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Report finds radical change is needed to support older people in rural Scotland

RCN Scotland has partnered with Age Scotland to publish a report that reveals health care for older people in rural Scotland is 'not fit for the future'

Health care for older people in rural Scotland is ‘not fit for the future’, according to a report published by RCN Scotland.

With support from Age Scotland, the college has published the report, Going the Extra Mile, after interviewing community nurses and analysing detailed survey responses from more than 170 older people.

Focusing on the country’s most remote and rural areas (including NHS Borders, NHS Dumfries and Galloway, NHS Highland, NHS Orkney, NHS Shetland and NHS Western Isles), the report finds that 'a radical shift in resources' is required in order to meet the needs of older people.

It stresses that rural areas are disproportionately affected by the nationwide challenge of an ageing population.

On the Western Isles, for example, just over 20% of residents are currently 65 or over, but that figure is set to reach nearly 40% by 2037, with many living alone.

The report finds that the nursing workforce is ageing too, with 60% of the community nursing workforce in the Western Isles aged 50 or over, at the same time as a national GP shortage is piling pressure on the NHS.

Among the key calls to action are the recruitment of community nurses and the development of the role of advanced nurse practitioners (ANPs) who have extensive clinical experience and the authority to admit, discharge and refer patients.

The geography of some remote and rural areas will make access to services even more difficult, with the report suggesting technology and digital communication could help to bridge the gap.

But the current generation of older people, who are most likely to use health services, are also least likely to use the internet and poor broadband provision is hindering progress.

Only 25% of survey respondents said they use email, with less than 8% saying they would be interested in making an appointment online.

And while 32% said they would be interested in having telephone consultations with their care team, only 11% use Skype or FaceTime.

Theresa Fyffe, RCN Scotland director, said: 'Patients in remote and rural parts of Scotland 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.'

Read the full report here.