Trusts operating in a rural environment play a vital role in the fabric of our health and care system. They provide services for widely dispersed populations, integrating with partners across local government, primary and community care in the best interests of their patients and communities.

The role of the trust as an ‘anchor institution’ is all the more pertinent in rural communities, where there may be fewer public service institutions and key employers playing a similar role. Acting as an anchor institution is about creating economic and social value for communities, being a major employer, a provider of key services and advice and supporting local businesses and voluntary sector organisations.

Rural trust leaders often comment on how deeply rooted staff feel and how they maintain strong connections with the communities they are serving. These providers also offer attractive learning and development opportunities for both generalist and specialist training.

Operating in rural areas doesn’t come without its challenges and these challenges are different from those experienced by trusts operating in urban areas. COVID-19 has brought a whole raft of new pressures to the health service and has shone a spotlight on the importance of addressing health inequalities in an integrated and community-focused way.

Rural hospitals as anchor institutions are critical to ensure integrated care systems are seen as partners to social and economic development, particularly after the pandemic, as many rural areas have high deprivation and will have been disproportionately affected economically from COVID-19. It is therefore important to fully understand the challenges, and the vital role that rural trusts play, so they can be best supported to meet the short and long term health needs of those they serve.

We hope this document shines a light on the value of trusts operating in rural areas to patients, staff, and their local communities.


Patricia Miller

Chief Executive
Dorset County Hospital NHS Foundation Trust