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CHAPTER THREE: LITERATURE REVIEW

RURAL SERVICES

Defining rural services

3.1 The concepts of 'rural' and 'rural services' are notoriously difficult to define. There is a long-standing debate over the usefulness of the concept of 'rural' as a generic term to describe widely differing areas. In terms of service provision, the implied focus on services within a geographical area does not match the pattern of service use by residents within rural communities, which has increasingly moved away from local services to using more distant services (Hope et al 2000).

3.2 The geographical focus of this literature review was on general research studies on rural services in Scotland, as well as more specific research and consultation exercises conducted within the twenty Rural Services Priority Areas ( RSPAs) - and associated Community Planning Partnership ( CPP) areas - which have been identified by the Scottish Executive because of the particular deprivation and accessibility problems they face.

3.3 The focus is on public, private and voluntary services. Public services, which include core services such as health, education, crime prevention, transport and jobs, are provided either by central or local government or by organisations such as the police, the NHS and local enterprise companies. Private sector services include shops, banks and other businesses. Voluntary services are those provided by communities and/or voluntary groups, sometimes in partnership with other organisations and bodies.

3.4 The Scottish Executive Research Specification points out that existing research on rural services has tended to focus on services that are 'known' or taken to be important ( e.g. education, health, financial, retail, community, police etc) and/or for which data are available. Consequently, assumptions are made about which services are key to rural communities and it is only about these particular predetermined services that communities have been asked to express views on accessibility, convenience and acceptability. In order to address this issue, there is a dual emphasis in the literature review on rural communities' perceptions of 'key services' and on service concepts, priorities and accessibility models which go beyond the assumptions that have been made by researchers, policy makers and service providers regarding what services are important and how to deliver/access them.

The range of services

3.5 The literature review highlights a number of common themes and key findings to emerge from both general research on service provision within rural areas, as well as more geographically specific research and consultation exercises carried out within the RSPAs.

3.6 This material suggests that there is a consensus among rural residents regarding the quality of life of rural communities. Central to this quality of life, however, is the importance of securing current levels of provision and in particular a small core of key services seen as indicative of a vibrant community. These include retail provision and particularly 'local' access to a shop, a bank, a post office and a petrol station. A primary school, a GP, childcare and a community hall are also seen as critical. The community hall is regarded as important because of its role in providing access to a range of services such as leisure, sports, educational, welfare, childcare and social activities, and also because it acts as a focal point in rural community activity. Leisure and recreation services for young people are also seen as key to rural communities. The provision of, and access to, appropriate social spaces and activities for young people to socialise and congregate around is consistently identified as a priority issue across all rural areas. Local employment opportunities, particularly for young people, and support for local businesses are also seen as pivotal to sustaining rural communities. For services other than those provided locally, the emphasis is on gaining or improving access to services. A recurring theme within the literature reviewed is the overriding importance of improving transport links within rural areas. This includes improvements to all forms of transport including public transport, ferry services in the island communities, community transport schemes, transport to healthcare appointments, road infrastructure, and the cost of fuel. Finally, another key issue for rural areas is the provision of affordable housing, particularly rental accommodation, and improving the quality of housing.

3.7 The literature review also generated material for use within the focus groups. The Scottish Office report, Availability of Services in Rural Scotland (2002), was used as a starting point for generating a list of services for use as a prompt within the groups. The key services identified within the report are: Education (nurseries, primary schools, secondary school); Health ( GPs; hospitals, dentists); Crime (police station); Information/advice (job centre plus; citizens advice bureau; libraries); Financial (post offices, ATMs, banks and building societies); Retail (petrol stations, chemists, convenience/general stores, supermarkets); Community facilities (community internet facilities, community/village halls). For the purposes of generating a comprehensive list of services to be used as a basis for discussion within the focus groups, the latter were added to by conducting a broad ranging review of material relevant to rural services provision.

3.8 The final list was not intended to be covered comprehensively within the groups, but rather to provide some useful prompts, in conjunction with examples of innovative services and projects (discussed below). The final list used (where necessary) in the groups, can be found in Annex 4 and will be useful for any future work on measuring satisfaction with services in rural Scotland.

ACCESSING RURAL SERVICES

Introduction

3.9 Although rural residents praise the quality of life enjoyed within rural areas, one of the key areas identified for improvement is access to quality services (Scottish Executive 2000, MacNee 1996).

3.10 Rural communities want to secure current levels of provision, especially a small core of key services seen as indicative of a vibrant community. These include: retail provision (including shops, banks, post offices, petrol stations), a primary school, a GP, services for young people, childcare and a community hall (Scottish National Rural Partnership 2000 Hope et al 2000). Village halls have a long established role in providing access to a range of services such as leisure, sports, educational, welfare, childcare, elderly and social activities in local communities and act as a focal point in rural community activity (Scottish National Rural Partnership 2000). For other services, the emphasis is on gaining or improving access to services, usually by improvement in public and other forms of transport although in the more remote communities the emphasis is on the cost of petrol (Hope et al 2000).

3.11 The remoteness and scattered nature of rural communities present challenges in terms of delivering and accessing services within these communities. Economies of scale are difficult to achieve in rural areas. In addition, the high cost of transport can hinder the provision of services locally as well as access to services in more distant population centres.

