National Centre for Remote and Rural Health and Care: Information Hub

A researcher within the NHS is in the early stages of developing a funding application to the current round of our NC Research, Evaluation and Personal Development Awards scheme focused on health inequalities and trans health in rural primary care. They are keen to connect with others who may have an interest in this area and are open to potential collaboration on the funding application and for research mentorship opportunities.

If this aligns with your interests or expertise, or if you know someone who might be interested, please feel free to get in touch with Prof Sarah-Anne Munoz sarah-anne.munoz@nhs.scot. 

Given the tight timeframe for the application (March 1^st), early expressions of interest would be particularly welcome.

The National Centre for Remote and Rural Health and Care is delighted to share details of the first programmes of work granted funding through our Remote and Rural Primary Care Research and Evaluation funding opportunity. The Centre has been able to identify funding to support NHS primary care practitioners who wish to carry out research or evaluation activities pertinent to remote and rural health and care in Scotland.

To be eligible, applicants must work within primary care that is located within and/or serves a rural or remote area in Scotland. We anticipate that each individual application will be for no more than £5,000. Applicants must be able to demonstrate that the work or activity will result in either/both of the following benefits: 

• Makes a contribution to the evidence-base for remote, rural, and island health and care research or evaluation.
• Increases their professional development as a remote, rural or island primary care practitioner. 

Funding applications are being considered for: 

• Postgraduate research e.g., Masters, PhD, EdD etc. 
• Other professional development work where it can be shown to contribute to post-graduate level remote, rural, and island research and/or evaluation.
• Publication costs, e.g. journal articles, open access articles etc. 

Applications opened in June 2024 and are being accepted until 1st March 2025, or on the allocation of all available funding. The Selection Panel met on 28^th August to review the submissions to date, and we are pleased to share information about three programmes of work that are receiving funding.

1. A music therapist based in Ayrshire and Arran has been awarded funding to undertake a master’s degree in healthcare management. Through the research component of the course, they will explore themes around the challenges in supporting the Allied Health Professionals (AHP) workforce in rural areas and the role of organisational leadership in that support.
2. A Lead Advanced Nurse Practitioner from Perth and Kinross has been awarded funding to commence doctoral studies. The professional doctorate will build on this practitioner’s master’s work on the impact of Advanced Nurse Practitioner led Comprehensive Geriatric Assessment underpinning the values of person-centred care. Incorporating nurse led CGA has been justified within urban primary care settings, proving effectiveness and improved patient outcomes however this has not previously been established or evaluated within rural and remote areas.
3.  A Specialist Orthodontist from Shetland has been granted funding towards their ongoing PhD studies researching the impact of orthodontics as a specialty on the climate crisis. The research is looking at the carbon footprint of patients undergoing orthodontic treatment in Shetland with factors such as travel to and from clinics having a potentially greater impact than urban equivalents.

These projects represent significant personal and professional development for these primary care practitioners working in remote and rural practice in Scotland. The Centre will also provide professional and pastoral support throughout their studies and assist with sharing the research findings and outputs to relevant audiences.

We are still taking applications. To find out more and fill in our application form visit our Turas page for details.

The National Centre has contributed to the recently published International Declaration on Rural Mental Health Research. The Scottish input into the paper drew on stakeholder work facilitated by the National Centre and the Community Knowledge Matters Network.

The paper suggests 10 guiding principles and standards for ethical rural mental health research relating to areas such as equity of funding, co-design and collaboration, trust and community engagement, data sovereignty and lasting impact.

The international declaration on rural mental health research can be viewed at International declaration on rural mental health research: 10 guiding principles and standards - Roberts - 2024 - Australian Journal of Rural Health - Wiley Online Library

Mental health in Scotland’s remote and rural areas is receiving much-deserved attention as the National Centre for Remote and Rural Health and Care champions the cause. Understanding the unique challenges faced by residents in these regions, the Centre is committed to helping enhance preventative and community-based supports alongside clinical care.

A recent highlight was the participation of Professor Sarah-Anne Munoz, Head of Programme for Research & Evaluation, in the Global Leadership Forum held in the Netherlands in June 2024. Selected as one of Scotland's delegates, Professor Munoz spent five days at this event, connecting with global leaders, exchanging knowledge, and exploring innovative solutions for rural mental health challenges.

