Good Practice Webinar: Enhancing access to health services in rural areas

Access to healthcare is a fundamental right for all people, regardless of geographic location. However, in rural and remote areas of Europe, challenges such as an ageing and declining population, inadequate infrastructure and connectivity, and a shortage of essential public services and professionals hinder access to healthcare. 

The EU Long Term Vision (LTVRA) aims to revitalise rural areas by providing efficient, accessible and affordable public and private services, including personalised healthcare solutions. This vision highlights the crucial role of access to health services in promoting health equity, supporting economic development, facilitating preventive and early intervention and influencing the decision to reside in rural areas. Therefore, improving access to health services across rural Europe goes beyond providing a basic right to healthcare. It is a multidimensional challenge that influences various aspects of rural life and therefore requires an integrated response. 

To effectively serve the rural communities, healthcare professionals must be well-equipped for their roles. Medical curricula do not provide enough opportunities to receive training in rural areas or training which equips medical professionals with skills needed to run a practice and provide care in rural areas. Health centres in rural areas may have limited medical equipment and technology, which can reduce the quality of the service provided, increase workloads, burnout and staff shortages. Regulatory measures promoting the right incentives to work in rural areas are not explored enough. This makes it more challenging to attract and retain young healthcare workers in rural areas. Finally, the feeling of social isolation in sparsely populated regions can lead to a reluctance to relocate to these areas.   

Linking rural healthcare with academia and ensuring educational opportunities are available is crucial. Access to medical education, training programmes, and specialised courses may be more limited in rural areas. We are starting to witness more rural placements and the establishment of “Longitudinal Integrated Clinical Placements”, an educational model used in healthcare training where students spend up to a year in a rural setting. However, these examples are still limited in numbers1. 

Rural health practitioners have come together in the EURIPA network (European Rural and Isolated Practitioners Association), which collaborates with the World Health Organisation (WHO) Equity Department to amplify the voices of those providing healthcare on the ground in rural areas. This webinar serves as an occasion to collaborate, drawing on the experiences of those working on the ground and provide insights into the policy context and how it can be improved.  

Studies on the impact of COVID-19 have highlighted the limitations of health systems centred around hospitals. They suggest the need to rethink and reorganise health provision on a territorial level and explore innovative ways to deliver health services. In recent years, different European countries have tried various approaches. These strategies include adjusting the geographic distribution of training admissions, delegating tasks from doctors to nurses, or providing incentives to encourage settlement in underserved areas2. Additionally, new forms of hospitals, such as clinical networks, multi-disciplinary teams, and a wider use of telemedicine and mobile clinics have been explored3. 

In response to the COVID-19 pandemic, the EU4Health programme (2021-2027) was adopted to reinforce crisis preparedness in the EU and strengthen the resilience of health systems. The previous programme: the Third Health programme provides support to the cluster of on-going projects focusing on problems of areas with lower availability of healthcare, the so-called medical deserts, retention of health professionals and task-shifting. Other Union programmes provide complementary support to policies, instruments, and actions improving accessibility of healthcare and they include  the European Social Fund Plus (ESF+) to support vulnerable groups in accessing healthcare, the European Regional and Development Fund to improve regional health infrastructure, the Horizon Europe for health research or Digital Europe and Connecting Europe Facility for creating the digital infrastructure needed for digital health. Finally, the Recovery and Resilience Facility provides substantial support to improve the resilience and accessibility of health systems.