NHS Highland will design and test new models of care for people living with multiple long-term conditions across the UK’s largest geographical health board area.
NHS Highland is set to play a leading role in one of the UK’s most ambitious health and care research programmes, with new models of rural and remote care for people living with multiple long-term conditions to be developed and tested across the Highlands over the next five years.
As a core partner in the SEISMIC SHIFT programme - Systemic Health Innovation Future Transformation - NHS Highland will receive a share of £6 million in research funding to redesign services around how patients actually experience illness, rather than around individual diseases.
The programme, led by the University of Strathclyde in partnership with NHS Highland, NHS Lanarkshire, NHS 24 and a UK-wide network of collaborators, 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.
A Highland approach to a national challenge
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 will use it as a testing ground for innovation that could be scaled across rural Scotland and beyond.
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.”
NHS Highland’s involvement is organised around three interconnected work streams - whole person, whole system, whole life - each addressing a different dimension of how care is designed, delivered and sustained.
Dr Beth Sage, Co-investigator, Consultant Respiratory Physician and Director of Research, Development and Innovation at NHS Highland, and Co-Lead of the programme’s Whole System work stream, 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.”
What the Highland team will deliver
The first Highland intervention will begin in June 2026 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.
Working with strategy and transformation colleagues, clinicians, allied health professionals, service managers, digital and IT teams, and third sector partners, the project will equip NHS Highland staff with practical systems-engineering tools developed in partnership with the University of Strathclyde, bringing clinicians, allied healthcare professionals in both community and hospital settings and primary care teams out of geographically separate silos into a more connected model.
It will also examine how digital systems, data flows and financial arrangements between primary and secondary care can be redesigned to support symptom-led treatment, develop a rural breathlessness pathway tailored to remote Highland communities in the later years of the programme, and explore how earlier, better-coordinated symptom management can reduce avoidable unscheduled care admissions across the region.
Building capacity that stays in the Highlands
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 SEISMIC SHIFT extension will run from August 2025 to August 2030 and is aligned with Scotland’s Population Health Framework and the wider health board strategy. 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.
Different geography, different solutions
While NHS Lanarkshire, one of the programme’s other NHS partners in one of Scotland’s most pressured urban systems is focused on people presenting with the symptom of breathlessness and reducing waiting times, accelerating diagnosis, and increasing quality of life, NHS Highland’s contribution is shaped by a different set of priorities.
The Highland team will share learning with Lanarkshire colleagues but design interventions specifically for the Highland population: 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.
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.”