Recruitment and retention of medical practitioners is a challenging contemporary policy issue for rural areas. In this paper we explore this issue in the context of doctors in rural and remote Scotland, drawing on findings from a service mapping exercise into the recruitment and retention of doctors in rural areas, conducted by interviewing key stakeholders in the delivery of healthcare in rural and remote Scotland, most of whom combine clinical and organisational responsibilities. The aim of this paper is to understand the key issues, drawing on what the stakeholders see across the day-to-day delivery of their clinical roles and within the varied levels of the organisational structure of Scottish healthcare to which they contribute. We build on a review of key literature of contemporary issues in rural Scotland, healthcare delivery in rural areas and wider international literature on recruitment and retention of medical practitioners. Our findings focus around three key themes: power of place; how people make place; and, place and policy. In our conclusion, we argue that the importance of this stakeholder research is three-fold. First, that such insights from stakeholders are important in shaping and preparing for future research on the topic, particularly interviewing those currently working. Second, it adds to and echoes the growing body of literature globally focussed on recruitment and retention, by expanding on the Scottish context. Finally, it proposes that appropriate and effective rural proofing is important in the implementation of new policies where place-based challenges or differences can emerge.
This research was funded through grant HIPS/19/37 from The Scottish Government’s Chief Scientist Office. This research would not have been possible without the time given by the key stakeholders to talk about recruitment and retention of doctors in Scotland. The authors would like to thank their
advisory panel and PPI partners for their help and input throughout the research to date, as well as Dr Diane Skåtun & Dr Verity Watson in the wider research team. This paper benefitted from having parts presented or discussed at various invited presentations, seminars, workshops and conferences so the authors, particularly Andrew Maclaren, would like to thank the organisers of the Health
Services Research Conference (held online in 2021), and ‘The North Strategic Planning Group’ in particular. Andrew Maclaren would like to thank Lily Maclaren for her support and keen eye in proofreading various versions of this work before submission.
Data Availability StatementAuthors elect to not share data owing to sharing data potentially compromising privacy of human data, ethical standards or legal requirements. We have committed ethically to maintaining interviewee confidentiality.