Archive | Innovation

GURRMS18 conference a massive success in Portree

Last week we highlighted the programme for the GURRMS (Glasgow University Remote & Rural Medicine Society) conference in Portree.  Over 80 students and delegates attended this event last weekend, and as expected, it was a superbly positive event that covered many aspects of rural practice in Scotland and beyond.

James McHugh, GURRMS President

It must be highlighted once again, that tickets for this event sold out within 15 minutes of becoming available online.  Behind the conference was a ton of work, ably overseen by GURRMS President and final year Glasgow medical student, James McHugh – who compered the activities along with his committee with aplomb, tight organisation and enthusiasm.

A good line up of varied speakers featured on the first day of the conference.  Dr Emma Watson opened the conference, and after this I gave a presentation on ‘Rural GP – Is it What It’s Cracked Up to Be’ – with an honest portrayal of opportunities and challenges that exist within a career of rural practice.  I used some of my own stories to highlight the privilege that many of us feel in being able to provide primary care (along with all the additional services of rural practice) to our communities, along with the breadth of practice that keeps days interesting, challenging and demanding of effective teamwork.  We touched upon some of the current challenges of getting health policy adequately rural-proofed, and reflected that this is a worldwide challenge – which makes for truly international career opportunities.

This was followed by Dr Luke Regan talking about ‘Why I Love My Job and You Should Too’ – he is an Emergency Physician at Raigmore Hospital in Inverness with experience of delivering rural emergency care both in Scotland and Australia. His talk included a simulated walk-through of a rural cardiac emergency, ably assisted by student ‘volunteers’ from the audience.

Prof Phil Wilson explored the research and academic opportunities available to rural GPs, and considered the ethical obligation on us all to appraise and share lessons learned from service and therapeutic innovations.

Phil Wilson on Scottish trials to use transcranial ultrasound to diagnose thrombolysable stroke

Dr Jacqueline Bennebroek then offered an insight into her work as a Rural Practitioner at the MacKinnon Memorial Hospital in Broadford, Skye.

Jacqueline on her role as a Rural Practitioner on Skye

Ben Price on the role of BASICS Scotland and emergency responders across rural Scotland.

Workshops were run on ‘The Lesser Spotted BASICS Responder’ by Dr Ben Price, and a Training Perspective of Rural Practice by Dr Ian Pooleman and Dr Ailsa Leslie.  Three well-delivered presentations in Pecha Kucha style featured from Duncan Stewart, Isla Kempe and Ellen Gardner on their student experiences, from elective placements to reflections on being a student on the new Longitudinal Integrated Clerkship now offered to Dundee 4th year students. The verdict – a big dose of reassurance that LICs offer a fantastic environment for learning medicine, and the fears about having gaps in knowledge did not materialise.  Indeed this has been shown in repeated reviews of LIC learning that students conclude their LIC placements with greater knowledge, insight and propensity to pass exams.

Rural surgical legend Dr David Sedgwick talked about his Life and Work as a Rural Surgeon over 25 years – most of which was at the Belford Hospital in Fort William.  The fact that David had just arrived back from teaching in Rwanda the previous day was particularly impressive, and highlighted again the role that rural doctors and surgeons can have in global healthcare.

Prof Sarah Strasser during one of the student workshops

The keynote talk ‘Rural Health Worldwide’ was delivered by rural health stalwarts Prof Roger Strasser and Prof Sarah Strasser.  They had travelled into Scotland the previous day, covering even more impressive mileage than David Sedgwick… it is perhaps testament to the GURRMS committee that they facilitated such experienced input, and that Roger and Sarah were willing to travel from Canada and Australia respectively to make it to Portree.  Their talk was followed by a particularly engaging question and answer session, and it was clear that delegates were inspired and enthused by the perspectives that Roger and Sarah brought to the conference.

10 Skills of a Rural Doctor – from talk by Roger and Sarah Strasser

The day concluded with an evening reception including ceilidh.  The next day GURRMS successfully ferried delegates across north west Scotland – with some walking in nearby scenery, some opting for whisky tasting, some going for mountain rescue training and some travelling to the Western Isles for a 2 day trip to see the hospital in Stornoway and the surrounding area.

Well done once again to the GURRMS Committee for a well-organised, good-natured and inspiring conference.  We hope to see plans develop for GURRMS19 next year – and we hope that the Scottish rural GP community will support the event once again.

