Six of the seven most remote hospitals in England are in deficit

People living in rural and remote areas of England face longer waiting times for NHS treatment, research suggests.

The report by the Nuffield Trust for the National Centre for Rural Health and Care argued that the way the NHS distributes funding between local health services is unclear, unfair and fails to fully compensate remote and rural areas for the extra costs they face.

Six of England’s smallest and most remote hospital trusts account for nearly a quarter of the £1bn deficit carried by NHS organisations in England.

“Although the evidence on any additional costs associated with rurality is mixed, those trusts which are unavoidably small due to their remoteness generally have high cost pressures, longer waiting times, more delayed transfers of care, higher average unit costs and a worse financial position,” the report said.

Of the seven most remote rural hospitals in England, six are in deficit.

The authors argued that England appears to pay less attention to the challenges of rurality than Scotland, Wales and Northern Ireland.

John Appleby, the Nuffield Trust’s chief economist and director of research, said the evidence is mounting that small and remote hospitals face higher costs that they cannot avoid, with comparatively poor performance against key NHS measures and dire financial positions.

“It is certainly worrying that the methods used to allocate funding to these hospitals are inconsistent, obscure and depend so heavily on judgment. We recommend that the true scale of costs is examined again, and that national bodies are much clearer about how they make their funding decisions,” he argued.