I visited Shetland to meet with key NHS Shetland personnel, including Ralph Roberts (Chief Executive), Sarah Taylor (Child Health Commissioner), Kathleen Carolan (Director of Nursing, Midwifery and AHPs), Sheila Fraser (PHN Development Manager), Kate Kenmure (Consultant Midwife), Elizabeth Robinson (Health Improvement Manager), Marc Beswick (Children’s Occupational Therapist), Clare Stiles (Team Leader, Child Health), Julie Kidson (CAMHs nurse), Gemma Passmore (Children’s Physiotherapist). I outlined my Strategic Plan covering all areas of work. The following points were discussed: concerns over identifying children living with domestic abuse; the nature of rural poverty; concerns around home educated children; issues of bullying for children; and a local initiative focussed on children with disabilities. There was a useful discussion on the Early Years work, covering health visitors, parenting programmes (Triple P,and Mellow Parenting), the limitations of applying Family Nurse Partnership in rural communities, and the challenges of Family Centres/Playbus in island communities. It is clear that while there are advantages in working in small communities, the challenges of rural sparsely populated areas are significant and can even rule out specific models as evidenced by the exclusion of Family Nurse Partnership in Shetland.