Raigmore Hospital in Inverness (stock picture).
A “seismic shift” is being promised in the way rural and remote health care is delivered for people living with long-term conditions, following the launch of the next phase of a multi-million pound project in the Highlands.
NHS Highland will receive a share of £6 million in research funding to help it design and test new models of care over the next five years.
As a core partner in the SEISMIC SHIFT programme – short for Systemic Health Innovation Future Transformation – NHS Highland will research ways services can be redesigned around “how patients actually experience illness, rather than around individual diseases”.
Covering an area larger than Belgium, NHS Highland faces a distinct set of challenges in supporting people with multiple long-term conditions – an ageing population, dispersed rural communities, workforce pressures, and the need to deliver consistent care from Caithness to Skye and from Lochaber to Easter Ross.
Rather than treating geography as a barrier, the Highland team behind the research project intend to use it as a testing ground for innovation that could be scaled across rural Scotland and beyond.
The programme is being led by the University of Strathclyde in partnership with NHS Highland, NHS Lanarkshire, NHS 24 and a UK-wide network of collaborators, and is one of three national programmes to receive renewed backing from a UKRI Engineering and Physical Sciences Research Council (EPSRC) and National Institute for Health and Care Research (NIHR) partnership, following a £17.9 million UK-wide funding boost.
Professor Anja Maier, Lead Investigator and Distinguished Professor of Engineering Systems Design at the University of Strathclyde, said: “NHS Highland’s participation in this research and innovation project helps us to design and test new models of care in a setting where geography, distance and complexity are part of everyday life.
“If we can develop approaches that work across remote and rural communities, where services must be joined up across large areas and around people’s real circumstances, we can generate learning taking a systems perspective that is highly relevant far beyond the Highlands. This makes NHS Highland a crucial testbed for how more person-centred, symptom-led care could be scaled nationally.”
Dr Beth Sage, Co-investigator, Consultant Respiratory Physician and Director of Research, Development and Innovation at NHS Highland, said: “In my day-to-day clinical work, patients don’t arrive with a diagnosis – they come because a symptom is affecting their life.
“Traditional NHS systems haven’t always reflected that reality. SEISMIC SHIFT gives us the opportunity to rethink how we deliver care around what matters most to patients, creating simpler, more responsive pathways from the very first presentation.
“It’s an ambitious and exciting programme, with the potential to improve care not just locally, but nationally especially for people living in remote and rural communities.”
The first Highland intervention will begin this month and run for 18 months. It will focus on building systems-thinking capability inside NHS Highland itself, embedding the skills, methods and mindset needed to design joined-up services around symptom clusters rather than single diseases.
The project hopes to bring clinicians, allied healthcare professionals in both community and hospital settings and primary care teams out of geographically separate silos into a more connected model.
In doing so, its supporters believe it will result in a model in which a community respiratory nurse in Wester Ross, a GP in Caithness, a hospital consultant in Inverness and the patient themselves can work to a single, coherent plan, regardless of how many miles separate them.
The project will also examine earlier, better-coordinated symptom management can reduce avoidable unscheduled care admissions across the region.
And it will also explore ways digital systems, data flows and financial arrangements between primary and secondary care can be redesigned to support symptom-led treatment.
Dr Sage said the programme is designed to leave a lasting legacy in the region:
“The purpose of this work is to build skills that remain within NHS Highland. By the time the five-year programme ends, we want individuals working right across the health board, in clinical roles, in strategy and transformation, in our community teams, who have been through this process and can take that systems thinking approach into other projects.”
The new phase of the SEISMIC SHIFT project will run until August 2030. It also has the potential to inform the design of major NHS Highland service developments currently in planning, including the new health and care facilities at Lochaber, Caithness and Skye.
Dr Sage added: “Our patients shouldn’t experience different standards of care depending on where in the Highlands they happen to live. SEISMIC SHIFT gives us the resources, the research partnership and the time to do something different about that.”
The latest £6m phase of the programme builds on a successful 18-month development phase launched in 2023, during which tests were carried out on new approaches to the prevention, diagnosis and treatment of breathlessness – a common and complex symptom among people with multiple long-term conditions.
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