As people age and become progressively frail and/or acquire disabling impairments, there is both a tendency for them to make an increasing proportion of their trips within their community and, as their walking ability decreases, there is an increasing need for them to make trips by a mechanised mode instead of walking. Hence for PRM to be able to do basic local “nuts and bolts of living trips” there is a need for local accessible DRT services. In some places these services are part of a package of local discretionary concessionary travel, but whether the services exist and whether they can be used free of charge, is a “postcode lottery”. MACS recommend that local DRT services become a necessary part of concessionary travel. It should be noted that the need to include local DRT services in the concessionary travel scheme was also identified in the SE’s report “Improved Public Transport for Disabled People” and in the report of the Equal Opportunities Committee. Many local services are dedicated to PRM and are operated by voluntary sector organisations. These services and similar services operated by Local Authorities, would need reimbursement on a full cost recovery system and staged payments in advance as there is no opportunity to fund delivery through accumulated profits. The spatial extent of a community varies between small towns, large cities, deep rural communities and in island communities. In island communities local air and ferry services are seen as local transport, essential for independent living. Concessionary travel should be valid on these services and the existing restriction of four trips per annum on ferries should be removed.

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4.11 Effective Working with Older and Disabled People Guidelines are needed for Local Authorities, people working in the voluntary sector, public transport operators and central government. The published Guidelines on Engagement do not adequately cover the difficult area of obtaining accurate information about the latent demand for travel of PRM. Usually in consultation exercises very few people are engaged with and their capacity to contribute is not developed. These people often comprise an un-representative cross section of PRM. Typically older people, especially those over 75, are not involved in the exercise. It is common for the wrong, or misleading, questions to be asked. That is, questions are asked about difficulties using the modes of transport as if the modes were an end in themselves. Modes are simply a means of reaching activities and facilities. Questions need to be related to the lifestyle of PRM, what they are actually able to do. With depressed expectations and little knowledge of wider possibilities (such as flexible on demand services, buses with lifts, etc.) simple questions about current problems with traditional modes can be very misleading and have led to policies that have resulted in “access without mobility”. Semi structured interviews require more understanding and empathy; more skill to complete and analyse, but they produce much more reliable information for passenger transport planners. Factual questions about what people actually do and how often produce more reliable results than hypothetical questions about what people would like to do, especially amongst people who may have very little knowledge of the outside world and exhibit some degree of confusion. The information from interviews should be used in conjunction with other data sets to construct a comprehensive overview of the nature of barriers to movement, the location of PRM and their distribution, the probable location of journey destinations (at a fixed point – shops, bingo, doctors, library, or widely dispersed – social visits to friend’s homes). Population data, car ownership and access to a car,

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housing data, etc are all held by Local Authorities or available from the national census and survey data. Simplistic consultation with a few people with disabilities can be counter productive. An ongoing relationship should be established with older and disabled people; their life styles explored and understood, their capacity to participate in the planning process developed. Then developments can be more accurately targeted on unmet needs and outcomes maximised by the most appropriate use of available budgets. 4.12 Developing Cost Benefit Analysis It is clear that the majority of service provision relevant to the patterns of movement of PRM can not be paid for by the income from fares. Even when efficiently configured, the unit cost of provision will be higher than on high volume routed services alone. The average ability of PRM to pay for travel is much lower than for the population as a whole. Any significant income, or benefit, from the subsidised provision of accessible passenger transport does not accrue to the transport sector. At present the transport sector is concerned only with the costs of provision. Benefits can accrue to health services, social work, the local economy and to the users in the many qualitative aspects of being able to live a more positive life style. In passing Resolution 54 in November 1985, European Ministers recognised that “….wider socio-economic cross sector benefits for transport provision for disabled people should be taken into account by Member Governments…and that, where appropriate, measures should be taken positively to identify these benefits”. This work has never been successfully taken forward. It is as relevant today as it was in 1985. The work would be a complex long term project, but the development of CBA techniques for the evaluation of the whole of passenger transport would put it on a compatible basis with all other forms of transport investment through STAG.

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Three main issues should be addressed:

(i) the ways in which types of benefit might be classified (ii) the ways in which benefits of different classification may

be identified (iii) the ways in which identifiable benefits may be measured

or evaluated in quantitative and qualitative (i.e. descriptive) terms.

