National Centre for Remote and Rural Health and Care: evaluation

Chapter 9: Conclusion

The first phase of The National Centre has delivered meaningful progress in some areas, particularly in education and training as well as research and evaluation. Stakeholders reported improved access to tailored learning resources, new 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 remote and rural practitioners.

However, progress is uneven and still emerging. Recruitment and retention and leadership and best practice remain challenging. Engagement has been concentrated amongst certain professional groups, with a perceived limited reach into pharmacy, optometry, dental and allied health professions. Visibility of The National Centre’s work is inconsistent, and some stakeholders are unclear about its offer in some areas. Persistent structural barriers, such as housing, transport and workforce pressures have had also had an impact.

Stakeholders recognise The National Centre’s potential but stress the need for clearer communication, stronger integration across workstreams and practical evidence of impact. As one participant observed:

“They have their four pillars, but they’re somewhat siloed… seeing everything they do as part of one programme needs to be encouraged.”

Notably, staff from The National Centre reflected that they have moved towards a more horizontal working model in recent months, referring to the four priority areas as ‘cogs’ rather than ‘pillars’, recognising their interdependence. Documents such as the quarterly highlight report from March 2025 demonstrate this, with projects now organised accordingly into cross-pillar workstreams.

Looking ahead, there is strong appetite for expansion beyond primary care, but this must be phased and strategic to avoid diluting The National Centre’s core focus.

Overall, building on the foundations established in Phase 1 will require:

• Increased visibility and deepening engagement with all parts of the rural health ecosystem, including community organisations and underrepresented professions.
• Strengthening cross-pillar collaboration to deliver joined-up solutions.
• Embedding evaluation and feedback loops to demonstrate tangible outcomes.
• Advocating for system-level changes, such as housing and infrastructure, that underpin workforce sustainability.

The National Centre is moving from early development to a more established role, but any future delivery options will require scaling what works, improving visibility and broadening engagement to deliver on its ambition of improving health and care for Scotland’s remote and rural communities.