The challenge of providing rural healthcare is exacerbated by inequalities that are often subtle and indirect. Complexity is the result of intrinsic and extrinsic factors, which can be more explicit when faced with provision of healthcare within the domain of generalist and isolated practice. These pressures often result in ‘inevitable innovation’ and rural practice continues to offer novel and effective means of addressing the rising tide of complexity in general practice.

I shall consider several scenarios from his experience as a rural GP, and present examples of where he has found and shared innovation which may be replicated in other areas of practice.