More photos below…

 

 

Continue Reading ·

International research into rural young people’s views

Research into rural youth launched to coincide with the Year of Young People

An initiative designed to research and better understand rural young people, aged 18-28, has been launched. The Rural Youth Project coincides with the 2018 Year of Young People and will combine an online survey, year-long in-depth video logs (vlogs) of 15-20 rural young people and a Rural Youth Ideas Festival.

The target countries for the research are: England, Scotland, Wales and, internationally, Austria, Australia and the USA.

Collaborative

The initiative is a social enterprise venture and is the brainchild of Jane Craigie and Rebecca Dawes. The Rural Youth Project has the support of partners interested and engaged in the rural youth ‘space’, they are LANTRA Scotland, the Scottish Association of Young Farmers (SAYFC), Scottish Enterprise, Scottish Rural Action, Scottish Rural Network and YouthLink Scotland, and will be managed by Jane Craigie Marketing.

Inspired by their participation in leadership initiatives, including the Scottish Enterprise Rural Leadership Programme and the Windsor Leadership Programme, Jane and Rebecca aim to identify and engage young rural leaders to help them drive positive change within their local rural communities.

“Rural young people are fundamental to the vibrancy, energy and economic outlook of rural places,” explains Jane Craigie. “We wanted to better understand what young people perceive their challenges and opportunities to be, as well as gaining a better understanding of their degree of optimism for the future.”

Important to understand the needs of rural young people

Rebecca Dawes, with her background in the SAYFC, added that there is a real lack of insight into this important group within our rural communities, hence the decision to run this project.

She said: “the research to date amongst rural young people, both nationally and internationally, has been fragmented, but what we do know is that rural areas have a lower percentage of 16-34 year-olds and evidence suggests that migration of young people away from rural areas hinges on education, employment opportunities, housing and public transport availability – some of the many research areas that we are surveying.

“With so much emphasis on youth this year, we want to make sure that rural young people have a voice that will be heard, what better way is there to share their outlook?”

The project, which will be repeated annually, aims to research a wide range of rural young people including those working in education, farming, retail and hospitality, as well as those who are in full time education, or unemployed.

“The project, which will be repeated in 2019-22, has the bold ambition to better inform society and policy-makers about the vibrant talent that is held amongst our rural youth, and to compare our findings with those from other countries around the world.

James Rose explained why the Scottish Rural Network are supporting the project “The future of rural Scotland is in the hands of its young people. In 2018, the Year of Young People, The Scottish Rural Network (SRN) is supporting the Rural Youth Project to gain a vital insight into what matters to young people in rural areas and bring together the people who will define our rural communities in the years to come.”

Penny Montgomerie from SAYFC added “Young people need to have the confidence to drive policy and influence decision makers on matters that impact them rather than relying on older generations to make presumptions on their needs.”

Jane Craigie Marketing will use their wide-reaching networks within the international agricultural and rural leadership community and the International Federation of Agricultural Journalists to publicise the project and its outcomes.

The survey will open on 26 January and close on 30 April 2018. The incentive for completing the survey is a pair of tickets to the TRANSMT Festival in Glasgow on 8 July or a pair of tickets for ButeFest 2018.

The 2018 Project will culminate in a three-day Rural Youth Ideas Festival, run by Jane Craigie Marketing on 20-22 July in rural Scotland and an action plan developed by the Project partners.

The survey can be reached via the Project website www.ruralyouthproject.com

Continue Reading ·

The Belford: an example of great quality rural healthcare

Dr Patrick Byrne, consultant at the Belford Hospital in Fort William, was involved in hosting a visit from a delegation from the Philipines.  This article featured in Lochaber Life Magazine earlier this month.  It has been reproduced here with the kind permission of Iain Ferguson of the Write Image (picture credits to Iain too).

PHILIPPINE VISITORS TO BELFORD

Dr Patrick Byrne

The Belford Hospital continues to punch above its weight on the national and international stage, welcoming a delegation from the Philippines a few weeks ago.  The visit was part of a week-long study tour to the UK by Presidents and delegates from the Philippine Royal Colleges of Physicians, Surgeons, Paediatricians and Obstetricians and Gynaecologists, alongside officials from the Philippine Ministry of Health.

