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Rural health made worse by poor access to GPs

20% of rural patients live more than 4km from their GP

Adrian O'Dowd

Monday, 20 March 2017

Poor health in rural areas and reduced access to GPs for a significant amount of people is being “masked” by idyllic images of the countryside, according to public health and local government leaders.

A new joint report, published at the weekend by Public Health England and the Local Government Association (LGA) said not enough was known about the health and wellbeing of people living in the countryside.

Official statistics were not providing a sufficiently accurate picture of people's health outside cities and this lack of information was masking pockets of significant deprivation and poor health in rural areas.

The report Health and wellbeing in rural areas says only 80% of rural residents live within 4km of a GP surgery, compared with almost all (98%) of the urban population. Only 55% of rural households compared to 97% of urban ones are within 8km of a hospital.

The report says: “Rural areas have worse access in terms of distance to health, public health and care services. Longer distances to GPs, dentists, hospitals and other health facilities mean that rural residents can experience ‘distance decay’ where service use decreases with increasing distance.

“Different models of service delivery may be needed for rural areas, including new models of workforce development.”

Rural areas make up 85% of the land in England and 9.8 million people (19% of the population) live there – a number that is increasing and ageing. They have, on average, 23.5% of their population over 65 compared with 16.3% of urban areas aged over 65.

Councils were facing increased pressures to meet the needs of an ageing rural population, which was also a longer distance from health services, said the authors.

To address the issue, the LGA, said government should make improvements to how it collated data to capture the health of rural communities, to help councils plan how they provide services.

Izzi Seccombe, chairman of the LGA's community wellbeing board, said: “We often think of rural areas as picture-postcard scenes of rolling green fields and farming land, yet this idyllic image is masking pockets of deprivation and poor health.

“Rural communities are also increasingly older, and older people often experience worse health and have greater need of health and care services. The remoteness of our rural communities from their nearest point of contact with a GP or hospital can leave those residents cut off from getting vital support.”

Duncan Selbie, chief executive of Public Health England, said: “Rural areas are very diverse environments with differing needs, particularly in remote places. Local authorities are already finding new and imaginative ways of reaching out to people in remote communities who so often go unnoticed.”

Responding to the report, Professor Helen Stokes-Lampard, chair of the RCGP, said: “GP practices in remote and rural areas often report difficulties in recruiting enough GPs and practice staff needed to meet the rise in patient demand.

“Many of the innovations we are exploring in order to cope with growing demand, for example working in federations of practices to pool resources, might also not work for practices in remote and rural areas as by their very nature, they might be too isolated.

“Measures are being taken. Health Education England’s targeted recruitment campaign offering bursaries to GPs to train and practise in under-doctored areas was piloted in a number of rural areas and early signs are that it has been a success. We need to see more schemes like this.”

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