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Healthcare in a rural setting

January 2005
Board of Science

Interprofessional working
Interprofessional working involves professionals collaborating to work together more effectively to improve the quality of patient care. It allows for flexible and coordinated services and a skilled and responsive workforce. [go to reference 112] Collaborative and interprofessional working can be seen as a key element in improving rural health service delivery. Mutual understanding and collaboration develops effective multidisciplinary teams. This allows professionals to work across the boundaries of traditionally defined roles, [go to reference 113] and enables effective role substitution. This provides rural healthcare professionals with the vital support of skilled personnel, for example nurse practitioners, midwives and pharmacists. This is particularly beneficial in rural areas where healthcare professionals often have to provide a broader range of services than those in urban areas.

A survey of 89 professionals working in rural/remote areas conducted at a RARARI Helse-Nord conference (2003) found that interprofessional working was considered vital. [go to reference 114] The majority of the 89 professionals surveyed were doctors, nurses and managers working in rural/remote areas in Norway and Scotland. In nswer to the question ‘Do you agree that working in multiprofessional networks is of major importance in remote and rural areas?’ respondents answered:
• Yes: 92 per cent
• No: 5 per cent
• Don’t know: 3 per cent

Case study – The changing role of nurse practitioners (UK)
Interprofessional working can be seen in practice in the UK, in various schemes run by Morecambe Bay NHS Trust. [go to reference 115] The Trust serves people living in urban and rural areas in parts of Cumbria, Lancashire and north Yorkshire. In response to the legal requirements to cut junior doctors’ hours, nurses are being trained to take on new roles. Two nurses – a theatre sister and a ward sister – are being trained in an 18-month project (due to finish in November 2004) to become colorectal surgical assistants. Training includes opening and closing surgical wounds. The Trust has also taken on Swiss nurses, who perform some anaesthetic work in Switzerland, to see if this role could be usefully implemented in the UK. There are some concerns as to how this new trend will be received by doctors, but it is believed that these types of pilot programme will provide an opportunity for different and ‘smarter’ ways of working. [go to reference 115]