National Centre for Remote and Rural Health and Care: evaluation

Appendix A: Survey Questionnaire

National Centre for RRHC Evaluation

Introduction

The National Centre for Remote and Rural Health and Care (National Centre) Phase 1 was established in October 2023 with the aims to:

1. Support delivery of improved care for remote, rural and island communities across Scotland.

2. Help reduce remote, rural and island health and wellbeing inequalities through a focused programme of work to improve the sustainability, capacity, and capability of remote, rural and island primary care and community-based workforce and service delivery.

The Scottish Government has commissioned the Diffley Partnership – an independent research organisation – to undertake an interim evaluation of the National Centre. As part of this evaluation, National Centre management, staff, users and Health board staff such as yourself have been asked to participate in this survey, lasting no more than 10 minutes, about your experiences with the National Centre and thoughts on its future.

Findings will be used to inform future policy direction for remote and rural health and social care, including decision-making around next steps for the National Centre.

Ask all

Q1. Where are you based?

Single code

1. NHS Ayrshire & Arran
2. NHS Borders
3. NHS Dumfries & Galloway
4. NHS Fife
5. NHS Forth Valley
6. NHS Grampian
7. NHS Greater Glasgow & Clyde
8. NHS Highland
9. NHS Lanarkshire
10. NHS Lothian
11. NHS Orkney
12. NHS Shetland
13. NHS Tayside
14. NHS Western Isles
15. NES National Board
16. NHS Scotland
17. Other (please specify)

Ask all

Q2. Which of the following best describes you?

Single code

Randomise

1. National Centre/NES management

2. National Centre staff

3. Healthcare professional

4. National Health Board staff (non-patient facing role)

5. Territorial Health Board staff (non-patient facing role)

6. Community Member

7. Academic

8. Third Sector Stakeholder

9. Other (please specify)

Ask if Q2=3

Q3. Which of the following best describes your role?

Single code

Randomise

1. GP
2. General Practice Nurse
3. Advanced Nurse Practitioner
4. Advanced Practitioner
5. Primary Care Practice Staff
6. Independent Contractor
7. Advanced Rural Practitioner
8. AHP
9. Paramedic
10. Other, please specify

Rural Education and Training

Ask all

Q4. Which of the following education/training activities have you made use of since the establishment of the National Centre (Select all that apply)

Multicode

1. Remote & Rural l Practitioner Supervisory Hub
2. Rural Advanced Practitioner Programme Level 11 Programme
3. Remote & Rural Health & Care Series of Learning Events
4. Dispensing GP Practices Education Programme Working Group
5. Remote and Rural resources that make use of Digital/TEL advanced technology programmes
6. Community Hub
7. Other (please specify)
8. None of the above

Ask if Q4=1-6

Q5. What formats have you used to access or deliver training? (Select all that apply)

1. Online
2. Blended
3. Self-directed learning
4. Working Group
5. Other (please specify)

Ask all

Q6. Can you provide an example of where you have applied new knowledge gained relevant to your remote and rural role?

[Open text]

Ask if user or remote, rural or island healthboard staff

Q7. Which of the following has the rural specific education, training or information helped you with? (Select all that apply)

Multicode

1. Improve clinical or professional confidence

2. Progress toward a qualification or accreditation

3. Meet CPD or revalidation requirements

4. Support or supervise others more effectively

1. Other (please specify)
2. None

Ask if user or healthboard staff

Q8. What, if anything, has changed in how you deliver care after accessing the rural specific education, information or resources available through the National Centre?

