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RuralGP.com at #ruralwonca

Today marks the start of the 14th WONCA World Rural Health Conference, being held in Cairns, Australia.

The programme is set to contain a fantastically diverse range of research and workshops covering everything from improvements in patient care, to developing new and effective ways to collaborate across boundaries in rural health.  You can follow the events on twitter using the #RuralWonca hashtag, and already there has been a huge number of comment and links

View the WONCA Rural Conference programme

So far, the vibe at #RuralWonca has been great… benefitting from Cairns hospitality (boosted by a dynamic and helpful team from ACRRM) and a stimulating range of input from stalwart experts in rural medicine, to young, enthusiastic students and young doctors.

Thursday saw a full day of proceedings for the WONCA World Working Party for Rural Health – with the annual Council meeting held in spectacular surroundings of a seminar room looking directly onto rainforest.  As well as hearing about events from the last year, and sorting out logistics for yet another busy year ahead, there was debate about how best to support member organisations and do everything possible to support the growing number of student and young doctor organisations.  The highlight of 2018 is set to be the 15th World Rural Health Conference.  Crumbs, we haven’t even started the 14th conference yet, but for a taster of what’s in store – in New Delhi – see the video below!

Friday brought the World Summit on Rural Generalist Medicine.  The concept and importance of rural generalism in health ecosystems is reaching high levels of resonance now within Australia (where political support for recognising this is higher than ever), and much further afield in both ‘developed’ and ‘developing’ nations.  It is clear that empowering rural generalism within healthcare systems has never been more important, with absolute needs to train future doctors in medical complexity, meet the demands of an ageing population and achieve the levels of health service efficiency that are often more easy to find in the generalist setting.

The Summit also saw the launch of the Japanese Rural Generalist Programme: a major achievement and indicative of the direction that other countries are likely to go too, not least through the inspiration that these developments bring.

You can follow tweets from the Summit meeting using the hashtag #RuralGeneralist

And now for the main event.  This looks set to be a stimulating and busy few days ahead, bringing together an enthusiastic and dedicated group of international confreres giving the opportunity to recognise and drive forward international innovation and collaboration in rural health.  We hope to feature a number of interviews and reports on RuralGP.com over the next few days, like we did with the last conference in Dubrovnik, between a very packed and interesting programme of events.

Follow the WONCA World Rural Health Conference on Twitter:

#ruralwonca

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What happens when Deep End goes Rural?!

Many readers will be familiar with the Deep End project, originating in Glasgow but which has spread far and wide in describing the work of GPs working in areas of urban deprivation.  The original project brought together 100 general practices serving the most socio-economically deprived populations in Scotland.  The project team has carried out a fantastic amount of work to highlight the impact of inequalities on prevalence of medical conditions and access to healthcare.

So what happens when a Deep End GP (or a GP and GP trainee, to be precise!) travel out for some time in a remote island practice?  Dr Maria Duffy and Dr Elizabeth Dryden did exactly that, when they travelled to Benbecula to spend a week with rural GP Dr Kate Dawson… and produced this short video of their experience…

 

You can follow the Deep End project on Twitter – see below.

We look forward to the sequel!

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Setting the right path for Canadian rural practice

Thanks to Dr Douglas Deans for highlighting this recently-published report from a collaborative taskforce in Canada, which has been set up to identify positive actions that are likely to result in a more robust, sustainable and supported rural health service in Canada.  The collaboration comprises the Society of Rural Physicians of Canada (SRPC) and the College of Family Physicians of Canada (CFPC).

The report is refreshingly succinct, relevant and pragmatic, and likely to be of interest to anyone who is trying to work out how to articulate the balance between effective action and strategic direction to influence national policies, in the context of conflicting and difficult policy decision-making.  Many rural GPs and educators will be familiar with the challenge of identifying realistic interventions which can translate into more sustainable recruitment and retention to rural communities, so this road map from Canada is likely to be a welcome read.

