Archive | RCGP

RCGP set to hold #RuralGPchat on Wed 26th July 8-9pm

The Royal College of General Practitioners (RCGP) is set to hold a ‘Twitter chat’ about rural general practice – aimed to highlight and discuss the key issues regarding rural general practice in the UK.

You can join the discussion on Twitter on Wednesday 26th July at 8-9pm.

#RuralGPchat

Calling all rural GPs and HCPs, plus patients who receive care through rural general practice – join our #RuralGPchat on…

Posted by Royal College of General Practitioners on Monday, 24 July 2017

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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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RCGP UK Rural Forum Update

RuralGP.com has been provided with this update from the RCGP UK Rural Forum.  Congratulations to Rob on being appointed Chair…

Greetings From Rob Lambourn,  new Chair, RCGP Rural Forum

Hello everyone,

Rob Lambourn

I’d like to introduce myself as new chair of the RCGP Rural Forum. In November 2016  I took over from Malcolm Ward who has done sterling work for the Forum having been  Chair since the Forum’s inception in 2009 –very  many thanks Malcolm.

I work in a small two-handed practice with my wife in Wooler in rural North Northumberland. I have been a member of the RCGP Rural Forum Steering Group, since its inception.  I am also RCGP UK Council member for North East England.  We live in the Scottish Borders with our small children, so know both English and Scottish healthcare systems, albeit the latter from a patient perspective. I am also a longstanding GP trainer and GP advisor to the North East Ambulance Service Clinical advisory Group.

My objectives as Chair are to ensure that the rural health voice is heard, noted and enacted upon both within and outside the College.   To help ensure this I have, in the near future, College meetings with Simon Ashmore and Rebecca Hughes [Executive Director GP Forward View and National Faculty Manager, Operations] and with Professor Nigel Mathers [Honorary Secretary, RCGP]  Outside the College I have forthcoming meetings with the Rural Services Network; an MP who is on the All-Party Parliamentary Group for Health and Social Care; the University of Central Lancashire [who are establishing a rural campus in the Lakes];  NHS England [Midlands and East] who are running a rural event;  GP Training Programmes in North Northumberland and Cumbria [with a view to establishing extended rural training posts].  I will endeavour to keep you posted!

We also have our own Rural Forum Conference and Educational Event on Saturday March 2017 in Glasgow – please come!   We have a full and exciting programme, from ECG interpretation to international comparisons, via CPR updates and child safeguarding [level 3]  – in all an excellent opportunity to learn and refresh skills and knowledge, network with other rural GPs, and help satisfy appraisal and revalidation.  We will also be [briefly] holding our AGM at the Event – if you would like to become involved with the Steering Group please let us know – new faces always welcome.

Best wishes to all,

Rob

Chair, RCGP Rural Forum

You can download the programme and registration form for the RCGP UK Rural Forum educational event by clicking here
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OBE for Dr John Gillies

jgilliesCongratulations to Dr John Gillies, former chair of RCGP Scotland and strong supporter of rural general practice – not just in Scotland but internationally – for his award of an OBE in the New Year’s Honours List.

John has sustained a longstanding interest in the contributions of Scottish rural practice to the wider development of the quality and community-focussed healthcare delivered in general practice.   His support for initiatives such as the GP Rural Fellowship Scheme has been instrumental to their success, and I have personally benefited from John’s mentorship on several occasions, including most recently at the WONCA World Rural Health Conference in Dubrovnik.

Miles Mack, Chair of RCGP Scotland, said: “I would like to congratulate Dr Gillies, both personally and in my role as Chair of RCGP Scotland, for his recognition in the New Years Honours List. This award is richly deserved, recognising his work over many years as a GP partner, academic and leader. 

“In his time leading RCGP Scotland John Gillies defined the role of modern general practice in his paper The Essence of General Practice, broadening the discussion to include compassion as a key attribute in healthcare. As one consequence of this, all Scottish medical students at graduation now receive a copy of a volume of poetry, Tools of the Trade, produced by the Scottish Poetry Library and RCGP Scotland and edited by John.

“His work has been invaluable as RCGP Scotland seeks to ensure general practice is fit for the future. He continues his influential work in international health care with Edinburgh University and his impact on Scottish healthcare will continue to build through his new role as Depute Director of the Scottish School of Primary Care.”

