Improving palliative and end of life care in remote, rural and island communities

Inconsistent access to care across the country 

People living in rural and island communities told us they often face a difficult choice: stay at home, or get the care they need, but not both.

Many find themselves far from family and support networks at the hardest time in their lives.

Key barriers include:

• Long travel distances and poor transport - especially on islands or in remote areas where buses and ferries are unreliable, roads can be affected by the weather, with travel often being costly.

• Lack of staff, including community nurses, GPs and social care workers, many stretched too thin to provide regular home visits.

• Limited care at home, particularly in the evenings, overnight or at weekends.

• Delays in accessing medication, sometimes involving waits of hours or travelling to multiple pharmacies.

• Pressure on unpaid carers, who often lack the training or respite they need and face social isolation and burnout.

Despite these challenges, rural communities have strong local networks, with friends, neighbours and community groups playing a vital role, especially where formal care is lacking. 

We’ve grouped our recommendations into actions that can be taken now, developed next, and delivered over the long term to improve palliative and end of life care for rural communities.

Across the UK, services are already finding creative ways to meet the needs of rural and island communities.