How a Cornwall NHS team built an award-winning farmers’ health hub

Getting a farmer to sit still for a health check is one of the harder jobs in medicine. So a Cornwall NHS team stopped waiting for them to turn up at a surgery and went to the one place they reliably are on a Wednesday: the livestock market.

Cornwall Partnership NHS Foundation Trust runs the Market Health Hub at Holsworthy, just over the Devon border, where a nurse is on hand every week in among the pens and the auction ring. No appointment, no charge, no long drive to a GP. Since it launched in 2023, more than 700 people have used it, many of them farmers from north Cornwall who cross for the market, along with others from north Devon and further afield.

The Trust runs it in partnership with the local Primary Care Network, Imagine If and the University of Exeter. The thinking behind it is simple. Bring the care to the places farmers already go, rather than asking them to find time they do not have.

And time is the whole problem. The average UK farmer is 60 years old, and 40% are over 65. Almost half work more than 81 hours a week. When days run that long, a health appointment slides to the bottom of the list.

Mental health weighs heavily too. A 2024 survey found that 91% of farmers believe poor mental health is the biggest hidden problem in farming. The Office for National Statistics reported that in 2023, 88 men working in agriculture died by suicide.

Rachel Williams, a consultant respiratory practitioner for the Trust, puts the case plainly. “Rural and coastal communities face unique challenges in accessing services,” she says. “Our aim is to improve health and wellbeing through a sustainable farming health hub.”

📷Market awards

From a market chaplain’s idea to an award winner

The project started with Sue Banks, a retired vet and market chaplain, who began scoping out a new kind of healthcare service aimed squarely at farmers. In January 2024, Rachel Williams linked up with the Imagine If Farming Health Hub, and from May that year she began attending Holsworthy Market, bringing a different service along each month.

It opened with something small and practical: monthly blood pressure monitoring and a finger prick test, with the local Primary Care Network providing the base at the market. That modest start has turned up plenty. Since the service opened to the public, 100 people have needed a blood pressure referral, and just under 30 have needed a diabetic referral.

Farmers are one of the hardest groups in the country to reach. They often live in isolation, work long hours and put the farm first, and many are fiercely self-reliant, which means a health appointment rarely makes the cut.

The recognition has followed quickly. In December 2025 the project won a South West Integrated Personalised Care Award for working together differently, a nod to how much of it has been built with farmers rather than for them. Then in April 2026 it was named Regional Champion in the Improving Health Outcomes category at the first NHS Excellence Awards.

The reach has surprised even the people running it. Although the hub is there for farmers across north Cornwall and Devon, it has seen visitors from as far away as Ireland and Scotland.

📷Market sign

How it works

The hub runs every Wednesday at Holsworthy livestock market, staffed by a nurse, a community navigator and a healthcare assistant. The offer covers basic health checks, condition-specific reviews, health coaching and prevention advice, with training in accidental counselling on the way. The team also works alongside public health and government bodies.

“It is about meeting farmers where they are,” Rachel says, “in spaces they know and trust.”

📷Market drop in

The market nurse who took the job on

The hub is already outgrowing its early days. In January, a market nurse joined from Stratton’s district nursing team. Buffy Flanagan helps farmers manage long-term health conditions and carries out health checks, and she can advise on everything from stopping smoking to diabetes and pain management.

“It is a busy market with a lot of our local farmers and other farmers passing through,” Buffy says. “I am here to look after their healthcare. For a farmer to get a GP appointment and then attend takes two or three hours out of their working day. Being here makes healthcare easier for them to access, and that can then improve health outcomes.”

The plan is for Buffy to run drop-in clinics, focused on chronic disease management such as asthma and COPD, vaccinations, holistic wellbeing and long-term pain support. The point is to let people look after their health without the travel or the wait for an appointment, stopping by for a quick check or a bit of friendly advice.

Why it matters

The hub is a collaboration between Cornwall Partnership NHS Foundation Trust, livestock markets, Imagine If and the University of Exeter. It leans on local experts and ties into the neighbourhood health agenda, and it lines up with both the 10-year Health Plan and the three shifts set out by Lord Darzi: hospital to community, analogue to digital, and treatment to prevention.

The University of Exeter is evaluating the project, with Gemma Brailey as research lead.

“The Farmers Health Hub is a testament to what can be achieved when research is co-produced with the people it is designed to serve,” Gemma says. “At the University of Exeter, we are leading the evaluation of this work to understand its impact and ensure that decisions about future investment and wider roll-out are grounded in robust evidence and lived experience.”

📷Market health hub