Recruiting and retaining family physicians in rural areas through financial incentives alone is not enough.  We need a coordinated and thoughtful alignment of education, practice policies, community involvement, and government support.  Family medicine residents who are educated in rural training sites, who immerse themselves in the communities and who see themselves supported by peers, specialists, health care providers, and evolving distance technologies, are more likely to choose rural and stay rural.

Dr Trina Larsen Soles – SRPC Co-Chair of Taskforce

News Release   Download the Report

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Rural GP Kate MacGregor is RCGP Scotland GP of the Year

From Argyll to Inner City Glasgow, GPs Awarded for Their Outstanding Care

The Royal College of GPs Scotland has announced the winners of the prestigious, annual GP of the Year and Practice Team of the Year awards.

Dr Kate MacGregor, RCGP Scotland GP of the Year

This year’s recipient of GP of the Year is Dr Kate MacGregor, a GP from Taynuilt Medical Practice in Argyll and Bute, a remote and rural practice. Dr MacGregor was nominated for the award by the family of a patient who suffered with Multiple System Atrophy, a rare condition. Dr MacGregor worked hard to get to grips with the disease, making sure the continuity of care offered to the patient was not broken, co-ordinating the care the patient received with specialists and a wider team, offering her personal mobile number, checking on them while she was abroad, offering care to the family and trying, as far as she could, to ensure that care could be received in the patient’s rural home, saving them difficult seven hour round trips to hospital.

It is Dr MacGregor’s compassion that led the partner of the patient to say that she should be ‘held up as an example to the public of the genuine difference that the GP can make to patients and their families at what can be the bleakest point of their lives.’ He said, ‘I cannot tell you how relieved we were to have a GP take ‘ownership’ of [his partner’s] care,’

The Practice Team of the Year is Garscadden Burn Medical Practice in Drumchapel, Glasgow. An inner city, urban practice, the team form one of the hundred Deep End practices that serve communities in the most deprived areas of Scotland, where Health Inequalities are rife. Dr Peter Cawston, Partner at the practice, and his team have worked to find new ways of working in an effort to improve the health and life chances of their local community. They have attached a Community Links Worker to their team and instigated ‘an entirely different, holistic approach to patient care rooted in the Drumchapel community.’ They offer social prescribing and networking with other local organisations has ‘become the norm’. The team practices what it preaches as a result of these changes and so yoga classes now form part of their own routine.

Speaking from his practice in Dingwall, Dr Miles Mack, Chair of RCGP Scotland, said:

“It is wonderful to see these awards go to two such diverse practices, representing the breadth of communities, and the breadth of GPs within them, who make up Scottish life and health. GPs really are at the heart of Scotland’s communities.

“Dr Kate MacGregor makes me proud to be a GP. The way she has taken on the difficulties blocking good care for her patients is a great example of the lifelong care GPs give families as a whole. Realising that her options from the wider healthcare system were going to be limited for this patient, because of their location, Dr MacGregor showed real gumption, took matters into her own hands and allowed her patient to receive continuous, trusted care beyond what seemed to be possible. That’s great general practice.

“In the case of Garscadden Burn Medical Practice, Dr Peter Cawston and his team have led the way in showing what a practice can offer to its community in times of real stress on the system. They have broadened what they can provide and worked together to build what is a truly inspiring resource for the people of Drumchapel. They are, obviously, an integral part of the community.

“At a time when GP services are under such severe stress throughout the country, these GPs and their teams exemplify just how vital the GP service is to Scottish life and communities. We see 90% of patients’ contact with the NHS in Scotland. It is a career to aspire to and a service that holds our communities together. Let us hope that decision makers’ support for general practice will grow to allow patients this sort of care as an expectation and let us hope that the doctors of tomorrow will be inspired to play such a vital role in their patients’ lives and will make general practice their professional choice.”

