Left behind: New transport rules risk stopping people from getting care
“If you can’t get there, you can’t get care.”
Since April 2025, changes to national rules for non-emergency patient transport have left more people across York and North Yorkshire struggling to reach vital hospital and clinic appointments.
For some, this means:
- Paying for taxis they cannot afford
- Relying on neighbours, friends, or family
- Missing treatment altogether because they simply can’t get there
This is a particular challenge in rural areas, where buses are infrequent, expensive, or simply don’t exist.
What is patient transport?
Non-emergency patient transport (not to be confused by community transport) is run mainly by Yorkshire Ambulance Service, with some services delivered by charities like St John Ambulance or private providers under NHS contracts.
These services are a lifeline for many people who need regular access to treatment, pain relief, or specialist care.
Non-emergency patient transport is meant for people who:
- Have a medical condition that makes it hard to use public or private transport.
- Have serious mobility or memory problems.
- Need equipment or support during the journey (for example, oxygen or a wheelchair).
- Cannot travel safely without help.
But with the new rules in place, many who previously qualified are now being told they no longer meet the criteria.
So what has changed with patient transport eligibility?
In April 2025, Yorkshire Ambulance Service started using the new national rules set by NHS England to decide who can get non-emergency patient transport.
Key changes include:
- Patients are only eligible if travelling independently would be unsafe or detrimental to their health
- Eligibility can also apply to people with significant mobility issues, or cognitive or sensory impairments that prevent them from travelling alone
- Some groups, such as people receiving in-centre haemodialysis (treatment for people with severe kidney problems), are automatically eligible for transport
- Patients are asked a set of questions at each booking to check whether they meet the national criteria
- If people do not qualify, they are signposted to alternatives such as community transport or the Healthcare Travel Costs Scheme (which reimburses some travel costs)
The aim of the changes was to create consistent rules across England, but the impact on patients is already being felt here in York and North Yorkshire, not helped by the added complexity of rurality as a barrier to healthcare across North Yorkshire, the largest county in England.
Why this matters now
Transport isn’t just about travelling from one place to another — it’s about being able to reach the care you need, when you need it. For people in York and North Yorkshire, where many live in rural or remote areas, reliable patient transport can be the difference between getting treatment or going without.
The scale of the service shows how important it is:
- Yorkshire Ambulance Service carries out around one million patient transport journeys every year, using over 370 specially equipped vehicles, 800 staff, and 200 volunteers. Yorkshire Ambulance Service
- Nationally, there are 11–12 million journeys each year, covering half a million miles every weekday (NHS England review)
- Nearly three-quarters of patients using patient transport are aged over 65 (NHS England final review report)
- The population of North Yorkshire (615,000) and the City of York (203,000) means more than 800,000 local people depend on reliable transport to access healthcare.
Missed appointments are already a major issue. As reported by NHS England, In 2021/22, 7.6% of outpatient appointments in England ended in a “Did not attend” — that’s about 650,000 missed appointments every month. Transport difficulties are among the reasons people cannot attend.
Closer to home, a 2025 report on community transport in Humber and North Yorkshire warned of rising demand since the new NHS transport rules came in. Many schemes are already under-resourced, meaning some people are being turned away.
Behind every number is a person whose health may suffer. If transport isn’t available, people risk worsening illness, missed treatment, and the extra costs of having to find their own way to care.
What Healthwatch want to know from you
With the new rules now in place, Healthwatch want to hear directly from people in York and North Yorkshire about the real-life impact.
Healthwatch would like to understand:
- Missed or cancelled care – Are you missing or cancelling medical appointments because you cannot get transport? What has this meant for your health?
- Alternatives – Are taxis, buses, community transport, or lifts from friends and family filling the gap, or are these options unreliable, unavailable, or unaffordable?
- Wider impact – How are the changes affecting people with disabilities, long-term health conditions, older people, and those on low incomes? Are some groups being hit harder than others?
- Hidden costs – Are you being forced to pay out of pocket, rely on favours, or simply go without care?
By gathering this evidence, Healthwatch can show where the system is falling short and press for changes that make healthcare more accessible to everyone.
Why your voice matters
Healthwatch exists to listen to you and push for change. It has the legal power to ask those in charge what’s being done to improve access to care.
By sharing your story, you can help Healthwatch:
- Show the impact of missed appointments and hidden costs on patients and carers
- Provide evidence to those who fund and organise local NHS, as well as North Yorkshire Council and City of York Council.
- Press for fairer, more accessible transport
Local voices
People are already tellung us how the new rules are affecting them:
“I didn’t even realise the rules had changed until I was told I no longer qualified. Without transport, I’m left with impossible choices — pay money I don’t have, rely on neighbours, or cancel appointments that I really need.”
“Living in a rural area means there’s no bus I can take and taxis cost a fortune. If patient transport isn’t available, I simply can’t get to hospital. It feels like the system forgets people like us.”
“My hospital appointments are 25 miles away. Before, I qualified for transport, but now I don’t. There’s no direct bus, and the only option is two buses and a taxi at the other end — which costs more than my weekly food shop. I’ve already cancelled one appointment because I just couldn’t get there.”
“I look after my mum who needs regular hospital treatment. Since the rules changed, she no longer qualifies for patient transport. I don’t drive, so every appointment means arranging time off work and paying for taxis we can’t afford. It’s exhausting, and I worry about what will happen if we just can’t manage it one day.”
Healthwatch want to hear more voices like these, so it can show the full impact of the changes and push for fairer, more accessible transport.
How to take part
The survey is anonymous and only takes 5 to 10 minutes. Please share it with anyone in York or North Yorkshire who might be affected.
You can complete it on behalf of someone you care for or support.
What you tell Healthwatch is in confidence (you don't have to leave your name or address) - and what you tell Healthwatch won't affect your care.
Take the survey on patient transport
Find out more about patient transport - and if its available
If you’d like help completing the survey, need a paper copy (including large print), or would prefer to give your answers over the phone, please get in touch:
Phone Healthwatch North Yorkshire on 01423 788 128
Email hello@hwny.co.uk
“Speaking up felt daunting at first, but it’s brilliant to know my story could actually help change things. If we don’t say anything, nothing will ever improve.”