During the forum, Professor Munoz visited rural Heerhugowaard for a specialised ‘match’ event, where she explored the pioneering ‘Art Farm.’ This intensive two-day session focused on addressing the mental health issues unique to rural settings and showcased innovative responses that could be adapted for Scotland.

The Global Leadership Forum, organized by the Global Leadership Exchange (GLE), serves as a critical platform for sharing insights and shaping the future of mental health care. Presentations from the forum are available on the GLE website, providing valuable resources for those interested in global leadership and rural health issues.

In addition to her participation in the forum, Professor Munoz, alongside Dr Rachel Erskine, Senior Specialist Lead at the Centre, has contributed to a significant international initiative. They were instrumental in the development of a position paper on ethical research practices for rural mental health, led by Charles Sturt University in Australia. This international effort culminated in the creation of the 'International Declaration of Rural Mental Health Research: 10 Guiding Principles and Standards,' which will soon be published in the Australian Journal of Rural Health.

The National Centre ensured that Scottish perspectives were well-represented in this global dialogue. We partnered with the Community Knowledge Matters Network to co-design an online survey to gather opinions from remote, rural, and island residents about the ethics of rural mental health research. The survey, which garnered over 150 responses, not only influenced the international declaration but is also being analysed in collaboration with rural community members. The results will be made available as open-source data through the CKM News — Community Knowledge Matters.

By sharing insights and learning from around the globe, Scotland is paving the way for innovative and ethical approaches to rural mental health research, support and services.

The National Centre proudly represented Scotland at the Arctic Congress 2024 in Bodo, Norway, joining over 1000 delegates!  We presented on active and healthy aging in remote and rural Scotland, as part of a session organised by the University of The Arctic Thematic Network on Health and Wellbeing.  Engaging discussions explored innovative models for supporting our aging population through primary and community care.

View the following links to some interesting models including https://www.uarctic.org/activities/thematic-networks/health-and-well-being-in-the-arctic/

Inuit and culturally-grounded health models: Epistemic inclusion in the Qanuilirpitaa? Nunavik Inuit health survey: developing an Inuit model and determinants of health and well-being | Canadian Journal of Public Health (springer.com)

Working towards ethical guidelines for research involving the Sámi — Sámiráđđi (saamicouncil.net)

The concept of One Health and incorporating it within health education in remote and rural regions: One Health in Northern Communities and Ecosystems | UiT

UArctic - University of the Arctic - Thematic Network on Northern Nursing Education

Most literature on integrated care focuses on urban settings, overlooking the unique challenges and solutions for remote, rural, or island communities.  Rural healthcare practitioners face unique challenges compared to their urban counterparts, necessitating strategic interventions to achieve health equity.  This special edition brings together nine papers that highlight these challenges and present targeted interventions.  The papers cover research and practices from seven countries across four continents, offering valuable insights for both rural and urban integrated care systems. Key highlights include:

• Canada: Cheng’s case study on an integrated care program for older people in Alberta shows how geographical isolation can catalyse greater integrated working.
• Spain: Espaulella-Ferrer and colleagues outline a new model of care for older people with complex needs in Catalonia, emphasizing the role of a nurse case manager.
• USA: Pires dos Santos and colleagues address integrated primary care for marginalized individuals in Arizona, highlighting challenges and solutions for remote regions.
• Brazil: Verissimo and colleagues discuss the essential role of trained lay community health workers in the integrated family health system.
• Ghana: Kpobi and Ferazzoli explore a community-centered approach to mental health services, emphasizing the importance of local assets and resources.
• Scotland: Abraham and colleagues report on a successful tele-dermatology model for an aging island population, highlighting the importance of digital solutions.
• Italy: Buffoli and colleagues emphasize collaboration between healthcare planners and urban/community planning authorities when locating new community healthcare facilities.

The special edition underscores the importance of addressing barriers to health equity, planning for demographic change, and understanding the impact of rurality on social determinants of health.  These papers offer valuable lessons for policymakers, practitioners, and academics dedicated to improving health outcomes and fostering innovation in rural and remote healthcare systems.

View the special edition at Guest editorial: Integrated care in rural, remote or island communities | Emerald Insight