RSN Priority - A fair deal on health and social care
Rural communities, like communities everywhere, need access to high quality health care and some require extra support from social care services. This is fundamental to wellbeing and anything less may pose a health risk. They should not have to pay extra for this (either directly or indirectly).
- Older age groups form a significant and growing share of the rural population. In 2011 29% of the rural population were aged 60 or over, up from 24% in 2001. Comparative urban figures were 21% in 2011 and 20% in 2001. By 2039 nearly half of all households in rural areas will contain people aged 65 or over.
- Rural and urban areas receive similar funding (per resident) under the NHS allocations to Clinical Commissioning Groups (CCGs). This does not reflect the older rural demographic, which places extra demand on NHS services due to chronic illness, disability and mortality.
- Rural residents face longer journeys to reach a GP surgery than their urban counterparts.
- Those who travel by public transport or walk have an average 18 minute journey, though this figure takes no account of the frequency of such transport and hence any waiting time.
- The Government’s resource allocation system for local government (Settlement Funding Assessment) provided urban areas with 40% more funding per resident than rural areas in 2016/17. With reducing budgets, spend to meet on growing social care needs risks overwhelming rural county and unitary council budgets at the expense of other services.
- Rural residents also face an additional cost burden for the adult social care provision in their areas. In 2017/18 they funded 76% of the cost of its provision through their Council Tax bills. The urban comparator figure was 53%.
- Home care providers face various challenges in rural areas, including difficulties recruiting staff and unproductive staff travel time between geographically spread clients. Rates of delayed transfer of care upon hospital discharge are higher in rural than urban areas.
- Almost 12% of all residents who live in rural areas are providing informal care to someone else on a regular basis. That figure doubles to 24% amongst older people who live in rural areas. Both these figures are higher than the urban equivalents.
Data sources are ONS, National Housing Federation, Department for Transport, Rural Services Network and Rural England.
On measures of healthiness the rural population can score rather well, but demand for health and social care services is growing and access to them is frequently a concern.
Significant challenges should be addressed by a Rural Strategy. They are:
- Ensuring that patients can get to secondary and tertiary health services;
- Delivering quality primary health care locally within rural settings;
- Making sure social care reaches those who need it in remote locations; and
- Benefitting rural clients through improved health and social care integration.