Who takes my mother to her hospital appointment? Transport and escort from a care home

The Thursday afternoon phone call

The home tells you your mother has an orthopaedic appointment on Tuesday at nine. And adds, as though it were obvious, that you will need to take her. You work, you live fifty miles away, and you are paying a weekly fee you assumed covered this sort of thing.

It is not your misunderstanding. There are two separate things here, and they have two different answers.

Transport and escort are not the same thing

• Transport is getting her there. The NHS runs a Non-Emergency Patient Transport Service, and it is free — but only for patients whose medical condition means they cannot travel by any other means. Eligibility is assessed against national criteria; it is not granted because someone is old, and it is not granted because the family is busy. Crucially, somebody has to request it: usually the GP, the care home, or the department that sent the appointment letter. It does not arrive by itself.
• Escort is a member of staff going with her — helping her move, being in the consulting room, understanding what the consultant says, and bringing it back to the home. This is almost never included in the fees, and where the home offers it, it is charged.

Hence the crossed wires: the home says "we don't escort" and the family hears "we won't organise anything". Ask about them separately.

Worth knowing alongside this: if your mother is on a qualifying low-income benefit, she may be able to claim travel costs to NHS appointments through the Healthcare Travel Costs Scheme. It is not means-tested help with escorts, but it takes the fare out of the equation.

The questions, in writing

1. "Has patient transport been requested, by whom, and for what date?" If nobody has asked, ask the GP or the home to make the request and to state the medical grounds.
2. "Do you escort residents to appointments? If so, at what hourly rate and with how much notice? If not, is that stated in her contract?"
3. "Is there a minimum charge?" Half a day billed for a twenty-minute appointment is common and should be known in advance.
4. "If nobody escorts her, who sends her medical summary and current medication list, and who brings the consultant's advice back into her care plan?" This is the question that actually matters. A woman with dementia arriving alone, with nobody who knows her history, is a wasted appointment — and the home still gets a letter it may not act on.
5. "What happens if we cannot come?" Ask before it happens, not the night before.

What to reread in the contract — today

Look at the list of what is included in the fee and what is charged separately. Escort to appointments sits with hairdressing, chiropody and outings among the most commonly billed extras. Care home contracts are covered by consumer law, and the Competition and Markets Authority is clear that charges must be transparent and disclosed upfront — a fee nobody mentioned before she moved in is exactly the sort of thing that guidance addresses. So ask for the schedule of extras in writing now, rather than arguing about an invoice later.

If the placement is council-arranged, ask the local authority what the care package covers: escorting to healthcare appointments is sometimes within the commissioned service, and "we don't do that" then becomes a contractual question rather than a policy.

How to reduce the number of trips

Every outing tires her, disorients her, and raises the falls risk for days afterwards. Before accepting a face-to-face appointment, ask:

• Can this be done by telephone or video? Many consultant follow-ups can, and the home can host it.
• Can the GP get the advice or the test result without a trip? An "advice and guidance" request between GP and specialist often replaces an outpatient visit entirely.
• Can appointments be grouped on one day?
• Is this review actually necessary? For a very frail person, a routine check meaning four hours out and a night of disorientation can do more harm than good. That is a legitimate conversation with the GP, not a withdrawal of care.

On the day

Ask that she leaves with:

• an up-to-date summary and full medication list, with doses;
• a note of what the family wants asked, if you are not going;
• hearing aid, glasses and dentures in — without them the appointment is worthless;
• warm clothing and something to eat if the wait may run long.

Afterwards, ask that the clinic letter goes into her records and that you are told what changes. A great many appointments are wasted because the letter arrives and nobody acts on it.

If the home will not help

1. A written request for the schedule of additional charges, with reference to the contract.
2. The home's formal complaints procedure, then the Local Government and Social Care Ombudsman, which covers privately funded as well as council-arranged care in England.
3. The GP practice and PALS, if the problem is the transport request rather than the home.
4. CQC should hear about a home where residents routinely miss healthcare appointments — access to healthcare is part of meeting assessed needs, a fundamental standard.

If you are still choosing a home

Take this on the visit: "Do you escort residents to hospital appointments, and at what cost?" It is one of the largest practical differences between two homes at the same weekly fee, and it appears in no brochure.

And if you would rather not make the calls yourself, that is the part we do. Tell us the area, your parent's needs and your timeframe, and you get a shortlist of homes worth calling, for £69. If you don't receive at least 3 homes matching the area and criteria you gave us, we refund you in full. Start here

This article is general information for families, not medical or financial advice. Patient transport eligibility criteria and travel cost schemes differ across England, Wales, Scotland and Northern Ireland and change over time. Curalune does not allocate beds and does not guarantee availability.