Rural Health
Background
The ageing population is increasing faster in rural authorities than in urban areas, compounded by the outward migration of young people and inward migration of older people. This will have a significant impact on local service needs and support systems across health and social care.
Source: Rural Health Plan - Welsh Assembly Government 2009
Two particular features distinguish the rural from the urban scene in Wales and both have an impact on health conditions.
They are:
- The problem of access to services for those living in the remoter communities
- Difficulties with integrating services provided for the individual when some are NHS based with others coming from local government and the voluntary sector.
Policy Context
The Rural Health Plan - Improving Integrated Service Delivery Across Wales has been developed by the Welsh Assembly Government to ensure that the future health needs of rural communities are met in ways which reflect the particular conditions and characteristics of rural Wales.
Service Planning
Local authorities(LAs) in Wales and Local Health Boards (LHBs) are required to formulate and implement a Health, Social Care and Wellbeing Strategy for their local area. They set out information including how health and well-being will be improved, what services will be required, how the services will be planned and delivered and what financial or other resources will be required. You can find more information below:
These strategies are informed by comprehensive health, social care and well-being needs assessment carried out by the LHB and LA in partnership with other statutory and non-statutory stakeholders. The Public Health Wales page below contains links to health needs assessment technical documents including those for several rural areas.
Public Health Wales Observatory produces a series of profiles which aims to provide information for health boards about the population in their locality and to act as a resource to assist with their planning of services. You can find more information below:
Service Delivery
The aim is to provide safe and high quality services at a point as near to the patient as possible whether this is by hospital admission or attendance, domiciliary visits or through telemedicine.
Initiatives
Accessing services and support then is one of the critical issues facing people living in rural communities.
Car Linc Mon enables local people to make essential journeys where there is no other suitable transport available. They offer individuals transport for shopping, GP and hospital appointments, and to visit families. The service is undertaken by volunteers. Car Linc Mon work closely with the Red Cross Transport service as well as Social Services.
WRVS Country Cars (Carmarthenshire) Is run in partnership with the local authority. It is a wellbeing project that adds value to the lives of so many people who would
otherwise be unable to leave their homes which could lead to isolation and loneliness.
Wales Air Ambulance is an all Wales charity providing a vital service through emergency air cover for those who face life-threatening illness or injuries.
Further consideration is being focused on where and how services can be brought closer to local people when it is safe to do so. This include services for specific chronic conditions for example Consultant or GPwSI (GPs with Special Interest) led outreach clinics and targeted at potentially more vulnerable groups such as older people,
those with disabilities or without transport and farmers who have been shown to be resistant to accessing services. They also include a range of pathology and screening tests and services supporting more local diagnosis and treatment, minimising the need to travel for healthcare.
One example here is the launch of a mobile breast screening unit by Breast Test Wales which offers wheelchair access.
The Designed to Smile programme,was rolled out through two super pilots in North and South Wales and sees a team of dental health support workers providing toothbrushes and toothpaste to school children along with oral health advice. Part of this service is delivered via mobile dental health units that play a key role in providing specialist preventive care and treatment to schools.
Use of new technology has an important role in bringing services and information closer to people in rural areas. ICT can support and enhance citizen’s lives in diverse areas such as: medical care, independent living, quality of life and assisted care.
Renal Dialysis in rural communities is being brought nearer to patients through satellite dialysis units in hospitals such as Aberystwyth, Carmarthen and Haverfordwest rather than having to travel to the parent unit. You can find out more from the link below:
The Twilight Service in Carmarthen aims to prevent hospital admissions from A&E and enable earlier discharge home. Trained care workers are available at the hospitals between the hours of 4pm and midnight in order to assist vulnerable older people who no longer need to be in hospital but need practical support to enable them to return home.
Resources
This Welsh Government report outlines the work of local innovation fund projects.
The 'Profile of Rural Health' in Wales has been produced by the Health Information and Intelligence team at the Wales Centre for Health now part of Public Health Wales.
The Institute of Rural Health Research produced a Summary and Report of its review of health data sets, literature and case studies to gather evidence for the Welsh Assembly Government to develop the Rural Health Plan for Wales.
A public and stakeholder engagement exercise to contribute to the development of the Rural Health Plan for Wales was conducted by the Opinion Research Service.
The Rural Support Wales website aims to provide advice, information and support for people living in rural Wales.
Rural Well Being is a health and well being information website for the people of rural Wales
Statistics
The Welsh Index of Multiple Deprivation (WIMD) is the official measure of deprivation in small areas in Wales produced by the Welsh Assembly Government. Deprivation refers to wider problems caused by a lack of resources and opportunities.
