In order to provide high quality services to all patients NHS Scotland plans and delivers some services on a national or regional basis. This is particularly the case for highly specialist treatments and those with low numbers of cases.

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

The group will develop a model with services provided as local as possible and specialised as necessary in order to ensure equity of outcomes. As part of the work, the group will seek to define what the "core services" are that should be provided locally, balancing these with the need for specialised care which may be provided outside the local area where clinically appropriate.

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.

Healthcare support workers in Scotland, by agreement from their employers, can enrol on the HNC in Healthcare Practice at their local college and can then progress to the nursing degree programme currently provided by the Open University, enabling them to remain in the workforce in their local Board area whilst studying. The Scottish Government provides a salary backfill payment to employers to compensate for time away from the workplace for both the Open University and HNC programmes.

It is the responsibility of the Scottish Ambulance Service to ensure that response times are as quick as possible, regardless of geography.

The Scottish Ambulance Service completed a full review of Demand and Capacity across Scotland at the end of 2019 which involved looking at demand data and resources to predict current and future demand and map out the levels of staff and vehicles required across different parts of Scotland. The outcome of the review saw an increase in resourcing and staffing in both urban and rural areas across Scotland.

Within our 24/25 Programme for Government we committed to working across the four nations on banning the sale of single use vapes (SUV) as well as the UK Tobacco and Vapes Bill.

SUV’s have been linked to a rapid increase in the number of young people vaping, particularly due to their low price. The SUV ban will be implemented from 1 June 2025 in line with the rest of the UK.

If passed the Tobacco and Vapes Bill, will restrict the promotion, advertisement and brand sharing of vapes.

Our Scotland-wide ‘Take Hold’ marketing campaign educated parents, carers and children about the dangers of vaping and increased the awareness of the harms and risks of nicotine addiction. It also contained a school toolkit.

We continue to work with Young Scot to support young people to understand the risks of using tobacco and nicotine products, and raise awareness of available cessation services and avenues to support young people to stop smoking/vaping.

The Scottish Government published our Cancer Strategy for Scotland 2023-2033 along with an initial three year Cancer Action Plan for Scotland 2023 – 2026 in June 2023. Over a 10-year period, our strategic aim is to improve cancer survival and provide excellent, equitably accessible care.

The strategy and plan have a focus on reducing inequities in access to cancer care and cancer outcomes. This means treatment and care will be equally good wherever anyone lives and whoever they are. Actions to tackle inequalities are incorporated into other ambitions in the action plan.

The Scottish Government is looking to improve our understanding of the experience of people with cancer living in rural and island communities. Examples include an independent evaluation of their access to cancer care services, and a research programme on rural healthcare funded by the Chief Scientist Office.

There is presently no national community audiology service. We are sponsoring the RNID ‘Near You’ scheme in partnership with the NHS in five Health Board areas. Benefits include locally-recruited staff, trained volunteers, savings of circa 500 clinical hours and 4,600 patient miles per year, and provision of domiciliary care.

Remote consultations are now part of free universal NHS funded eye examinations. The Government is also in the process of rolling out new enhanced services including the Community Glaucoma Service. No specific assessment has been made of the impact this has had on rural areas, but these commitments support patients being treated closer to home.

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.

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.

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.

Public Health Scotland publishes annual data on NHS eye examination on their website at: https://publichealthscotland.scot/publications/ophthalmic-workload-statistics/ophthalmic-workload-statistics-statistics-as-at-year-ending-31-march-2024/.

Figure 5b of that report provides data on referrals from community optometry to the hospital eye service.

Through implementation of the Women’s Health Plan we have established an NHS Board Women’s Health Lead Network with a Lead in every NHS Board. The Network enables the Leads to identify both common and local challenges and exchange ideas on innovation and best practice, along with discussions on progress to implement the Women’s Health Plan.

We have a clinical Menopause Specialists Network, which enables clinicians across Scotland with an interest in menopause care to share initiatives and good practice and discuss emerging challenges encouraging consistency of advice which can then be shared with local primary care teams.

We also established a National Menstrual Health Clinical Network to provide clinicians across Scotland with access to peer support, consistent expert clinical advice and facilitate further learning opportunities.

Further information about the progress to date against each of the priorities in the Women’s Health Plan can be found in the Women’s Health Plan Final Report.