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Posted: June 14th 2019

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Rural health care - A rapid review of the impact of rurality on the costs of delivering health care

The Nuffield Trust was commissioned by the National Centre for Rural Health and Care to explore the key issues around the impact of rurality and sparsity on the costs of delivering health care.

The report can be read here.

Rural health care - a rapid review of the impact of rurality on the costs of delivering health care

The Nuffield Trust was commissioned by the National Centre for Rural Health and Care to explore the impact of rurality and sparsity on the costs of delivering health care.  

This report evidences the additional costs in rural areas including: staff recruitment, retention and costs; higher travel costs; increased fixed costs associated with providing services within safe staffing guidelines; and difficulties in realising economies of scale when delivering services in sparsely population rural areas.

New Research Capacity at National Centre

A Researcher has now been appointed to support this initiative. She is based within the LORIC Centre at Bishop Grosseteste University. She will begin the process of supporting the research work of the Centre from May onwards.

She will support the following tasks:

Identification of Universities that would like to participate in a National Centre Network focused on rural health research

A stock take of extant rural health research which is pertinent to the mission of the National Centre

Beginning the process of scoping out a Journal of Rural Health and Care

Horizon Scanning in terms of trends and intelligence which might inform the direction on key policy issues for the Centre

Action Research

Community Pharmacy. A Joint project between Lincolnshire LIVES first responders and the pharmarcy department of Lincolnshire co-operative society is underway with funding from the National Centre. It aims to reduce A&E admissions by enhancing the advanced first aid skills of pharmacists. The outcomes will be evaluated by the university of Lincoln, and more information will follow in due course.

Research proposals. The National Centre has identified funding to support up to three small research proposals. It is currently considering applications on the themes of refugee doctors, coastal strategies for recruitment and retention, the challenges around retention of rural GPS, and the challenges facing dispensing doctors in rural settings.

New routes and opportunities for tackling recruitment and retention in health and care in rural areas

The second piece of research looking at recruitment and retainment issues in the NHS has just been commissioned. This estimated completion of this research is summer 2019.

The steps being taken are:

Rapid evidence review – of the national literature pertinent to routes to securing new workers (and retaining them) for the health and care workforce in rural areas, including the role of developing more generic roles so that clinicians can work across professional boundaries. The review will extend to Australia and the USA (where there are some robust evaluations of workforce development programmes). The national work will involve capturing ongoing activity relevant to the health and care sector in local devolution deals and Government-funded innovative projects.

Defining routes – analysis of the evidence collected in the review in step ‘1’ to: (a) identify the range of routes which present opportunities for securing workers/ delivering services in support of health and care workers; (b) identify and assess the potential of, and practice in, developing more generic roles enabling (more junior) clinicians to work across professional boundaries.

Selection of case studies – purposive selection of case study initiatives/ practice for more in-depth analysis that are complementary to the linked Action Research projects that will be commissioned by the National Centre for Rural Health and Care.

Primary research – interviews with local stakeholders, strategic managers, delivery providers, workers/ volunteers, etc., to supplement background documentation on case study initiatives.

Interim analysis and reporting – analysing and writing up findings from steps ‘1’-‘4’ above.

Liaising and synthesis across projects – liaising with the action research projects and their evaluator to ascertain their progress and key findings in order to enable synthesis across different elements of the research.

Workshop/ event – bringing together learning from across the different elements of the project with stakeholders from a range of groups/ organisations with interests in workforce issues in rural areas.

Final reporting – production of a report and summary of findings and policy recommendations.

We believe that there is a real gap in the amount of research undertaken in the context of rural health and care inequalities.

We are delighted that the University of Lincoln has agreed to fund a Professor of Rural Health and Care based within the Centre. We have established links with a number of HE organisations and specialist agencies engaged in rural health and social care research. We are currently working actively with a number of partners on a series of linked research proposals to the NIHR call for Rural Research which has a deadline of July 2018.

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