Rural and Coastal Areas Facing Serious Health Challenges

Patrick Mitchell, Director of Innovation, Digital and Transformation, Health Education England

A combination of worsening health, ageing populations, social deprivation, and workforce staffing issues are leaving health and care services in rural and coastal areas facing serious challenges.

Services are having to meet the needs of populations with deteriorating health and a range of significant physical and mental health conditions, whilst also trying to address staffing shortages in key disciplines.

That’s why at Health Education England (HEE), we have unveiled plans for a new evidence-based pilot programme aiming to help tackle health inequalities working with the five geographies that have the most challenged social determinants of health and the lowest staffing levels per head of population. These are Lincolnshire; Kings Lynn; Great Yarmouth; Northeast Essex/West Suffolk and East Kent.

These plans, based on global evidence, set out an ambition to help reduce ill health and inequalities through education, training and use of digital technology.

These are being designed on a mix of existing proven interventions but be anchored around some key initiatives that internationally have been proven to be effective in sustaining a local community’s recruitment and retention of health professionals.

HEE’s regional teams will work in collaboration with the ICS pilot areas, supported by HEE’s national teams to establish a targeted and sustained programme of education and training.

HEE will work closely with ICS colleagues to utilise existing HEE activity such as the Medical Education Reform Programme and tailor them to the needs of the population. A key element of this will be working with local teams who have knowledge of the context and specific issues of those areas to fully understand the health and workforce issues. This will enable us to focus our work on ensuring trainees develop a broad range of skills needed for rural and coastal practice.

It is also vital to develop residents’ digital skills and confidence to enable them to access help and information in a variety of ways and make the most of technology available in the NHS.  Several ICS’s have already trialled innovative projects including training local residents to use online services and appointing digital ambassadors in the workforce and the community to promote the importance of digital skills.

Meanwhile, HEE is developing solutions to secure the workforce by learning from global research, particularly the importance of a rural upbringings; positive undergraduate clinical and educational experiences in rural settings; and targeted training for rural practice at postgraduate level.

Health inequalities in rural and coastal areas are not going to improve unless we find achievable ways to work together to target our resources at locations facing the biggest challenge. Therefore HEE ‘s plans focus on three key pieces of work:

Widening participation and access to medical schools, with ambition to increase applications from rural communities.

Introduce innovative rural and coastal healthcare apprenticeship programmes.

Instigate initiatives focussed on increasing digital and health literacy, including the ability to access, assess and use health information amongst members of the public.

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