3.12 Imaginative solutions are needed to preserve existing services and improve their quality. The solutions will vary depending on the particular service in question and the area - remote communities may need the provision of services on the ground while in other areas transport to services in towns may be more cost effective.

3.13 Different options for providing services to rural communities have been identified, including: working in partnership with other service providers by sharing premises, staff or vehicles; making better use of technology; outreach and mobile services; one stop shops; and an affordable, accessible and flexible range of transport options, including community transport schemes, to access services elsewhere (Scottish National Rural Partnership 2000, Rural Poverty and Inclusion Working Group 2001).

Joint/partnership working

3.14 Partnership working can overcome the problems of cost by providing services jointly. Joined up working practices, through working in partnership with other local public agencies, the private sector and voluntary sector, can lead to a more efficient use of resources (Rural Poverty and Inclusion Working Group 2001). It can help to secure the retention of an existing service and can provide opportunities for an enhancement or expansion in the range of services available in a community (Scottish National Rural Partnership 2000). Joint use of resources ( e.g. premises, staff, building on existing networks such as the Post Office) allows agencies to retain a presence in the local area and continue to provide services through face-to-face contact whilst reducing some of the costs associated with this kind of service delivery (Scottish National Rural Partnership 2000). The sharing of premises, or 'co-location', can also provide a focal point for the community (Pickering 2003). The examples shown below are once again drawn from services that currently exist within some of the Community Planning Partnership's in which the RSPAs are located.

One-Stop Service Points (Highland)

Highland Council has 32 service points which are used as one stop shops to provide advice and information on council services. In some other service providers also share the building or information is provided about other service providers e.g. local Tourist Board, GPs. The service point officer has access to Highland Council's main computer network allowing local people exactly the same access to services as people walking into the council's main office in Inverness.

The Highland Council Service Point in Bettyhill operates on a part time basis between 9.00am and 2.00pm weekdays. At other times, several other service provides use the building as a base from which to offer their service. They pay rent to the Teleservice Centre who own the building ( e.g. the Bank of Scotland, Armadale Medical Practice, Citizen's Advice Bureau; the social work department of Highland council). The Teleservice Centre continues to have volunteers in the building on a part time basis. The Teleservice Centre was struggling to exist before it was approached by Highland Council about sharing the building. Its activities have been significantly strengthened since the partnership with Highland council.

Source: Scottish National Rural Partnership (2000)

One-Stop Servicepoints (Argyll & Bute)

This Three Islands Partnership project has brought together a range of public services under one roof on the islands of Islay, Jura and Colonsay, to provide a complete one-stop-shop service. These Servicepoints are the first port of call for any queries about services, whether council, business or health. Residents can phone or drop into the Servicepoint. Each of the Servicepoints also has videoconferencing equipment which any islander can use, including for, for example, a medical consultation. In addition, at each site, there are three PCs, which are attached to Argyll and Bute Council's network. This allows free access to the internet and e-mail. During 2005, the Servicepoints were accessed on over 17,000 different occasions.

Argyll & Bute Council is the lead agency for this project, but The Partnership ensures the joint working of the Council, Argyll & the Islands Enterprise Company, the NHS, the Scottish Executive and the local community companies so that that the residents of Islay, Jura and Colonsay are able to access services more easily with the use of new technology.

Source: Argyll and Bute Council

Multi-Use Centre - Dalmellington (East Ayrshire)

Dalmellington Area Centre provides residents of the Doon valley with easy access to a comprehensive range of public services, all under one roof. The services provided include council services, doctors, dentists, and the police as well as electronic service delivery by other government departments including the Benefits Agency. Funds have been pooled amongst public services in East Ayrshire to provide the facility and the re-location of employees from a range of different agencies under one roof has ensured continued cooperation and seamless access to public services.

Source: Duffy and Lardner, 2002.

New Young Persons' Drop-in for Maybole (South Ayrshire)

A drop-in facility for young people in North Carrick provides young people with a confidential and accessible resource where they can access advice, information and support on a variety of issues relating to their physical and mental health and well being ( e.g. diet, exercise, healthy lifestyles, sexual health, drug/alcohol, stress, anti social behaviour, crime, careers, community safety). The centre is based within a school, is open on Mondays during lunch breaks, and is staffed by qualified personnel including the school nurse, an Integrated Community Schools Development Worker, a Community Education Worker and a Youth Support Worker. The initiative is also supported by local GP's.

Source:http://www.chyps.co.uk/familysupport/dropinmaybole.shtml

Mobile provision

3.15 Mobile provision may reduce the need to have a fixed presence in the community, thus saving costs and allows services to be delivered on the ground to more people. Mobile provision can involve the use of purpose built vehicles, which are timetabled to visit a number of communities ( e.g. mobile libraries, banks, cinemas). The use of effective advertising is necessary to inform people where and when the service will be visiting (Pickering 2003). Peripatetic services can be provided through mobile staff (Scottish National Rural Partnership 2000).

The Screen Machine (Highland and Argyll & Bute)

The Screen Machine is a mobile cinema operated by a partnership between Hi Arts, an independent charitable company, Highlands and Islands Enterprise and the Scottish Arts Council. It has been in operation since 1998. The Screen Machine is a 17m lorry with a 4 by 2m screen, 101 seats, and its own power supply. The main aim is to bring a cinema experience of the highest quality and up-to-date films to remote communities in the Highlands and Islands Enterprise area.