[Open text]

Ask all

Q9. S ince October 2023, have you faced any of the following barriers to accessing or delivering rural-specific training or education supported by the National Centre? (Select all that apply)

Multicode

1. Lack of time
2. Lack of awareness
3. Not enough places available
4. Format not suitable for me
5. Training not aligned to my needs
6. Lack of access to supervision
7. Lack of interest in the training
8. Lack of resource to deliver training
9. Other (please specify)

Ask all

Q10. To what extent do you agree or disagree that there is emerging rural clinical supervision capacity to support training needs in your area for…

• Yourself
• Colleagues within the sector

Single code

1. Strongly agree
2. Somewhat agree
3. Neither agree nor disagree
4. Somewhat disagree
5. Strongly disagree
6. Don’t know

Rural Research and evaluation

Ask all

Q11. Since October 2023, have you been involved in any of the following research or evaluation activities related to remote, rural or island health that was supported by the National Centre? (Select all that apply)

Multicode

1. Academic study programme (PhD, MSc, Fellowship with rural focus)
2. Research or publication opportunity supported or facilitated by the Centre
3. Evaluation involving rural or remote services
4. Service-led project evaluation
5. Community Hub Partner
6. International comparative research with rural relevance
7. None of the above

Ask if Q11=1-6

Q12. What was your role in the activity?

Single code

1. NC Awardee Recipient
2. Co-investigator
3. Co-designer or community collaborator
4. Stakeholder advisor
5. Participant (e.g. interviewed, surveyed)
6. Supervisor, mentor or academic advisor
7. Training or event participant
8. Remote and Rural researcher network member

Ask if Q11=1-6

Q13. In which of the following areas will this involvement help you: (Select all that apply)

Multicode

Randomise

1. Improve your rural research skills
2. Contribute to changes in rural practice or service delivery
3. Gain qualifications or professional recognition
4. Increase your interest in future research opportunities
5. Increase confidence to engage in rural research or evaluation
6. Enhance visibility of my work in rural research and evaluation
7. Strengthen my connections within rural health research and evaluation
8. Support others in conducting rural health research and evaluation
9. Other (please describe)

Ask if Q11=1-6

Q14. Has this work led to shared learning relevant to rural and island contexts (e.g., publication, presentation, internal sharing)?

Single code

1. Yes
2. No

Ask if Q14=1

Q15. Can you elaborate on how this work has led to shared learning?

[Open text]

Ask if Q11=1-5

Q16. What barriers did you face when engaging with or delivering rural research/evaluation? (Select all that apply)

Multicode

Randomise

1. Lack of time or flexibility
2. Limited access to funding
3. Difficulty finding supervision
4. Insufficient support from workplace
5. Limited awareness of opportunities
6. Lack of relevant R&R evidence base
7. Geographical isolation
8. Limited peer network
9. Other (please specify)

Rural Leadership and best practice

Ask all

Q17. Have you been involved in or are you aware of any national or international rural & remote (R&R) networks for knowledge sharing or collaboration?

Single code

1. Yes
2. No

Ask if Q17=1

Q18. Can you please describe what National Centre rural networks you have been involved in?

[Open text]

Ask all

Q19. Have you been involved in any rural/National Centre leadership working groups or practitioner model projects aimed at improving primary care delivery in R&R settings?

Single code

1. Yes
2. No

Ask if Q19=1

Q20. Can you please describe any National Centre rural projects that you have been involved in since October 2023?

[Open text]

Ask if Q19=1

Q21. As a result of your involvement, have/will you: (Select all that apply)

Multicode

Randomise

1. Connected with new colleagues or services
2. Shared examples of good practice
3. Applied models or ideas from elsewhere in your work
4. Been able to influence change locally
5. Gained more confidence in a leadership role
6. Other (please specify)

Ask all

Q22. Are you aware of work starting in the National Centre on rural leadership?

1. Yes

2. No

Ask if Q17=2 and/or Q19=2

Q23. What has limited your ability to engage with or deliver National Centre leadership or network activities? (Select all that apply)

Multicode

Randomise

1. Lack of time
2. Lack of workplace support
3. Activities not relevant
4. Format of engagement not suitable
5. Lack of awareness of opportunities
6. Not sure how to get involved.
7. Other (please specify)

Remote and Rural Healthcare Recruitment and Retention

Ask all

Q24. Are you aware of or involved in any remote and rural (R&R) healthcare recruitment and retention improvement programmes being led by the National Centre?