Teaching & training for most healthcare providers in the Philippines tends to be concentrated in the largest hospitals in cities, ignoring the district and rural locations.  This is in contrast to the UK where every hospital has a role to play and sometimes the best experiences and training is to be found in the smallest facilities, where one-to-one supervision from consultant teachers is often the norm, not the exception.  The purpose of their study tour was to learn from UK practices, specifically how supporting and investing in rural hospitals leads to a more efficient healthcare system across the region, and the country.

Led by the immediate Past President of the Royal College of Surgeons, Mr Ian Ritchie (who has family ties to Corpach), the delegates specifically requested to see an example of good training in a small hospital of approximately 100 beds.  Mr Ritchie replied, “I can bring you to a 34-bed hospital where training and patient care is not just good, but excellent”.  The importance of this visit, was underlined by the presence of the most senior NHSH personnel – Prof Elaine Mead (Chief Executive Officer), Mrs Gill McVicar MBE (Director of Operations) and Dr Emma Watson (Director of Medical Education).

Each, in turn, reiterated the importance of consultant-led services and training at Belford Hospital, both now and going forward. However, it was Miss Alison Bradley, a former Belford trainee, now a senior surgical registrar in Glasgow, who captivated and inspired everybody, proving that rurality is no impediment to ambition; quite the opposite, in fact, as she explained the details of her PhD research into pancreatic cancer.

Mr Ritchie said, “It was very clear to all who visited that numbers of beds is not an indicator of good training, it is that key relationship between a trainer and a trainee which, in Fort William, you all demonstrate to a very high degree.  The high point was certainly the Belford.”  In her letter of thanks, on behalf of the College of Paediatrics, Dr Cynthia Daniel echoed this, adding “I am certain with you and the rest who share the same passion for training and service, Belford Hospital should be safe for the next 150 years and beyond”.

Continue Reading ·

Reflections on an LIC in Lochaber

Lewis Mundell, student of Dundee University, recently completed a Longitudinal Integrated Clerkship in Fort William as part of his medical school training.  This article featured in Lochaber Life Magazine earlier this month.  It has been reproduced here with the kind permission of Iain Ferguson of the Write Image (picture credits to Iain too).

Training to be a Doctor in Lochaber

Lewis Mundell, LIC Student

I have spent almost a year in the Lochaber community, training as part of a project undertaken in partnership between the University of Dundee and Tweeddale Medical Practice. This is a trial project and a first in the UK. The purpose: to improve the teaching of medical students.

Other Medical Students in Dundee mainly spend their time in hospital in the form of four-week placements in different medical wards. The project I have been doing under the supervision and guidance of Dr Jim Douglas is focused on learning in the community where 90% of healthcare takes place. A focus is spent on patients, to learn from them rather than tutorials or textbooks.

Although the majority of my time has been spent in Tweeddale, 40% of my time has been spent in Raigmore and the Belford Hospital as well as working with Physiotherapists, District Nurses and Pharmacists. By being in the community, I have gained a better perspective of health care, understanding the challenges patients face when the GP simply says ‘visit the Physiotherapist’.

The most unique part of this year has been the ‘Patient Journey’. This has allowed me to follow people through their health care experience from ‘cradle to grave’. I have followed mothers through pregnancy; seen children cope with infections; learned from teens struggling with depression; saw life-saving surgery; watched a patient fight cancer and the hardest part – the privilege of being present at the end of life. Each of these experiences has been humbling and I will never forget the people involved.

Many medical ‘experts’ have said ‘how can a student learn everything he needs to know without being trained in a city, in a ‘centre of excellence’? I would argue that a community like Lochaber is a centre of excellence as it is a centre of people, all actively engaged in training a medical student. In comparison to cities, where community is reduced, Lochaber can recognise its own need for doctors and other health care professionals and therefore its need to train these professionals locally.

Once again I would like to thank you all for allowing me to join your community. I have learned so much! I will definitely consider returning to this area for future training and possibly long-term employment when I’m qualified. It is impossible to list the many people who have helped me, but a special thanks goes to Dr Jim Douglas and all the staff at Tweeddale, Dr Amy Macaskill and the CMHT, Theresa Mackay and the Midwifery Team, Belford Staff, Jaquai Parfitt, Staff at Raigmore, Fleming & Fleming, Lloyds Pharmacy, Macmillan Cancer team and not least the Scottish Ambulance Service.

