Swathes of countryside becoming 'healthcare deserts' with £100 trips for hospital care

Patients living in rural areas are being forced to spend £100 on taxis to attend routine hospital appointments amid the closure of local services, nurses have warned.

The Royal College of Nursing warned that the countryside is becoming a “healthcare desert” with 10 million people struggling to access GP appointments and hospital treatment.

Poor broadband and mobile phone signal, unreliable public and patient transport and the closure of local services are all to blame for increasingly inadequate healthcare provision in rural areas, it is claimed.

It comes as the head of the NHS raised concern that small hospitals are being “hollowed out” with threats to further services because of shortages of doctors and nurses.

Nurses said people living in rural areas are facing 60-mile round trips to their nearest major hospital for outpatient appointments, amid closures of nearer services.

The RCN’s annual congress in Liverpool will hear today how ambulances can take nearly an hour to reach patients with life-threatening conditions in some parts of the country.

Last night nurses warned that plans for a “digital first” NHS service are doomed because huge swathes of the countryside cannot get even basic 3G mobile phone coverage.

Gwen Vardigans, from North Yorkshire, said: "Most city dwellers have a romantic view of country living, idyllic cottages, fresh air and healthy living. The reality for rural residents is very different if you or a member of your family requires healthcare.”

Speaking ahead of a debate on the issue on Thursday, nurses revealed their experiences of the struggling healthcare system in the countryside.

One told how a patient with sepsis in North Devon had to wait 55 minutes for an ambulance to arrive, despite the condition being life-threatening.

Another said she had waited with a patient having a heart attack at a GP surgery in Dorset for 45 minutes before an ambulance arrived from more than 20 miles away.

Community nurse Ali Purkiss, from Devon, said: “It’s an eye opener. It does make you think, if it was you or a member of your family and an emergency happened, you possibly wouldn’t survive.”

She said cuts to hospital transport and poor public transport meant patients in North Devon faced a £100 taxi fare for a round trip to the nearest hospital - around 25 miles away in Exeter - to attend routine appointments.

“It can be a big deciding factor in whether they go or not,” she said. “Some patients end up calling an ambulance when they really don’t need one but that’s the only way they can get there because they can’t get in a taxi.”

Lack of mobile phone signal meant it was sometimes impossible to make vital calls, she said.

Jane O’Brien, a former practice nurse from Dorset, said a GP practice closure led to thousands of patients being relocated to other practices miles away at just four weeks’ notice, she said.

The closure had the knock-on effect of causing month-long waiting lists to see a doctor at other local practices.

Dawne Garrett, the RCN’s professional lead for older people and dementia, said poor phone and broadband connections meant she could not access vital blood results while making a home visit in rural North Lincolnshire.

She had to make a 20-mile round trip to the nearest GP practice to download the test results.

“There’s a huge lack of infrastructure, a lack of technology,” she said. “I should be able to show the patients I’m visiting their records and notes but I can’t do that because the broadband is too weak. I can’t download anything.”

She said: “Relying on technology to bridge the gap makes no sense when rural broadband provision is so woefully inadequate, and asking people to travel to super hospitals can’t work when there is threadbare public or hospital transport. It’s time for the government to review healthcare provision in rural areas, and to introduce a fully funded staffing strategy so the countryside doesn’t become a healthcare desert.”

The long term plan for the NHS sets out a “digital first” vision, with up to one in three hospital outpatient appointments scrapped.

Ms Garrett said: “A digital NHS isn’t going to work if we can’t even get mobile signal. People are talking about 4G and 5G but we just want 3G that works. We just want a consistent service.”

A Department of Health and Social Care spokesman said: "Our Long Term Plan is backing primary and community care with an extra £4.5 billion per year as well as unlocking the potential of technology to provide patients with more options, better support and the care in the right setting.

“We are working hard across government and the NHS to improve rural connectivity, as well as ensuring we have the staff we need to provide excellent face-to-face care to patients no matter where they live, including targeted recruitment to attract GP trainees to rural areas.”