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The Scottish Government has a number of incentives already in place, amongst which is the Scottish Distant Island Allowance (SDIA), an addition to salary which supports staff with the costs of travelling to and from the mainland. NHS staff who work in the majority of Scotland’s islands are eligible to receive SDIA.

There is also the Scottish Government funded ‘Golden Hello’ scheme, administered by NHS Scotland Boards, which provides up to £10,000 to every GP taking up an eligible post in a rural area.

To attract dentists to rural areas we have made available a range of grants and allowances including the recruitment and retention allowance, which allows new trainee dentists practicing in eligible areas, to qualify for a ‘Golden Hello’ payment of up to £37,500 in the first three years of practice.

Furthermore, to support GPs to develop the skills required to work in rural areas, NHS Education for Scotland (NES) offers the Rural GP Fellowship. The fellowship provides qualified GPs with direct experience of working in rural and island areas across rural and island Health Boards, with the fellowship lasting a full year.

ScotGEM offers a unique four-year programme tailored to meet the current and future needs of NHS Scotland with a focus on rural medicine, healthcare improvement and developing interest in General Practice. ScotGEM students are eligible to apply for and receive a ‘Return of Service’ bursary of £4,000 per annum which commits them to working for NHS Scotland for the corresponding number of years following graduation. In addition to the return of service bursary, the Scottish Government pays the tuition fees for eligible students, offering an attractive package for potential applicants.

In addition to the Scottish Government funded incentives, staff being recruited to posts in rural and island areas may also be eligible for relocation expenses, the decision to offer relocation expenses lies solely with boards.

Telemedicine is essential to supporting care across Scotland. Access to services has shifted significantly over the past 5 years and we expect this to continue as we roll out improved ways to engage with health and social care services. Digital services are supporting people across Scotland to reduce unnecessary travel whilst also saving time, cost and uncomfortable journeys.

Challenges in delivering healthcare vary across Scotland due to population needs, as a result there is not a one-size fits all solution.

Work is already underway to progress reforms to ensure long-term sustainability, reduce health inequalities, deliver services closer to home, further harness the benefits of digital technology, and improve population health outcomes in Scotland.

To support sustainability of acute health services within remote, rural and island communities, we have convened an NHS Board-led working group which is working to develop a framework for delivery of health services in rural and island areas and considering how best to deliver the right care in the right place.

This group will determine a framework for the delivery of sustainable care for our rural and island communities, supporting effective local decision making while allowing service design and delivery to be adapted to place-specific needs and circumstances.

Health boards are expected to offer vaccination in a way that best suits the needs of their communities, using a patient-centred approach, as set out in Public Health Scotland’s (PHS) 5-year Vaccination and Immunisation Framework and Delivery Plan.

This plan states that boards should “ensure availability of a range of flexible, responsive, and good-quality immunisation services that meet the needs of all communities, including our rural and island communities”.

The Scottish Government continues to fund Scottish Ambulance Service mobile vaccination units. These are available to every Health Board to deliver across all vaccination programmes and are to be used to reach under-served communities, including those in rural areas.

Boards also offer flu and COVID-19 vaccinations to housebound patients at home on request. Details on how to arrange this are included in the vaccination appointment letter.

Lastly, there is the option for rural health boards to explore the use of Community Treatment and Care services to support vaccination programmes in rural communities.

NHS Board’s baseline revenue allocations are set out annually in the Scottish Budget, as published on the Scottish Government’s website. In addition, resource and capital spending limits are reported in Board’s annual accounts, which are published on their websites.

The Scottish Government allocates funding to territorial NHS Boards based on the NRAC formula. The NRAC formula takes into account factors in addition to population levels, including excess costs of delivering healthcare in remote and rural areas.

Since 2006-07, baseline funding for health and social care has increased by 120% in cash terms and 37% in real terms.

Since 2012-13, over £3.5 billion of additional funding has been committed to those NHS Boards below their NRAC parity levels, ensuring all Boards remain within 0.6% of parity.

More information on the NRAC formula is available at:

The Scottish Government is committed to developing a sustainable health and social care system that ensures people get the right care, at the right time, in the right place.

Our vision is for ‘a Scotland where people live longer, healthy and fulfilling lives.’ is supported by four key areas of work: improving population health, a focus on prevention and early intervention, providing quality services, and maximising access, all underpinned by a person-centred approach.

The majority of health boards across Scotland have all, or some of their constituent population in a rural area. Health Boards and Health and Social Care Partnerships take account of the diverse needs of their populations and plan their service provision according to that need.

Officials engage with Health Boards and HSCPs on a regular basis to review health outcomes.

Scottish Government does not hold information centrally on public transport to health facilities.

The Scottish Government's Transport to Health delivery plan aims to ensure access to healthcare facilities is fully considered within regional and local planning, including planning for our rural communities.

Our vision is that all disabled people can travel with the same freedom, choice, dignity and opportunity as other citizens. The Accessible Travel Framework launched in 2016, is focused on improving the overall journey experience for disabled people by removing the barriers which prevent them travelling.

The delivery plan for 2024-2026 has been published in early October 2024. This covers delivery for the final two years of the Framework, and includes Transport to Health as a workstream.

Health Boards received core capital funding of £453 million as part of their 2025-26 budget allocation from the Scottish Government, which is an increase of £139 million on 2024-25. This will be primarily focussed on delivering improvements to existing facilities and upgrading medical equipment. It will also allow the plans to complete the Baird Family Hospital and ANCHOR Cancer Centre in Aberdeen and for plans to replace the Belford Hospital in Fort William to be taken forward.

In the last 5 years, the Scottish Government have successfully delivered facilities that support remote and rural healthcare such as Badenoch and Strathspey Community Hospital and Broadford Hospital in Skye. There has been substantial investment in national treatment centres which serve all of Scotland, including the NTC Highland which is located in Inverness.

On 30 October, the Scottish Government published the Transport to Health delivery plan which sets out commitments against transport and healthcare across the work of Health and Social Care and Transport Scotland. The plan was informed by the 2019 Transport to health and social care report prepared by the Mobility and Access Committee for Scotland (MACS) on behalf of Ministers.

As set out in the plan, we will support Regional Transport Partnerships to develop their own plans around Transport to Health. An example of this will be continuing to support the work of the Health and Transport Action Plan led by NESTRANS and partners in Aberdeenshire.

Transport Scotland have included Transport to Health as one of seven thematic workstreams in their approach for delivery of the Accessible Travel Framework.

The Scottish Government’s role is to set the strategic policy for the NHS in Scotland, NHS Boards are responsible for service delivery. All Health Boards should consider patient transport needs when they plan and deliver services.

On 30 October, the Scottish Government published the Transport to Health delivery plan which sets out commitments against transport and healthcare across the work of Health and Social Care and Transport Scotland. The plan was informed by the 2019 Transport to health and social care report prepared by the Mobility and Access Committee for Scotland (MACS) on behalf of Ministers.

As set out in the plan, we will continue to use the NHS annual delivery plans to re-emphasise the need for Health Boards to consider patient access as part of the care pathway and reflecting the opportunity that is emerging for reducing the number of patient journeys through alternative options.