Health think tank The Nuffield Trust has published its review on the impact of rurality on the costs of delivering health care in partnership with the National Centre for Rural Health and Care.

Those trusts which are unavoidably small due to their remoteness generally have high cost pressures, longer waiting times, more delayed transfers of care, higher average unit costs and a worse financial position. Of the seven most remote rural hospitals in England, six are in deficit.

The report emphasises that the cost of providing health care varies significantly across the UK due to a range of factors, such as differences in property and land prices, staff retention rates and population density, amongst others.

The report suggests that the particular challenges faced by remote services include:

• Difficulties in staff recruitment and retention and higher overall staff costs.
• Higher staff travel costs and therefore less productive staff time.
• The scale of fixed costs associated with providing services within, for example, safe staffing level guidelines.
• Difficulties in realising economies of scale while adequately serving sparsely populated areas.

Overall it argues that unless funding is calculated with these differences taken into account, there will be a widening gap in the quality of health services around the country.

Full articles:

→ The Telegraph - Patients living in the country get a raw deal from the NHS, study finds

→ Nuffield Trust - Rural and remote health services lose out on NHS funding

→ Nuffield Trust - Rural health care: A rapid review of the impact of rurality on the costs of delivering health care