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The Scottish Government has not conducted any specific studies to monitor whether the current GP contract has resulted in a widening disparity between remote and rural healthcare provision and urban healthcare provision, however we have well-established reporting arrangements in place at the national level to monitor implementation of the GP contract by HSCPs. These reporting arrangements allow us to gain both quantitative and qualitative information on progress.

The National Performance Framework Quality of Care Experience indicator measures people’s rating of the overall care provided by their general practice over time, including a breakdown by urban/rural classification.

One of the key aims of the new palliative care strategy, Palliative Care Matters for All, is that, by 2030, adults and children in Scotland will have more equitable access to well-coordinated, timely and high-quality palliative care, care around dying and bereavement support based on what matters to them, including support for families and carers.

Development of the draft strategy was informed by evidence gathering, guided by a Strategy Steering Group and a number of expert working groups. This included carrying out surveys mapping palliative care delivery across Scotland, including in rural and island communities.

The outputs of this work have given us a clearer picture of the delivery and accessibility of palliative care across Scotland, which has helped to inform the actions set out in the draft strategy.

The requested information on how many travelling consultants there have been within NHS (a) Highland, (b) Western Isles, (c) Orkney, (d) Shetland and (e) Grampian in each year since 2021 is not centrally held.

The Scottish Government will announce its spending plans for 2025-26 in its budget, on 4 December, with more detailed consideration of portfolio spend priorities, including the Monitor Farm Programme, being taken shortly thereafter.

The information requested is not held centrally by the Scottish Government.

The first cohort of 52 ScotGEM students graduated in summer 2022 after completing the four year course. Of these, 45 undertook Foundation training in Scotland with 42 completing their required foundation year 2 (FY2) in August 2024; a small number opted to go less than full time. Of those 42 individuals, 10 have chosen GP training and have taken up GPST 1 posts in Scotland, with two of these in the North which contains the areas denoted by the question, as follows:

a) Highland - 2 trainees

b) Western Isle – 0 trainees

c) Orkney – 0 trainees

d) Shetland – 0 trainees

e) Grampian – 0 trainees

The Scottish Government continues to work closely with partners including Higher Education Institutions, Health Boards, Skills Development Scotland, and the Scottish Funding Council on skills development, employability and widening access to NHS Scotland careers. As part of this work part time, distance learning and earn as you learn models of education, which may benefit rural and island areas, are currently being explored by the Allied Health Professions (AHP) advisory group that oversees the implementation of the AHP Education and Workforce Policy Review recommendations.

The Scottish Government, in collaboration with the Centre for Workforce Supply and the National Centre for Remote and Rural Health and Care is developing a model of sustained ongoing direct support for employers across health, social care, social work and children’s services in rural and island areas to overcome barriers to recruitment and retention The direct support model will consist of three key elements including a Rural and Island Recruitment Forum, a Living Library and a Recruitment Toolkit.

The 2018 GP contract included a programme of service redesign to ensure that arrangements for GP services better met the needs of the whole system and the needs of communities; it makes no new requirements of remote and rural GP practices. The 2018 GP contract is intended to reduce current risks to practice stability and sustainability by addressing some of the key risk factors relating to rising workload, premises and employment of staff. This in turn intended to make the partnership model more attractive to newer generations of GPs.

The Scottish Government established the Remote & Rural Working Group chaired by Professor Sir Lewis Ritchie in response to the concerns of rural GPs about the 2018 contract. The group produced the Shaping the Future Together report in January 2020 and various actions were undertaken as a result.

The NRAC formula is an objective measure of the need for health care services across Scotland.

Under the existing formula the additional cost of providing health services in remote and rural areas is factored within one of the key components in determining funding allocations, with the formula giving greater weights to areas where there is evidence of unavoidable excess costs of supplying healthcare services.

The Scottish Government have committed to continually review the funding formula. This process is managed by the Technical Advisory Group for Resource Allocation (TAGRA) and supports vital work to reduce health inequalities; ensuring that we continue to allocate funding according to the relative need for healthcare in each Board area. Work is underway to review this, however, funding formulas are inherently complex and the review will take time.

The Scottish Government conducted an initial survey of residential rehabilitation providers in Scotland and published the results in November 2021. This showed that, at that time, there were 12 reported beds in Highland and 6 in the Western Isles. None were reported in Orkney, Shetland or Grampian.