The challenge

Eliminating barriers to heath uptake and attendance is a core part of the Department of Health’s strategy to reduce heath inequality. One perceived barrier is the cost of transport to secondary care appointments and the Department was keen to evaluate the impact of enhancements to the scheme whereby those eligible could claim repayment of travel expenses. However, decentralisation and a low scheme profile meant that hard information on scheme metrics was limited.

What did we do?

To deliver a fast track, cost effective solution, we focussed on gathering intelligence from healthcare professionals rather than a highly disparate and hard to reach scheme user and non user base. We talked to Department of Health and NHS officials at national level and conducted an online survey amongst trust managers. We telephoned hospital cashiers and receptionists in hospitals, dentists and doctors’ surgeries and mystery shopped Patient Advice lines. We also analysed printed scheme material at both local and national level.

We found that, while there were indications that the enhancements had improved scheme performance, there remained obstacles to take up and made a wide range of recommendations on ownership, segmentation, channels, media, processes and future measurement to address the most significant issues.

What was the breakthrough for The Department of Health?

Our key breakthroughs were:

• Talk to service providers at all levels; national management, central administration, local management and location administration and front line staff
• Where responsibility is split, talk to both sides; in this case primary and secondary care staff
• Cover all formal communications; forms, posters, leaflets and help lines
• Use multiple information points to reinforce and confirm insights as well as provide a fuller picture