The UK’s NHS is the largest employer in Europe with approximately 1.3 million staff. Around 83%
of the journeys associated with the NHS are made by private car. In this context, every healthcare
authority was required to produce a travel plan by December 2010, including an emphasis on promoting
walking and cycling as a means of accessing hospitals. Evidence shows that although the
take–up of travel plans is increasing across the NHS, the impact of travel plans in promoting walking
as a travel option is relatively low among hospital staff. A scoping study has been conducted
aiming to bridge the gap between research and practice by capturing the views of the NHS representatives
on hospital travel plans by a nationwide survey and review of hospital travel plans. The
survey findings show that despite having a high potential to promote walking as a key travel option
among the hospital staff, the measures to promote walking were cited as the least effective. A
Spearman’s ⇢ correlation coefficient test was performed to evaluate the correlation between travel
plan measures to promote walking and restrictive measures to reduce the use of cars. The results
show that the effectiveness of measures to reduce the use of cars is positively correlated with the
effectiveness of measures to promote walking. The effectiveness of travel plan measures to secure
the targeted outcome is attributed to the methods used to address the determinants for changing
travel behaviour whilst designing travel plan measures and the successful adoption of innovative
strategies in the given context.
A theoretical framework has been developed based on the Theory of Planned Behaviour and five
key research hypotheses have been proposed to demonstrate the key determinants for changing
travel behaviour. The analysis was based on a nationwide survey among the NHS hospital staff in
England in 2013. There were 863 completed responses, out of which 459 responses were from hospital
staff, who solely relied on car journeys for commuting purposes. Structural equation modelling
was performed to investigate the effects of socio–economic, psychological and situational
factors in determining intention to change travel behaviour among the car users only. The model
estimation results show that the effects of cognitive attitude towards walking and objective mobility
were significant on determining intention to change travel behaviour. The respondents exhibited
a habitual nature of travel behaviour, which is characterised by longer commuting distance and
journey time than the national UK average. The practical implications of the study were addressed
by providing recommendations that need to be considered whilst designing travel plan measures.
The recommendations were based on the concept of Model for Planned Promotion. This study
provides a basis for further conceptualisation of travel behaviour change and identifies several areas
that need further investigation in relation to designing interventions to promote walking in the
context of healthcare
