Our Challenges

We are looking to help spark ideas for enterprising solutions to the challenges of health, care and wellbeing in rural England. Find out more about them here!

Challenges, of course, also bring opportunities. We know the success of community co-operatives in safeguarding and transforming services like shops and pubs. Can such a model also help keep people more healthy, cared-for and connected?


Rural communities are not alone in facing challenges when it comes to physical and mental wellbeing. Across England and elsewhere, we see increasing pressure on care and health services, an ageing population and concerns whether everyone is as happy and fit as they could be.

Those living in rural parts of the country often experience such challenges more sharply. The proportion and average age of older people in rural areas is greater than in urban areas. Real hardship can be found even in the most affluent places and opportunities to socialise in small communities can be surprisingly few.

When distances are greater and transport options may be limited and costly, accessing facilities and delivering services are both more difficult. This so-called ‘rural premium’ is well-known, though not always reflected in funding and service design.


Half of rural households are 5+km from a hospital


We see clear opportunities for developing community-led, co-operative solutions to some of these issues with a growing focus on:

  • preventing ill-health through lifestyle choices and behaviour change, much easier with mutual as well as professional support
  • recognising the wider social determinants affecting health, from housing to transport
  • mental health and wellbeing, including addressing isolation
  • strengthening existing neighbourly and community networks to help people be connected and supported where they liveinnovation
  • innovation and flexibility shown by policy-makers and commissioners in health and social care, with personal budgets, collaborative commissioning, self-management and social prescribing.

Good health and well-being are about more than healthcare. A good start in life, education, decent work and housing and strong, supportive relationships all play their part.

David Heymann, Chair / Duncan Selbie, Chief Executive – Public Health England

Public Health England Strategic Report

Carer with client - looking at each other
Woman with dementia and young woman