Costs Versus Benefits From an Environmental, Service User, Unpaid Carer and Staff Perspective, of a Hybrid Community/Regional Collaboration to Provide Functional Electrical Stimulation Rehabilitation to a Rural Population

Rationale Service users and unpaid carers living in rural mid‐west Wales travel long distances to attend a Functional Electrical Stimulation (FES) gait clinic in South Wales, United Kingdom (UK). It negatively affects their symptoms, and is financially and environmentally costly. An alternative rural/hybrid clinic was set up representing a community/regional service collaboration. Aims and Objectives To compare a hybrid community‐based rural FES clinic led remotely by specialists in a regional, urban hospital in South Wales, with business as usual. Method Qualitative and quantitative measures were collected from multiple perspectives. Services users and unpaid carers were interviewed, and staff from both services gave feedback. Costs and savings were estimated for travel mileage and time, fuel costs, CO2 emissions, loss of earnings for service users and unpaid carers, hotel costs and staff costs. Results Service users and unpaid carers saved an estimated average £121.42 per appointment when attending the local hybrid clinic compared with travelling to the South Wales clinic. An estimated 123 travel miles were saved per appointment and 417.2 CO2 total emissions saved. An average of 3 h 31 min travel time were saved per appointment; 11 lost working days total were saved for service users and unpaid carers. Costs remained the same for the South Wales service, with an estimated £554.19 additional staff costs for the rural community service, for the hybrid clinic. Conclusion Financial costs for service users and unpaid carers, and the environmental impact of travel to healthcare appointments, should be considered as part of holistic clinical decision‐making and healthcare service design. Rural community healthcare services require different delivery models compared with urban hospital‐based services, and this needs to be reflected in funding allocation.