Source:http://www.ruralgateway.org.uk/download/88/carnoustiepres.ppt

Log on Music Bus (Dumfries and Galloway)

As a result of research indicating that a high percentage of young people in secondary schools in Dumfries and Galloway would like the opportunity to experiment and create their own music, an innovative Music Bus took to the road in 2002. The bus tours the region offering workshops in music technology, giving young people the chance to come on board and make their own music using the latest music creation software with support by a professional music tutor. The bus also visits youth centres, children's festivals, Open Days, community events, family learning days, school holiday and evening events and events held by other organisations in the region.

Source: http://www.dumgal.gov.uk

The Food Train (Dumfries and Galloway)

The Food Train is a low cost shopping service allowing housebound older people to benefit from a fresh diet and increased social contact. It also offers volunteering opportunities for a whole range of people - from people with time to spare and wanting to give something back to the society to people with special needs and mental health issues who are able to gain confidence in successful social interaction as well as young people through the New Deal programme gaining work experience.

Source: http://www.dumgal.gov.uk/dumgal/

Rapid Response Service (Dumfries and Galloway)

The Rapid Response Service is run by the NHS in Wigtown West and Mid Galloway and offers augmented support to patients in their own home. This diverts people away from hospital admission as well as reducing the time that older people spend in hospital when ready for discharge. The project offers an immediate alternative to hospital or care home and focuses on rehabilitation within the patient's home.

Source: http://www.dumgal.gov.uk/dumgal/

Healthy Living Initiative - the C.H.I.P. Van (East Ayrshire)

A mobile Healthy Living Initiative which has become known locally as the "C.H.I.P. (Community Health Improvement Partnership) Van" focuses on 18 of the most socially and economically excluded areas in East Ayrshire, 11 of which are located within the formally designated SIP area. The CHIP Van's philosophy of "Help Yourself to Health" is put into practice by providing a range of community focused services including: First point of contact for advice, information and sign-posting; Referral to and from specialist health services and lifestyle agencies; Provision of practical services e.g. dietary advice, cooking skills, smoking cessation and exercise.

The project responds to community needs through the establishment of community based groups and services, which offer a calendar of local health improvement activities such as: Stress management classes; Community health fairs; Lifestyle referral scheme; Cancer awareness; Smoking cessation; Exercise classes; Nutrition and budget cookery classes; Internet access; Health helpline.

Source: http://www.eacoalfieldsip.org/projects/healthy_living.asp

Remote provision

3.16 Technological developments such as the Internet have created new opportunities for rural communities to access local services that do not require face-to-face contact (Scottish National Rural Partnership 2000). These opportunities include not only the delivery of information to users but also the opportunity to access services interactively such as booking appointments with GPs online. The use of new technology has the added advantage of providing a confidential service for people, such as Internet banking or NHS Direct (Pickering 2003). In some cases, residents can use home-based ICT connections. In other cases, a community facility is made available for this purpose.

Rural Training Bus (South Ayrshire)

In South Ayrshire, a Rural Training Bus provides small villages and remote communities with an access point for ICT. With eight PCs powered by an on-board generator, the bus provides residents with an opportunity to gain computer skills and in the future to provide opportunities to access a wide range of resources and services through the internet. The bus parks outside village halls where a free crèche service is also provided.

Source: Scottish National Rural Partnership (2000)

Yipworld.com (East Ayrshire)

Yipworld.com is an internet model of youth provision incorporating a range of formal and informal activities for young people aged 10-25 years living in the Coalfields Community of East Ayrshire. Based in Cumnock it comprises a cybersuite with Internet PCs, a recreation room with pool tables, public information, a crèche, counselling room, café and jukebox. As well as being a project in its own right, Yipworld.com acts as a conduit through which other projects can work. For example, young people can contact local community police officers at their designated email address in order to ask for their advice on a confidential basis. The project is a place where young people can go to learn, socialise and have fun, and be involved in running the centre.

Source: Scottish National Rural Partnership (2000)

3.17 Providing health care in remote and rural areas is becoming more and more difficult as healthcare professionals are choosing to work in urban areas. The combined effects of working alone, geographical remoteness, professional and personal isolation, long hours and lack of specialist training mean that some practitioners no longer have the skills, nor feel confident enough to work in rural areas. As a result the Health Service is facing recruitment problems with a range of healthcare professionals in rural areas. In order to continue to support and sustain local communities, especially people in very remote and island communities, a variety of different ways of accessing health services are being considered and introduced. These include increasing the use of Tele-health facilities in remote areas so that some consultations are undertaken using video-conferencing; and the introduction of NHS 24 so that the public can seek advice from a specially trained nurse at anytime by telephone.

Transport to centralised services

3.18 Where services can only be provided in urban or more populated areas the provision of high quality transport links is crucial. Improvements to public transport are important, alongside alternative transport solutions. Community transport schemes provide an effective way of coordinating transport provision and rural communities express a desire for wider access to transport schemes tailored to the needs of individuals such as dial-a-bus schemes and taxi subsidies (Shucksmith et al 1996 Rural Poverty and Inclusion Working Group 2001 Scottish National Rural Partnership 2000). Indeed, community-run/voluntary services can work effectively where public and private sector services do not as the incurred costs of staff tend to be less and the unit cost of provision is therefore lower (Pickering 2003). The introduction of reduced 'rural liability' for road tax and government subsidies to reduce the cost of petrol in rural areas have also been suggested by rural residents (Shucksmith et al 1996).

