Warning over rural healthcare for older people

Healthcare for older people in more rural areas has been deemed 'not fit for the future'. Picture: Contributed

Healthcare for older people in more rural areas has been deemed 'not fit for the future'. Picture: Contributed

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HEALTHCARE for older people in rural areas across Scotland has been deemed “not fit for the future” as funding and recruitment are moving too slowly to tackle the needs of the ageing population, a new report has warned.

Nursing leaders have urged ministers to move quickly to address the acute lack of services and the rising number of frail, vulnerable people by investing in community resources and improving technological infrastructure to create a more mobile workforce.

While it is a good thing that many people are living longer lives, we should be under no illusion of the challenges this will bring for our NHS and in our remote and rural communities

Shona Robison

The Going The Extra Mile report from the Royal College of Nursing (RCN) Scotland said that by 2037 nearly four in 10 people living in the Western Isles will be over 65 years old, compared with just over one in five in 2012.

In the Borders, 35 per cent of the population will be over 65 by 2037, and 34 per cent in Dumfries and Galloway, according to data contained in the report from National Records of Scotland.

Theresa Fyffe, RCN Scotland director, said: “Patients in remote and rural areas already struggle to access services and the geographical distribution of patients makes delivering a flexible service closer to home much more difficult.

“The future may therefore demand a more mobile and flexible nursing workforce along with technologically competent and confident staff and patients.”

The RCN called for greater development of senior nurses, known as advanced nurse practitioners (ANPs), who have the clinical expertise to make decisions on patient care.

The report also highlighted the need to improve digital participation among staff and patients.

Scottish Conservative health spokesman Jackson Carlaw said the report raised “complex and challenging” issues which require urgent attention.

He said: “This RCN report comes as no surprise whatsoever and highlights areas in which the SNP government should be doing much better.

“Preparation to care for the ageing population should have begun long before now. Despite the Scottish Government spending millions on trying 
to get it right, it’s now obvious that their strategy isn’t ­working.

“These issues need looked into urgently because our elderly population, their families, carers and health professionals deserve much better.”

Scottish Lib Dem health and housing spokesperson Jim Hume said there was a “domino effect” caused by poor broadband and transport, which affected frontline health services.

He added: “If older people are to be treated with the dignity they deserve, the SNP must pull its full focus towards the adequate funding of local services.

“With a growing population of older people, we cannot afford the Scottish Government to have its eye off the ball.”

Researchers trawled through more than 170 responses from communities in areas such as Shetland, Highland and the Borders, alongside interviews with community healthcare teams.

The Scottish Government pledged to do more to focus on the challenges faced by people living in rural areas, and conversations are already under way on how to transform nursing roles in the light of future demand.

Health Secretary Shona Robison said: “While it is a good thing that many people are living longer lives, we should be under no illusion of the challenges this will bring for our NHS and in our remote and rural communities.

“We are also working to ensure that the record numbers of staff in our NHS are working as effectively as possible, as part of a wider healthcare team, and that we make full use of all the skilled professionals in our NHS.”

She said integration of health and social care services would help the issue, with NHS Highland and Highland Council leading the way on this initiative.

Ministers have also invested £360 million in eHealth, which aims to improve patient digital access.

Robison added: “This is a timely contribution to this work, in particular as we ask stakeholders like the RCN and the public to consider the long-term future of health and social care in Scotland. Services in rural areas are crucial and this RCN report will feed into our nationwide discussion.”

Case Study: ‘Everyone pulls together to help island’s elderly’

POOR weather and transport are among the challenges facing Christopher Rice, an advanced nurse practitioner working on the tiny island of Bressay in Shetland.

The island, which is connected to Lerwick by a 30-minute ferry ride, has 450 residents who are reliant on Rice for all their healthcare needs.

The 33-year-old, from Liverpool, said: “I provide 24-hour care seven days a week to the people on the island.

“I go to see folk in their homes and I work out of my own house, so I have everything patients could need.”

If the weather is too wild or the patient is too unwell, then Rice can call the lifeboat or a helicopter to transport a patient to the mainland for treatment, but he said that rarely occurs.

Rice, who has been in Shetland for four years, said: “It’s certainly a big change from working in a city, but the community pulls together.

“Everyone in the community looks out for each other and keeps an eye on elderly people who need help. When the weather is bad I get a Red Cross volunteer coming in, so we put the soup on and go out to visit people who might be in need of help.”

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