The Trust is committed to promoting and upholding its duties in relation to the Rural Needs Act (Northern Ireland) 2016 and having due regard to rural needs in the development of all our policy and public service delivery decisions.  The Trust is also committed to its reporting and monitoring obligations in accordance with Rural Needs Act (Northern Ireland) 2016.  The Trust has carried out the following activity to comply with, and mainstream, the duties outlined in this legislation.

• The Trust’s Board and Senior Team are continually briefed to ensure ownership of the rural statutory duties at a strategic level and has considered this Report before submission.
• The Trust’s Northern Partnership and Population Health Committee chaired by the Trust Chairperson, seeks assurance that the Trust is compliant with rural needs statutory requirements.  The committee is chaired by the Trust’s Chair alongside the Director of Strategic Planning, Performance and ICT as the Lead Director.  Membership includes other Non-Executive Directors, senior Trust staff and representatives from Community and Voluntary Sector partners, and service user and carers’ representatives. The Committee reports directly to Trust Board.
• To ensure effective mainstreaming and monitoring of the “due regard” within the Rural Needs Act the Trust’s mandatory policy development process includes a section on requirements relating to the Rural Needs Act as a requirement for staff to consider the social and economic needs of persons in rural areas when drafting a policy/proposal/plan or strategy or designing/redesigning of services.
• The Trust’s Equality Unit provides support to colleagues across the Trust in relation to rural needs impact and advice and guidance is provided on the Trust’s Staffnet to raise awareness and support staff. One to one advice clinics are available upon request.
• The Trust continues to implement various projects specifically designed to improve health and well-being in rural communities, focusing on farm families and reducing isolation. During the reporting period, the follow projects and events were held in partnership with rural communities:
  • In partnership with Ballyclare Ladies Farm Forum and Ulster Farmers’ Union, we hosted a ‘Celebrating Rural Women’ event. Such events acknowledge the importance of recognising rural women’s contributions and creating opportunities for connection.
  • Over a third of Northern Ireland’s carers live in rural areas and to celebrate Carers Week 2025, the Trust hosted an event for rural carers to offer connection, support and relaxation.
  • Following a successful pilot project, the Rural Melody Ladies Choir has resumed, with over 30 members, the aim is to connect local rural women and providing a platform for rural ladies to meet, interact and an opportunity to perform at various events.
  • The Farm Families Check Programme continues to aim to improve the health and social wellbeing of farmers, farm families and rural dwellers across Northern Ireland by increasing access to health screening services.
• During 2025/2026, as part of the ongoing assessment work for the Transformation of General Surgery, the Trust hosted a Rural Transport Workshop, to gain a clearer understanding of the travel challenges faced by people living in rural areas when accessing healthcare services. The event brought together service users, healthcare professionals, transport providers, community and voluntary sector representatives and other key stakeholders. Key themes identified included limited public and community transport availability, lengthy and complex journeys, accessibility difficulties, dependence on private transport, and the cost of travel.  The workshop findings have informed the assessment and will be used to guide future service planning, decision-making and the development of actions aimed at improving access to services for rural populations.

The Trust is mindful that the level of ‘regard’ due will depend on the circumstances and, in particular, on the relevance of rural needs to the decision or function in question.  The greater the relevance and potential impact for people in rural needs, the greater the regard required by the duty.

In the section below, the Trust has provided detail on those policies which were considered as having a bearing on rural needs and therefore subject to a rural needs impact assessment. In preparing this monitoring template the Trust considered policies in respect of the social and economic needs of persons in rural areas and for the majority, no rural needs were identified.  In the interests of openness and transparency, the Trust has provided the following hyperlinks to the webpage detailing screening outcome reports of Section 75 equality screenings of Trust policies. Many of the Trust policies are clinical, internal or technical in nature and have no bearing on rural needs.

Screening Outcome Reports

Assessment of Rural Needs and Impacts

The following information has been compiled in respect of each policy, strategy and plan which has been developed, adopted, implemented or revised and each public service which has been designed or delivered by the public authority during the reporting period.

Provision of Advocacy, Support services to looked after and care experienced children.

This regional service applies to all looked after children living in Northern Ireland regardless of whether they reside in a rural or urban setting.

Ensuring equal access to services, regardless of where service users live, is a fundamental requirement. The Education Authority and the Health and Social Care Trusts already have policies in place that consider the needs of children and young people from rural communities, including those who are looked after.

Artificial Intelligence (AI) Policy

This is a staff related technical policy that provides a framework to ensure processes are in place to mitigate against any potential negative outworkings of Gen AI tools.  The policy applies to all staff and all use cases of AI, whether clinical or non-clinical.  This policy has no bearing or impact on rural needs.

