We think that our proposals will mean that more patients will be using the Vale of Leven Hospital in future to access outpatient, daycase and diagnostic services. This means that fewer people in Argyll, the Lochside and West Dunbartonshire will need to travel to Glasgow or Paisley to access care. In total we anticipate that 18,350 fewer journeys will need to be made for planned care. The changes that we propose for unscheduled medical care would mean that between 1,000 and 1,900 patients would have to travel to the Royal Alexandra Hospital each year. Significant numbers of these will travel by ambulance. We firmly believe that the Vision we have developed represents the best possible balance between providing local access to high quality services and a requirement to travel for more specialist or intensive care on the occasions when it is required. We understand that local people have concerns about transporting patients to the Royal Alexandra. However, since 2004 approximately 5,000 patients each year have travelled to there to receive Accident and Emergency care. The Scottish Ambulance Service has not identified any adverse clinical outcomes as a result of transferring these patients, or as a result of the closure of the Erskine Bridge or local roads. Similarly, an audit that was undertaken after A & E services transferred to the RAH revealed that there was no detrimental clinical impact on patients from the Vale of Leven area as a result of this change. We do appreciate that relatives, carers and friends want to visit patients receiving care in Paisley. There is already a subsidised bus service (the 340) between the Vale of Leven and Royal Alexandra Hospitals in place to make the journey easier. We propose to promote this service and encourage more people to make use of it.