Surgeons and anaesthetists will be specially trained to work in remote parts of Scotland for the first time under plans to save the country's network of rural hospitals.

Uncertainty has surrounded emergency medical care in the Highlands and islands for years as health boards have struggled to fill vacancies.

Now a long-awaited report commissioned by the Scottish Government on safeguarding the future of hospitals in these scattered communities has been submitted.

It recommends new training programmes to prepare consultants for the wide-ranging demands of working in small hospitals hours from specialists in city centres.

Hiring people to jobs perhaps a year in advance and honing their skills for the exact role is also suggested. There are six rural general hospitals in Scotland, covering communities from Fort William to Orkney and serving more than 150,000 residents, as well as holidaymakers.

However, as doctors have specialised in narrower medical fields NHS managers have struggled to replace consultants who leave. This and rules on doctors' working hours have already threatened services in Fort William, Oban and Wick.

A working group was set up to examine the issues in 2005 and it is understood discussions about how to staff rural hospitals have at times been tense.

The finished report states rural general hospitals should have at least three consultant surgeons, a three-strong consultant-led anaesthetic team and three medical specialists.

It also lists the core services patients can expect to have in their nearest rural general. These include resuscitation, initial fracture management, Caesarean sections, appendix removal and diagnostic tests such as CT scanning.

David Sedgwick, consultant surgeon at Belford Hospital in Fort William, said: "What this report does is define the rural general hospital. In particular, it confirms they have the vital 24:7 consultant-led service in medicine, surgery and anaesthesia."

Programmes for teaching staff the necessary skills have already been devised.

The report says anaesthetists should have experience in a range of areas including niches such as transporting very ill adults and children and resuscitating newborn babies. Surgeons should also study a broad spectrum of medical fields including gynaecology, ophthalmology and neurosurgery.

Mr Sedgwick said: "For the first time a blueprint for training consultants and GPs has been devised so that appropriately trained doctors can be recruited to provide community and hospital health care to these communities."

Professor Neil Douglas, chairman of the Academy of Medical Royal Colleges in Scotland, which brings health professional bodies together, warned there were still issues to be addressed.

He said: "We have a major job to do to make sure people want to work in these locations. One of the things that requires quite a lot more work is not only to make sure medical students get exposed to these settings but also trainees (junior doctors), because it is less likely you will want to work in these places if you have not enjoyed working there before."

Community health care is also examined in the report. It describes GPs, who can be isolated, joining forces to arrange the kind of pro-active care which can prevent people falling ill.

A Scottish Government spokeswoman welcomed the report, saying it "presents a model of safe and sustainable services for patients living in rural areas".