Continue Reading ·

Prof Paul Worley – Rural Health Commissioner for Australia

In a really interesting development for rural health internationally, Australia has appointed its first Rural Health Commissioner.

Charged with the responsibility of overseeing and driving a wide range of activities around supporting ‘rural generalism’ the post offers a chance to provide more co-ordinated leadership across domains, regions and disciplines to make rural health strategy more cohesive in Australia.

Professor Paul Worley has been appointed as the first Rural Health Commissioner and this move has been widely welcomed across the rural health community.  He brings an impressive portfolio of experience to the post, including in clinical, academic, educational and strategic development aspects of rural health.  You can watch Dr David Gillespie MP announce the post, and Prof Worley outline some of his visions for the future (at 5min 55s), in the video below.

Twitter and other social networks – including the WONCA Working Party on Rural Health international email list – have been buzzing with positivity about the new post, and it is likely that this approach might pave the way for similar developments in other countries.

In Scotland, we are watching developments with interest.  Rural medicine and health services are of significant importance in Scotland’s National Health Service – 98% of Scotland’s land mass is rural, and 18% of Scotland’s population live in a rural area, with many more flocking to rural areas during holidays.  And yet despite considerable aspects of medical care being delivered by GPs and primary care teams, within community hospitals, A&E units and facilities outwith the usual remit of GPs, there continues to be relatively little in the way of co-ordinated clinical governance and strategic unity to link rural and isolated practitioners together.  These services provided by rural GPs remain considered to be on the ‘fringes’ of general medical practice.  Therefore the opportunities created by appointing an experienced individual to provide leadership, stimulate innovation and inspire positive approaches, are sorely needed in areas other than Australia.

Having met Paul at the WONCA World Rural Health conference in Cairns this year, I’m delighted to hear this news and inspired to think that this is a situation to watch closely.  I have little doubt that we will be reflecting that Scotland could benefit from a similar approach in the near future.

Well done Australia, and all the folks involved in making this happen.  These are exciting times.

Continue Reading ·

Students present Bright Ideas for Rural Practice

This year, the Rural GP Association of Scotland has once again run its student conference scholarship programme.  This is a significant investment for RGPAS, which uses money raised into its Educational Trust fund to support these scholarships.  The scholarships offer heavily-subsidised tickets to enable undergraduate students in the UK to attend and participate in the annual RGPAS conference.

To apply, students were asked to submit a 60 second sound or video clip explaining their Bright Idea for Rural Practice.  We are delighted to feature the winning entries below.

A number of these will be selected for PechaKucha-style presentation at our conference in November.  You can read more about the scholarships here, and also a great write-up of last year’s conference by one of the scholarship holders then, Catherine Lawrence from Hull & York Medical School.

There is still time to sign up to the conference, which takes place from 2-4 November 2017 in Inverness.  £130 for GPs or £65 for trainees gets you two-and-a-half days of quality CPD, along with a conference dinner (and wine).  It’s a great way to catch up with like-minded colleagues, and hear updates on clinical and non-clinical topics that are relevant to rural practice in Scotland.

Well done to all our scholarship winners.  We look forward to meeting you in Inverness!

Rohan Bald (Glasgow): Tackling Loneliness

Emma Bean (Glasgow 5th Year): Drones

Josephine Bellhouse (Glasgow): Improving Use of Communication Technology

Katherine Cox (Glasgow 4th Year): Developing Videoconferencing Peer Support

David Gibson (Glasgow): Awareness of Rural Medicine as a Career

Haiyang Hu (Glasgow): Access to Mental Health Services

Saskia Loysen (Glasgow): Increasing the use of Telemedicine (and pyjama bottoms)

Eloise Miller (Glasgow): Develop Rural Medicine Intercalated Degrees

Danielle Parsons (Aberdeen 4th Year): a Rural Medical School for Scotland

Gregor Stark (Glasgow 5th Year): Rural Research Consortium

Rosslyn Waite (Dundee): Improving Connectivity

Hannah Webb (Glasgow 2nd Year): Access to Sexual Health Services

Continue Reading ·

STI Management: Syndromic vs. Laboratory-based Approach

Clinical considerations and ethical deliberations from a rural Caribbean clinic

Dr Josie Reynolds recently contacted RuralGP.com to offer to write about her experiences and observations from rural Jamaica.  We’re delighted to feature the first of these articles here…

As doctors, we are most comfortable with our diagnoses when we have investigative results to confirm them. This is especially true for those trained in high-income countries, as more and more sophisticated laboratory tests and imaging have become part of everyday practice.

