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Julie Colclough on improving access to hospital services for patients in rural areas

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Julie Colclough, a GP based in the rural Cartmel Surgery, near Grange-Over-Sands in South Cumbria, and Clinical Lead for the Grange and Lakes Primary Care Network, talks about how the New Hospitals Programme can help improve the health and wellbeing of patients in some of the most rural communities in England.

Tell us about you and your GP practice

I’ve been working as a GP in the Cartmel area since 2015 and took over the practice, based at Cartmel Surgery, in 2018. With around 3,000 patients, we’re located in a beautiful part of the country and one which illustrates the rural healthcare challenges faced by a large part of Lancashire and South Cumbria.

Many of my patients live in extremely remote locations, such as isolated farmhouses, and face travel challenges as well as difficulties accessing technology such as high-speed broadband.

The practice looks after a predominantly older population, aged over 70. While the focus of primary care is on keeping people well and at home, inevitably as people get older, they are more likely to need support from hospitals to address more complex health needs. This can mean travelling significant distances for hospital appointments or admissions.

Our main local hospital, Furness General Hospital, is 40 minutes by car from Cartmel, and the journey can take much longer in bad weather or if there are problems on the road network. Referrals to hospitals in Lancaster or Preston for more specialised treatment take even longer.

What opportunities do you think the New Hospitals Programme offers patients in rural areas?

While the patients in my practice live far away from any hospital buildings, the chance of improving access and outcomes for rural patients through large-scale investment from the New Hospitals Programme is extremely welcome. 

Many people find our current hospitals daunting; made up of old buildings, which are often poorly laid out and confusing to navigate. Opportunities to address long-standing problems with the poor condition of the hospital estate in Lancaster and Preston, as well as a commitment to improving the way services work together across the region, is very important.

As plans develop, I want to make sure we take full account of geography and the large travel distances involved in many parts of our region and improve equality of access to healthcare services for people living in rural and remote areas.

The digital world has opened up the ability for patients to have virtual appointments with hospital consultants from the comfort of their homes. There are huge opportunities to expand this by developing IT links based in a range of buildings for people who do not have a suitable internet connection at home.

Similarly, when patients need to attend a hospital site for tests, better integration across the region could mean these tests can be carried out more flexibly. The opportunity to use other sites closer to home for a range of tests would be significantly more convenient for many people. Reducing unnecessary travel is much better for patients and fits with the ambition of a greener approach set out in the New Hospitals Programme.

What changes to future hospitals would particularly help your patients?

When patients do need to travel to a main hospital site, access and parking is always a particular cause for concern. Plans need to address improving access by car and recognise that if people do use public transport, there are a limited number of buses and trains from rural areas. Clinic times and appointments need to reflect the ability of patients from rural areas to attend when they need to be there in person.

For older people used to the peace and quiet of the countryside, being admitted to a hospital far from home can be extremely stressful and take them away from family and friends. The opportunity to plan new buildings needs to take this into account, creating an environment where people feel comfortable and in the right frame of mind to get better as quickly as possible.

More generally, investment in the estate at Furness should focus not just on creating better services and a more pleasant environment, but also better technology, training and education. We want to create the sort of hospital which will attract more clinical staff to want to work there, making the services local people depend on more sustainable.

Author: Julie Colclough, a GP based in the rural Cartmel Surgery and Clinical Lead for the Grange and Lakes Primary Care Network.

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