Call for Evidence: Rural Health Workforce Toolkit

In 2017, interested partners began discussions around how to bring some real focus to the challenges and opportunities of providing health and care in rural settings. We began with a symposium on rural health and care, held in Lincolnshire, UK, which attracted worldwide attention.

We identified some underpinning themes common to the challenges of delivering rural health and care, which fall under four headings:
  • Data – scoping and measuring the challenge and the existing response to it
  • Research – identifying and testing what works
  • Technology – shrinking distances between rural communities and adding to their human capacity
  • Workforce and Learning – making the case for rural settings as the location of choice for ambitious health and care professionals
The National Centre for Rural Health and Care (NCRHC) was established in 2018 with a mission to reduce health inequalities in rural areas. NCRHC has led the development of a number of policy developments including a Parliamentary Inquiry into Rural Health and Care and the development of a first Rural Proofing for Health. The toolkit provides examples of good practice to help with the establishment of local delivery planning and supports practical approaches to service delivery in rural settings. It has been used extensively in key locations including Devon, Lincolnshire, Cornwall and Cumbria. A specific Northern Ireland focused toolkit has since been developed.

The main determinant of health and care outcomes has proven to be the workforce challenge. Consequently, we now propose to produce a dedicated toolkit focusing specifically on the rural health and care workforce. Our generic toolkit identified 12 key questions about workforce, which are the starting point for the new toolkit.

Another impetus is the NHS Long Term Workforce Plan, published in June 2023 and shaped around three priority areas of Train, Retain and Reform. It is stark in its description of workforce shortages, both now and in a future worst-case scenario of a dearth of 360,000 staff. But there is little reference to place in this strategy, and almost none on the specific challenges facing rural communities.

Our focus is on Plan, Recruit and Retain, recognising that rural service delivery requires a dedicated workforce which perceives rural practice as a positive career choice from the outset. We are looking for interesting case studies, from anywhere in the world, which demonstrate best practice in rural recruitment, training and retention, and how it might be financed. This is a global issue and there is innovative regional practice emerging in “grow your own” policies, rural placements for health professionals, and targeted rural training. We aim to produce a timely response to the workforce crisis which will be of practical value to rural health and care practitioners and providers across the UK and beyond.

Survey Questions
This call for evidence focuses on the key questions about workforce identified in our previous toolkit. We would welcome your thoughts on any or all of these, together with relevant examples of good practice, innovation and research from anywhere in the world. There is no need to answer all the questions, just those which are relevant to you. We would also appreciate your suggestions for contacts to whom to send this call for evidence
The current situation in your area
1.Does workforce planning in your area align with available evidence about local health needs and trends? How well does this work for rural parts of your area?
2.How realistic and sustainable are future workforce plans for rural parts of your area?
3.Do you cover any rural or coastal locations which have a modest resident population, but which experience a seasonal influx of visitors or tourists? If so, how much variation in demand for services do you experience? Are any additional resources available at peak times?
4.What policies are in place in your area to ensure the wellbeing of professionals who work in rural and more isolated settings?
5.If your role (or that of your staff) involves home visits or regular travel to outlying locations, to what extent is the extra time and cost taken into account and/or compensated? Is it realistic?
6.To prepare professionals, including General Practitioners, for a career in more remote areas, can they access training or development opportunities to give them the breadth of knowledge and confidence they need to work alone with less access to professional back-up?
7.Following the formation of Integrated Care Systems, Primary Care Networks and community multidisciplinary teams, what opportunities have arisen to address workforce issues that are prevalent in rural areas?
8.What measures are in place to ensure that professionals moving into agricultural areas have sufficient knowledge of diseases most likely to be found among farming communities?
9.There are many organisations in the voluntary and community sector that support or complement statutory health and social care services. What opportunities exist to extend training and networking opportunities to those working or volunteering in this sector?
What more could we usefully do?
10.What options could be explored to ensure that professional staff have career development or progression opportunities, without them necessarily needing to move away from the area?
11.How could rural based professionals be helped to access opportunities to maintain and update their knowledge, not least for Continuing Professional Development and mandatory training?
12.How could valuable networking and peer learning opportunities be facilitated for rural based professionals, without them having to make long or time-consuming journeys?
13.What resources are needed for the planning, recruitment, training and retention of the rural health and care workforce, and how might these resources be funded?
14.What form would you like the Rural Health Workforce Toolkit to take, and what outputs would you find most useful? Please select all that apply.
15.This space is for any further comments you may have, and your suggestions for contacts to whom to send this call for evidence.
Thank you very much for your participation. Please provide your contact details below – this is optional but will enable us to follow up any examples you provide for inclusion in the Toolkit.
16.Name:
17.Email:
18.Geographical location:
19.Professional role(s):
20.Organisational affiliation(s):
Please follow this link for a copy of this form as a word document. If you would like to know more about the National Centre for Rural Health and Care, or the Rural Health Workforce Toolkit, please visit the NCRHC website or contact:
Anna Whelan
NCRHC Secretariat
anna.whelan@roseregeneration.co.uk