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Hinterland - 16 August 2021

In Hinterland this week – some challenging health stories, an interesting reflection on re-wilding, some broadband innovation and finally a big staycation question. Read on...

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Rewilding 5% of England could create 20,000 rural jobs

Fascinating article – this piece tells us

Rewilding 5% of England could create nearly 20,000 jobs in rural communities and increase employment by 50% compared with intensive farming, figures show.

Hybrid roles in animal husbandry and ecology, positions in nature tourism and specialist roles in species reintroductions could be among the new positions, according to analysis from Rewilding Britain, alongside benefits for biodiversity and the climate.

The drive to restore nature on a large scale in the UK’s landscapes has sparked fears of job losses in the agriculture community owing to perceived links to abandoning farmland and halting food production.

But Prof Alastair Driver, the director of Rewilding Britain who put together the figures, said the analysis showed rewilding on marginal land could increase employment without stopping traditional agricultural activities.

“You’re looking at approximately a 50% increase in jobs compared with traditional intensive farming,” Driver said, cautioning that while the figures were positive, there would not be a rewilding industrial revolution.

NHS waiting lists could rise to 14 million in England next year – report

This is the second of a brace of stories about the impact of longer waiting times  and bigger waiting lists, which will undoubtedly impact more severely on rural areas due to the major pockets of co-morbidities

Up to 14 million people could be on NHS waiting lists in England by next autumn, new analysis suggests.

Currently, some five million are waiting for routine operations and procedures - many of whom are in pain.

But the Institute for Fiscal Studies has warned there is a huge hidden backlog of patients who are still yet to come forward for treatment.

The government pointed to the £1bn it had given to the NHS this year to clear the backlog.

There have been repeated warnings over the length of hospital waiting lists in England. A record number of patients are currently waiting for surgery - such as hip or knee replacements - with more than 385,000 patients waiting more than a year, compared to just 1,600 before the pandemic.

Three hours wait for an ambulance? Cumbrian town fights to keep its service

I have come across some excellent first responder schemes and Im not sure its appropriate to class it as some might in the view of this article as a second class alternative to standard state provision. I do appreciate however that the loss of this service in such a deep rural setting will be very challenging for the residents affected.

Living in one of the remotest communities in England, the residents of Alston Moor in Cumbria count themselves lucky to be surrounded by the breathtaking peaks of the Pennines.

But living somewhere so beautiful comes with downsides – there are just a couple of pubs, it is many miles to the nearest supermarket and a takeaway delivery is out of the question.

And now the community of 2,500 people is at risk of losing what it believes is vital to its health and survival – its local ambulance service. Alston Moor currently has four emergency medical technicians (EMTs) who live locally and operate an ambulance serving the 80-square-mile area.

But if North West Ambulance Service (NWAS) proposals go ahead, the EMTs will be replaced by a community first responder – a trained member of the public rather than a professional – who can reach an emergency quickly to help patients until an ambulance arrives from elsewhere in the county.

More than 200 people silently protested against the plans outside a meeting between the parish council and NWAS last week. District councillor and local GP Michael Hanley said the removal of the service could cost lives. “Never have we had a situation where we haven’t had a local ambulance.If we rely on Penrith or Carlisle, it can take two to three hours for an ambulance to come, and the community first responders are not trained to the same level at all as the EMTs.

“[Doctors] talk about the ‘golden hour’ – the time between when the person rings on the phone to getting them to hospital – so if there’s something very dire like a severe heart attack or a severe accident, that first hour is very, very important. If it takes two-and-a-half to three hours for an ambulance to get here, it’s possible some people will die,” he said.

Huge gulf in hospitals' ability to contain Covid

I’m itching to know more about the rural/urban split in terms of this article and the performance of the hospitals concerned.  I suspect that small rural hospitals may feature prominently and if its anything like their performance in other aspects of care, not uniformly in a good way….

A major analysis of the spread of Covid within hospitals has shown a massive gulf in ability to contain the virus during the first wave.

Overall, more than one in 10 people in hospital with Covid actually caught the virus while they were there.

But the analysis of 314 UK hospitals showed that ranged from just one in 100 cases caught in hospital, to more than one in four.

The researchers said the wide variation needed "urgent investigation".

Stark difference

The study, by nine UK universities and published in the Lancet, analysed hospital data from two-thirds of Covid patients in the first wave.

They estimate between 5,700 and 11,900 people were infected in hospital.

"There will be tragedy behind this story, people that came into hospital with one problem, caught Covid and sadly died," one of the researchers, Prof Calum Semple, from the University of Liverpool, said.

There was a stark difference between general hospitals, which the researchers said could not be explained by the number of patients coming in the door.

Reliable tests

"Even hospitals with literally thousands of patients coming in there are outstanding examples of infection control," Prof Semple said.

"There's a number of factors - we know there were challenges around PPE [personal protective (or protection) equipment] at the start."

The design of some hospitals - such as those with more side rooms - would also affect how easy it was to contain Covid.

The availability of testing, which is now used to separate Covid and non-Covid patients, may also have been an issue.

"Reliable tests in the emergency department, that come back within the hour, has been a game-changer and has made my life a million times easier," critical-care consultant Dr Annemarie Docherty, from the University of Edinburgh, said.

More infectious

Specialist residential hospitals had even bigger challenges with the virus spreading.

More than two-thirds of Covid cases in mental-health hospitals were caught there.

Things are improving, though.

The average proportion of cases caught in hospital was 11% in the first wave but now stands at 2-5% despite the emergence of the more infectious Delta variant, first identified in India.

Part of this will be down to understanding of the virus and how it spreads, such as airborne and asymptomatic transmission, that has emerged since the early days of the pandemic.

UK launches £4m fund to run fibre optic cables through water pipes

Brilliant innovative approach if it comes off

The government has launched a £4m fund to back projects trialling running fibre optic broadband cables through water pipes to help connect hard-to-reach homes without digging up roads.

The money will also be used to test out monitors in pipes that can help water companies identify and repair leaks more quickly. About a fifth of water put into public supply every day is lost via leaks and it is hoped that sensors could help deliver water companies’ commitment to reduce water loss by half.

Infrastruture works, in particular installing new ducts and poles, can make up as much as four-fifths of the costs to industry of building new gigabit-capable broadband networks, the government said.

The project is designed to help cut those costs, and is part of a plan to improve broadband and mobile signals in rural areas.

The digital infrastructure minister, Matt Warman, said: “The cost of digging up roads and land is the biggest obstacle telecoms companies face when connecting hard-to-reach areas to better broadband, but beneath our feet there is a vast network of pipes reaching virtually every building in the country.

“So we are calling on Britain’s brilliant innovators to help us use this infrastructure to serve a dual purpose of serving up not just fresh and clean water but also lightning-fast digital connectivity.”

And Finally

And relax! From gong baths to mindful drinking: how to really unwind on a holiday at home

This article brought a smile to my face – I send it to you in the spirit of the great staycation. It helps us consider:

With the pandemic scrambling travel plans, many of us are staying put this summer. But can your own house ever be as restful a vacation setting as flopping on a sunlounger?

About the author:
Hinterland is written for the Rural Services Network by Ivan Annibal, of rural economic practitioners Rose Regeneration.


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