Elderly rural residents face a crisis situation because of austerity and poor access to social care, says a report.

Called Issues Facing Providers of Social Care at Home to Older Residents in Rural England, the study highlights the challenged faced by the rural elderly.

Older residents in the countryside often face unique challenges in terms of home-based social care, related to demographics, service provision and costs, it says.

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The government and service providers should take steps to stave off a worsening situation, warns the report.

Without action, vast numbers of vulnerable individuals risk being abandoned simply because of where they live.

The study was published on Thursday (25 January) by the Rural England CIC think tank, which buys in administrative support from the Rural Services Network.

    Rural-proofing

The report calls for greater focus on rural-proofing in the NHS Sustainability and Transformation Plans.

Margaret Clark, chairwoman of Rural England’s Stakeholder Group, said: "This report highlights worrying evidence about the poor provision of, and access to, home-based social care services for elderly individuals in rural England."

The situation had severe consequences for the health and wellbeing of an increasing number of people in rural communities.

"We urgently need government and service providers, at all levels, to work together to find a solution to the delivery of good quality social care in rural areas and to stave off what will otherwise become a crisis situation," said Ms Clark.

"Those living in rural areas deserve better."

Rural councils, on average, pay significantly more (13%) than urban councils when commissioning adult social care services, says the report.

    Economies of scale

Yet among the challenges identified by the report are that lower population density in rural areas – with less clustering of service users in the same area – prevents economies of scale.

This means providing care at home can be prohibitively expensive.

At the same time, there is significant pressure on local authorities to achieve cost savings in social care, which can result in a lessening of the home care that is offered or a reduction in quality.

The report also flags the ‘penalty of distance’, whereby health services are typically further away and often inaccessible by bus (especially with services reducing).

In addition, home care staff are typically not paid for travelling time despite needing to go further to tend to the needs of service users.

With the ever worsening of public transport in rural areas, for those older people without access to a car a medical appointment, even with a GP can be a real struggle.

    'Moment of crisis'

As a result, the authors warn that, for the rural elderly, first contact with social services is often at a ‘moment of crisis’ – reducing the opportunity for sometimes life-saving earlier intervention.

Philip Dunne MP, co-chairman elect of the All-Party Parliamentary for Rural Services said: "I know the pressure providers are under in rural areas from greater distances and challenges in finding qualified staff, though technological advance is beginning to help.

"I hope this report will help raise the voice for those in need of care in rural areas to contribute to the Green Paper on Social Care that the Government will be producing over coming months.

"I look forward to playing my part in ensuring this voice is heard."

The report also draws attention to other problems faced by the rural elderly, including the higher prevalence of fuel poverty.

This is often because of generally lower incomes, and older housing that exacerbates fuel costs and may be inappropriate for those with diminishing mobility.

    Rural families

Additionally, the report notes that the rural elderly face specific challenges of isolation, often geographically separated from family.

Younger generations are likely to move away in search of better employment opportunities in cities – and further cut off by poor digital connectivity in many rural areas.

Data shows that those aged 65 and over comprise 20% of the rural population, higher than the 16% of the urban population.

The percentage of the population aged 85 and over, the group most likely to need care, is 3% in rural areas compared to 2% in urban. Ageing of the population is also fastest in rural areas.

Changing legislation to address the care issues is going to be a long process, says the document.

This will not start until the summer of 2018 with the promised publication of a Government Green Paper.