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Opportunity: RCGP Scotland Remote & Rural Lead

rcgpslogoRCGP Scotland’s Membership Liaison Group are looking for a new Remote and Rural Lead.

This role involves acting as the RCGP Scotland lead for remote & rural affairs as part of the Membership Liaison Group: informing the work of the College in Scotland in relation to remote & rural activities through the development and facilitation of relevant programmes of work.

The full Role Description can be downloaded below, which includes further details including information on how to apply. The deadline for applications is 11 December 2015.

For further information, please contact Euan Bailey, Projects Administrator, on Euan.Bailey@rcgp.org.uk, or telephone 020 3188 7750.

Remote & Rural Lead Role Description
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Reflections from WONCA Rural Dubrovnik 2015

wonca_logo_final_01Today I am attending RCGP Scottish Council in Edinburgh.  As part of this, I was asked to report on my experience in attending the WONCA World Rural Health Conference in Dubrovnik – on 14-18 April 2015.  I thought it might be helpful to share this report here.

WONCA Rural Conference, Dubrovnik – 14-18 April 2015

Report to RCGP Scottish Council

In April 2015 I attended the WONCA World Rural Health conference, held in Dubrovnik.  Five months on, it is helpful to reflect back on the experience of attending WONCA Rural, and what I have acted upon since my return from Croatia.

Firstly, I would like to thank RCGP Scotland for financial support to attend the conference.  Such support is effective and appreciated to help release GPs like myself from practice commitments.  It is clear that Scotland has much to share about developing and innovating rural general practice, as well as being able to learn from approaches taken by our international conferères too.

I am also grateful for support from Drs Miles Mack, John Gillies and the RCGP Scotland team in preparing material for the conference.

WONCA Rural 2015 brought together rural practitioners from across the world. Historically there has been a higher proportion from the UK, Eastern Europe, Canada, USA, Australia and New Zealand.  However it is clear that there is growing membership from African and Asian countries, and indeed there are intentions to hold the next WONCA Rural Conference in Africa.

There were many lessons, benefits and conversations during the 4 day conference.  As usual, informal discussion amongst confrères opened up more learning than the conference presentations: and there was plenty of inspiration and quality research/innovation being presented in these sessions. Whilst in Dubrovnik, I posted a number of podcast interviews to this website.

WONCA World President, Michael Kidd, addresses the conference…


There were a number of core themes that I took away from WONCA Rural…

International similarities

Rural practitioners are united by similar challenges and attractions of rural practice. There are often frustrated levels of bureaucracy as a result of providing a wide spectrum of care across traditional domains of healthcare.  From connectivity and immediate care provision, to blurred funding streams between primary care and community hospital work, and a constant difficulty in navigating the politic that goes with negotiations; it was reassuring to listen to more experienced GPs from other countries who have the same issues that we have in Scotland.  Younger rural GPs all express a frustration with the need to ‘learn politic’ and persuasion skills in order to achieve even basic improvements in clinical care. This is made particularly challenging as management training is lacking from most GP training programmes.

Recruitment and retention challenges exist internationally, and there are common approaches to this.  The role of mentorship models is increasing, along with recognition that ‘single handed practice’ is declining in popularity and sustainability – and are being replaced by federated, group or other networked practice models.  There was interest in the GP Rural Fellowship programme in Scotland, which has helped to introduce recently-qualified GPs into rural posts.  However the challenge of filling posts remains ever-present and similar across the world.

We found that one presentation in particular – on the ‘pipeline approach to (rural) GP recruitment‘ – resonated with taking the recruitment challenge in Scotland forward.

It is widely accepted that harnessing the interest and enthusiasm of medical students in rural practice, can be a powerful means by which the attractions (and realistic perspective) of rural practice can be highlighted.   Action is needed to ensure that funding is increased to facilitate greater involvement of undergraduate training opportunities in rural practice; similarly support to trainees in rural practice needs to be protected and expanded.  The John Flynn programme – run by the Australian College of Remote & Rural Medicine (ACRRM) is a great example of what can be achieved by supported training opportunities in rural practice.  Pragmatic support of undergraduates and trainees is vital: appropriately funded accommodation, travel and consideration of the impact on spouses/partners and family.

That said, we are not alone in having to navigate the constraints of geographically-defined training schemes, although there is work especially in Canada and the USA to provide rural-track training programmes, similar to the ones now in place in Scotland.

