Professor Chris Whitty, the Chief Medical Officer for England and Chief Scientific Adviser for the DHSC outlined his views on health trends and projections over the next 20 years at a recent Nuffield Health Trust Summit 2020

The Summit brings together around 150 policy makers, senior managers and clinicians, researchers and international experts to reflect on the pressing issues facing health and social care and bridge the gap between evidence, action, policy and delivery.

Professor Whitty highlighted concerns for rural areas while discussing internal patterns of migration within the UK.

Younger people migrate towards cities for education and work while older people generally migrate out of cities to rural areas. 

This therefore means that rural and small town areas are getting older at a much greater rate than overall projections. 

This brings with it problems in dealing with the health of rural communities as Professor Whitty articulates, ‘It is generally harder to attract health staff, harder to attract nurses and harder to provide hub and spoke services’ in rural areas. 

The full video of his presentation can be viewed here

The Rural Services Network has long campaigned for fairer funding for rural areas and has highlighted a number of key health facts relevant to rural areas

• 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.

The Rural Services Network is calling for a Rural Strategy to be developed by Government which is fully funded and comprehensive and among other key issues, addresses these challenges in relation to rural health:

• 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.