Addressing rural health inequalities as an anchor institution

Dorset County Hospital is the main provider of acute hospital services, and the largest employer, in West Dorset. As well as providing health services to our local community, we employ over two and a half thousand people; we spend millions of pounds each year on goods and services and have a major impact on our local environment. As such, we are an anchor institution and have an important role to play in both the social and economic development of our communities following the pandemic. Fundamental to this is our hospital’s Social Value pledge which commits to reduce avoidable inequalities and improve health and wellbeing across our community.

As an Acute hospital, serving a largely rural population, we face key challenges including an ageing population, 29% of Dorset’s population are 65 years and over, predicted to grow by 34% in the next 5-8 years. We serve hard to reach, isolated communities with weak transport links and lengthier travel times to reach hospital; compounded by digital exclusion. Recruitment and retention of healthcare professionals is difficult due to a lack of working age people and outward migration of younger people. We face increased financial pressures, having to deliver the same level of quality whilst undertaking small activity numbers; and productivity challenges working across multiple sites including community hospitals. Our local coastal communities have some of the highest levels of social deprivation nationally.

As an NHS anchor institution we have a responsibility, and the capacity, to help proactively address health inequalities across our region. Health inequalities were prevalent prior to the pandemic, particularly across rural communities. COVID-19 has highlighted and exacerbated these inequalities. The pandemic has had a disproportionate, detrimental impact on people living in rural areas of high deprivation, ethnic minority communities, those with learning disabilities and others with protected characteristics and older people. To overcome this inequity and build back fairer will require a new approach to levelling up to tackle inequalities. We need a different relationship with the community, providing a wrap-around service which delivers outstanding healthcare, whilst also improving the socio-economic well-being of the population we serve. 

For Dorset County Hospital our social value programme is the cornerstone of this ambition. We have committed to deliver on our pledge to procure more goods locally, supporting local businesses; increase local employment through targeted recruitment and schemes such as the Kickstart programme; by supporting the well-being of our workforce as a good employer; to champion equality, diversity and inclusion and by improving our environmental sustainability contributing to the NHS Net-zero goals. We are also working with our Dorset ICS partners and other civic partners to develop a system-level approach to improving health equity and the wider social, economic and environmental vitality of our region.

As we progress we will evaluate and report on our social value outcomes and our impact on reducing avoidable inequalities as an anchor institution. As we move beyond the pandemic, we aim to create a lasting, positive social impact, improving the overall well-being of the communities we serve.


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