Communities Take The Lead In Tackling Rural NHS Recruitment Challenges

A new study funded by the National Institute for Health and Care Research (NIHR) has explored how remote and rural communities are taking practical steps to attract and retain healthcare staff and their families.

The project, Come and Work Here!, examined five rural case studies – three in Scotland and two in England – documenting local, community-led initiatives designed to help address long-standing recruitment and retention challenges within the NHS.

Researchers found that communities are using a wide range of creative approaches to attract health professionals, including promotional videos, social media campaigns, help with accommodation, and informal support to help new arrivals settle into village life. Many of these initiatives drew on local assets and relied on volunteers with skills in communications, marketing or community engagement.

However, the study also highlights challenges, including the sustainability of volunteer-led efforts and wider barriers such as housing, access to schools, and employment opportunities for partners. Retention activity was often informal, relying on local networks rather than structured support, and the researchers call for stronger collaboration between communities, the NHS and government to develop sustainable, place-based workforce strategies.

“Successful recruitment and retention need to focus on the whole person and family, not just the job. There is an important role for communities to play – but they cannot be expected to solve all the challenges,” the authors conclude.

The team has also worked with the Scottish National Centre for Remote and Rural Health and Care to produce a freely available online ‘library of examples’, showcasing practical actions that communities have taken to support recruitment and retention.

Read the full NIHR report: Come and Work Here!
Explore the library of examples: Scottish National Centre for Remote and Rural Health and Care
Read the journal articles:
– Journal of Health Services Research & Policy
– Rural and Remote Health Journal

The Rural Perspective

The findings reinforce what both the State of Rural Services 2025 report and the Delivering for All roadmap have highlighted, that rural health and care systems face distinctive workforce and access challenges that require tailored policy responses.

According to State of Rural Services 2025 (Rural England CIC), many forms of primary and emergency healthcare are concentrated in urban and more accessible rural areas, and there has been a net decline in the number of GP surgeries in rural England. Although this reduction has been smaller than in urban areas, it has increased the distances that many rural residents must travel to access a GP. The report also finds that the number of hospitals in rural areas has declined by 35% over the past 15 years, with both travel and ambulance response times significantly longer than in urban areas. It notes that “many rural areas lack any healthcare-related infrastructure, be this a GP surgery, a dentist, a chemist or pharmacy, a care home or a defibrillator, let alone a hospital.”

In Delivering for All, the RSN calls for a rural workforce strategy to aid training and recruitment across all health and care services, including dentistry, and for fair funding that reflects the higher cost of delivering services in rural areas. The roadmap also emphasises the value of the third sector as an integral partner in delivering person-centred care and promoting wellbeing within rural communities

Kerry Booth, Chief Executive of the Rural Services Network: This research underlines the need for joined-up action. Rural communities bring energy and commitment, but they need system-level support to ensure that good will is matched by sustainable policy and investment.