Dumfries and Galloway Accessible Transport Forum

The Dumfries and Galloway Accessible Transport Forum ( ATF) runs a range of innovative community transport projects:

• South Rhins Community Development Trust Social Car Scheme: volunteers use their cars to transport passengers on essential journeys such as hospital or GP appointments.
• Annandale Transport Initiative: Community and voluntary groups have access to three community minibuses for outings and trips. The buses are based in Moffatt, Lockerbie and Annan. Groups can hire the minibus by booking through the transport coordinator.
• Auchencairn Community Council Car Care Project : Provides transport for people in Auchencairn who need to get to the surgery and hospital appointments.
• Gretna Day Centre Minibus Project: This was developed to allow the wider use of an existing minibus (operated by the Day Centre) to transport people to and form the Centre and delivers meals to people at home. The aim is to provide some regular services for people with mobility problems. The service is available to people within the groups the Day Centre exists to help i.e. all older people and disabled people of all ages. The minibus generally runs on a fixed route, timetable basis, but deviates on request. Some pre-booking is accommodated. Services operate five days a week and are timed to provide opportunities to attend the doctor's surgery and chiropody clinic, connect with local bus services, or to reach the local shops and post office.
• Langholm Community Centre: Has purchased an accessible minibus for the use of their member groups. There will be an emphasis on meeting the transport needs of young people.
• Red Cross: The Red Cross operates a transport and escort service throughout the region, for people in crisis or with mobility difficulties.
• Upper Nithsdale Minibus Project: The aim of the project is to provide reasonably priced transport to enable recognised local clubs and organisations to take part in education, recreation and social events.

WRVS Good Neighbours Voluntary Car Scheme: Has established a voluntary car scheme in the Stewartry, which is complementary to the conventional public transport network. The part time coordinator is employed to deal with recruitment, training and support for volunteers, as well as the promotion and administration of the transport services. The service is provided for essential purposes only, such as hospital appointments or shopping trips for people with mobility problems. Such trips may be impractical by public transport or can be used to link with public transport.

Source: http://www.dumgal.gov.uk

Demand Responsive Angus Rural Transport Pilot Scheme: Angus Transport Forum

This project coordinates transport resources in three Angus glens to provide improved transport and delivery facilities to the residents of and visitors to the glens. It aims to provide a sustainable, reliable and cheap alternative to private transport and the limited public transport available. The project's economic benefits have included an increase in tourism in the area as a result of the improved access created by the project. This has resulted in more trade for crafts and other local cottage industries. Other benefits which have been identified as a result of the project include increased efficiencies through transport companies pooling resources in service delivery. The project contributes to social inclusion by widening transport access for otherwise excluded sections of the community including the elderly, the unemployed and youth groups.

Coalfield Community Transport ( CCT) (East Ayrshire)

CCT was launched in May 2002 to provide community and voluntary groups in the Coalfield Area with affordable and accessible transport to enable them to participate in community activities. In addition, it works to improve access to services and jobs. CCT operates a fleet of five minibuses. Services are available 7 days a week, 363 days each year. The Dayhopper Club was launched in June 2003 and provides a shopping and excursion service to the most vulnerable and excluded members of society, including individuals in receipt of benefit, older and unemployed people, lone parents, and people with a disability or who are geographically disadvantaged. The club has 700 members ranging from 2-94 years in age and a waiting list of 156 individuals. Over 75% of the members are over 70 years and almost 60% have no access to personal transport.

Source: http://www.east-ayrshire.gov.uk

Wheels2Work (East Ayrshire)

A scooter loan service is a new initiative introduced in April 2004 to assist young people aged 16-25 years to gain access to work or training.

Source: http://www.east-ayrshire.gov.uk

Travel Connections (South Ayrshire)

Travel Connections was established in 2002. It offers a 'menu' of complementary and subsidised transport services, where existing transport is unavailable, including door to door subsidised taxis, to enable residents in local villages to access employment, training, education and health related services and opportunities. The project comprises the following elements:

• an administrator to coordinate the resource
• a contractual arrangement with local private hire companies to provide vehicles at those times not covered by public transport services
• encouragement of employers to expand existing transport arrangements to the local industrial estate to the wider area using the project as a model
• commercial hire of appropriate vehicles transport for specific one off events e.g. health events
• establishment of a database of need that provides invaluable information for mainstream transport providers to inform and shape any future transport provision.

Source: http://www.south-ayrshire.gov.uk

Accessing information about services

3.19 Accessing a service assumes knowledge of the existence of that service. A number of ideas have been put forward for improving remote and face-to-face access to information about available services.

3.20 For example, the provision of a 'Contact Centre' can facilitate remote access to services. A 'Contact Centre' is a facility where Customer Service Advisors are able to provide services for members of the public by telephone, e-mail, fax, digital television, mail, video conferencing and other remote methods of contact (no face-to-face contact). Rather than the current extended list of telephone numbers required to contact individual services, customers will only have to dial one main telephone number. This contact can be made available 24 hours per day and 7 days per week.

3.21 A First-Stop-Shop is a means whereby receptions, local offices and local service centres are merged to provide one single site where staff deal with enquiries on any aspect of public services. Accordingly, this reduces the need to send callers to other offices and the culture of "we don't deal with that here". Standard office hours are normally adhered to, however, they can be extended if considered necessary. Face to face contact is the main but not only method of customer contact used within these facilities.

