Date: 11th May 2022
Subject: Rural Social Care and Health
Chair: Cllr Roger Phillips, Herefordshire Council
Hosted: Online Event via Zoom

- To download the agenda associated for this meeting, click here

- To download a copy of the RSN's 'Market Sustainability and Fair Cost of Care Fund' presentation click here

- To download a copy of the NCRHC's 'APPG on Rural Health and Social Care's - Inquiry into Health and Care' presentation click here

- To download a copy of the learning outcomes click here

Learning Outcomes

• Key issues facing rural councils in delivering care services include:
  • Resource, rural areas receive significantly lower levels of funding from Government than urban areas.
  • Workforce, recruitment, and retention of staff in rural areas is more challenging generally and are exacerbated by the lack of affordable housing, travel costs, etc.
  • Demography, rural areas have a higher concentration of older people compared to urban, which places a higher burden on rural local authorities to deliver care services.
  • Self-funders, there are higher levels of people funding their own care in rural areas, making them more sensitive to funding reform.
  • Care Homes, there are greater numbers of care homes in rural areas compared to metropolitan areas, many of these care homes however service the needs of non-rural residents.
  • Sparsity, there are geographical challenges in providing care in large and remote rural areas due to the time and costs involved in delivering care over long distances.
• Market Sustainability and Fair Cost of Care Fund - RSN Chief Executive stated that a recent meeting with the Care Minister it was highlighted the need for local authorities to start build strong health foundations, if not they will not be looked upon favourably for future funding. As a condition of receiving funding, local authorities will need to evidence the work they are doing to prepare their care markets and make submissions to DHSC by 14 October 2022. RSN will be contacting local authority health members to ask them to share their submissions, so it can track allocations to establish whether rural receives it fair share of funding.
• The Local Government Finance Settlement 2022 to 2023 included additional funding for local authorities to cover some of the demographic and unit cost pressures facing social care. The Market Sustainability and Fair Cost of Care Fund is additional to those pressures and will help local authorities to meet their new duties.
• Launch of the Report of the Inquiry into Rural Health and Care after 18 months of intensive work by the Rural Health and Care APPG and the National Centre for Rural Health and Care a Full Inquiry Report was launched on 1 February 2022. The full report is accompanied by a useful Overview.
• Chief Medical Officer – Professor Sir Chris Whitty was at the launch and incredibly supportive of the findings stating, “rural areas have received much less attention than they should have”, a point echoed in his Health in Coastal Communities Report.
• The APPG Rural Health and Care Inquiry report tells us rural areas are different:
  • There is a disproportionately older population, often with more complex co-morbidities and a paucity of younger people.
  • The ebb and flow of rural populations due to seasonal demands associated with tourism and agriculture makes provision of health and care even more challenging.
  • Health in rural areas is not just dictated by the quality, range and capacity of health and care providers. Access to good public transport, digital connectivity, housing and education plays an imperative role too.
  • Economic uncertainties have a significant impact in rural areas, resulting in high levels of unhealthy behaviour and suicide.
  • Due to poor data collection and the granularity of data used, there is an incorrect assumption that all rural areas are affluent.
  • The NHS is a huge system which is place blind and its big is beautiful mentality often unwittingly drives health inequalities. A person, not system centred approach is needed.
  • Much can be learned from international best practice. The Inquiry took evidence from 89 witnesses from both UK and Overseas and the third sector. International evidence shows that retention is high in rural areas if you recruit and train in rural areas.
• Rural areas need a strategy that recognises the economic and social benefits of delivering levelling up in rural areas: without such recognition rural England will be overlooked, by-passed, and pushed down further, rather than levelled up. Such a strategy needs to be delivered across departments and focused on genuinely levelling up and revitalising rural area/economies.
• Recommendations from the Inquiry into Rural Health and Care Rural Health Report are divided in to four areas:

1. Build understanding of the distinctive health and care needs of rural areas
2. Deliver services that are suited to the specific needs of rural places
3. Develop a structural and regulatory framework that fosters rural adaption and innovation
4. Develop integrated services that provide holistic, person-centred care

Member Best Practice and Case Studies

• Devon Communities Together have recently completed a piece of work on digital pathways to care, looking at rural digital health inequalities. The project was funded by NHSX and was delivered by working with the Devon CCG and VCSE partner Wellmoor. To access the findings click here.
• Mobile UK is working on a report highlighting case studies on how technology is being used in the health sector. The report is expected to be published by July and will be shared by the RSN.

Action Points for All Members

• To raise the profile of rural health and care by lobby local MPs and signposting the APPG Rural Health & Care Inquiry Report.
• Contribute to relevant local ICS to help shape their quality and equality impact assessments to ensure rural needs are incorporated.
• Reach out to Local Medical Committees and the local Royal College of GP
• Contact the National Centre for Rural Health and Care if you’d like to be one of 4 pilot areas to implement Rural Proofing for Health Toolkit.

Useful Links

• The State of Care in County and Rural Areas a joint report published by the Rural Service Network and County Councils Network in September 2021, highlighting the challenges faced by rural areas.
• Revitalising Rural Campaign led by the Rural Services Network highlighting a number of key policy areas and Government asks. Relevant campaign elements for the Health and Care Sub-Group include:
  Access to Rural Health and Care Services
  Managing an Older Rural Population

• RSN’s Rural Lens Review of Adult Social Care Reform White Paper published in December 2021.
• Rural Health Care Alliance is a membership organisation managed by the RSN on behalf of the National Centre for Rural Health and Care and offers a range of useful resources.

Attendance and Apologies

Attendance

Apologies