National Centre for Remote and Rural Health and Care: evaluation

Executive Summary

The Scottish Government commissioned this evaluation to assess the progress of the National Centre for Remote and Rural Health and Care (National Centre) during its initial two-year delivery phase (October 2023 to September 2025). The National Centre was established to strengthen the sustainability, capacity and capability of primary care and community-based services in Scotland’s remote, rural and island communities. Its work is structured around four pillars: Education and Training, Research and Evaluation, Recruitment and Retention, and Leadership and Best Practice.

Purpose and Approach

The evaluation examined delivery against agreed targets, identified benefits and challenges and explored priorities for future development. A mixed-methods approach combined documentary analysis, a stakeholder survey (73 responses), 13 semi-structured interviews and two reflection workshops.

Key Findings

Education and Training has achieved several headline targets, including funding rural practitioners for advanced training, establishing the Remote and Rural Supervisory Hub and delivering more than 30 multiprofessional training sessions. These initiatives have improved access to tailored learning and begun to address professional isolation. However, bespoke training for dispensing practices and digital learning programmes remain in development.

Research and Evaluation has made some progress in building a rural evidence base. Academic study programmes and professional development awards have supported 27 MSc participants and 14 small-scale research projects. Evaluation frameworks for key initiatives are in place, but most evaluations will conclude in 2026. Uptake of the Rural Practitioner Publishing Award has been low, and international comparative research outputs are still emerging.

Recruitment and Retention has advanced more slowly, potentially reflecting systemic barriers. The Rural Recruitment and Retention Stakeholder Network is operational, and pilots such as Making it Work in Skye have generated valuable learning. However, most improvement programmes remain in development, and structural issues including housing, transport and funding models continue to constrain impact.

Leadership and Best Practice has achieved its networking target, positioning Scotland in global conversations on rural health. Four practice model projects are underway, including the Rural Leadership Course and Community Training Hub Pilot, but impacts are not yet visible. Awareness of leadership initiatives remains low; engagement has been concentrated among a small group of stakeholders.

Benefits and Challenges

Stakeholders (healthcare professionals and managers, and partner organisations) reported tangible benefits from engaging with the National Centre, including expanded access to education and training resources, increased opportunities for research and evidence-sharing and stronger collaboration across networks. These developments matter because they begin to address long-standing gaps in professional support and knowledge exchange for rural practitioners.

However, challenges persist. Visibility of the Centre’s work is inconsistent, engagement has been uneven across professional groups and workstreams have sometimes operated in silos. Structural barriers such as housing and transport remain outside the Centre’s direct remit, but significantly influence recruitment and retention. Mechanisms to capture and share practical outcomes need strengthening to demonstrate impact and secure ongoing support.

Cross-Cutting Themes

Several themes recur across pillars: strong foundations but limited visibility; the need for horizontal integration; the importance of community engagement; and appetite for expansion beyond primary care. Stakeholders support broadening the Centre’s remit to include secondary care and social care, but stress that this must be phased and strategic.

Considerations for a Strategic Framework

Future planning should focus on consolidating successful models, deepening engagement with underrepresented professions and communities, improving visibility through a public-facing platform, embedding evaluation at every stage and advocating for system-level enablers such as housing and digital connectivity. Integration across workstreams will be essential to deliver joined-up solutions.

Conclusion

The inaugural phase has validated the rationale for the National Centre and demonstrated its potential as a catalyst for change. Education and research have delivered tangible benefits, while recruitment and leadership have been slower to progress and deliver, but laid important groundwork. Potential future phases offer an opportunity to build on progress, scale effective interventions and position the National Centre as a driver of innovation and equity in rural health and care.