Territorial tensions: misaligned management and community perspectives on health services for older people in remote rural areas

This paper presents findings from a qualitative study investigating older people's health service provision in remote rural Scotland. Comparing stakeholders' perspectives, contested issues were exposed where community members, service managers and policymakers disagreed. Considering these, led to the proposal that fundamental tensions exist between community and management/policy stakeholders' perspectives and these underlie service change conflicts. While highlighting issues for older people's service design, findings suggest that impacts of the current planning process require to be understood, and aspects need to be changed, before the voice of older people can inform local service policy.