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Applications due by 7th April for Scottish Rural GP Fellowships 2017

Just a reminder that the closing date for applications to the Rural Fellowship for 2017 close this Thursday, 6th April. See the links below for more information.

beafellow.ruralgp.com

NES Logo 2005Applications are now being invited for the GP Rural Fellowship Scheme, overseen by NHS Education for Scotland.

The Fellowships offer a fantastic opportunity to build skills and experience in rural general practice, whilst experiencing the challenges and opportunities first-hand – during a well-supported year which includes nine weeks of study leave and a generous study budget.

The Fellowships are located across rural Scotland, from Dumfries & Galloway, to the Shetland Isles, including islands such as Islay, Arran, Skye and the Uists.

Many previous rural fellows have stayed in rural practice, and an article was recently published in the Journal of Rural & Remote Health – highlighting the strengths and successes of the programme which has been running for over ten years.

Rural Fellowship Facebook Page     Rural Fellowship – Official Information

Closing date for applications: Thursday 6th April 2017

Fellowships (one year) commence in August 2017.

Watch the latest video about the Fellowships…

Current Rural Fellow Gemma Munro explains more about her time as a Rural Fellow.

Why be a rural GP?

NHS Highland made this video of rural practice in Kintyre…

 

… and here’s a video from last year featuring some of the current Fellows and others involved with the scheme…

Interested?  We want to hear from you…

All the Rural Fellowship sites will welcome you to chat on the phone or visit and tour round what’s on offer.  We can fix up a chat with current or previous rural fellows, and you can ask questions on our Facebook page.  There is a lot of information available from the websites mentioned already, but sometimes it’s easier to arrange a chat on the phone or Skype… all descriptors of the Fellowships (on the official fellowships page) have contact details where you can find out more.

A couple of years ago we interviewed some of those involved in running the Rural Fellowships.  Hear more from them about what they think the fellowships can offer recently qualified GPs…

Gill Clarke – Fellowships Co-ordinator

gillGill has been running the fellowship scheme now for three years.  I asked her about the opportunities available, and why she thinks the fellowship scheme is a good way to enable recently-qualified GPs to experience rural practice.

Gill is very happy to be contacted about any of the fellowship options.  gillian.clarke1@nhs.net


Angus MacTaggart – Islay Rural GP

angusAngus is one of two principals of Islay Medical Services, which now delivers primary health care across the island, as well as out of hours and hospital services.  He describes the attractions and challenges that he identifies with rural practice.

You can contact Angus at: Angus.mactaggart@nhs.net


Jonathan Hanson – Skye Rural Practitioner (Mackinnon Memorial Hospital)

jonathanJonathan has trained in a multitude of specialties, and has found his ‘perfect’ job requiring constant generalism.  He represents the growing number of ‘acute rural GPs’ who provide hospital-based services as well as out-of-hours GP cover.  With additional strings to his bow such as anaesthetics, the services provided in Broadford mean that patients can frequently be treated locally, instead of facing long journeys to secondary care.

The contact for the Skye Fellowships is now Melanie Meecham: melanie.meecham@nhs.net


Fiona Duff – Primary Care Manager for Caithness & Sutherland (NHS Highland)

fionaFiona oversees GP services to the North of Scotland, which covers a wide geographical area.  Two fellowships are available in this area.  In this interview, Fiona highlights why a move to Sutherland could be a great career move to aspiring rural GPs.

Apologies for the phone interference in this interview, hopefully it is not too distracting!  You can email Fiona at: fiona.duff@nhs.net

 

 

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New Report: Health & Wellbeing in Rural England

Thanks to David Syme for highlighting this report which was published on 11th March 2017.

It offers a comprehensive view of the challenges and positive aspects of accessing and providing rural healthcare in England.

The report mentions eight key ‘health risks’ of rural areas:

  • Changing population patterns
  • Infrastructure
  • Digital access and exclusion
  • Air quality
  • Access to health and related services
  • Community support, isolation and social exclusion
  • Housing and fuel poverty
  • Employment and under-employment

There will of course be similarities between the issues raised in this report, and communities elsewhere in the UK and beyond.