Family Support Services across the Northern Health and Social Care Trust

The service offers volunteer‑led support to families, including measures to prevent children entering care and to reduce parents’ isolation. The revised service will additionally aim to identify and support families not currently engaged with statutory services, helping to reduce isolation and prevent future statutory intervention.  Consideration has been given to the social and economic needs of people accessing the service and this proposed new service expands the current service provision, with delivery at home locations offering particular benefits for people living in rural areas.

CareLine Live

CareLine Live is a web-based system which enables real-time monitoring of domiciliary care visits and allows family members to remotely access information about care delivered through a mobile application. Access to these features requires an internet connection and a suitable digital device.

In developing and implementing the CareLine Live, consideration was given to potential impact on rural residents, particularly in relation to broadband connectivity, mobile coverage and digital access.   These factors may affect some families’ ability to fully utilise the remove viewing functionality   However, broadband availability in rural Northern Ireland (NI) has significantly improved.  DAERA’s NI 2023 statistics reported that 93% of rural areas had access to superfast broadband, compared with 99% of urban areas. While some disparity remains, coverage levels are high and continue to improve.

CareLine Live will not change the delivery of domiciliary care services, which will continue to be provided in service users’ homes regardless of location. The Trust has considered potential rural impacts and does not anticipate any significant adverse effect on rural service users, but will continue to monitor implementation and feedback to identify any emerging accessibility issues.

Community Nursing Beds for Provision of Assessment and/or Rehabilitation within the Antrim Locality

When developing this proposal, the Trust considered the needs of people living in rural areas who may have limited access to local assessment and rehabilitation services. Securing 18 assessment/rehabilitation beds within the Antrim locality will support timely access to appropriate care, improve patient flow, and help ensure that patients can access the care they require without unnecessary delays.

The proposal is intended to benefit patients across both rural and urban areas of the Trust by increasing the availability of appropriate beds and supporting effective discharge planning.  As the service will be provided within an established nursing home setting in the Antrim locality, no adverse impact on rural service users has been identified. The Trust will continue to monitor service delivery and accessibility to ensure the needs of rural residents are met.

The Provision of Counselling Service Pilot for unpaid family carers to be delivered within Northern Health and Social Care Trust’s (NHSCT) four localities to service the needs of the adult unpaid family carers.

The counselling service is available across all four Trust localities, for adult unpaid family carers, and will provide flexibility through virtual appointments, with face-to-face sessions available on request at a suitable and accessible venue.

The Trust recognised that some rural residents may experience challenges accessing virtual counselling due to broadband connectivity or digital access. However, broadband coverage in rural Northern Ireland has improved significantly, with 93% of rural areas having access to superfast broadband. To support accessibility, face-to-face appointments will be available on request at appropriate locations, with flexible appointment times offered to meet carers’ needs and promote equitable access across rural and urban areas.

Tissue Viability Nursing Team; Service Operational Guidelines

The service supports the management of complex and chronic wounds within community and care settings, reducing the need for unnecessary travel for patients and carers and the team operate as a Trust-wide service, accepting referrals from a range of healthcare professionals, including community nursing teams and care homes, helping to ensure equitable access to specialist advice and support regardless of location.

The Trust considered the potential impact of the Rover App, which is used on Trust-approved devices to capture and upload images as part of the referral process. While the app requires an internet connection to access its full functionality, images can be captured in offline mode where connectivity is limited. The Trust recognised that broadband and mobile coverage can be more variable in rural areas and may affect access to previous documentation during assessments, however, broadband has improved significantly.

The Trust considers that the guidelines promote equitable access to tissue viability services across rural and urban areas.

Review and the revision of the Managing Choice for Discharge from Inpatient Bed Policy

The policy aims to ensure that patients who are medically fit for discharge can access appropriate services, facilities and resources in a timely manner, reducing unnecessary delays in hospital.

In developing the policy, the Trust considered the needs of patients and families living in rural areas and engaged with the Trust Engagement Advisory Board to help identify and consider potential impacts. The Trust recognises that suitable care home placements or alternative care settings may not always be available within a patient’s local area. As placements are dependent on demand, resources and availability within the independent care home sector, some patients may be discharged to facilities further from their home community.

The Trust recognised this may require relatives and friends, particularly those living in rural areas, to travel longer distances to visit and may present additional challenges where access to public transport is limited. To mitigate this impact, individual circumstances and available placement options are considered as part of the discharge planning process, with ongoing engagement with patients and families throughout. While some rural residents may experience increased travel requirements, the policy supports timely discharge to appropriate care settings, and no significant adverse rural impact has been identified.

Alternative formats

Rural Needs Monitoring Report 2025/2026 (Word document, 125KB)