Patient First, the UK's largest patient safety event, will return to London's ExCeL on 21-22 November 2017
The Department of Health’s (DoH) 2010 report, following on from an extensive consultation on the issue of charging for parking at hospitals in England, found that the introduction of widespread free parking would have adverse consequences including congestion and capacity problems, and lack of future investment, that would compromise the convenient access that people say is their most important need. The report concluded that Trust Boards should continue to be responsible for developing local parking policies that reflect the circumstances of their location and the needs of the local community.
Recently, BBC’s 'That’s Britain' looked into the subject of hospital parking, but, unfortunately, they failed to cover the topic in any great depth, merely addressing issues that are well known and therefore creating a fairly biased view. The BBC declined to use an interview conducted with the British Parking Association’s CEO Patrick Troy, which could have provided much needed balance to the piece.
The DoH received almost 1000 responses to the consultation including members of the public, patient advocate groups or organisations, hospital trusts and other NHS organisations, as well as local authorities, other community organisations and special interest groups. What was interesting was that although most of the organisations representing the interests of patients and the members of the public who responded were universally in favour of free parking for all, most of them recognised the implications of this and seemed to accept that this was probably not a feasible option. They did, however, strongly feel that charging policies needed to be examined particularly with reference to the level of tariffs and provision of concessions and that hospitals should not be seeking to make money from parking operations.
It is hardly surprising therefore that there has been an increase in media attention and complaints coming about as a result of Freedom of Information requests seeking details of income from parking vs. expenditure. Where a hospital is viewed to be making a substantial surplus from parking the inevitable questions are asked as to how the money is being spent and why tariffs haven’t been reduced – the public may be able to accept charging to cover costs but they take a dim view of what they consider to be profiteering.
Those who are tasked with the complex job of managing parking and all that comes with it will know that setting tariffs is not simple and that many factors have to be considered. Parking charges have a strong influence on driver behaviour: in a more general environment than healthcare they are often used to limit the time people stay in a particular place and ensure a good turnover of parking spaces. However, one could argue that the healthcare environment is somewhat unique and that choice as to whether to stay or go is often not in the hands of the patient or the people accompanying them. Therefore, they cannot see why they should be hit with what they consider to be extortionate parking fees in a situation that was beyond their control. It’s fair to assume after all that the longer a person stays in a hospital, the higher the likelihood there is something medically significant going on.
The whole situation is never simple and highly emotive and the issues usually attract prolonged debate, but the real question is are healthcare sites doing all they can to ensure that their parking policies are - and can be seen to be – fair, and take into account the nature of their environment? And if so, will they stand up to scrutiny and can charges and policies be justified?
The DoH report goes on to say that one of the most important factors in parking management is considering the needs of all people who need to use healthcare sites. Concessionary schemes play a vital role in showing that this consideration is being given but they can appear complicated. Who qualifies? Who doesn’t? And where do you draw the line?
The DoH expects all hospitals to have a concessionary parking scheme in place which gives due consideration to the needs of a wide range of patients and visitors. However, the Healthcare Facilities Consortium reports that their benchmarking data taken from the 2011 ERIC returns shows that only 28% of NHS Trusts said that they had a scheme in place, this statistic does seem shockingly low and it will be interesting to see whether the 2012 ERIC figures show an increase in light of the guidance given in the DoH report.
Even when concessionary schemes are available, it would seem that many patients and visitors claim they were not aware of their existence or that they were eligible. Many complaints and bad PR on this issue could be avoided if the schemes were widely advertised and eligible patients advised early but if one believes the hype this often isn’t happening or being done explicitly enough to get the message across.
Communicating with patients and visitors
At the next meeting of the British Parking Association’s Healthcare group, to be held on 21st February at York Teaching Hospitals NHS Trust, concessionary schemes will be looked at in detail and a debate will be opened up to allow those present to share how they approach this enabling everyone to learn from the experiences of others and for the group to consider best practice models. The group will discuss the issue of communicating schemes to patients and visitors as well as looking at how to tackle eligibility criteria.
Other current issues being discussed amongst this group include the implications of the Protection of Freedoms Bill which is due to become statute at the end of 2012. The Bill itself is very wide ranging, covering issues relating to civil liberties – but significantly for parking it makes it a criminal offence to immobilise a vehicle, move a vehicle or restrict the movement of a vehicle on private land without lawful authority, so in other words healthcare providers can no longer clamp or tow away.
The BPA were extremely concerned about a blanket ban on clamping and towing away because in some circumstances one or either can be the most appropriate course of action. The Bill does state that further provision is to be made to extend the power to make regulations for the police and others to remove vehicles that are illegally, dangerously or obstructively parked. But in reality what are the practicalities of calling the police to come and remove a vehicle which is obstructing an ambulance bay or helipad? The BPA has done considerable lobbying on this issue but government has stood firm on this section of the bill with only a few small concessions.
As part of the BPA’s lobbying on the Protection of Freedoms Bill it was pointed out that if clamping is no longer an option, then the whole issue of bringing better regulation to ticketing on private land must be addressed to protect both the landowner and motorist. The BPA put the case forward that provision should be made so that the keeper (or in some circumstances the hirer) of a vehicle can be held liable for unpaid parking charges where the identity of the driver is not known. This was granted and will be on the face of the Bill.
A condition of the granting of keeper liability to the private parking sector is that an Independent Appeals Service (IAS) must be in place prior to its introduction and the BPA has been asked to formally deliver an IAS to the sector. The introduction of an Independent Appeals Services will give motorists a formal mechanism of appeal against tickets issued on private land and bring some much needed consistency between the public and private parking sectors. It will also provide a more effective method of settling disputes over unpaid tickets via a route other than the courts. The BPA is already working on setting up the IAS with a mandate that the service will be and will also be seen to be totally independent, therefore once established the Association will play no active part in its operation.
It is clear from all of this that employing best practice and raising standards in healthcare parking are crucial to demonstrate to the public that due diligence is being given to management and policy planning. This makes the revision work that is about to take place on the BPA’s Charter for Hospital Parking quite significant. The Charter achieved around 75 signatories when launched in 2010 and has the potential to be a valuable instrument in addressing the key issues surrounding managing parking at Healthcare Facilities. The DoH 2010 report hailed the Charter, alongside the NHS Confederation’s “Fair for All not Free for All” publication, as valuable resources which will spread best practice far more effectively than guidance from government. The report then went on to suggest that consideration should be given to regularly refreshing these publications and therefore the BPA is responding to this by reviewing the Charter to ensure it is current and fit for purpose.
The Charter will be re-launched as one part of a comprehensive Healthcare Parking Toolkit which will provide those managing parking at healthcare sites with resources, templates and information. More details about the toolkit will be published shortly and it will also be discussed at the February meeting in York.
The BPA and the members of the Healthcare Special Interest Group welcome new faces at the meetings; the larger the group becomes the more valuable it will be for networking and best practice sharing for all involved. If you were unable to get to the York meeting further meetings will take place on 11th July in Salisbury and then 28th November 2012.