News / Rural care findings prompt NRAC review

04 June 2008

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The Scottish government has promised to consider the impact of the National Resource Allocation Committee (NRAC) formula on health boards’ ability to maintain and develop NHS services in remote and rural areas.

Cabinet secretary for health and wellbeing, Nicola Sturgeon, accepted the government’s Remote and Rural Steering Group’s report into providing care outside urban areas. This included reviewing how the NRAC formula, which is due to be introduced from 2009/10, affects the delivery of rural care.

Ms Sturgeon gave the NRAC formula the green light in February.

One in five people in Scotland live in rural areas and the report said they should have a framework of sustainable healthcare provision. It proposed most care be provided within local communities through community care teams and community and rural hospitals.

It said NHS boards would have to invest to implement the model and called on the government to reconsider the effect of the NRAC formula on their allocations.

NRAC found little evidence of unmet rural and remote need.  It  noted differences in rural maternity services, which tend to have longer lengths of stay. The formula takes account of this.

The NRAC formula also an adjusts for unavoidable excess costs of providing healthcare in remote and rural areas. This affects isolated and island areas. It found the three island health boards had hospital costs about 15% higher than the Scottish average. It also makes an allowance for additional travelling time needed to provide community-based services.

This looks set to be adjusted further. Ms Sturgeon set out plans to provide enhanced services in six rural and remote hospitals. 

The new enhanced core services include day case surgery, midwife-led maternity care and management of patients who have suffered a stroke.

‘I am confident this approach will help deliver a secure, first class service and ensure that everyone in Scotland enjoys equal access to the NHS, no matter where they live,’ she said.

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