Social Media

There are numerous networks to join, and participation in these international approaches is important to develop further within Scotland.  Social media is an easy way of reducing professional isolation, and there were several workshops looking at how to encourage others to join the conversations, and improve fluency in its use.  Throughout the conference, the twitter hashtag #woncarural2015 was used and a search for this now will reveal the active conversations taking place at the time.

I use Twitter regularly to keep an eye on recent trends/new guidelines etc.  It was great to meet some of the faces behind these twitter profiles!

confgroup

@davidrhogg @IVLINE @ruralgreengp @ruralflyingdoc and Leslie Rourke

Identity

Rural practice needs to improve its collective identity.  It was apparent that those countries with a thriving network of rural GPs had a stronger buzz about rural GP opportunities – as well as highlighting generic benefits of general practice.  The ACRRM is perhaps a model that we need to reconsider in Scotland – by building up and consolidating what we already have.  The current setup of relatively un-linked institutions, from RCGP, Rural GP Association of Scotland, School for Rural Health & Wellbeing, NES, RRHEAL, Centre for Rural Health and the RCGP Rural Forum serves to dilute the collective identity, duplicate certain efforts, and I think something needs to be done to pull these organisations tighter together with a more collaborative strategy.

In November 2014 the Rural GP Association of Scotland (RGPAS) became the new name for the Remote Practitioners’s Association of Scotland (RPAS) and we have been building specifically on work to support practising rural GPs, as well as undergraduates in rural practice.  We’ve also improved social media and online presence.

There remains a wider need to realise the potential synergies that could be realised by organisations working better together.

Use of existing mechanisms 

One particularly interesting conversation with an experienced GP in Australia, led to learning about the set up of a ‘Managed Educational Network’ – and how such established routes of networking can be harnessed to achieve wider goals.  He advised on the importance of identifying existing organisations and their objectives, in galvanising resource to make projects happen.

On my return, I met with RRHEAL and NES, and highlighted the obligations from RRHEAL’s mission objective to facilitate managed networks in rural practice.  This has resulted in a PDSA to assess whether a Scotland-wide MCN (clinical network) or MEN (educational network) could help to link up Scotland’s rural GPs by VC on a semi-regular basis.

Innovation in rural health care

There were some great examples of where rural practice is leading new approaches in training, clinical skills development and other aspects of clinical care.  Some of these are similar again to current work in Scotland.  The increasing role of simulation training particularly for high intensity low frequency clinical scenarios was evident from several speakers.

Lessons from conference workshops have already been put into action on Arran where we have been developing the use of simulation training.

The increasing role of ultrasound in clinical practice was also raised frequently.  Given that this is a safe, potentially transmissible and higher acuity diagnostic near-patient test, we are likely to see its use in rural practice develop considerably.

The role of the rural GP in providing leadership and advocacy in more generic challenges of rural living was apparent.  Whether representing rural healthcare on a political level, engaging in media work or leading projects such as improvements in connectivity – all these aspects of professional life were common.

Presentation of ‘RCGP Scotland Being Rural’ 

I presented the RCGP Scotland paper to an audience of approximately 50-60 on the Saturday morning of the conference.  This was well received, and the twitter conversation continued well past the conference conclusion too.   The wider perspective provided by Miles Mack’s mind map of challenges to rural practice, was appreciated and recognised by colleagues across the globe.  In particular, the constraints resulting from infrastructure difficulties in rural areas was a common theme.

Here’s a summary video of the main points of the Being Rural paper.

Summary

Attendance at WONCA Rural allowed an important Scottish input to the debates and conversations about international rural health.  It was an opportunity to obtain a wider perspective on how others are dealing with common challenges including recruitment, retention, burnout, effective training of the ‘next generation’ and representation of the generalist approach amongst an increasingly specialist medical world.  I hope that Dr John MacLeod, Lochmaddy GP and one of the founding members of WONCA Rural, would have been proud of the ongoing Scottish participation from those of us who made it to Dubrovnik.  Personally, it helped to open many doors for future collaborative working, particularly with confrères in Australia, New Zealand and Canada.

Next actions

There have already been outcomes from participating at Rural WONCA.  The priority now is to share the momentum that exists amongst WONCA partners to inform, enthuse and stimulate better representation, and an effective collective identity, amongst rural GPs in Scotland.  RCGP Scotland has a pivotal role in supporting both existing and prospective members and I hope that it will be possible to translate this effectively into useful actions via the RCGP Scotland Rural Strategy Group.