You can download the report from this link.

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Report from Islay: GURRMS Medical Student Conference

Student led conference in Islay provides novel long-term solution to rural GP recruitment

By Keenan Smith, Gregor Stark and Alistair Carr

Six months ago, we were sitting in the Glasgow University Union listening to Alistair explain his plan. He’d just returned from a five week GP placement on Islay where his eyes had been opened to the challenges and excitement that lay in rural general practice.  Despite the recruitment crisis facing general practice everywhere, and rural general practice in particular, he was convinced that if other students could experience what he had, it would inspire them too.

That evening, the five of us formed the Glasgow University Remote and Rural Medicine Society (GURRMS).  Our founding goal was to host a conference with a real and lasting impact.  With a message that no delegate could ignore: rural GP provides an exciting and dynamic career that should not be written off as a sleepy backwater of a career.

We wanted to create something that would change not just how 60 medical students thought, but that would become a staple of the undergraduate social and educational calendar – changing perceptions for years to come.

If we were going to make that much of a difference, we were going to have to think big.  We knew this had to show off everything that rural practice had to offer and that this meant going to Islay.

The Gaelic College in Bowmore was the conference venue

To say we didn’t have doubts would be a lie, we had thousands, but the largest was the central premise of the entire project: if we offered this to students, would they even want to come? A close second to this was: how would we find the funding for a conference involving the immense logistical challenges of providing transport, accommodation, and catering in an island with a permanent population of 3,500.

Despite our reservations our 60 delegate tickets sold out within four and a half hours – clearly demonstrating the demand among medical students for more exposure to rural practice. Following this, we were successful in securing sponsorship from organisations that were able to appreciate the vision and scope of what we were trying to achieve.

Dr Angus MacTaggart explaining the joys of being a rural GP

When Friday 10th of March came around, every seat in the Gaelic College was filled with eager students. Most were from Scotland but some had come from as far away as Plymouth, Oxford and Hull.

A spectacular view across Loch Indaal was the backdrop to the inaugural National Undergraduate Remote and Rural Medicine Conference. The morning session started with a talk by Dr Angus McTaggart defining what rural medicine is and the rewards it can offer. This was followed by the EMRS team talking about their role and how they interact with rural GPs.

EMRS doctors Michael Carachi and Kevin Thomson

Following a short break Dr Kate Pickering talked about the importance of medical leadership, after which a workshop took place. This gave the opportunity for two of Islay’s retired GPs, Drs Chris Abell and Sandy Taylor, to engage the students in a discussion about the benefits and challenges of working in a rural environment. Simultaneously to this another workshop took place, led by the Rural GP Fellows Drs Jess Cooper and Durga Sivasathiaseelan, leading a discussion about how to act in a rural emergency and also providing information about the Rural GP Fellowship programme.

During lunch the students chatted with patients who had volunteered to come in to speak about their experiences of rural healthcare and also to give a flavour of island life. Following lunch, Mr Stuart Fergusson kicked off with a talk about rural surgery in Scotland, after which Professor John Kinsella, Chair of SIGN Guidelines, gave a talk about the limitations of guidelines in a rural setting where he made the interesting comparison of rural medicine to the ICU environment.

Obligatory visit to sample local produce!

After another break, with more excellent catering by the Gaelic College team, the EMRS guys provided a brief overview of the realities of pre-hospital care which was then followed by five student presentations. These provided a showcase of the projects that students have undertaken whilst on rural placements or undertaken during intercalated degrees. The educational content of the day finished with a panel discussion about what Realistic Medicine is and how that applies in the rural context.

The Saturday was used to explore rural life and further experience the community we were being invited to be a part of. Some of the students explored the beautiful scenery by going for a hill walk and some participated in a joint RNLI and coastguard training exercise which involved three of the students being winched out of the sea. For the students that had caught wind of Islay’s whisky reputation, a tour of the Bruichladdich distillery was arranged where they were treated to some proper Islay hospitality.