But in rural, remote settings, particularly those of low and middle income countries, the practicality and cost of diagnostic testing can become a barrier to treatment. This barrier is intensified in the management of sexually transmitted infections by the taboo and stigma that surround these conditions.

Because of this it has been argued that a syndromic approach to STI management can be more appropriate to tackle the burden of disease. Syndromic management of STIs works by grouping symptoms and signs of disease into syndromes and treating based on the most common causative pathogen(s), e.g. vaginal discharge syndrome, lower abdominal pain and male urethritis syndrome.

This practical approach in the most resource poor environments can help to tackle high burden of disease, therefore reducing significant morbidity, infertility and increasing spread of infection. In these settings there is a strong argument for forgoing the lab tests and treating empirically.

But what about those settings that fall somewhere in the middle?

At what point is it more appropriate to treat following laboratory testing?

Are there any markers that indicate the tip of balance in favour of a laboratory-based approach?

 

Picture a rural Caribbean health clinic. The mountainous community can seem remote based on the terrible conditions of the roads, but in fact as the crow flies there is only 10 miles to the capital city. There is also fairly regular transport by bus to the city Mon – Sat, and a public run clinic in town which provides free STI testing and treatment (all be it slow).

Community members, however, have very little disposable income and primarily lead subsistence lifestyles. With this in mind, working as a primary care physician at the clinic, I was not keen to send people away without treatment in case they did not go to get testing & treatment and the infection continued to spread. Syndromic management, therefore, seemed the way to go…

But the more I thought about syndromic management – STI management without any laboratory testing – the more negative implications I could think of:

  • Contact tracing – this is still possible, but do you treat all sexual contacts even if symptom free? This could expose numerous people to the risk of unnecessary medications when there is no guarantee that they have the disease.
  • Missing concomitant STIs e.g. HIV – it’s not uncommon for STIs to come in pairs and symptoms are frequently vague or non-existent. Treating syndromically without testing misses the opportunity to pick up some of the more serious infections that may be present simultaneously.
  • Contributing to antibiotic resistance – as one of the biggest threats to modern medicine, antibiotic resistance cannot be ignored. Whilst syndromic management may be the pragmatic approach, the greater picture needs to be considered.
  • Relaxed approach – could syndromic management give patients the impression that STIs are not very serious as no testing is required? Could this apparently relaxed approach translate into less incentive to prevent reinfection?
  • The subtle symptoms – for the barn-door cases, where signs & symptoms are clear and fit neatly into the box, this approach is straight-forward. But what about the grey areas? Or the patients which don’t follow the usual pattern?
  • Impact on doctor-patient relationship – with a less evidence-based approach and therefore greater risk of treatment failure, is there a danger of loss of trust or breakdown of relationship between the healthcare provider and patient?
  • Reliable statistics – guidelines for syndromic management often mention adding in treatment for certain infections, e.g. gonorrhoea, if there are high levels in the region. However, in low-middle income settings, the epidemiological data is less likely to be complete and therefore recorded levels may be misleading.

 

I found myself in a struggling health system, but provisions were not non-existent – should I accept the flaws of the approach and treat syndromically or encourage patients to overcome the barriers and receive a better standard of care overall?

I realised too that part of my reserve for syndromic management linked into a deeper notion: by accepting syndromic management as routine are we reinforcing the idea that disadvantaged people deserve second rate healthcare?

Or perhaps my scientific-based training was blinding me to the benefits of syndromic management? Was my personal desire to get to the bottom of the cause preventing me from putting the important things first?

Either way, it appears to me that a more sophisticated set of guidelines is required from the Global Health Sector to reflect the variations in development of health systems worldwide, rather than a binary choice which may work for some, but not for all.

What do you think? What would you do in a similar situation? Which factors would tip the balance in your decision?