David Hogg, September 2015

Now want a different perspective?  See these other reports from Dubrovnik 2015.

 

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RCGP Rural Forum – Conference 2015

Rural Forum LogoPlaces are still available at the RCGP Rural Forum 2015 conference, due to take place on Saturday 6th June 2015 – at the Beardmore Hotel & Conference Centre, Glasgow.

Early bird discount (of £20) ends on 30 April.

They have organised a number of high quality speakers, including:

  • Professor Mike Pringle, President, Royal College of General Practitioners whose lecture is entitled – Strengths & Weaknesses of Rural Practice and my View on the Future
  • Dr Miles Mack, RCGP Scotland Chair whose lecture is entitled – Being Rural – Progress and Challenges in the Implementation of the RCGP Scotland Rural Strategy
  • Dr Chris Williams, Sessional GP, North of Scotland is running a session on Social Media:  Networks, Engagement and New Tools for Rural Communities
  • Dr Iain Livingstone, FRCOphth, Research Fellow, Glasgow – The Eye Phone:  A Portable Eye Examination Kit
  • Dr Colville Laird, Director of Education BASICS Scotland – Training the GP Rural Workforce
  • Dr James West, Consultant Paediatrician and Dr Hal Maxwell, Remote and Rural Lead MLG – Paediatric Emergency Care
  • Ms Maxine Pott, Corporate Finance Director, RMT Accounts & Business Advisors, Newcastle Upon Tyne – How to Maintain Financial Viability in Remote and Rural Practices
Download the Programme

 

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Reporting soon from WONCA Rural Conference in Dubrovnik

dubrovnik banner 492x170This week sees the 13th WONCA World Rural Health conference take place in Dubrovnik, Croatia.  It looks set to bring together rural health professionals from across the world, and just looking at the programme, it is clear that there is a lot of experience being gathered in one place.

I’m delighted and grateful that RCGP Scotland has supported me in attending the conference, and we will be presenting our ‘Being Rural‘ report on the Saturday, during Scientific Session 14.  In addition, this will be a huge opportunity to share ideas and meet similarly-challenged confreres in the world of rural health – and I hope to come back with useful, relevant ideas that have worked in other areas… to bring this back to the work we’re doing at the RCGP Scotland Rural Strategy Group and wider, and to see implementation of the things we know need to be better.

As part of this, I hope to run a daily blog report of sessions attended, and lessons learned.  Depending on wifi, I’ll be participating in the twitter coverage using the hashtag #woncarural2015.

 

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RCGP Rural Forum – Conference 2015

Rural Forum LogoThe RCGP Rural Forum has just announced details of its annual conference, due to take place on Saturday 6th June 2015 – at the Beardmore Hotel & Conference Centre, Glasgow.

They have organised a number of high quality speakers, including:

  • Professor Mike Pringle, President, Royal College of General Practitioners whose lecture is entitled – Strengths & Weaknesses of Rural Practice and my View on the Future
  • Dr Miles Mack, RCGP Scotland Chair whose lecture is entitled – Being Rural – Progress and Challenges in the Implementation of the RCGP Scotland Rural Strategy
  • Dr Chris Williams, Sessional GP, North of Scotland is running a session on Social Media:  Networks, Engagement and New Tools for Rural Communities
  • Dr Iain Livingstone, FRCOphth, Research Fellow, Glasgow – The Eye Phone:  A Portable Eye Examination Kit
  • Dr Colville Laird, Director of Education BASICS Scotland – Training the GP Rural Workforce
  • Dr James West, Consultant Paediatrician and Dr Hal Maxwell, Remote and Rural Lead MLG – Paediatric Emergency Care
  • Ms Maxine Pott, Corporate Finance Director, RMT Accounts & Business Advisors, Newcastle Upon Tyne – How to Maintain Financial Viability in Remote and Rural Practices

A £20 early bird discount is available if you book before 27 February 2015.

Download the Programme

 

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Rural connectivity in Scotland – a step forward?

phoneOn Wednesday 10th September, I attended a meeting in Edinburgh about connectivity in rural Scotland.  Following the report ‘Being Rural’, launched a few weeks ago by the RCGP Scotland Rural Strategy Group, the meeting was organised to discuss our concerns with the relevant departments of the Scottish Government.

