Community-Engaged Approaches to Building and Sustaining Scotland’s Rural Health and Care Workforce

Background: Recruiting and retaining healthcare professionals in rural and island areas remains one of Scotland’s greatest challenges, directly impacting access, equity, and the sustainability of services. The NHS National Centre for Remote and Rural Health and Care (established in 2023) leads a coordinated national response to these challenges through research, evaluation, and innovation programmes focused on strengthening the rural health and care workforce.

 

One such initiative—the Skye Community-Engaged Recruitment Group—has pioneered a model of locally driven, system-supported recruitment and retention that integrates community engagement into workforce planning. This work aligns with the Sustainable Development Goals (SDGs), particularly those addressing reduced inequalities and improved health and wellbeing.

 

Approach: The National Centre has developed a Menu of Options for Improved Recruitment and Retention, mapping evidence-informed, contextually adaptable strategies for workforce attraction, induction, and retention across Scotland’s rural, remote, and island (RRI) settings. This includes mechanisms for community participation, such as the “Living Library” (developed in collaboration with the University of Aberdeen and rural communities), which documents practical tools and examples of community-enhanced recruitment. The Skye model, evaluated through co-designed qualitative and developmental approaches, provides a transferable framework underpinned by five evaluation dimensions: Effectiveness, Impact, Relevance, Efficiency, and Sustainability (EIRES).

 

Results: Findings: indicate that structured community involvement strengthens the visibility and attractiveness of rural posts, supports early integration of new staff, and enhances professional belonging. The evaluation framework developed through this collaboration provides a replicable tool for assessing the effectiveness and sustainability of community-engaged workforce initiatives. Early insights from testing the framework suggest improved coordination between communities and health boards, greater local ownership, and enhanced workforce resilience.

 

 

 

Implications:Embedding community insight within workforce policy and practice can transform recruitment from a transactional to a relational process. The National Centre’s programmes illustrate how community-engaged models can contribute to achieving equitable, sustainable rural health systems by addressing workforce gaps at both structural and human levels.

 

The next phase involves scaling and adapting the framework across diverse rural contexts in Scotland, offering an evidence-based, SDG-aligned model for regions worldwide seeking to strengthen integrated rural health and care systems.