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Support for people with long-term neurological conditions in rural English communities

02 May 2019
Volume 24 · Issue 5

Abstract

Almost one-fifth of the population in England lives in rural areas. Compared to urban populations, the rural population is older and faces greater difficulties in accessing medical services. At the same time, healthcare teams in rural areas face particular challenges in recruiting and retaining staff, travelling between patients and keeping specialised knowledge up-to-date. Drawing upon a recent health needs assessment for people living with long-term neurological conditions in a rural English county, as well as a broader review of the literature, this paper considers the challenges of rurality and discusses potential solutions. Technological and community-based responses have often been suggested as responses to challenges of rurality. However, there is likely to be a need for up-front investment of resources and careful consideration of individual and community needs before these solutions can be applied to rural neurological care.

According to 2017 data produced by the Local Government Authority (LGA) and Public Health England (PHE), 19% of the population of England lives in rural areas (LGA and PHE, 2017). Compared to urban populations, rural populations typically comprise older people and have poorer access to healthcare services (Butow et al, 2012; Brundisini et al, 2013; Todd et al, 2014; LGA and PHE, 2017). At present, there is limited research exploring healthcare practitioners’ experiences of providing services in rural communities within the UK. Recent NHS reforms have emphasised the importance of ‘place’ and localism, but have tended not to directly address the potential challenges of implementing localism within sparsely populated rural areas and areas that are remote from public services. For example, the NHS long-term plan (NHS England, 2019) encourages a shift away from acute hospitals and towards community care. However, the sole reference to rural healthcare within the plan relates to small acute hospitals, with no discussion of challenges within rural community services.

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