NHS patients in rural areas of England face extra long waits for treatment, according to a study.

The Nuffield Trust think-tank says urban areas benefited most from measures put in place to help the NHS cope with the coronavirus pandemic.

Researchers found rural hospitals now faced an uphill challenge when it came to restoring services to normal.

NHS England says that funding reflects the higher costs of delivering care in rural communities.

The Nuffield Trust report says while the number of Covid cases in rural areas was lower than in big urban centres, the pandemic’s impact on services has been much greater.

It says the coronavirus crisis highlighted pre-existing problems facing rural trusts.

For example, it can be hard to recruit and retain doctors and nurses who are willing to work in smaller hospitals, which means trusts rely more heavily on expensive agency staff to fill gaps in rotas.

This, in turn, has a detrimental effect on the finances of hospital trusts which struggle to balance the books.

In addition, rural trusts often have only a limited capacity to treat any extra patients as they are often already very busy.

Prof Richard Parish, chair of the National Centre for Rural Health and Care, said: “We continue to be concerned that Covid has made a number of rural inequalities worse.

“There doesn’t appear to be much short-term prospect of respite. When there is, we still have to make progress towards a level playing field.

“This would involve, for a start, reducing the reliance on agency staff in rural health settings, speeding up rates of hospital discharge and reducing waiting times for elective surgery.”

The number of nursing vacancies has jumped by 2,626 (8.3%) over the past year from 31,634 to 34,260, according to NHS Digital’s analysis of posts advertised on NHS Jobs, the health service’s main recruitment website. However NHS Digital stressed that trusts can also employ nurses using other means.

The figures confirm other recent evidence that the health service is now seeing more nurses leave than join for the first time in its history. Last week the NHS’s statistical arm disclosed that one in 10 of all nurses now quits each year. Statistics it released then showed that during 2016-17, just under 33,500 nurses left the service – 3,000 more than joined and 20% higher than the number who quit in 2012-13.

Hospitals in Surrey – where health and social care secretary Jeremy Hunt is an MP – and Kent and Sussex are also failing to recruit enough nurses and midwives.

Between April and June, NHS bodies managed to recruit just 303 of the 3,225 nurses and midwives they needed – a success rate of 9.4%. The West Midlands had the highest success rate (42.4%) with such staff, closely followed by the north-east (39.4%) and Yorkshire and the Humber (27.4%).

The overall number of vacancies for all types of staff – including doctors, scientific, therapists, administrative and clerical personnel – which hospitals across England advertised to fill in July to September hit 87,964.

That was also the highest number since NHS Digital began collecting vacancy data in April 2105 and publishing it quarterly. The figures show that NHS bodies were also short of 10,498 doctors and dentists in that quarter.