Transport in dialysis as a hotspot - and work on reducing the impact

A quick look around -
https://academic.oup.com/ckj/article/18/9/sfaf220/8230992?__cf_chl_f_tk…

Under the current guidelines on transport I'm not sure if there is incentive to do so for patients, and transport contracts.

There most likely is for staff.. There is guidance only as far as patients are concerned , and I'm not aware that there is any sustainability aspects in that
This is one thing that comes up in terms of methods used for transport every year in the PREM.
https://kidneycareuk.org/get-involved/help-us-influence-change/transpor…

My own experience as an 'expert by experience' patient under SaTH
My own unit still sticks to old, uncomfortable contract minibus ambulances running on petrol or diesel, or a voluntary service for morning shifts with cars provided by a charity.
There is a 2 hour delay before a complaint can be made.

Some patients make their own way by car

I technically could cycle but access is not designed for cycling nor is the route a solid link cycle path. With access for vehicles over a 5mph limiter set of speed bumps (bad enough for walking) there are 2 cycle parking areas including a locked one for staff I rarely see it used.
In this instance there IS a bus stop nearby, but the bus is hourly. It takes around 15 mins by car or an hour by bus to reach my home destination.
Ironically the unit is based in a NHS health 'Hub' to alleviate the strain on the local hospital. The design is entirely car dependent despite being 10min walk away from the main train station and bus hub.

Looking at your key points.
This could include, but not limited to;

improving allocation of patients to nearest dialysis unit
- often patients are allocated by health or clinical needs ie a satellite might not be ideal for some patients who are more vulnerable or need a doctor on site.
At the end of the day we do need far more dialysis units..

improving hospital transport routes and reliability - that's been a challenge since 2014, and sadly one the that usually brings somewhat sarcastic laughter or eye rolls from patients and staff alike. - There has been some progress since I believe .

supporting patients to use public transport .. I can see this working with a patient buddy system perhaps, as patients are technically a bit vulnerable especially post dialysis.. OR ensuring the bus stop is very close to the unit & perhaps local bus drivers made aware.. Similarly re transport services (train stations are often unmanned for instance)

supporting walking and cycling - as above I'd love to see this improved for both patients and staff.. I do wonder if the Dutch Cycling Embassy has any statistics on this, either in the Netherlands or other countries..

In the US - so in theory we can scale it down for the UK - although this is for varied transport, not dialysis specific
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2831947?__…

I'd be interested to see what people come up with myself.
I've calculated that my recent home treatment machine breakdown has cost me around £1,100 in funds for taxis.. Over a couple of months.

Some fun facts - using a rough AI calculator for a 5.3 mile trip there & back, I've created 72kg of Co2 in a carbon footprint, using mostly hybrid taxis.
Using by bike it'd be less than 5.
And an electric minibus would be around 16, presumable less per person if full

Hope this personal insight leads to a few more questions..
James