Directory 'Guid Services for Older Folk' (Dumfries and Galloway)

This Directory was produced to plug an information gap. Whilst the Council assists many older people, it was known that a lot more were reluctant to approach Social Services. It was also known that if older people could access services before they hit a crisis as opposed to the point or just after crisis then they would be more likely to journey through successfully - possibly even avoiding a crisis situation developing. This Directory gives practical information on support services that are available by direct referral i.e. an older person could access services without going to Social Services. There is also a list of 'approved contractors' from the Council's Property Services department. There is an 'information bank' containing information on a broad set of generally useful services and information; a section on home safety advice; information about day centres and care homes. This directory has been useful to agencies as well as older people with the Police promoting its use in the fight against bogus workman scams.

Source: http://www.dumgal.gov.uk/dumgal/

Other issues that can restrict access to services

3.22 In some cases, access to services is restricted by factors other than transport and these need to be taken into account when considering service provision. For example, access to lifelong learning opportunities ( e.g. education, training and skills development courses) can be constrained not only by transport but also by the availability, accessibility and affordability of childcare, and by the location, time and cost of courses. Similarly, access to council services ( e.g. libraries) and health services may be hindered by inconvenient opening hours. The availability of professional care for vulnerable young people was seen to be a problem in Dumfries and Galloway which brought forward an innovative early intervention scheme:

Better Neighbourhood Services Fund ( BNSF) Young People (Dumfries and Galloway)

The aim of the BNSF young people's initiative is to improve services for young people and to give them more opportunities to become productive and active members of their communities. Young people in Dumfries and Galloway face many challenges. Often these challenges relate to the fact that young people are a small population, scattered over a wide rural area. It can be difficult for young people in the region to access information and support services and this can place them at risk of becoming socially excluded. BNSF Young People aims to address these issues by:

• Making information and support services more accessible and increasing the number of young people who use them.
• Increasing the number of 'low-level' interventions for vulnerable young people. The aim here is that if young people can get support at an early stage, they will be less likely to go on to require more intensive services later on.

BNSF is funding the following projects in order to achieve these aims:

• Dumfries and Galloway Befriending Project: recruits and trains adult volunteers - 'befrienders' - and matches them with vulnerable young people. A befriender will meet a young person once a week/every 10 days and provide opportunities for positive activities like swimming, football, cinema or going for a coffee and a chat.
• Summer activities in Maxwell High School: young people developed a programme of activities themselves that reflected what they themselves wanted.

Source: http://www.dumgal.gov.uk/dumgal/

QUALITY OF RURAL SERVICES

Defining quality

3.23 There is no generally accepted definition of service quality. Service quality is recognized as a subjective assessment made by individuals based on their experience of using services. Hope et al (2000) adopted a definition of service quality as being 'a level and standard of service which meets the needs, expectations or aspirations of service users'. In their survey the degree of satisfaction expressed by respondents was used to measure their perception of the extent to which current provision meets their needs, expectations or aspirations.

Satisfaction with the quality of rural services

3.24 Overall rural residents are positive about living in rural areas. They emphasize the quality of life, and they value the specifically rural features, such as the attractive environment, the peace and quiet, the community atmosphere, and the relative safety they feel (MacNee 1996 Hope et al 2000 Mauthner et al 2001). Studies consistently show that most rural residents choose to move to or remain in the rural area in which they live and say that the positive features of rural life outweigh the negative ones. Their decisions involve a conscious and explicit trade-off between ready access to urban facilities and the other benefits they derive from rural living (Hope et al 2000 Mauthner et al 2001).

3.25 Research suggests that overall, there are high levels of satisfaction with rural services (Scottish Executive 2000 Mauthner et al 2001 Shucksmith et al 1996 Hope et al 2000). In a study of rural services, Hope et al (2000) found that of the 33 services covered by the survey, satisfaction rates were 90% or more for 10 of them; including those most associated with decline: post offices, libraries, chemists and banks ⁶. A further 10 services had satisfaction rates between 80% and 89% including: GPs, food shopping, dentists, opticians and primary schools. Seven services had satisfaction rates of less than 60% and these were 'other leisure' services, road repairs, sports facilities, clothes shops, out of school care, activities for young children and activities for teenagers. These represent the major gaps in provision since there is relatively high and generalised dissatisfaction.

3.26 There are also exceptions to the general picture of satisfaction with services in terms of types of locality e.g. smaller remote communities and particular sections of the population e.g. those living in households without a car (Hope et al 2000).

3.27 Older people consistently express high levels of satisfaction with service provision despite more restricted access to services. This seems to be the result of lower levels of expectation among this age group (Hope et al 2000).

3.28 For households with young children the main issues relate to services for children in particular the future of local primary schools and the persistence or reintroduction of composite classes in some primary schools (Hope et al 2000).

3.29 There are generally high levels of satisfaction with preschool facilities with dissatisfaction such as it is focusing on the range of provision (Hope et al 2000). Access to transport does not emerge as a key issue for this particular group as a high proportion of households either have two cars or make arrangements to ensure that non working women are not 'trapped' in the home (Hope et al 2000 Mauthner et al 2001).

