Transforming Care in Rural England 

Rural communities across the UK face unique and complex challenges in accessing effective social care. Geographical isolation, workforce shortages, and inadequate infrastructure exacerbate the difficulties of delivering equitable services in these areas. Despite these challenges, innovative models and community-driven initiatives offer opportunities to rethink and reshape how rural social care is provided.

In 2023/2024, IMPACT ran a network on ‘social care in rural areas’. One of the local networks was coordinated by Chris Watson who is the founder of Self Directed Futures. Chris has over 24 years experience of working across the public and voluntary sector in the fields of health, social care and community development, with a focus on working with people with learning disabilities to achieve citizenship within their communities.

In the report attached to this blog, Chris examines the critical issues affecting social care delivery in rural areas, drawing lessons from the IMPACT Social Care in Rural Areas Network and related research. He also highlights the need for commissioners to adopt strategies that prioritise community involvement, promote innovative care models, and foster collaboration across sectors.

Evidence and broader insights from the IMPACT network reveals the following:

• Transport and Accessibility – Nearly all respondents highlighted the significant barriers posed by inadequate transport infrastructure. Care workers in areas like Peterborough and North Somerset cited long travel times and personal vehicle costs as disincentives, while service users struggled to access support without reliable transport​.
• Staffing and Workforce Challenges – Staffing shortages emerged as a critical concern, particularly in areas like Cheshire East, where low population density made rural care routes unfeasible for larger providers​.
• Economic and Funding Constraint – Many areas, including East Riding of Yorkshire, reported that funding mechanisms often overlooked the unique challenges of rural care, leaving smaller, community-based providers under-supported​​.
• Digital Exclusion – Poor connectivity in both rural and coastal areas was a recurring theme, impeding the adoption of digital tools for care delivery and client support​​.

Recommendations from the IMPACT network

To address these challenges and build a resilient, equitable rural social care system, commissioners should focus on the following:

1. Invest in Transport Solutions

• Support community-led transport initiatives, such as local minibus services, to ensure care workers and clients can reach services efficiently. These initiatives can be co-designed with residents to align with specific local needs.
• Explore partnerships with local transport providers to subsidise travel costs for care workers, reducing financial disincentives.

2. Enhance Workforce Recruitment and Retention

• Introduce incentives such as full-salary contracts, travel reimbursements, and professional development opportunities to attract workers to rural areas.
• Collaborate with local schools and colleges to develop targeted training programmes, creating a pipeline of care workers familiar with rural living.

3. Prioritise Place-Based and Community-Driven Care Models

• Expand support for Care Micro-Enterprises (CMEs), including grants and streamlined regulatory pathways, to foster hyper-local care delivery.
• Encourage intergenerational living schemes and shared lives models to create integrated support networks that reduce reliance on formal services.

4. Bridge the Digital Divide

• Invest in rural broadband and mobile infrastructure to enable the adoption of telehealth and other digital tools.
• Provide training programmes for care providers and clients to maximise the benefits of digital care platforms.

5. Leverage Geospatial Mapping and Data Analytics

• Use geospatial mapping tools to identify underserved areas, optimise care delivery routes, and allocate resources efficiently. For example, mapping tools can help pinpoint the shortest and most cost-effective travel paths for care workers, reducing fuel and time costs.
• Analyse geographic data to identify recruitment hotspots and target outreach to local talent pools. By focusing on areas with untapped potential, commissioners can strengthen the workforce in a strategic and cost-effective manner.

6. Shift to Flexible, Outcome-Based Care Models

• Transition from rigid time-and-task commissioning to outcome-based models that empower providers to deliver care flexibly. For example, rather than focusing solely on the number of hours of care provided, commissioners can incentivise providers to achieve specific outcomes, such as reducing social isolation or improving mobility.
• Pilot programmes such as ‘Wellbeing Teams’ that prioritise client satisfaction and wellbeing, allowing providers the autonomy to determine how to meet these goals within broad guidelines.

7. Focus on Integrated, Preventative Care

• Collaborate with health services to develop preventative care initiatives, such as fall prevention and age-friendly community planning, reducing demand for reactive care.
• Support holistic approaches that integrate housing, transport, and community engagement into care strategies.

8. Promote Flexibility and Innovation in Funding

• Simplify access to Individual Service Funds (ISFs) and direct payments, enabling rural residents to customise their care options.
• Provide funding mechanisms that encourage innovative approaches, such as support for microenterprises and informal care networks.

9. Build Collaborative Networks and Partnerships

• Establish regular forums for stakeholders, including Voluntary, Community and Social Enterprise (VCSE) organisations, health services, and rural residents, to share insights and co-develop solutions.
• Use lessons from successful programmes, such as place-based commissioning initiatives, to inform broader strategies.

Key recommendations include:

• Developing community-based care approaches, such as care microenterprises (CMEs) and intergenerational support models.
• Enhancing funding mechanisms, including Individual Service Funds (ISFs) and direct payments, to empower individuals and local providers.
• Addressing digital and transport barriers through targeted infrastructure investments.
• Encouraging integration between social care and health services to deliver holistic support.
• Fostering a culture of partnership and inclusivity to better understand and meet the diverse needs of rural communities.

By embracing these strategies, commissioners can help transform rural social care, ensuring that individuals not only receive services but also live fulfilling and connected lives.