It has been recognised that there are:

(i) Direct benefits to system users. (ii) Indirect benefits to non-users of the system. (iii) Benefits to other private sector individuals and organisations. (iv) Cross-sector benefits between different government and

other public sector agencies. The significant levels of revenue funding needed to develop an accessible passenger transport system will not become available unless justified through CBA and STAG appraisal. MACS recommend that this work should be started as a matter of urgency, especially in the light of its complexity and long term nature. 4.13 Policy into Practice. At present the meritable goals of social inclusion and equality for PRM are often referred to. They are sometimes further defined as all PRM having accessible services in their area. The general perception of what accessible is, is often restricted to the presence of low floor buses being introduced on local public transport routes, this giving PRM the “opportunity” to travel, in theory. This measure of social inclusion or equality is output oriented; it measures only the presence of the infrastructure. Real social inclusion and equality can be achieved only when people are actually making journeys, physically reaching activities and facilities. Further, they should be able to reach a representative range of activities i.e. not constrained to predominantly shopping or

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medical and care facilities. They should be able to visit these destinations as frequently as anyone in the mobile population. Hence, the understanding of social inclusion and equality should be expanded. Social inclusion and equality should be set as long run objectives and defined in terms of the range of activities and facilities that older and disabled people should be able to visit and the number of times they are able to do so. This specific, measurable objective could then be defined in terms of outcomes, and progress towards it could be measured in meaningful terms. 4.14 Access to Ferries DiPTAC has prepared guidelines on access requirements for ferries. MACS was part of the DiPTAC Working Group and recognised that there was a need to develop an additional section relating to the shore to ship to shore part of the journey. For many large modern ferries (e.g. Cross Channel) this is not a big issue, as walking onto the ferry is like walking along a corridor. There is a problem however, in boarding and disembarking from small ferries. In practice many of these smaller ferries in the UK are Scottish ferries. MACS was to progress this work and produce a section which could be issued with the DiPTAC guidance document. The MACS Working Group to take this work forward was unable to function due to long term sickness of two members and one leaving. Other Members were not available as with the expectation that MACS would be wound down, recruitment was suspended. This is a significant piece of work to progress, especially in relation to the many small ferry services in Scotland. MACS recommend that it should be progressed in liaison with DiPTAC, as a matter of urgency so that the additional section can be issued with the main DiPTAC guidance document.

ANNEX A A. MACS’ Objectives A.1 MACS is interested in:

• Optimising outcomes - Identifying and prioritising key developments, which, for a given budget, will maximise outcomes in terms of increasing the mobility of people with reduced mobility;

• Confirming that changes have the desired effect – Identifying

and monitoring changes, which will result in people with reduced mobility actually making journeys to a range of facilities and activities.

A.2 MACS considers that:

• it is not appropriate to evaluate or judge whether someone is more deserving than anyone else;

• where the budget for services is limited a smaller operating

area should be chosen rather than rationalising trips as this will affect performance (and it is easier to expand than contract a service). Schemes should be monitored for their effectiveness and performance outcomes measured;

• A service should be provided on an equity basis with non-

disabled people;

• Research approaches are outdated and can be part of the problem rather than part of the solution;

• 1 journey = 1 trip is not applicable in rural areas where trips are

of necessity multi-purpose; • travel demand centres should provide flexibility if properly

structured;

• it is important not to forget that in some places and for some disabled people the car is the only transport mode possible and

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ANNEX A

public transport, concession schemes and DRT will never be 100% suitable.

A.3 Considerable further work and investment (capital and revenue) is needed to meet MACS’ aspirations to optimise outcomes for disabled people. A.4 The Improved Public Transport for Disabled People (IPTDP) Research1 does not always ask the right questions and leaves some practical distributional issues unanswered.