3.30 These findings are echoed by other studies. For example, in a survey study, MacNee (1996) found that more respondents considered that services had improved (62%) rather than deteriorated (45%) ⁷. Better health services were considered to be the main improvement in each area. Mauthner et al (2001) found that families praised rural services and facilities especially the high quality schools, health services and activities for young children ⁸ . Using data from the 2002 Scottish Social Attitudes Survey, Farmer et al (2004) found that there were higher levels of satisfaction with health services (including local GP, in-patients stays and out-patient clinics) in remoter rural areas compared to those in urban areas.

Priority issues for rural services

3.31 A number of key areas are consistently identified by communities as limitations to rural living and key priority areas for improvement and have been highlighted in a range of academic and government research publications. These include: limited transport; lack of affordable housing; leisure and recreation facilities for young people; and limited access to specialist health services (Mauthner et al 2001 Shucksmith et al 1996 MacNee 1996 Hope et al 2000).

3.32 Transport: Rural transport is a key factor in determining whether people in rural areas can access a full range of services, and rural residents cite transport as the over-riding problem in rural areas (Rural Poverty and Inclusion Working Group 2001 MacNee 1996 Shucksmith et al 1996 Mauthner et al 2001 Scottish National Rural Partnership 2000). People in rural communities have both limited travel opportunities and higher transport costs. The inadequacy of rural transport is consistently identified as a critical area for improvement within rural areas, and one which would significantly contribute to a higher quality of life in rural communities (Scottish National Rural Partnership 2000). Public transport can be inadequate or non-existent. Rural people complain about the lack of frequent, reliable, appropriately timed and affordable transport. The lack of patient transport to hospital appointments can also be a problem (Rural Poverty and Inclusion Working Group 2001). Scattered rural communities are often heavily dependent upon the car as their only means of access to services and there are concerns about the rising cost of petrol and dwindling number of petrol stations (Scottish National Rural Partnership 2000).

3.33 Housing: Housing is a major concern in rural areas. There is a lack of affordable housing to rent for low-income households especially public housing; the cost of renting is high; and the quality of housing is often poor (Rural Poverty and Inclusion Working Group 2001 Shucksmith et al 1996).

3.34 Leisure and recreation services for young people: The lack of leisure and recreational facilities for young people in rural areas, and the absence of appropriate social spaces for young people to socialise and congregate in, is a commonly voiced criticism made by rural people of local services and an area identified as a top priority for improvements (Scottish National Rural Partnership 2000 Hope et al 2000 MacNee 1996 Mauthner et al 2001). Young people of different age groups have very different needs. While local facilities might be appropriate for younger age groups, teenagers tend to be more interested in meeting in larger urban centres outwith their communities. Young people make strong distinctions between different age groups and are reluctant to share premises or time-slots in community facilities with younger children or adults. The transport problems identified above can exacerbate the social isolation experienced by young people. Inadequate and expensive public transport means that they are dependent on others for transport to services in larger towns. Young people whose parents do not own a car face particular difficulties (Scottish National Rural Partnership 2000). A recurring theme within research on young people is the need for much more direct consultation with young people themselves about their requirements for accessing services.

3.35 Limited access to specialist health services: Limited access to specialist health services is often cited as a problem within rural areas (Mauthner et al 2001 Shucksmith et al 1996 MacNee 1996). For some people, this is because of transport problems to specialist health services, involving a long and uncomfortable journey, staying away overnight, and/or inconvenient public transport. For others, such as older people, providing an increased amount of specialist care in the community can minimise unnecessary lengthy stays in hospitals.

RESEARCH AND CONSULTATION ON SERVICE ACCESS & QUALITY CONDUCTED IN & AROUND RSPAS

3.36 The literature review found a wealth of local research and consultation evidence in the Community Planning Partnership areas within which the RSPAs are located. There are, however, variations between areas in the breadth, depth, type, coverage and geographical focus of available material. Local research and consultation has tended to focus on particular populations ( e.g. young people, older people), be issue-based ( e.g. transport, housing) and cover issues of the wider rural population of local authority or community planning areas. It is difficult therefore to come to general conclusions about views held about access and quality of rural services.

3.37 A wide variety of methods - including qualitative and quantitative - have been used in the local area research to information including, amongst others:

• Citizens' Panel questionnaires ( e.g. Argyll and Bute, Angus)
• Consultation meetings ( e.g. Eilean Siar)
• Community appraisals ( e.g. Eilean Siar)
• Area consultation workshops/interviews ( e.g. Highland)
• Community audits ( e.g. Orkney)
• Brainstorming days/seminars/conferences ( e.g. Orkney, Angus)
• Community engagement exercises ( e.g. Orkney)
• Resident Surveys ( e.g. East Ayrshire, South Ayrshire)
• Project evaluations ( e.g. Dumfries and Galloway).

3.38 The findings from the focus groups suggest that service quality was less of an improvement issue than access. These findings concur with the literature review, which suggests that overall there are high levels of satisfaction with rural services, and that the single most important area of improvement identified across all rural areas is access to quality services, and particularly improvement of transport services.

