Abstract This paper considers the problem of deriving realistic access measures between population demand and health service locations, in the context of a rural region of England. The paper reviews approaches used in earlier work by the authors and others, and considers new public transport information systems that are now becoming available. An application is presented which incorporates the modelling of both private and public transportation travel times for access to district general hospitals in Cornwall. This information has been assembled from published timetables in order to evaluate the use of more sophisticated access measures that might be used when such data becomes more generally available. The work is set within the context of an ongoing substantive research programme concerned with health outcomes in the rural South West of England.