1 Barham, P., Dudleston, A., MacLeod, P., Rye, T. - Improved Public Transport for Disabled People – Scottish Executive Social Research 2006

ANNEX B B. Understanding Accessibility and Mobility B.1 Accessibility describes the ease with which trips can be made and includes access to facilities. Mobility describes the making of the trips. B.2 The IPTDP research creates confusion by using the term “accessibility” inconsistently2. In some places it is used as an abbreviation for physical accessibility, and in other places it has the broader meaning more commonly adopted in recent years within government policy. Definitions need to be consistent throughout all SG reports. B.3 It is essential that consideration of mobility should reflect that observed behaviour is taking place in circumstances of resource and capacity constraint. Demand is therefore being suppressed and MACS believes that this is not fully understood by researchers. This therefore leads to inaccuracy in research findings. B.4 Although observed behaviour can be used as an indicator when identifying what needs to be done, there are limits to this approach where there are mobility challenges. Accessibility audits are also required. This means that the breadth of potential actions is complex and extends beyond the sphere of transport delivery to wider social and policy factors. For example, inaccessible transport may be a barrier to disabled people’s employment, but the provision of accessible transport alone will not necessarily lead to disabled people achieving parity of employment, and thereby increasing their trip-making as a result of commuting.

2 E.g. in some places the term appears to mean physical accessibility “1. Difficulties in relation to the availability of transport, 2. Difficulties in relation to the accessibility of transport, 3. Information needs 4. Affordability 5. Fear of travel – confidence 6. Personal barriers to travel”. Whereas in other places e.g. “The evidence suggests that although affordability is a key element of accessibility….” the broader meaning is implied.

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ANNEX B B.5 The absence of a complete understanding of the variability of the barriers within the research findings on both the accessibility for and mobility of disabled people places severe limitations on the extent to which actions can be identified at a practical level. B.6 The IPTDP research identifies that there is a need for improvements, but it largely fails to identify what these improvements should be, nor a framework for identifying their importance.

ANNEX C

C. Main Issues Identified in the Review of Recent Research The main issues and messages emanating from the review of the research are set out below under the following three headings:

Practical Action needed Prioritisation Future research

C.1 Practical action needed

• Consideration needs to be given to what the right interventions should be. Giving people a range of modal choices may not be possible in some areas and for some people due to resource constraints;

• A considered integrated approach needs to be adopted for

the development of flexible door-to-door transport. Environmental issues need to be included in any consideration;

• Travel needs are not understood in any systematic way.

Disabled people are best able to describe their own needs but have no opportunity for a dialogue with providers to develop practical solutions3. Fluent communication is needed between transport providers and disabled people and this means reaching the right people and asking the right questions and should include those who currently have limited or no travel opportunity, no experience of using passenger transport;

• The development of travel despatch centres would assist in

the efficient allocation of available transport;

3 DHC 2006 – Alternative methods of assessing eligibility for concessionary travel – Final report to MACS.

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ANNEX C • Give users the ability to undertake self-assessments that

could be evaluated and used to influence funding decisions for personal travel;

• There is a need for a technical specification and information

flow between transport providers and users and potential users with proactive marketing and encouragement for people and voluntary organisations to pass on available information. Targeting of friends and family who provide support and the use of other non-traditional methods to ensure information is available;

• Solutions and funding programmes, whether targeted at

personal needs (e.g. concessionary fares) or at infrastructure (e.g. upgrading bus stops), do not always ensure equitable outcomes. Clear objective outcomes and effective monitoring of these outcomes is needed;

• The introduction of free concessionary travel has widened

the gap between those with good mobility and poor mobility4. A more flexible door-to door system is required.

4 Older and disabled people with good mobility are able to make full use of the free public transport scheme. Evidence from Wales and Scotland has identified significantly increased travel by public transport as a result. People whose mobility is such as to prevent or deter them from using public transport cannot benefit from this concession.

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ANNEX C C.2 Prioritisation

• Tighter budgets and accountabilities for service delivery

create a culture within which unbudgeted needs and support are less likely to be provided, unless underpinned by appropriate legislation, funding and administrative structures. The 1985 Transport Act is enabling rather than regulatory and doesn’t produce knowledge. There is currently no duty on LAs to assess the needs of people who are excluded because of the lack of a suitable transport system.

• A more conducive culture is needed in transport delivery to

ensure that staff, administration, infrastructure and funding recognise the specific needs of People with Reduced Mobility. There is a corporate/directors/Board leadership responsibility and stakeholders are currently faced with a daunting agenda and do not know where to start.

• A step change is needed in funding levels. Currently,

disabled people travel less than is optimal for an efficient, inclusive society. Equal weight needs to be applied to different disabilities – currently there is more attention given to the needs of wheelchair users than people with sensory impairment and other disabilities that are not visible.

