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The Scottish Government considers the varying needs of all parts of our population when developing plans and strategies, including the needs of people living in rural and island areas. We recognise that our rural and island communities have specific, place-based needs when it comes to the effective delivery of public services, including healthcare.

That is why we have established an NHS Board-led working group which is considering ways to improve delivery of safe, quality and sustainable healthcare services across rural and island Scotland.

More broadly, work is underway to develop a systematic approach to mainstreaming rural policy, the Rural Assessment Toolkit, which will support identifying and addressing the needs of rural communities and economies in our work.

Under the Islands Act 2018, the Scottish Government has a duty to consider issues that affect island communities in the development and delivery of all policies, strategies and services. We are also working with island communities and local authorities to develop a new National Islands Plan to be published later this year.

These workstreams support our endeavours to meaningfully improve outcomes for our rural and island communities across portfolios.

The requested information on what percentage of healthcare staff currently working in rural areas are locum staff, broken down by NHS board is not centrally held.

This information is not held by the Scottish Government. You should contact the Scottish Ambulance Service directly.

Telemedicine can describe a range of different digital solutions to support consultations and engagement with the NHS. As a result, it is not possible for the Scottish Government to set out a conclusive percentage.

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.