References:

http://apps.who.int/iris/bitstream/10665/82207/1/WHO_RHR_13.02_eng.pdf

http://www.phac-aspc.gc.ca/std-mts/sti-its/cgsti-ldcits/section-4-1-eng.php

http://sti.bmj.com/content/80/5/333

http://applications.emro.who.int/aiecf/web79.pdf

http://siteresources.worldbank.org/INTPRH/Resources/STINoteFINAL26Feb08.pdf

http://hetv.org/resources/reproductive-health/rtis_gep/syndromic_mngt.htm

https://www.idealclinic.org.za/docs/National-Priority-Health-Conditions/Sexually%20Transmitted%20Infections_%20Management%20Guidelines%202015.pdf

http://onlinelibrary.wiley.com/doi/10.1046/j.1365-3156.1999.00360.x/full

https://www.hindawi.com/journals/isrn/2014/103452/

Continue Reading ·

What matters in remote & rural practice? Your input requested…

RuralGP.com has just received this request from Elizabeth, who is seeking contributions to research that she is carrying out into the needs of remote & rural practice in Scotland.  If you are able to assist, please contact Elizabeth directly…

My name is Elizabeth Lemmon, I am a PhD student based at the University of Stirling and currently undertaking an internship at the Scottish Government within the Health and Social Care Analysis Team. The aim of the internship is to carry out some research into remote and rural general practice in Scotland in an attempt to better characterise them in terms of their activities and the challenges they face. I’m currently pulling together data which are publicly available on general practices to improve the evidence base and identify where further data analysis are needed.

I am contacting you to ask if anyone would be interested in sharing their experiences within remote and rural general practice and highlight any areas which you feel are priorities or which need further research?

I understand that there is currently work taking place within the Scottish Government on the Primary Care Evidence Collaborative which is developing a 10-year evaluation framework for primary care transformation. The work I will be doing during my internship on remote and rural practices will help to identify priorities for data, research and analysis and ensure that rural issues are included.

Any feedback is much appreciated!

Elizabeth Lemmon
Scottish Graduate School of Social Science Intern
Health and Social Care Analysis
Scottish Government
Email: Elizabeth.Lemmon@gov.scot
T: 0131 244 3469

 

Continue Reading ·

Podcast from @fakethom and @RuralGPScot highlights #ruralLGBTQ work in #ruralGP

Back in March, the Rural GP Association of Scotland (RGPAS) launched a range of guidance designed to make rural practice in Scotland more accessible to lesbian, gay, bisexual, transgender (LGBTQ+) patients.

At the annual RGPAS Conference last year, held in Inverness, we were delighted to welcome Dr Thom O’Neill to talk about LGBTQ+ inequalities in rural areas, and some of the practical ways that as GPs we can reduce barriers to healthcare.

Thom’s presentation stimulated a lot of discussion, and led to a project whereby he worked with RGPAS to develop factsheets, posters and other materials to help rural GP practices ensure that their services are welcoming to LGBTQ+ patients – especially younger patients.

You can find out more about these resources at: www.ruralgp.scot/lgbtq-plus.

We are aware that since then a number of GP practices have had discussions in their teams about how to make their health services more LGBTQ+ accessible.  We’ve also had a number of international enquiries about this work – including from Canada, New Zealand and Australia – who have been keen to use this work to increase awareness.

Thom has also been asked to adapt the factsheets for secondary care use in some parts of Scotland too.  So, as expected, the theme seems to have resonated with a wide number of clinicians and service managers.

Thom and David recently caught up to discuss how these guidelines came about, and to explore some of the themes of why LGBTQ+ patients seem to face specific inequalities of access to health care – and how rural practice has some unique opportunities to improve this.  We hope to have Thom back to this year’s RGPAS Conference (2-4 November, once again in Inverness – details soon) for an update on what how this work has been developing.

You can listen to the podcast here:

In the podcast above, we make reference to the work of Alex Bertie about recording his experience of seeking help and assistance with gender dysphoria.  Alex’s videos make for some insightful and compelling viewing, but this one is specifically about his thoughts about the GP consultation – and the difference that a more supportive and informed consultation can make particularly at a challenging and difficult time.

Continue Reading ·

Highland innovations in eHealth

Thanks to RGPAS member Dr Richard Weekes for highlighting some fantastic work going on in NHS Highland to innovate eHealth applications aimed at improving access to healthcare in rural settings.

Here’s an introductory video showcasing some of the projects…

…an STV news item about the PILLCAM project in Ullapool to provide easy access to endoscopy facilities – using some very novel technology…

… and more about bringing endoscopy to rural communities…

… and the RAPID project to overcome connectivity challenges in rural Scotland…

Continue Reading · 0