• Research has missed the opportunity for a gap analysis

(asking the right questions based on people’s involvement in activities rather than on their impairment). This is addressed in section 4.1 above.

• The opportunity should be taken to include mobility as part of

the joint single shared assessment concept already in use within Health/Social Services.

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ANNEX C

• Services are currently provided based on what can be provided within the allocated budget and are not provided based on the scale of needs.

• There is a lack of capacity within DRT services and there is

still unmet need. Needs including unmet need should be assessed and budgets developed to meet these needs.

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ANNEX C C.3 Future research

• A gap analysis is needed to show the shape of latent demand and this should involve breaking the information down into smaller age bands than normally used.

• Much can be learned from the actual travel behaviour of

disabled people, to develop solutions that are already working. This requires research on actual travel patterns and capabilities based on observed behaviour.

• Design systems should take account of functional issues

rather than categorisation in relation to disability e.g. affordability, knowledge, motivation, lack of sleep, fatigue, pain etc. This will help planners and operators understanding of this market in more useful detail5.

• Longitudinal studies are needed of the responses of disabled

people to transport change covering lifestyles, opportunities, and travel patterns.

• There are opportunities to capitalise on the new transport

planning structures in Scotland and the new legislative requirements for Disability Equality, but only if research has identified what might be practical in each setting. This means asking the right questions in order to provide appropriate user-friendly ergonomic systems.

5 The IPTDP use (via Scottish Household Survey) of the three categories: disabled adults / adults with Limiting Long Term Illness/other adults is not at all useful.

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ANNEX D D. List of Meetings and Attendees 11 April 2007 Present: Trevor Meadows (Convener) Jane Horsburgh Georgina Hobhouse George McKendrick Roderick McLeod John Moore Alan Rees Emma Sinclair (Secretary) Ruth White (Scottish Executive) Stephanie Bow ( PTUC Secretary) (Observer) 23 May 2007 Present: Trevor Meadows (Convener) Mairi O’Keefe George McKendrick Roderick McLeod John Moore Alan Rees Fiona McCall Bryan Alexander Emma Sinclair (Secretary) Lynne Duff (Scottish Executive) (Observer) Andy Kirby (DPTAC) (Observer)

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18 July 2007 Present: Trevor Meadows (Convener) George McKendrick John Moore Alan Rees Fiona McCall Bryan Alexander

Emma Sinclair (Secretary) 28 September 2007 Present Roderick McLeod (Acting Chair) Bryan Alexander Jane Horsburgh Fiona McCall George McKendrick John Moore Alan Rees

Emma Sinclair (Secretary) George Davidson (Scottish Government) (Observer) Lynne Duff (Scottish Government) (Observer) 22 November 2007 Present: Roderick McLeod (Acting Chair) Jane Horsburgh Fiona McCall George McKendrick John Moore Alan Rees Emma Sinclair (Secretary) George Davidson (Scottish Government) (Observer) Jimi Adeleye (DPTAC) (Observer)

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31 January 2008 Present: Roderick McLeod (Acting Chair) Jean Dunlop (by phone) Fiona McCall George McKendrick John Moore Alan Rees Emma Sinclair (Secretary) Richard Lyall (Scottish Government) Alison Dewar (Scottish Government) John Ewing (Scottish Government) Fiona Locke (Scottish Government) Bill Brash (Scottish Government) Jimi Adeleye (DPTAC) (Observer) 21 February 2008 Present: Roderick McLeod (Acting Chair) Bryan Alexander Jane Horsburgh Fiona McCall John Moore Alan Rees Lynne Duff (Secretary) Alison Dewar (Scottish Government) John Ewing (Scottish Government) Diane McLafferty (Scottish Government) Fiona Locke (Scottish Government)

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20 March 2008 Present: Roderick McLeod (Acting Chair) Bryan Alexander Jane Horsburgh Fiona McCall John Moore Lynne Duff (Secretary) Alison Dewar (Scottish Government) Fiona Locke (Scottish Government) Final Meeting of Present MACS Committee held in 2008-09 Reporting Year 17 June 2008 Present: Trevor Meadows (Convener) Roderick McLeod Jane Horsburgh Alison Dewar (Secretary) Diane McLafferty (Scottish Government) Fiona Locke (Scottish Government) Bill Brash (Scottish Government)