Single code

1. Yes
2. No

Ask if Q24=1

Q25. Can you describe which R&R healthcare recruitment and retention improvement programmes that you are aware of or are involved in?

[Open text]

Ask all

Q26. Have you engaged with any networks focused on R&R healthcare recruitment/retention?

Single code

1. Yes
2. No

Ask all

Q27. Have you engaged with any shared learning focused on R&R healthcare recruitment/retention?

Single code

1. Yes
2. No

Ask all

Q28. Have you accessed new information, guidance or support that will help you to improve recruitment and or retention in your service or area since the establishment of the National Centre?

Single code

1. Yes
2. No

Ask all

Q29. What support or actions do you think are most needed to improve Remote, rural, island healthcare recruitment and retention locally?

[Open text]

Overall Centre evaluation

Ask all

Q30. How well do you feel the National Centre is progressing in developing activity across each its four main priority workstreams?

Single code

Randomise

1. Education and training
2. Recruitment and retention
3. Research and evaluation
4. Leadership and best practice

SCALE: Very well, good, fair, poor, very poor, don’t know

Ask all

Q31. Have you seen examples of the following through the National Centre?

Multicode

Randomise

1. Increased understanding of health inequalities faced by remote, rural and island communities
2. Expanded access to education and training resources tailored to remote and rural health and care
3. Improved support for professional development and career progression in rural settings
4. New or enhanced models of care that support service sustainability in remote and rural areas
5. Increased opportunities for research, evaluation, or evidence-sharing relevant to rural practice
6. Evidence based approach to recruitment and retention of staff in remote and rural primary and community care
7. Greater collaboration and knowledge exchange across rural health and care networks
8. Better use of digital tools or technology-enhanced learning to support rural workforce development
9. More inclusive engagement with rural communities and service users in shaping services
10. Increased collaborative working
11. Too early to say
12. No clear changes
13. Other (please specify):

Ask all

Q32. And what benefits, if any, have you personally experienced as a result of participating in National Centre activities?

Multicode

Randomise

1. Increased understanding of health inequalities faced by remote, rural and island communities
2. Expanded access to education and training resources tailored to remote and rural health and care
3. Improved support for professional development and career progression in rural settings
4. New or enhanced models of care that support service sustainability in remote and rural areas
5. Increased opportunities for research, evaluation, or evidence-sharing relevant to rural practice
6. Evidence based approach to recruitment and retention of staff in remote and rural primary and community care
7. Greater collaboration and knowledge exchange across rural health and care networks
8. Better use of digital tools or technology-enhanced learning to support rural workforce development
9. More inclusive engagement with rural communities and service users in shaping services
10. Increased collaborative working
11. Too early to say

1. No clear changes
2. Other (please specify)

Ask all

Q33. Please share any specific examples of good practice you have seen from the work of the National Centre?

[Open text]

Ask all

Q34. Do you have any suggestions for how the work of the National Centre could be improved?

[Open text]

Ask all

Q35. Are there any individuals or groups that you think the National Centre should engage with?

[Open text]

Ask all

Q36. As the Centre develops beyond its first phase, to what extent do you support or oppose expanding the scope of the National Centre to meet priority needs beyond rural primary care?

Single code

Rotate scale

1. Strongly support
2. Somewhat support
3. Neither support nor oppose
4. Somewhat oppose
5. Strongly oppose
6. Don’t know

Ask all

Q37. What are the barriers to expanding the scope of the National Centre beyond primary care?

Multicode

Randomise

1. Workforce capacity and pressures
2. Funding
3. Difference between primary care and other forms of care
4. Recruitment of skilled workers
5. Retention of skilled workers
6. Skill development
7. Knowledge of best practice
8. Difficulties collaborating across organisations
9. Other (please specify)

Ask all

Q38. What would support expanding the scope of the National Centre beyond primary care?

[Open text]