Students participating in the Saturday hill walk

The informal feedback we have got thus far has been overwhelmingly positive: certainly more than one rural elective is being sought after last weekend. A recurring theme has been how impressed students were by the strength of the island’s community and the generosity of the locals.  Formal feedback is in the process of being collected and will be made available in due course.

The 2017-18 GURRMS committee has now been elected and have exciting plans for the future. Watch this space!

GURRMS 2017-18 committee – what does the future hold?

Cool shades featured throughout the conference!

GURRMS would like to thank all our speakers: Dr Angus MacTaggart; Dr Michael Carachi and Dr Kevin Thomson; Mr Stuart Ferguson; Dr Kate Pickering; Dr Jess Cooper and Dr Durga Sivasathiaseelan; Dr Chris Abell and Dr Sandy Taylor; Professor John Kinsella; Cameron Kay; Beth Dorrans; Josie Bellhouse; James McHugh; Eloise Miller and Hannah Greenlees.

Also our sponsors: the Royal College of Physicians and Surgeons of Glasgow; the Rural General Practitioner Association of Scotland; the Faculty of Pre-Hospital Care of the Royal College of Surgeons of Edinburgh; the University of Glasgow; NHS Highland and Bruichladdich distillery.  And finally a huge thanks to all of the medical team of Islay for your support and for believing in us.

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New: Historical Perspectives on Rural Medicine

A key new text reflecting the development of rural practice over the last century, has just been published by the Wellcome Witnesses to Contemporary Medicine series.

Introduced by Professor Geoffrey Hudson, this volume comprises edited transcripts of two Witness Seminars held in 2010 and 2015 on the history and development of rural medicine. Participants in London and others world-wide contributing via video link, addressed the development of the curriculum for teaching rural and remote medicine; the importance of community involvement; and the growth of national and international networks and organizations. Discussion also included: the impact of specialization; professional identity and status; the relationship to other health professions; technological developments; and the challenges of isolation.

The collection of evidence for the series included input from UK rural GPs Jim Douglas, Gordon Baird, John Wynn-Jones, Iain McNicol, Jim Cox and David Hogg.  International stalwarts included Bruce Chater, Roger Strasser, Jim Rourke, Sarah Strasser, Ian Couper, Richard Hays, Oleg Kravtchenko, Tanja Pekez-Pavlisko and Jo Scott-Jones.

Subjects ranges from pre-NHS rural practice to modern day technology, and the use of that for activities such as Practice Based Small Group Learning, and initiatives such as the Northern Ontario School of Medicine, and Scottish GP Rural Fellowships.  Themes include 24-hour working, the psychosocial stresses of rural medicine, and the interface between generalist practice and secondary care.

Making this tome available as a free online PDF means it can be easily accessed and searched, including for future research activity.  You can also purchase it online at amazon.co.uk (RuralGP.com does not receive any commission from this).

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Recruiting now for Scottish Rural GP Fellowships 2017

beafellow.ruralgp.com

NES Logo 2005Applications are now being invited for the GP Rural Fellowship Scheme, overseen by NHS Education for Scotland.

The Fellowships offer a fantastic opportunity to build skills and experience in rural general practice, whilst experiencing the challenges and opportunities first-hand – during a well-supported year which includes nine weeks of study leave and a generous study budget.

The Fellowships are located across rural Scotland, from Dumfries & Galloway, to the Shetland Isles, including islands such as Islay, Arran, Skye and the Uists.

Many previous rural fellows have stayed in rural practice, and an article was recently published in the Journal of Rural & Remote Health – highlighting the strengths and successes of the programme which has been running for over ten years.

Rural Fellowship Facebook Page     Rural Fellowship – Official Information

Closing date for applications: Thursday 6th April 2017

Fellowships (one year) commence in August 2017.

