BORTH, CEREDIGION, WALES: An 83-year-old man who has survived two heart attacks and received treatment for three types of cancer had to drive himself for a four-hour round trip to attend hospital tests after facing difficulties arranging patient transport.
The incident has raised concerns about access to healthcare in rural areas, where long distances, transport cancellations and limited local services can make hospital appointments difficult for older patients.
A Difficult Journey for Heart Tests
Charles Swift, an 83-year-old resident of Borth in Ceredigion, Wales, was referred to Withybush Hospital in Haverfordwest, Pembroke shire, for heart tests in August 2026.
The hospital is approximately 70 miles from his home. This meant a round trip of around 140 miles, taking more than four hours by car.
Despite his medical history, Swift struggled to arrange non-emergency patient transport through the Welsh Ambulance Services Trust (WAST).
When he contacted the service, a call handler reportedly asked whether he could walk, climb stairs and whether he owned a car. Swift answered yes to all three questions and was told to use his own vehicle.
He questioned why older patients were expected to drive such long distances when they needed medical attention. He also described the journey as tiring.
According to a report published by BBC Wales on 29 October 2026, Swift’s experience continued when his transport for another hospital appointment was cancelled on a Friday afternoon, just three days before the scheduled Monday visit.
He decided to cancel that appointment because he could not arrange another way to travel.
However, he later managed to obtain hospital transport for a subsequent appointment. He described that journey as comfortable and trouble-free.
The experience highlighted how transport arrangements can affect a patient’s ability to attend planned medical appointments, particularly when the hospital is far from home.
Why Rural Patients Travel Further
Swift’s experience also highlights the healthcare challenges faced by people living in rural communities.
Borth is located in Ceredigion, where patients sometimes need to travel to hospitals outside their immediate area to access specialist treatment.
Although Bronglais Hospital is located relatively close to Borth, some services have increasingly moved further south, according to local councilor Hugh Hughes.
Hughes met Swift shortly after his first hospital visit, when the health board wanted him to return for another appointment.
He described Swift as distressed and exhausted. The older patient was unsure how he would manage another long journey after the difficulties he experienced during his first visit.
Hughes argued that although travelling to other hospitals is sometimes necessary, longer journeys are becoming more common for rural patients.
Public transport also presents significant challenges. According to the BBC report, train journeys from Borth to Haverfordwest take at least three and a half hours each way.
For older people, particularly those managing ongoing health problems, such journeys can become physically demanding and difficult to arrange.
Understanding Patient Transport Eligibility
Non-Emergency Patient Transport Service (NEPTS) helps patients who cannot travel independently to healthcare appointments because of medical reasons.
In Wales, the Welsh Ambulance Services Trust provides this service for eligible patients attending hospitals, clinics and day centers.
However, having a medical appointment does not automatically qualify someone for hospital transport. Eligibility depends on the patient’s medical needs and ability to travel safely.
According to the trust’s published eligibility guidance, patients may qualify in circumstances such as:
- Receiving regular dialysis or cancer treatment.
- Requiring oxygen or stretcher support during a journey.
- Needing to travel in their own wheelchair.
- Being unable to walk without continuous support.
- Having a medical condition that makes using public transport unsuitable.
The service assesses individual circumstances before approving transport.
Importantly, the trust’s current guidance also explains that having access to a car does not necessarily mean a person can travel independently.
Medical conditions, treatment-related difficulties and other circumstances can affect whether someone can safely complete a journey.
This distinction is particularly important for older patients who may own a vehicle but struggle with long-distance driving.
Following Swift’s complaint, WAST reviewed his initial telephone conversation.
Mark Harris, the trust’s assistant director of operations, said the transport request would not have been refused if staff had received more information about Swift’s circumstances.
The organization also confirmed that it had changed its call-handling procedures and provided additional training to staff.
Pressure on Hospital Transport
The difficulties experienced by Swift are taking place against wider pressure on non-emergency patient transport services.
WAST has acknowledged that demand for patient transport has exceeded its available capacity. According to its published information, demand exceeded available capacity by more than 30,000 patient journeys in the previous year.
The trust has also identified increasing demand and longer travel distances as challenges affecting its ability to provide transport for every eligible patient.
These pressures can lead to short-notice cancellations, making it difficult for patients to arrange alternative transport.
To improve the service, WAST has been reviewing vehicle and staff allocation, improving journey planning and introducing digital booking and cancellation options.
The organization is also strengthening its eligibility assessments to ensure that available transport reaches patients with the greatest medical needs.
Mark Harris acknowledged that the service sometimes receives more journey requests than its vehicles can accommodate within a day.
He said the organization was undertaking a significant improvement program to address these difficulties.
Community Transport Fills Gaps
Community transport organizations are helping some patients who struggle to reach hospitals when other transport arrangements are unavailable.
One example is Dolen Teifi, a community transport organization based in Llandysul. It operates 42 vehicles and works with approximately 160 volunteer drivers across Ceredigion and Carmarthenshire.
Its drivers complete around 50 journeys to hospital appointments each week.
The charity has also experienced increasing demand from patients whose hospital transport has been cancelled shortly before their appointments.
Its manager, Rod Bowen, reported that Dolen Teifi had received 145 calls over two months from people whose hospital transport was cancelled the day before their appointments.
The organization managed to help approximately one-third of those callers.
Unlike the non-emergency ambulance service, which provides free transport to eligible patients, Dolen Teifi charges an average of 57 pence per mile to help cover its operating costs.
Bowen also highlighted the difficulties older people face when driving to hospitals in unfamiliar areas.
He noted that more patients were having to travel beyond their nearest hospital to receive specialist services, sometimes travelling another 40 to 50 miles.
Community transport can provide an important alternative, but its availability depends on local vehicles, volunteer drivers and financial resources.
Health Board Responds to Concerns
Hywel Dda University Health Board acknowledged the difficulties experienced by patients who need to travel longer distances for specialist treatment.
Andrew Carruthers, the health board’s chief operating officer, said the organisation covered a large rural area and recognised the challenges patients faced when accessing healthcare.
He also confirmed that the health board worked closely with the Welsh Ambulance Services Trust and would raise the concerns to explore ways of improving available transport options.
The health board normally expects patients to organize their own transport to hospital appointments. Patients who cannot travel independently for medical reasons may be eligible for support through the non-emergency patient transport service.
Hugh Hughes called for stronger coordination between the health board and ambulance service, warning that some patients were not receiving the transport support they needed.
Conclusion
The experience of 83-year-old Charles Swift highlights the difficulties older patients can face when accessing hospital services in rural communities.
His 140-mile journey for heart tests demonstrates how transport eligibility decisions, limited vehicle capacity and last-minute cancellations can affect access to planned healthcare.
Although non-emergency patient transport services operate under specific medical eligibility criteria, individual circumstances remain important when assessing whether someone can travel independently.
Better coordination between hospitals, ambulance services and community transport organizations could help reduce these barriers.
For older patients and people managing serious health conditions, reliable transport is an important part of accessing timely medical care.
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