April Edition of Casebook from the Rural Health and Care Alliance

April 2025 Edition

Welcome to this month's edition of Casebook, with articles on a design code for health and wellbeing, a report on “Fixing NHS Dentistry” as well as a story on funding for community pharmacies.  Also featured are findings from the Nuffield Trust and Kings Fund on public attitudes and opinions towards the NHS and social care, plus a BBC article about a van touring Cornwall seeking to drive up clinical trial participation. And finally, an invitation to attend the Grand Opening of the Campus for Future Living. Read on…

Design Codes for Health and Wellbeing

Quality of Life Foundation has released new guidance, Design Codes for Health and Wellbeing, which has been developed in partnership with the TCPA, along with  Tibbalds, TRUUD, and Henley Business School, with support from UDL. It provides practical advice for embedding health and wellbeing into the design coding process, ensuring that places support healthier lives for everyone.

Why design codes matter

Design codes set expectations for the design of buildings, spaces, and places. They help create high-quality developments by providing a structured framework that planning authorities, developers, and communities can use to shape future growth. By prioritising health and wellbeing within design codes, we can:

• Address local health priorities through better urban design
• Reduce health inequalities by improving access to green space, active travel, and healthy food
• Create certainty for developers and decision-makers, ensuring that health-focused placemaking becomes standard practice.

Who is this guidance for?

Design Codes for Health and Wellbeing is designed for planners, developers, local authorities, public health professionals, and community groups involved in shaping the built environment.

It sets out a policy framework and practical principles for incorporating health into design codes, complementing existing national guidance on placemaking.

Embedding Health into Rural Place-Making

The Design Codes for Health and Wellbeing guidance from the Quality of Life Foundation champions design-led approaches that support better quality of life in all communities—including rural areas.

With a strong emphasis on community voice, local health data, and context-sensitive design, this new guidance ensures that rural places benefit from healthier homes, accessible green spaces, and connected, walkable environments. It offers practical tools to shape developments that respond to the unique challenges of rural living—such as access to services, isolation, and mobility—while protecting the identity and character of the countryside.

Download the guidance here

Fixing NHS Dentistry

The latest "Fixing NHS Dentistry" report by the Public Accounts Committee provides a comprehensive overview of the ongoing concerns in NHS dental services across England, with an emphasis on the unique challenges faced by rural communities. This article highlights the key findings that pertain to the accessibility and provision of dental care in rural areas.

Rural communities are disproportionately affected by deficiencies in NHS dental care. The geographical isolation, scarcity of health facilities, and significant workforce shortages create barriers that are less prevalent in urban settings. The report sheds light on these rural-specific challenges, underlining the necessity for focused attention on these areas.

Key Findings Relevant to Rural Communities

• Workforce Challenges: The report emphasises the severe shortage of dental professionals willing to practice in rural areas. With over 5,500 vacancies in the NHS dental profession, many of which remain unfilled for extended periods, rural regions continue to struggle with attracting and retaining dental care providers.
• Disparities in Access: Access to dental services varies significantly across different regions, with rural areas often experiencing lower access rates. For example, the report points out that regions like Somerset ICB have markedly fewer dental treatments per 1,000 people compared to urban counterparts such as South Yorkshire ICB.
• Contractual and Systemic Issues: The inefficiencies of the current NHS dental contract, which has remained largely unchanged since 2006, disproportionately impact rural areas. The contract’s structure often does not incentivise dental practices to take on NHS patients, especially for more complex treatments, which are needed more acutely in rural settings due to lower overall service availability.

The COVID-19 pandemic has exacerbated the challenges in rural dental care, with a notable decline in the proportion of adults seen by NHS dentists. Recovery efforts have been hampered by systemic inefficiencies and flawed recovery planning, further complicating the delivery of essential dental services in these areas.

The "Fixing NHS Dentistry" report provides critical insights into the systemic challenges facing NHS dental services, particularly in rural England. The detailed examination of workforce issues, access disparities, and contractual limitations offers a clear picture of the urgent need for reform to address the unique obstacles faced by rural communities in accessing dental care. This understanding is vital for stakeholders at all levels as they work to improve the accessibility and quality of NHS dental services across the country.

Readers can read the report in full here

Community Pharmacies to Expand Services Under New Government Funding Deal

Community pharmacies in England are set to offer expanded services to patients following a new funding agreement between the government and Community Pharmacy England. The deal, announced on 31 March 2025, includes a record £617 million in additional investment over two years, as well as the cancellation of £193 million in historic debt for pharmacy owners.

