Buses & Hospitals in LB Enfield

1. Buses & Hospitals in LB Enfield December 2014

2. Introduction • Access to hospitals in LB Enfield is a significant issue for residents and the Borough. For around 10 years the issue has been very closely related to NHS proposals to re-organise clinical services including closure of Chase Farm A&E. • TfL did a comprehensive review of hospital access in Enfield in 2005. The NHS also did a 2012 study into the travel impact of the proposed clinical changes. • During this time bus services have continued to improve with route 307 re-routed to terminate at Barnet Hospital in June 2012. Route 444 to be made high frequency when the new contract starts March 2015. • The NHS re-organisation came into effect in late 2013. • Enfield Transport Users Group (ETUG) have proposed major alterations to the bus network. One of the reports objectives is to improve access to hospitals. • TfL and LB Enfield have agreed to re-examine access to hospitals for Enfield residents

3. Use of hospitals by Enfield residents Enfield Patient Attendances by hospital for the year 2011/12 (From Table 4.1 NHS/PBA TIA) Estimated Enfield patients affected by changes to medical services at Chase Farm Hospital (From table 4.2 NHS/PBA TIA) • Chase Farm is Enfield residents’ main hospital and remains so following reorganisation.

4. Approach to Study • Where do Enfield residents travel to & from to receive healthcare? • To what extent does the bus network match those travel patterns? • How much do people use the bus to access each hospital and has this changed following the hospital re-configuration? • What does the origin-destination of hospital bus trips tell us about accessing health care by bus?

5. Methodology • Plot NHS data on attendance at hospital by electoral ward • Overlay key bus routes • Compare bus boardings before/after NHS re-configuration • Analyse passenger travel patterns • Identify Issues • Develop service planning ideas

6. Access to GPs & Walk-in clinics Source: NHS Enfield CCG website

7. Access to Chase Farm Hospital (CFH)

8. Access to North Middlesex Hospital (NMH)

9. Access to Barnet General Hospital

10. Summary of Findings Main findings: • People travel to their nearest hospital. - Nearly 30% of all CFH trips on route W8 either started or ended at Enfield Town, within 2 miles of CFH - 75% of all NMH trips on route 491 start or end between Edmonton Green bus station, less than 1.5 miles NMH • Indications are that CFH remains the borough’s main hospital but evidence of a reduction of travel to CFH & corresponding increase to NMH. - 22% increase in boardings at NMH between 2011 to 2014 - 25% decrease in boarding at CFH between 2011 to 2014 - Currently 1152 weekday boardings at CFH and 1143 weekday boardings at NMH • Evidence that passengers are willing to interchange. • The bus network provides good connections between each hospital & their main catchment areas.

11. Service Planning-Key Issues • No direct link from NE of Borough to Chase Farm Hospital. • Relatively low frequency of service to North Middlesex from Eastern Enfield. • Relatively weak links from Winchmore Hill / Bush Hill Park to North Middlesex Hospital.

12. Route 317 extension Estimated Cost: £330,000 pa Option A: Via Church Street, Windmill Hill & The Ridgeway Option B: Via Church Street, Chase Side & Lavender Hill Option C: Via Church Street, Silver Street, Lancaster Road & Lavender Hill Option D: Via Church Street, Silver Street & Holtwhite’s Hill Option B generated the most trips & was taken forward. Service Planning Ideas (Issue 1)

13. Service Planning Ideas (Issue 1) • Benefits • Higher frequencies between CFH & Enfield Town. • New Links from Gt. Cambridge Road area to CFH area. Some new trips generated as a result. • Disbenefits • Insufficient trips to justify the expenditure of circa £330k. • Provides additional levels of service between Enfield Town & CFH where additional capacity isn’t required. • Does not serve the most densely populated areas of NE Enfield.

14. Route 491 frequency to 5 bph Service Planning Ideas (Issue 2) • Estimated Cost: £348,800 pa • Benefits • Improves bus wait-time and interchange at Edmonton Green. • Improved level of service including to Brimsdown. • Disbenefits • Expensive to operate. Requires a subsidy of £230,000 pa • Benefits do not quite meet our investment criteria; but getting close! • - Route 491 serves an area where demand is growing. Will therefore work with LB Enfield to understand progress of new development.

15. Route W10 restructuring Estimated Cost: £738,000 pa Preferred routeing: Via Worlds End Lane, Eversley Park Road, Church Hill & Station Road. Option A: Via Worlds End Lane, Green Dragon Lane & Green Lanes. Option B: Via Worlds End Lane, Green Dragon Lane, Wades Hill & Station Road. Option C: Via Green Lanes, Barrowell Green and Firs Lane rather than the entire length of Firs Lane. Service Planning Ideas (Issue 3)

16. Benefits • Could provide an all-day 2 bph service between Crews Hill, Willow Road & Enfield Town. Currently only off-peak service. • Creates a direct link to Green Lanes & North Middlesex Hospital from the east of Winchmore Hill. • Creates new links west of Winchmore Hill. • Brings a number of households within walking distance from the bus network resulting in new trips being generated. • Disbenefits • Expensive to operate. Requires subsidy of £460,000 pa • Requires additonal stand space at NMH and highway works on unserved roads. • Uncertainty of structural constraints (e.g. weak bridge at Farm Lane). • Potentially controversial on roads unserved by buses. Service Planning Ideas (Issue 3)

17. Service Planning Ideas- Summary Potential Schemes

18. Discussion/Questions?