3.39 Most of the priority issues identified within the focus groups are consistent with those revealed by the literature review. There were however a wider range of issues covered under each theme. The most frequently occurring issue in both the groups and the literature related to transport. Health was another prominent issue common to both as were refuse collection and recycling, and retailing. Youth issues and the needs of the elderly featured strongly in the literature, but they were not high amongst the priorities of the discussion groups. The same is true of education and training, housing and leisure opportunities. The other significant issues covered in local research and consultation, but not prominent in the discussion groups, were job creation and crime issues. The groups felt that emergency services, telecommunications and utilities were important, but there is little coverage of these issues in the literature. The remainder of this section summarises the findings of the literature review under each of the service areas it covered. This comprises of:

• Transportation
• Healthcare
• Young People
• Older People
• Education and Training
• Job Creation
• Refuse Collection and Recycling
• Retailing
• Telecommunications
• Crime
• Housing
• Leisure Facilities
• Utilities

Transportation

3.40 Transport consistently emerged as the over-riding problem in most rural areas and concerns were divided between physical infrastructure and the means of transport. Road safety was another important issue.

3.41 In relation to infrastructure, the most frequently cited problem was the poor state of repair of the road system. This was raised in all areas except East Ayrshire, South Ayrshire and Dumfries and Galloway (Angus Council [January 2001], Argyll and Bute Council [June 2001], Comhairle nan Eilean Siar [1995, 1996, 2000], Highland Council [2004], AB Associates [1998]). Another concern in Highland (Highland Council [2004]), Orkney ( AB Associates [1998]) and Eilean Siar (Comhairle nan Eilean Siar [1996]) was the need for wider or higher standards of roads. In three areas, Angus (Angus Council [January 2001]), Argyll and Bute (Argyll and Bute Council [October 2001]) and South Ayrshire (South Ayrshire Council [2005]), the need for better footpaths and cycle ways were raised. In Angus (Angus Council [October 2001]) and South Ayrshire (South Ayrshire [2005]) it was felt that improvements in these would reduce reliance on car based transport.

3.42 Consultations in Highland (Highland Council [2004]), Angus (Angus Council [October 2001, 2003]) and Argyll and Bute (Argyll and Bute Council [October 2001]) covered concerns about road safety. In Argyll and Bute the problem was linked to poor road maintenance in combination with the need to reduce speed and improve driving skills. Respondents in Angus also wanted to see more speed reduction and traffic calming measures.

3.43 In almost all areas, dissatisfaction with public transport has been expressed. The problems cited included frequency, reliability, appropriate timings, direct services, integration and cost. Access to transport was regarded as a particularly high priority issue in the very remote areas ( e.g. Highland (Highland Council [2004]) and island communities (Comhairle nan Eilean Siar [1995, 1996, 2000], AB Associates [1998]). In the Community Planning Partnership areas that included island communities, the frequency and cost of ferry services was an issue (Comhairle nan Eilean Siar [2000], AB Associates [1998], Orkney Islands Council [2004], Orkney CPP [2005]).

3.44 In relation to private transport, the high cost of fuel in the Highlands was raised as an issue as was the higher cost of delivering goods as a result (Highland Council [2004]).

Healthcare

3.45 The emphasis within the local literature was also ( i.e. as in the focus groups) on local access to health care - for example retaining the local GP on one of the Islands (Orkney CPP [2005]). More local access to specialist health care services was seen as desirable in Highland (Highland Council [2004]). Transport to hospitals and other healthcare facilities was raised in the very remote areas of Eilean Siar (Comhairle nan Eilean Siar [2000]). For example in a survey in Eriskay one third of respondents indicated that they had problems reaching hospital or their doctor's surgery. A need for longer surgery hours were raised by two communities in Eilean Siar (Comhairle nan Eilean Siar [1996, 2000]) and in East Ayrshire (East Ayrshire Council). Another consultation in Eilean Siar ( NHS Western Isles Siar [2003]) raised awareness of the special healthcare needs of religious minorities ( e.g. need for female health professionals, hospital food and access to places of worship). Literature in Eilean Siar (Comhairle nan Eilean Siar [2000]), Argyll and Bute (Argyll and Bute Council [2003]), Highland (Highland Council [2004]) and Orkney (Orkney Young Scot [2005]) all raised a need for measures to prevent or to cope with alcohol and/or drug misuse.

Young People's Services

3.46 The literature indicated that significant attention has been paid to finding out about the needs of young people. The importance of providing leisure, recreation and community facilities specifically for young people was identified in several areas (Angus Council [January 2001], Angus CPP [2004], Argyll and Bute Council [2004], East Ayrshire SIP [2000], Comhairle nan Eilean Siar [2000], Highland Council [2004], AB Associates [1998], South Ayrshire Council [2002]). Evidence from a deprived Social Inclusion Partnership area ( SIP) in South Ayrshire (South Ayrshire Council [2002]) pointed to the success of initiatives aimed at improving access to such facilities. In this instance young people in the SIP reported better access to sports facilities and youth clubs compared to residents of less deprived areas. In Highland (Highland Council [2004]) and in Orkney (Orkney Young Scot [2005]), the need to have transport available for young people to reach facilities was cited. Shared recreational facilities were also seen as a solution to problems of provision in Highland (Highland Council [2004]). The need for better education, training and skill improvements for young people were raised in Angus (Angus CPP [2004]) and Argyll and Bute (Argyll and Bute Council [2001, 2004]). The need to increase job opportunities for young people was raised in Highland (Highland Council [2004]). Improved information on issues such as health and well-being were seen as important in South Ayrshire (South Ayrshire Council [2002]). Action to reduce bullying at School was raised in Angus (Angus CPP [2004]) and Orkney (Orkney Young Scot [2005]).