This is the first full-year funding package agreed with the sector since 2023 and is part of the government's wider effort to shift more healthcare services from hospitals into the community under its "Plan for Change."

As part of the reforms, pharmacies will begin offering new services such as:

• Free access to the morning-after pill via the NHS, helping address disparities in access
• Support for patients prescribed antidepressants to improve community mental health care
• Broader consultation services, including advice on prescriptions and blood pressure checks
• Increased incentives to identify undiagnosed high blood pressure
• Enhanced funding for medicine supply and dispensing

The government states the package aims to improve patient access, ease pressure on GPs, and reduce NHS waiting lists.

While government officials describe the investment as a “first step” toward long-term reform, Community Pharmacy England has acknowledged it as a move toward stabilising a sector that has faced financial strain for years.

The funding increase for 2025–2026 represents a 15% uplift from the previous year, taking the total community pharmacy funding package to over £3 billion.

Public satisfaction with the NHS and social care in 2024: Results from the British Social Attitudes survey

The Nuffield Trust and The King’s Fund has recently published their findings on the NatCen survey on public attitudes and opinions towards the NHS and social care. The 2024 survey results show that the British public are deeply unhappy with the way the NHS runs – just 1 in 5 people said they were satisfied. This is the lowest level of satisfaction recorded since the survey began in 1983 and shows a steep decline of 39 percentage points since 2019. Only 2% of respondents were ‘very’ satisfied with the NHS, down from 4% in 2023.

Satisfaction across NHS services varied with key findings as follows:

• Public satisfaction with A&E services has fallen sharply, from 31% to just 19%, and dissatisfaction has risen from 37% to 52%. These are the worst figures on record by a large margin and make A&E the service with lowest satisfaction levels for the first time.
• Satisfaction with NHS dentistry has continued to collapse. As recently as 2019 this was at 60%, but it has now fallen to a record low of 20%. Dissatisfaction levels (55%) are the highest for any specific NHS service asked about.
• Satisfaction with GP services continued to fall, mirroring the trend over the last few years. 31% of respondents said they were satisfied with GP services, compared with 34% in 2023.
• Inpatient and outpatient hospital care is the part of the NHS with the highest levels of satisfaction, with 32% saying they were satisfied and only 28% dissatisfied.

To find out more access the full findings here.

Clinical research van reaching rural communities

The BBC recently reported on a specially designed van which is visiting parts of Cornwall to make it easier for people in rural areas to take part in clinical research.  The initiative is seen as a vital step in reducing health inequalities and improving patient outcomes.

The vehicle is part of a pilot project exploring how mobile units can increase trial accessibility and efficiency. Historically participation in clinical trials in parts of Cornwall has been low and it is hoped deployment on the van will increase participation figures.

The project is a collaboration between the National Institute for Health and Care Research (NIHR), the UK Vaccine Innovation Pathway, pharmaceutical company Moderna and EMS Healthcare.

To find out more, click here.

Campus for Future Living Grand Opening Event

The Campus for Future Living located in Mablethorpe is throwing open its doors and welcoming visitors to see the finished building and all it has to offer. The Grand Opening event will take place on Thursday 12 June 2025 between 10am and 5pm and is a chance to check out the space, enjoy some tasty treats and meet the team. There is no need to RVSP for the event but for more information about the Grand Opening contact: [email protected]

The £8 million development, made possible with support from Connected Coast through Towns Fund investment, is set to become a hub for innovation in healthcare, training, and wellbeing in the East Midlands region. Find out more about the Campus for Future Living here.

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RURAL SERVICES NETWORK

Up to date news on Health and Care
The Rural Services Network provides a useful source of themed news content and data. Check out the latest news on Health & Wellbeing and Vulnerability, where you’ll find articles on a diverse range of rural issues affecting rural communities. You might also find this research on Over 65 Population Projections useful too.

Latest from RSN Member Insights
RSN Member Insights is the place to discover the statistics that define communities within our membership.  It is regularly updated with new analyses, and these will be highlighted in the 'What's New' section of the RSN's Weekly Rural Bulletin. The Rural Bulletin also provides a selection of the most rurally topical news items, so do subscribe and encourage your colleagues to subscribe to what is an invaluable weekly periodical.

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