Watch the latest video about the Fellowships…

Current Rural Fellow Gemma Munro explains more about her time as a Rural Fellow.

Why be a rural GP?

NHS Highland made this video of rural practice in Kintyre…

 

… and here’s a video from last year featuring some of the current Fellows and others involved with the scheme…

Interested?  We want to hear from you…

All the Rural Fellowship sites will welcome you to chat on the phone or visit and tour round what’s on offer.  We can fix up a chat with current or previous rural fellows, and you can ask questions on our Facebook page.  There is a lot of information available from the websites mentioned already, but sometimes it’s easier to arrange a chat on the phone or Skype… all descriptors of the Fellowships (on the official fellowships page) have contact details where you can find out more.

A couple of years ago we interviewed some of those involved in running the Rural Fellowships.  Hear more from them about what they think the fellowships can offer recently qualified GPs…

Gill Clarke – Fellowships Co-ordinator

gillGill has been running the fellowship scheme now for three years.  I asked her about the opportunities available, and why she thinks the fellowship scheme is a good way to enable recently-qualified GPs to experience rural practice.

Gill is very happy to be contacted about any of the fellowship options.  gillian.clarke1@nhs.net


Angus MacTaggart – Islay Rural GP

angusAngus is one of two principals of Islay Medical Services, which now delivers primary health care across the island, as well as out of hours and hospital services.  He describes the attractions and challenges that he identifies with rural practice.

You can contact Angus at: Angus.mactaggart@nhs.net


Jonathan Hanson – Skye Rural Practitioner (Mackinnon Memorial Hospital)

jonathanJonathan has trained in a multitude of specialties, and has found his ‘perfect’ job requiring constant generalism.  He represents the growing number of ‘acute rural GPs’ who provide hospital-based services as well as out-of-hours GP cover.  With additional strings to his bow such as anaesthetics, the services provided in Broadford mean that patients can frequently be treated locally, instead of facing long journeys to secondary care.

The contact for the Skye Fellowships is now Melanie Meecham: melanie.meecham@nhs.net


Fiona Duff – Primary Care Manager for Caithness & Sutherland (NHS Highland)

fionaFiona oversees GP services to the North of Scotland, which covers a wide geographical area.  Two fellowships are available in this area.  In this interview, Fiona highlights why a move to Sutherland could be a great career move to aspiring rural GPs.

Apologies for the phone interference in this interview, hopefully it is not too distracting!  You can email Fiona at: fiona.duff@nhs.net

 

 

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BASICS Scotland Paediatric Tele-Education Course

basics_logo_new_large_csNews just in from BASICS Scotland about their latest educational offerings…

We are pleased to announce the latest start date for our popular Paediatric Tele-Education Course

Book now for 24th April Start!

This popular course is specifically designed to refresh your knowledge of Paediatric Emergency Medicine

The course covers 9 topics over 9 weeks presented live over internet based video conferencing and recorded for you to watch at your own convenience.

Live sessions will take place on Tuesday evenings 7pm-8pm to allow those with busy schedules during the day to participate.

Topics covered include:

  • Fever and Meningitis
  • Head Injury
  • Seizures
  • Allergy & Anaphylaxis
  • Asthma
  • LRTI
  • Epiglottitis & Croup
  • Gastroenteritis & Dehydration
  • Pain Relief

Can’t make the live sessions?

Don’t worry, each live session is recorded and made available on our E-learning website for you to view in your own time – access to course materials ends 6 weeks after last live session.

Book Now as closing date for registration is Friday 7th April 2017.

What does it cost?

The cost for this course is:

  • £135 for BASICS Scotland members
  • £150 for non-members

To download the information flyers and application form, visit the BASICS Scotland Tele-education page.

To help evaluate the benefits and cost-savings of Tele-education and Remote Skills Training, BASICS Scotland have commissioned a report which can be viewed on the BASICS Scotland website.

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