Rural Proofing for Health

"Rural Proofing for Health: A Toolkit for Primary Care Organisations" was the culmination of two years of work by the Institute of Rural Health to identify the issues of concern for the providers and users of health services in rural areas, and to produce a resource for Primary Care Organisations to help them to consider the needs of people living in rural communities and to ensure that the health services they provide are rurally sensitive.

The Rural Proofing for Health project arose out of a concern about the priorities, choices and strategic direction that would be taken by the then newly formed Primary Care Trusts in England. The Countryside Agency had developed a "Rural Proofing Checklist" for use by Government Departments. It was apparent to the Institute of Rural Health that there was potential to develop the rural proofing approach for use by frontline health service providers to raise awareness of the rural dimension to health service delivery, and to aid decision-making concerning the design and delivery of health services to rural communities.

The first two years of the Rural Proofing for Health project (November 2002 to April 2005) were funded by the Department of Health (DH) and the Department for Environment, Food and Rural Affairs (Defra). The aim was to produce a resource to help Primary Care Organisations consider the needs of people living in rural communities when determining service delivery priorities, so as to result in rurally sensitive services.

The academic base which informed the development of the Toolkit was established through consultation with a large number of rural Primary Care Trusts in England. Forty rural PCTs responded to a consultation about the challenges faced in delivering health care services to people living in rural communities. Although the majority of Primary Care Trusts (PCTs) are urban based, during the consultation process they clearly identified important areas for improvement in service design for rural users.

Three PCTs, representing different rural typologies, then volunteered to be involved in the next stage of the project - Morecambe Bay, Mendip and South Worcestershire. A wide range of staff from each of the three PCTs were interviewed to establish the challenges in delivering care in rural areas. These interviews, along with the wider consultation, established the evidence on which to base the Toolkit.

The next stage of the work was to develop the content of the Toolkit and to trial and validate it with the collaborating PCTs. Following this period of consultation, trialling and validation, "Rural Proofing for Health: A Toolkit for Primary Care Organisations" was published in July 2005, in both hard copy and electronic format (available at www.ruralhealthgoodpractice.org.uk). The Toolkit was officially launched in the House of Commons, on Wednesday 19^th October 2005, with an address by Jim Knight MP, Minister for Rural Affairs, Landscape and Biodiversity. Attendees included rural MPs, PCTs serving rural areas, and representatives of the House of Lords.

The Rural Proofing for Health Toolkit is a guide to help to identify the health needs of residents living in rural areas so that those needs can be incorporated into policy making at a strategic level, and into the design and delivery of services by health service providers on the frontline.

The objectives of the third and final year of the Rural Proofing for Health project (June 2005 to May 2006), funded by Defra, were: ongoing promotion and evaluation of the Toolkit as an action research methodology; to develop a facility to offer advice, support and information to aid implementation and as part of the evaluation; to further promote the database of good practice in rural health and wellbeing/rural proofing for health website; and to work in partnership with PCTs to provide support for the implementation and application of the Rural Proofing for Health process.

A parallel project conducted by the Institute of Rural Health, with funding from Defra, saw the development of a Database of Good Practice in Rural Health and Wellbeing to highlight and disseminate effective rural service delivery models. The searchable online database can be found at www.ruralhealthgoodpractice.org.uk. Details of several of the innovative examples from the database were included in the Rural Proofing for Health Toolkit.

An electronic copy of "Rural Proofing for Health: A Toolkit for Primary Care Organisations" is available for download at www.ruralhealthgoodpractice.org.uk.

For more information please contact: Alice Earp ()

Institute of Rural Health, Gregynog Hall, Tregynon, Nr. Newtown, Powys SY16 3PW

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