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Healthcare in a rural setting

January 2005
Board of Science

Foreword
The British Medical Association (BMA) resolved at its 2003 meeting to further investigate the difficulties in recruiting and retaining doctors in rural practice. In particular, the BMA is concerned about the sustainability of services in rural areas and the resulting problems with access to healthcare. The BMA had previously published a report on the nature of rural general practice in the UK, written by the general practitioners committee (GPC) of the BMA and the Institute of Rural Health (IRH). [a] The joint report addressed four key issues in rural general practice, assessing the current level of evidence for each:
• access for patients in rural areas
• rural deprivation and the Deprivation Payments Scheme
• issues of dispensing and other General Medical Services income
• definitions of rurality.

The Board of Science decided to build on the earlier GPC/IRH report and widen the discussion on rural healthcare in the UK. In this report the key areas of medical education and training, recruitment and retention, and accessibility and sustainability of healthcare are examined in the rural context, with a focus on primary care. UK and international examples of good practice are included and recommendations for action made. The report is aimed at all healthcare professionals and organisations that can respond and improve healthcare in rural areas.
Professor Sir David Carter
Chairman, Board of Science
January 2005

a) Go to reference 3.
b) The Board of Science, a standing committee of the BMA, provides an interface between the medical profession, the government and the public. The Board produces numerous reports containing policies for national action by government and other organisations, with specific recommendations affecting the medical and allied professions.

Read the report online or download as a pdf using the link on the right

Editorial board
A publication from the BMA science and education department and the Board of Science
Chairman, Board of Science Professor Sir David Carter
Director of professional activities Professor Vivienne Nathanson
Head of science and education Dr Caroline Seddon
Project managers Nicky Jayesinghe
Angela Sharpe
Research and writing Louise Lakey
Editorial secretariat Fleur Conn
Hilary Forrester
Darshna Gohil
Emily Hoy
George Roycroft

This report was prepared under the auspices of the Board of Science of the British Medical Association, whose membership for 2004/2005 was as follows:
Professor Sir Charles George President, BMA
Dr Michael Wilks Chairman, BMA representative body
Mr James Johnson Chairman, BMA council
Dr David Pickersgill Treasurer, BMA
Professor Sir David Carter Chairman, Board of Science
Dr P Maguire Deputy chairman, Board of Science
Dr P H Dangerfield
Dr G D Lewis
Professor S Lingam
Dr S Minkoff
Dr O Moghraby
Dr G Rae
Dr D M Sinclair
Dr C Smith
Dr S J L Smith
Dr D M B Ward
Dr S J Nelson Co-optee
Dr G Buckley Co-optee
Dr E Coyle Co-optee
Dr A Holdcroft Deputy member

For further information about the editorial secretariat or Board members please contact the science and education department: info.science@bma.org.uk

Acknowledgements
The association is very grateful for the help provided by the BMA committees and many outside experts and organisations. We would particularly like to thank:
• Dr James Douglas, Project Director, Remote and Rural Areas Resource Initiative
• Professor Lewis Ritchie, Head of Department of General Practice and Primary Care,
University of Aberdeen
• Brenda Spettigue, Senior Trainer, NHS Expert Patients Programme
• The BMA Rural Health Steering Group:
• Dr Graham Buckley, Chair, Association for the Study of Medical Education
• Dr Sally J Nelson, Director of Public Health, South Wiltshire Primary Care Trust
• Dr Russell Walshaw, Part-time general practitioner in Winterton North Lincolnshire and
Medical Secretary to the East Yorkshire & Northern Lincolnshire Local Medical Committees
• The BMA Board of Medical Education
• The BMA General Practitioners Committee.

Abbreviations
A&E: accident and emergency
BASICS: British Association for Immediate Care
CPD: continuing professional development
DH: Department of Health
E-learning: electronic learning
EU: European Union
EWTD: European Working Time Directive
GMS: General Medical Services
GP: general practitioner
GPC: general practitioners committee of the BMA
IPE: interprofessional education
IRH: Institute of Rural Health
ISU: Indiana State University
IUSM: Indiana University School of Medicine
RARARI: Remote and Rural Areas Resource Initiative
RHF: Rural Health Forum
RRAPP: Rural and Remote Area Placement Program (USA)
SEHD: Scottish Executive Health Department
WONCA: WONCA is an acronym comprising the first five initials of the World Organisation of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians. WONCA’s short name is World Organisation of Family Doctors