Title: ‘Come and work here!’ Exploring the role of local community-led initiatives to improve recruitment and retention of healthcare staff in remote and rural areas
Funder: Chief Scientist Office, Scotland

Abstract: Background_x000D_ _x000D_ Recruitment and retention of healthcare staff in rural and remote areas is a challenge for health services. Much of the focus of research in this area has been on work organisation and practitioners themselves. (Several members of the applicant team are currently involved in a study in Scotland of the experiences and preferences of doctors in remote areas, funded by the Scottish Chief Scientist Office (CSO), to develop new interventions to improve recruitment)._x000D_ _x000D_ However there has been less focus on the experiences of the people in remote and rural communities and what they themselves can do to attract staff. Some communities have experimented proactively with initiatives to promote their local area; to get involved in the recruitment and selection process; and to welcome and integrate new health professionals and their family members into local life. These community-led initiatives are often ad hoc and undocumented; there is potential learning about what has worked and what has been less successful that remains untapped._x000D_ This project has been suggested by the public research partners on our CSO study as a way to capture this learning. One is now a co-applicant on this proposal. _x000D_ _x000D_ Aim_x000D_ To improve recruitment and retention of healthcare practitioners in remote and rural areas_x000D_ _x000D_ Objectives_x000D_ _x000D_ 1. To explore the experiences of remote and rural communities of trying to attract healthcare staff to their area_x000D_ 2. To map local context and describe initiatives undertaken to improve recruitment_x000D_ 3. To understand how community initiatives have been received by staff who have been recruited and their families _x000D_ 4. To assess which initiatives seem to have been most successful (or not) and why_x000D_ 5. To provide resources for other communities and the NHS based on this learning_x000D_ _x000D_ Project plan_x000D_ _x000D_ This is a qualitative study with three parts:_x000D_ _x000D_ 1) Mapping: Drawing on our existing network of PPI and professional contacts, we will identify 6 diverse remote and rural communities, 4 in Scotland and 2 in Yorkshire/North East England. In each we will conduct an initial site visit (if possible) and focus group to identify, describe and categorise different types of community-led recruitment and retention initiatives which have been tried. Participants may include local councillors/council officials and representatives of other local community organisations (e.g. Chambers of Commerce, Tourist Boards, schools)._x000D_ _x000D_ 2) Interview study: In-depth interviews with up to 30 people who have been involved in designing recruitment and retention initiatives in these areas, and professionals (including nurses and allied health) and family members who have been the intended audience of such initiatives. Interviews will be analysed thematically. _x000D_ _x000D_ 3) Job advert/recruitment campaign analysis: as part of our existing grant, we are already collecting examples of job adverts for doctors (written and video). We will extend this to include adverts for other professionals, identified both by interview and focus group participants, and by wider searching of publicly available sources. We will analyse both visual and text content._x000D_ _x000D_ Outputs and dissemination_x000D_ _x000D_ We will develop a repository of initiatives and suggestions for other local communities and the NHS. Our advisory panel includes a range of people with high-level links to remote and rural workforce policy and health professional training in both England and Scotland, who will support national dissemination

Lay abstract: Research questions_x000D_ _x000D_ • What community-led initiatives have been tried to attract and retain healthcare staff and their families in remote and rural areas?_x000D_ • How far are these initiatives judged to have been successful and why?_x000D_ • What community-based resources and assets can help explain differences between communities?_x000D_ _x000D_ Background_x000D_ _x000D_ Recruitment and retention of healthcare staff in rural and remote areas is challenging. Most research has focused on practitioners themselves and the organisation of work, with less focus on what people living in remote and rural communities can do to attract staff. Some communities have experimented with initiatives to promote their area; get involved in recruitment; and welcome and integrate new health professionals and family members. These community-led initiatives are often ad hoc and undocumented; there is potential learning about what has worked well or not that remains untapped._x000D_ _x000D_ This project has been suggested by the public research partners on another study of rural medical workforce led by PI Locock, to capture this learning. One is now a co-applicant on this proposal. _x000D_ _x000D_ Aim_x000D_ _x000D_ To improve recruitment and retention of healthcare practitioners in remote and rural areas_x000D_ _x000D_ Objectives_x000D_ _x000D_ 1. To explore experiences of remote and rural communities of trying to attract healthcare staff _x000D_ 2. To map local context and describe initiatives undertaken to improve recruitment _x000D_ 3. To understand how community initiatives have been received by staff who have been recruited and their families _x000D_ 4. To assess which seem to have been most successful (or not) and why_x000D_ 5. To provide resources for other communities and the NHS based on this learning_x000D_ _x000D_ Methods_x000D_ _x000D_ Qualitative case study design with three components:_x000D_ _x000D_ 1) Mapping: We will identify 6 diverse remote and rural communities, 4 in Scotland and 2 in Yorkshire/North East England. In each we will conduct an initial site visit and community focus group to identify, describe and categorise different types of community-led recruitment and retention initiatives. _x000D_ _x000D_ 2) Interview study: In-depth interviews with up to 30 people who have been involved in designing recruitment and retention initiatives in these areas, and professionals (including nurses and allied health) and family members who have been the intended audience of such initiatives. _x000D_ _x000D_ 3) Job advert/recruitment campaign analysis: as part of our existing workforce grant, we are already collecting examples of job adverts for doctors. We will extend this to include adverts for other professionals, identified both by interview and focus group participants, and by searching publicly available sources. _x000D_ _x000D_ Data collection and thematic analysis will be informed by ‘asset-based community development’ (Kretzmann and McKnight 1993). To facilitate cross-case comparison we will develop detailed case descriptions. For job adverts we will analyse both visual and text data, and develop a taxonomy of initiatives. _x000D_ _x000D_ Timeline_x000D_ _x000D_ Pre award: ethics approval_x000D_ Months 1-3 Mapping phase, focus group and site visit _x000D_ Months 4-11 Main data collection: interviews and collection of recruitment campaign/job advert materials_x000D_ Months 9-13 Analysis _x000D_ Months 12-15 Develop of online repository of initiatives, disseminate_x000D_ _x000D_ Outputs and dissemination_x000D_ _x000D_ We will disseminate the repository of initiatives and suggestions for other communities and the NHS through the policy and practice networks of the team and our advisory panel.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE