Building Rural-Urban healthCare Equity for Scotland (BRUCES) – a multi-methods research programme in cancer, musculoskeletal health and frailty
Principle Investigator (lead Institution) Professor Peter Murchie and Dr Rosemary Hollick (University of Aberdeen)
Funding amount – £996,081
Lay Summary
This programme is called BRUCES – Building Rural-Urban healthCare Equity for Scotland. It aims to understand how and why health and healthcare for people living in different types of rural communities differs from those living in urban areas, and how we can improve it. We are a team of experienced doctors, researchers (including health economists, social scientists, policy experts) and patients interested in improving rural healthcare delivery.
Rural-dwellers can receive less or different care from those living in urban areas, resulting in poorer health. To improve care, we need to better understand why rural health outcomes are poorer and identify ways to make it fairer. Our research focuses on examples of common long-term health issues (cancer, musculoskeletal conditions and frailty) and will involve 4 steps:
1) Firstly, we will bring together learning from our ongoing research using large healthcare datasets to develop a detailed, rural-focused understanding of the health of people with cancer, musculoskeletal conditions and frailty, how they use health services, and identify patients who may be disadvantaged. We will also explore how local and national policies support (or not) care delivery in rural areas and identify existing models of rural care in Scotland, rest of UK and elsewhere that have worked well. The key lessons and gaps in our understanding will inform the next 3 steps.
2) We will interview (i) people living in rural areas with cancer, musculoskeletal conditions and frailty to explore their experiences of care and (ii) health and social care professionals delivering services to people living in rural areas. This will help us set out what ‘good care’ looks like, the specific workforce (recruitment and retention) challenges of delivering care to rural communities and what needs to be continued/changed to achieve good care across rural Scotland.
3) We will work out what aspects of care people living in rural areas value the most, and the costs of possible solutions identified in steps 1 and 2. This will help us understand what modifications may need to be made to existing ways of providing care and will help inform our recommendations in step 4.
4) We will bring together work from steps 1-3 to prioritise actions to improve care for people living in rural communities across our exemplar conditions and beyond. Working closely with the Scottish Government’s National Centre for Remote and Rural Health and Care (launched on 5/9/23) we will test out our findings in workshops with patients, carers, health and social care staff, health managers, policymakers and academic experts. We will create an action plan to introduce and measure impacts of the most promising solutions, producing guidance to support local and national service planning. We will also build rural research capacity throughout Scotland.
Our patient co-investigator and Patient and Public Involvement (PPI) group members have helped write this research programme, ensuring a strong focus on patients and carers. They have helped develop plans for involving patients and carers throughout the programme and will help us test our findings and create action plans.