Disentangling the knots: making effective use of funding for rural and remote general practice in Scotland
A new joint report from the Rural GP Association of Scotland (RGPAS) and BASICS Scotland calls for a different approach to funding, supporting and developing rural healthcare — one that builds on what we already know and puts rural professionals at the heart of future solutions.
Disentangling the knots
For too long, rural and remote healthcare in Scotland has been supported through a series of well-intentioned programmes, projects and initiatives which have often struggled to achieve lasting change.
There is no shortage of evidence about the challenges faced by rural communities and the professionals who care for them. There is also a substantial history of projects which have developed innovative approaches to recruitment, retention, education, service delivery and rural healthcare.
But too often, valuable work has been time-limited, funding has ended, organisational structures have changed, or responsibility has moved elsewhere. Knowledge and expertise can be lost, momentum disappears and rural clinicians are left facing the same problems again.
Our new joint report, Making effective use of funding for Rural and Remote General Practitioners in Scotland, asks whether it is time to do things differently.
We don’t need any more evidence
What we need is to consolidate what is already there, understand what we already know and then implement it.
The report highlights a number of significant programmes and investments which have contributed to our understanding of rural healthcare over many years — from the Remote and Rural Areas Resource Initiative and the Islands Network of Care, through to Being Here, Making it Work, the Scottish Rural Medicine Collaborative, Rediscover the Joy of General Practice and the National Centre for Remote and Rural Health and Social Care.
So what needs to change?
RGPAS and BASICS Scotland believe that rural professionals and organisations need to be equal partners in designing the solutions to the challenges facing rural healthcare.
The report sets out four recommendations.
1. Direct and sustainable funding
Key organisations should not have to rely on short-term arrangements, underspends or funding that arrives too late to allow effective planning. The report calls for direct annual funding for RGPAS and BASICS Scotland to support their work with rural GPs and rural healthcare.
2. A collaborative “Far End” approach
The report proposes the development of a permanent collaborative framework — a “Far End” — bringing rural organisations and policymakers together to understand and address rural health inequalities. The proposal draws on lessons from the successful Deep End approach while recognising that rural communities have their own particular circumstances and challenges.
3. New approaches to recruitment and retention
Rural recruitment cannot always be approached in the same way as recruitment to urban practice. The report proposes practical approaches including a Scottish rural healthcare “one-stop” resource and innovative, not-for-profit approaches to locum provision and medical student elective placements.
4. Preserving Scotland’s rural healthcare knowledge
More than two decades of valuable evidence, research and experience exists, but much of it is increasingly difficult to access. The report calls for a properly accessible repository of rural healthcare research and knowledge, alongside consideration of an archive of oral histories from rural healthcare providers.
Why now?
The report is not an argument that nothing has been achieved. Quite the opposite.
There has been a huge amount of good work, much of it involving rural clinicians, managers, educators, communities and organisations working together to find solutions that fit the places in which they are needed.
The concern is that we have repeatedly failed to build on that work consistently enough.
The same challenges continue to appear: workforce shortages, recruitment and retention difficulties, geographical inequality, professional isolation and the particular demands of delivering healthcare across remote and rural communities.
The report argues that Scotland has an opportunity to take the accumulated knowledge, experience and innovation of the past and use it to create something more sustainable for the future.
A different way forward
At the heart of the report is a simple principle:
Rural healthcare should be designed with rural professionals and communities, not simply for them.
That means recognising the expertise already present within rural general practice and rural healthcare organisations, providing sustainable support for organisations doing this work, and creating structures which allow people to work collaboratively rather than repeatedly starting again.
The “knots” can be disentangled — but only if we stop tying new ones.
Read the full report
Making effective use of funding for Rural and Remote General Practitioners in Scotland is a joint report from the Rural GP Association of Scotland (RGPAS) and BASICS Scotland, published in October 2026.