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

Community participation to design rural primary healthcare services | BMC Health Services Research | Full Text (biomedcentral.com)

This study explores the use of community participation to design rural primary healthcare services in Scotland. By involving members of four rural Scottish communities in workshops, the researchers aimed to gather local input on healthcare priorities and service designs. The study found that communities prioritised aspects such as local healthcare practitioners, emergency triage, anticipatory care, and health volunteering. While some communities embraced innovative service models, others replicated existing ones, highlighting the diversity in receptiveness to change. The paper demonstrates the value of engaging rural communities in service design to ensure that healthcare solutions reflect local needs and are contextually appropriate.

This research emphasises the importance of co-design approaches. It offers valuable insights for policymakers, service planners, and healthcare providers seeking to create healthcare models that are both community-centred and sustainable.

An exploration of the longer-term impacts of community participation in rural health services design - PubMed (nih.gov)

This paper reflects on a community participation project conducted in three remote Scottish communities between 2008-2010, which aimed to co-design rural health services with local residents. The study revisited these communities in 2014 to examine the longer-term impacts of the participation process, exploring the extent to which the designed service models were implemented and the challenges faced. The key finding was that while the community-led initiative led to some knowledge change and one notable service innovation—a volunteer first responder scheme—broader service changes were limited. The study highlights barriers to implementing co-designed services in rural contexts, including insufficient community engagement, power imbalances, and governance issues within health authorities.

This research underscores the importance of understanding local social dynamics and involving rural communities in service design, but it also emphasizes the challenges of sustaining these initiatives over time. The paper is relevant for healthcare practitioners and policymakers seeking to implement community-centred health services in remote areas.

Being-Here-final-report-November-2018.pdf (scot.nhs.uk)

The Being Here Programme, initiated by NHS Highland and funded by the Scottish Government, aimed to test and develop new models of delivering sustainable health and care services in Scotland's remote and rural areas. This evaluation report summarises the programme’s efforts to address the challenges of recruitment, retention, and service delivery across pilot areas including West Lochaber, the Small Isles, and Argyll & Bute.

The report highlights the successes and challenges encountered during the programme. New multi-disciplinary teams and community-based roles were trialled, resulting in reduced reliance on locums and improved sustainability of local services. However, issues such as professional isolation, technology access, and community engagement remained concerns. The programme also sought to strengthen community resilience by involving residents in the co-design of services and addressing their needs, though long-term sustainability was questioned in some areas.

For rural health in Scotland, this paper is significant as it offers insights into models of rural healthcare delivery, the importance of multi-disciplinary teamwork, and strategies for engaging communities in service planning. It highlights both practical successes and persistent challenges, which are relevant for policymakers and healthcare professionals involved in rural healthcare delivery.