Archive | Reports

New approaches to rural practice in Scotland

skye (1)Dr Jim Douglas, GP Fort William and chair of the 2012 Dewar Group, has produced the following documents (with colleagues) to help define current challenges in rural practice, and suggest ways of addressing them.

A proposal for ‘National Park Status for Remote Health and Social Care in Scotland‘ outlines why viewing sustainable rural health care as a fragile ecosystem, can help to define the interdependencies that can exist in rural communities – and how shared values and objectives might be achieved more easily by viewing rural healthcare in this way.

An appendix to this document has also been produced, called ‘Wildlife Species in Scotland and Remote Care Policy – What can we debate?‘ – and offers fresh, slightly humorous but relevant comparisons between aspects of rural healthcare and threatened species.

A third document entitled ‘Bench Testing and Risk Management of Remote Practice Models‘ offers advice on how new models of healthcare might be tested prior to implementation.  A number of clinical scenarios are suggested, which can then be played in different scenarios – taking into account weather, transport, and local resource.

jimMore information can be obtained – and feedback provided – to Dr Douglas using contact details provided in the document.



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A Student Perspective

Click the photo to download the PDF (9.1MB)

Emily Tait, a 4th year medical student at Dundee University, has published this e-book following a student module travelling around rural Scotland.

It deserves much wider publicity. Emily has managed to pick up on some really important themes that are relevant to remote and rural practice, and presented her observations in a very impressive book incorporating great photos and professional layout.

You can download a copy of this book using the PDF link below. It is hoped that it might even be developed into a web-based resource. Emily is to be congratulated for a fantastic effort and highly relevant piece of work that has been completed in the short space of a student module.

Read more for yourself…. (9.1MB)

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Poster: Rural GP Training

Developing a skillbase appropriate to the rural and community hospital setting is a hot topic, surrounded by issues of recruitment, retention and revalidation.    This poster from RRHEAL and NHS Education for Scotland looks at the components that are important to consider, and how they might be delivered in the context of a rural GP training programme.

Education and training needs vary depending on the situation of different rural hospitals, but a common theme was the skill set required to deal with unsorted emergency presentations within rural “No Bypass Units”.

You can download the poster by clicking below.

Click to download PDF poster.

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Rural Mentoring Survey: Results

Many thanks to everyone who took part in the mentoring survey, which closed tonight after 2 weeks.  This was kindly hosted by RCGP.  Over fifty rural medical practitioners responded, with some useful and insightful results.

The raw data are presented below.  If you can’t see anything, you can also download a PDF file here.  Apologies that this is slightly clunky – and please note that comments are presented at the end of the PDF.  If you have a large screen, it may be worthwhile opening up two windows so you can follow the questions and free text answers at the same time.

Further analysis will be carried out to summarise the main conclusions.  It is hoped to present this on in the next few weeks.  In the meantime, I have made the following observations on what could be considered the ‘next steps’:

  • Development of a profiles page, giving details of rural GPs who are prepared to act as mentors for committed trainees. (With some time for thought about how this should be co-ordinated and supported).
  • Development of a scholarship scheme for medical student electives.
  • Play down the role of social media, and improve quality student/trainee access to good rural practice experience.

Discussion can take place via the various email groups, or post a comment below.


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Helicopter Safety

Courtesy of

For anyone who is likely to come across a search and rescue helicopter, this comprehensive guide may be of interest.  Just published by Duncan Tripp, winchman/paramedic with RAF Lossiemouth, it offers advice and information about many relevant aspects of helicopter search and rescue – from BASICS Responders who may require casualty evacuation, to mountain rescue teams needing search assistance.

The 31 page document describes considerations for approaching helicopters (which of course is generally don’t, until the pilot indicates that it is safe), emergency ditching procedures and functions of the search tools on board.  There is also a guide on winching people, dogs and stretchers, and the command/control structure that develops for aircraft during a major incident.

You can download the document (PDF, 9.5MB) from the link below.

Click to download the guide (PDF).


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Scottish Ambulance community resilience plan

The Scottish Ambulance Service has proposed a strategy to improve the networking of local emergency responders who are able to support the service in rural and remote areas.

The document highlights a number of proposals for involving local communities to assist in activities from emergency care to anticipatory and preventative measures.

The deadline for responses was in fact May 10th, however late submissions may be accepted – see the website for contact details.

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Time to Care: RCGP reports on Rural Deprivation

RCGP Scotland has just released its report Time to Care – which aims to be a pragmatic contribution to the efforts in improving healthcare to Scotland’s most deprived areas, including rural areas.

The following explanation, taken from the Foreword, outlines why the report is not to be seen as “yet another” document outlining the already-knowns in health & deprivation…

“At the outset, the working group made three decisions. First, given the plethora of reports on inequalities in health, collating research evidence, there was no need to produce another report of this type. Second, the report would not comprise a “toolkit” for general practitioners, implying that others know the answers and general practitioners simply need to implement the solutions.

Third, the working group would engage with general practitioners working in the most deprived areas, capture their experience and views, and communicate these findings to others.  This would focus on the 100 practices serving the most deprived communities in Scotland (which we named the ‘Top 100’ practices) but would also include general practitioners working in remote and rural areas out-with the Top 100 as there are many people living in pockets of severe deprivation which are not large enough to register within analyses of deprivation based on datazones. We also commissioned a short review of the literature on the challenges faced by these communities (Chapter 4).”

The report is available from the RCGP Scotland website.

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Journal Focus: Reflections on Swine Flu

With efforts focussing once again on the influenza pandemic, I found this article from a GP team in rural Scotland interesting. Back in June 2009, our colleagues in Cowal & Bute discovered that they would soon be one of the early hotspots of the swine flu outbreak.

In their article “Major incidents in rural areas: managing a pandemic A/H1N1/2009 cluster” which features in Rural & Remote Health, Stark et al describe the nature of the response, and detail the challenges faced from a rural perspective.

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