Better technology and nursing skills development are needed to improve the care of older people in more remote areas of Scotland, says a new report.
With healthcare for older people in rural parts of Scotland “not fit for the future”, RCN Scotland and Age Scotland have identified seven core objectives to deliver community care:
- shifting resources to the community
- taking a whole-system approach to recruitment and retention
- developing and supporting the advanced nurse practitioner role
- ensuring nurses and other professionals are confident users of technology
- significantly improving broadband infrastructure to connect services with patients and support a mobile workforce
- bringing services and communities together to change attitudes and improve digital participation, particularly among older people
- supporting older people to live independent and active lives.
The proposals are set out in ‘Going the Extra Mile’ which describes the challenges of accessing remote and rural areas in order to care for an ageing population. According to new statistics, the estimated population of Scotland on 30 June 2014 was 5.3 million, the highest ever recorded, and life expectancy is higher – at 77.1 years for males and 81.1 years for females.
Addressing greater use of new technologies, the report says:
- the lack of broadband and other connectivity issues needs to be addressed as a matter of urgency as they are constant barriers to developments in remote and rural areas
- staff out visiting patients have no mobile reception or secure wireless internet connection in a number of remote and rural areas so can be out of contact with the practice and patient
- backfill, training and support needs to be properly planned for community nurses in remote and rural areas to be able to develop the skills necessary to use technology and promote telehealth and telecare in the community
- older people are still the least likely to use the internet, so all local service delivery partners should work together to proactively seek out older people who could benefit from digital services and put in place measures to improve digital literacy and get them online.
An example from NHS Orkney notes that videoconferencing kits are available to all GP practices, but bandwidth is an issue.
The report flags up the RCGP’s warnings about GP recruitment and retention problems, and calls for a greater role for advanced nurse practitioners and a more mobile and flexible nursing workforce along with technologically competent and confident staff and patients.
The report includes findings from an RCN survey which indicate that public transport is also a significant problem.