FEATURE: The challenges of rural health care
The pressure on the NHS both nationally and locally has been well documented.
And here in Lincolnshire the impact of that pressure has been felt of late.
‘A severe shortage of doctors and nurses’ meant there was concern that paediatric services could temporarily close at Boston’s Pilgrim Hospital.
While it was announced recently that 98 per cent of services would be saved, it still means that some high-risk births and a small proportion of children’s medical care will be temporarily transferred to other hospitals.
And back in February this year, we reported how health bosses were considering temporarily moving specialist older adult mental health services from the Pilgrim Hospital to elsewhere due to increased demand on services during the winter.
This was not done in the end but the idea was to free up hospital beds for the elderly and frail waiting to be discharged home.
Brexit has brought with it a new series of issues as some of our doctors and nurses who came here to work from outside the UK, have decided to leave.
Then there are concerns over transport distances for patient care in Lincolnshire, along with a whole host of other obstacles.
So could a new ‘National Centre for Rural Health and Care’ that was launched in June help pave the way for tackling some of the issues people face in rural areas?
Jan Sobieraj, deputy chair for the centre, which was launched at the Bishop Grosseteste College in Lincoln, hopes so.
As Chief Executive of United Lincolnshire Hospitals NHS Trust, he joined the Trust from the NHS Leadership Academy, created to develop outstanding leadership in health to improve people’s health and their experience of the NHS.
He said: “Lincolnshire is a great county, lots of exciting things go on here and if we can encourage investment into Lincolnshire, look at how to run services better and research ideas so Lincolnshire gets the benefits...
“In rural settings there can be a 25 minute travel time (when providing health care) but in an urban area you can walk down a street and pop in.
“In rural areas it can take hours.”
The hope is that the centre, which was established as a ‘Community Interest Company’ will become a ‘centre of excellence’ in policy development, research, technology, education and training for rural health care.
And ideas will be taken from other parts of the UK - and the world - that provide rural health and care.
“We can do some trend analysis, and a good example might be fuel poverty,” explained Jan.
“So sometimes people struggle to heat their homes and we can look at pneumonia and cold-related illness, and what interventions we can put in place.”
That involves looking at what can be done to prevent the need for people to go into hospital.
“We are working with partners across the county to improve policy and to bring in ideas to improve the care that people need,” he added.
While the National Centre was not formed in response to Brexit, Jan acknowledges that Brexit has brought with it more pressure in terms of staffing.
“We have lost staff since Brexit,” he said.
“Some people regard themselves as not wanted. It makes it harder for us to retain those staff but there has not been a mass exodus.”
He added that central Government’s clarification on the rights of those EU workers who are in the UK has helped but that those staff “are still watching and monitoring what is happening”.
“We have lost staff since Brexit. Some people regard themselves as not wanted. It makes it harder for us to retain those staff but there has not been a mass exodus.”
Some have gone back to their original countries as the job situation for doctors and nurses has improved there.
“Their home market was very lean. The market has improved in their countries but we could end up with a tougher market.”
Nationally there are around 30,000-40,000 nurse vacancies and 10,000 doctor vacancies and there was already a shortage in paediatrics.
“The paediatric situation we are in cannot be attributed to Brexit,” he said.
“In paediatrics one in four posts are vacant.”
With some physicians posts advertised not filled, he added: “That as a whole makes it a lot tougher - and people are retiring earlier.”
“In paediatrics one in four posts are vacant.”
While the pressure on children’s services at Pilgrim Hospital is down to a shortage of staff, there are no plans to centralise any of those services to Lincoln, Jan stressed.
“The new centre won’t immediately fix things but will put Lincolnshire on the map nationally.”
And he added that a new medical school coming to Lincoln next year will help even further. At full capacity it will train up to 400 students a year.
Coordinator of the Social Issues in South Lincolnshire group, Father Jonathan Sibley, of St Mary’s Church in Long Sutton, said: “What they are doing (by launching the centre) is crucial and timely and that it has been launched now, irrespective of Brexit, is important.”
The group works to help tackle many issues such as social injustice, poverty, rural isolation, homelessness, and unemployment.
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