Working as a Rural and Remote Community Link Worker across the Scottish Highlands brings unique challenges. The core aim of the role is the same everywhere: supporting people to access non-clinical support through social prescribing. In rural and remote areas, however, delivering that support can look very different in practice.

When I started in the role, it quickly became clear that what might look like a straightforward solution on paper can become a real puzzle in practice – both in terms of what is possible in rural areas and because of the challenges people themselves are facing.

Referrals come from GP practices across the Highlands, supporting people living in areas of deprivation to access services, groups and resources through one-to-one appointments. The needs range from mental health and isolation to financial worries, long-term conditions and major life changes. In rural areas, how I deliver this support needs to be flexible.

working across distance

One of the main aspects of rural work is geography. Covering large areas with small towns, villages and remote communities means many appointments take place by telephone or video call rather than face-to-face. While remote appointments are not right for everyone, they offer some people a safer and more comfortable way to engage with support. This allowed me to reach people who might otherwise have struggled to engage due to distance, mobility or transport issues.

However, building rapport remotely takes time and intention. I cannot rely on body language, presentation or subtle visual cues to understand the person I’m working with or their situation. I have learned that listening carefully, often slowing down and allowing space for people to talk openly is even more important when the client is not in the room.

Distance also shows up in a very practical question: how does someone actually access support? Transport can be a barrier. A group may exist. A service may be open. But if someone cannot physically get there, it might as well not exist. 

There are car schemes, but they do not always work in practice. Some schemes cannot accommodate people with mobility needs and some people are unable or unwilling to pay. Public transport, if available, can be limited, unreliable or too complicated for someone already facing multiple health challenges. Carers can also struggle because they cannot leave the person they care for. A befriending service that offers to sit with the cared-for person can help, but gaps remain.

This is where being a Community Link Worker differs from simply signposting to problem-solving and supporting. I have to think differently about access. If attending a group is not realistic, is there a one-to-one option? If travel is too much, is there telephone or online support? If confidence is low, is there a gentle first step?

And when those barriers are worked through, the change can be quiet but astonishing.

One person shared after working with one of my colleagues, being “in a much better place and able to get out and about more, walking and visiting friends.” Another had been unable for a long time to attend a group because of transport. Once that was resolved with our referral to transport services, they were able to engage.

For another, it was about confidence: “Mindset has improved, now feel able to use wheelchair for support to access things I want to do, feel much more settled and wellbeing improved.” 

Another key difference in rural work is the availability of local and specialised services. Smaller communities often have fewer groups or third sector organisations. Even when a service exists, access can still be a barrier.

Because of this, national services offering telephone or online support often become a vital option. They cannot always replace local, in-person support, but they can provide consistent, accessible help when choices are limited. Much of rural social prescribing lives in the gaps between what should ideally exist and what someone can actually access.

I started at Change Mental Health as a Rural and Remote Community Link Worker. I now manage a team of Community Link Workers across different settings and that change widened my view. I see both the individual and the system-level challenges. I understand what it feels like to search for an option that works for one person in a remote village. That is where collaboration comes in.

collaboration at every level

For me, collaboration is vital to the success of social prescribing. Things change quickly and the service needs to keep its finger on the pulse of what is happening in local communities. One of the best ways to do that is by maintaining close relationships with organisations. This ensures that people receive the right information, making the referral appropriate with other organisations attracting the right people at the right time. All in all, it’s a win-win.