Older People's Services

3.47 The literature in several areas lists the needs of the elderly as being a priority (Argyll and Bute Council [2001], East Ayrshire SIP [2000], Highland Council [2004], Orkney CPP [2005]). For older people, the general point to make is that the normal range of support required ( e.g. hedge cutting, grass cutting, weeding, food, general support), has another dimension in rural areas, mainly due to the problems of access ( e.g. transport to health care services, residential care in local communities). In Dumfries and Galloway (Dumfries and Galloway Council [2003]) there was a call for services that focused more on prevention of problems of old age rather than only providing ones that alleviate the problems once they occur. Also in Dumfries and Galloway, a need was identified to help older people apply for services and benefits they may not necessarily be aware of and to enhance incomes generally.

Education and Training

3.48 In rural areas (Hope st al. [2000]), particularly for households with young children the main issues related to services for children. In particular the future of local primary schools, distance to travel, lack of after school care and school equipment were raised. Distance was seen as a barrier to accessing adult education and training opportunities, as were the costs and timing of courses in Argyll and Bute (Argyll and Bute Council [2002]). Remote access was seen as a solution to this problem in Orkney (Orkney CPP [2005]).

Job Creation

3.49 Consultations and research with residents in Argyll and Bute (Argyll and Bute Council [2000]), Highland (Highland Council [2004]), Orkney ( AB Associates [1998]) and Eilean Siar (Comhairle nan Eilean Siar [1996]) all raised as a priority the need to create jobs and/or encourage business development that would lead to job creation. In Highland the emphasis was on providing opportunities for young people after college and university to prevent population loss. The need to create jobs for young people was also recognised by Eilean Siar. The need to encourage tourism as a job generator was specifically raised in Argyll and Bute and in Highland (Kyle of Sutherland Initiative [2002]). Also in the Kyle of Sutherland it was felt that improvements in tourist infrastructure would lead indirectly to improved job opportunities by encouraging more visitors.

Refuse Collection and Recycling

3.50 The literature review identified refuse collection and recycling as priority issues within several of the CPP areas, particularly in relation to promoting or retaining a clean environment. Litter therefore was a key issue in Argyll and Bute (Argyll and Bute Council [2001]), Angus (Angus Council [January 2001], Angus CPP [2004]) and Orkney ( AB Associates [1998]) as was street cleaning in Angus (Angus Council [January 2001]) and Argyll and Bute (Argyll and Bute Council [2001]). Better recycling facilities was raised as a need in Highland (Kyle of Sutherland Initiative [2002]).

Retailing

3.51 Retail provision was noted as a key issue particularly in the more remote areas of Highland (Highland Council [2004]) and Eilean Siar (Comhairle nan Eilean Siar [2000]) but also in Angus (Angus CPP [2004]). The key issues were the range and price of goods available. In Angus the focus was on young people's needs. In Eilean Siar, one survey revealed that half of those surveyed had commented about the need for better shops. Retention of a post office was a key issue in Eilean Siar, 74% of those asked stated that it would cause problems to respondents if it were withdrawn (Comhairle nan Eilean Siar [2000]).

Telecommunications

3.52 The literature review identified broadband and mobile phone coverage as an issue for young people in Highland (Highland Council [2004]).

Crime

3.53 Anti social behaviour, vandalism and drink/drug related crimes were seen as a concern in most areas. The connection between alcohol and/or drugs and crime was made in Angus (Angus Council [2003]). Education about the use of drugs and alcohol was seen as a solution in Argyll and Bute (Argyll and Bute Council [2003]) and Orkney (Orkney CPP [2005]). Specific mention was made of a need for more visible policing in Angus (Angus CPP [2004]), Argyll and Bute (Argyll and Bute Council [2003]).

Housing

3.54 Residents within some of the CPP areas ( e.g. Argyll and Bute (Argyll and Bute Council [2004]), Highland ( DTZ Peida and NFO Social Research [2003]), Orkney (Orkney CPP [2005]), Angus (Angus CPP [2004]) were concerned about the lack of affordable housing. Concerns were expressed in Highland about the increase in holiday home ownership (Highland Council [2004]). In Orkney there was an issue with affordable housing to attract new worker to the islands, including young people and those with families (Orkney CPP [2005]). Concerns were raised in Highland about the relatively poor quality of housing stock ( e.g. dampness, cost of heating and the cost of structural repairs) ( DTZ Peida and NFO Social Research [2003]). In Dumfries and Galloway a need was expressed for more local residential care accommodation for older people to prevent them being taken to homes located away from their communities (Dumfries and Galloway Council [2003]). An issue raised in East Ayrshire was the long waiting times for appointments with housing officers (East Ayrshire Council).

Leisure Facilities

3.55 The literature review also revealed that leisure, recreational and community facilities, particularly for young people, are identified as a priority issue for rural areas ( e.g. Argyll and Bute (Argyll and Bute Council [2004]), Eilean Siar (Comhairle nan Eilean Siar [January 2000]), Highland (Highland Council [2004]), Orkney (Orkney CPP [2005]), Angus (Angus Council [January 2001]) and East Ayrshire (East Ayrshire SIP [2002]).

Utilities

3.56 In contrast to the groups, little mention was made of issues relating to utilities. In Argyll and Bute (Argyll and Bute Council [2004]) and in Orkney (Orkney CPP [2005]) a desire was expressed for more renewable energy.

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