Is this important?

Connectivity has become a crucial issue for the sustainability of rural areas – and not just for healthcare.  The digital divide is now more evident than ever, and the gap continues to drive inequalities of access to healthcare.  With integration of health and social services due to commence in April 2015, there will be an inevitable requirement for greater sharing of data and collaboration.  It will be vital that adequate connectivity is in place – in terms of reliable landline, mobile and broadband networks.  It is clear that connectivity needs to be placed high up the agenda if integration – as well as the wider sustainability of public services in rural areas – is to succeed.

Of course, focus should not rest exclusively with health services.  Access to broadband is a strong determinant of social functioning, as well as professional collaboration.  For rural areas to remain attractive to tourists, new business and to maintain a vibrancy of community, this will depend on improving equity of access to decent network capacity.

What’s RCGP Scotland doing about this?

So through the RCGP Scotland Rural Strategy Group, last week’s meeting followed from one held a few months earlier, and this time it was clear that we were speaking to the decision-makers at the core of Scotland’s broadband and mobile network strategy.  Representatives from Community Broadband Scotland, the Digital Directorate of the Scottish Government and the Digital team of the Scottish Futures Trust met with us to get a better insight into the problems we are facing… and it was useful for us to get an insight into the scale of the challenges that they face too.  ‘Backhaul’ – or the data capacity required to connect exchanges, as well as subsea and cross-country fibre cabling – is a major issue.  There seemed to be a commitment to get this right the first time, not least as this will determine how future-proofed the longer term strategy will be.  Aside from the copper cabling connecting your surgery to the exchange, every mobile phone mast and exchange needs to plug into larger data ‘pipes’ to keep the information flowing.  This can be complex, costly and time consuming – and yet is an essential component to achieving better connectivity.

What is clear is that there are a number of high-level organisations working on the issues.  It is therefore important that we ensure that health care (specifically general practice) connectivity needs are well represented.  There is over £300 million of public money, being used to attract around £3 billion of investment into Scotland’s digital infrastructure over the next 5 years.  This is all designed to tie into the Scottish Government’s ‘World Class 2020 vision‘ to be a world class digital nation.

On the one hand, I do take the view that development of local connectivity infrastructure is outwith the remit of a rural GP/practice team, especially with so much other clinical/non-clinical work going on.  However, it is clear that engagement with communities to consider their options, and represent their difficulties effectively, is necessary for this investment to be spent appropriately.  At the very least, we need to help RCGP members to navigate the complex state of multiple organisations being involved with superfast broadband rollout, to ensure that any engagement is as relevant and fruitful as possible.

All very good, what does this mean for me?

For rural GPs and healthcare teams across Scotland, we’ve been keen to give decision-makers a pragmatic view of the challenges faced at present.  These include:

  • branch surgeries being unable to operate properly as remote access to computer records (such as EMIS/Vision notes, Docman’d ECGs/discharge letters and other medical information) being reliant on broadband speeds above 2Mb/s
  • difficulties in setting up group/federated/branch practices – particularly at a time when increasing numbers of surgeries are considering this option for recruitment/retention reasons
  • isolation faced by rural GPs by not being able to connect to webinars, online video and other CPD material
  • difficulties faced by BASICS GPs and First Responders in being available on-call (or more frequently, being tethered to the home phoneline – which makes for a poor level of work/life balance)
  • dangers faced of lone working without mobile phone coverage, sometimes taken for granted in less rural areas

Site visits have already been undertaken by some of the organisation mentioned, in some areas, and there are local examples of excellent progress – for instance the Isle of Coll, and Applecross.  An invitation to Arran has been taken up by the Scottish Futures Trust, and this will be arranged in the near future.

What can I do?

Over the next few months, we hope to report frequently on engagement between RCGP Scotland and the organisations mentioned above.  Much of this work has been building on the ton of work done already by Dr Drew Inglis from the Emergency Medical Retrieval Service – you can read more about this work at nobars.ruralgp.com – and you may already be receiving Drew’s regular email updates.

In short, keep your ear to the ground, and ensure that your wider advocates – not least your MSP – are aware of connectivity issues in your area.  The next few years look set to stage some fervent action to get Scotland’s connectivity up to decent standard including in rural areas.  We need to ensure that the needs of rural healthcare teams are placed high up the agenda.

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