Optimising planned patient transportation: A qualitative descriptive study of current practices in KwaZulu-Natal, South Africa

Background: Planned patient transportation is a key component of healthcare provision in KwaZulu-Natal. However, persistent inefficiencies in the transportation system have been associated with suboptimal health outcomes among patients. Understanding current planned patient transportation practices is therefore imperative to guide improvements in the Emergency Medical Care referral system. This study aimed to describe current planned patient transportation practices in KwaZulu-Natal, South Africa. Methods: A descriptive qualitative design was employed. Semi-structured interviews were conducted with 11 purposively selected Emergency Medical Services managers, and five focus group discussions were conducted with 35 pre-hospital emergency care providers recruited using maximum variation purposive sampling. Data were transcribed verbatim and analysed thematically using NVivo. Ethical approval was obtained from the relevant ethics committees. Results: Findings revealed four superordinate themes related to enablers of effective planned patient transportation: (1) digital transformation and operational innovations; (2) stakeholder collaboration and community engagement; (3) decentralised healthcare delivery; and (4) policy coherence. Conclusion: Planned patient transportation is essential for healthcare access and continuity of care but remains constrained by coordination, resource, organisational and policy challenges. Strengthening referral systems, stakeholder communication, policy standardisation, digital health systems and resource allocation may improve transportation effectiveness and support patient-centred, equitable primary healthcare delivery in KwaZulu-Natal and similar settings. Contribution: The findings provide insights to guide planned patient transportation service improvement through system strengthening and process enhancement.