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RPAS Conference Student Scholarships 2014

Craigmonie Hotel, Inverness

Craigmonie Hotel, Inverness

Things are heating up for this year’s RPAS 2014 conference, to be held in Inverness from Thursday 6th November.  A full programme is planned, spanning a range of topics relevant to rural general practice.

We are pleased to announce the introduction of RPAS Conference Student Scholarships – to enable up to seven medical students to attend with expenses paid.  In addition we have subsidised the cost of student registration fees, to make it more possible for students who have an interest in rural practice, to attend.

What’s on offer?

  • 4 free student places, including Thursday night’s accommodation at the Craigmonie Hotel
  • 3 free students places (not including accommodation)
  • a reduced rate for all other students who wish to attend – £25 conference fee (reduced from £100) for the full programme

Who’s eligible to apply?

You must be an undergraduate medical student at a Scottish university (intercalated, international and mature students also welcome to apply).  We are keen to hear from any students who have an interest in general or rural practice.

How do I apply?

Simples… complete the form below – closing date Friday 10th October 2014.  Please specify whether you require accommodation on the Thursday.  We’ll get back to you a few days after the closing date, either to confirm you’ve been successful with a scholarship, or to offer you a discounted rate to attend the conference.

Closing date now passed.  Thanks for all entries, we’ve been in touch with all successful applicants.  If you wish to attend the conference at a reduced student rate of £25 (for Thursday & Friday) please see this page.

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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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Medical Students – why go rural?

videoiconRural practice offers a wealth of learning opportunities for medical students.  If you’re thinking about ‘going rural’ for your GP placement, you might want to watch this video that has been produced to highlight what rural practice has to offer.

Aberdeen and Dundee Universities already have rural programmes for GP experience.  Glasgow is making these increasingly available.  If you’re interested, speak to your GP department about what rural practices you can go to as part of your GP block.

Some useful links:

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Nominations invited for RCGP Scotland GP of the Year

rcgpsThe Royal College of General Practitioners (Scotland) is pleased to announce the launch of GP of the Year 2014.

Each year RCGP Scotland, the professional membership organisation for general practitioners, seeks recommendations from patients or family members to nominate their GP for the prestigious RCGP Scotland GP of the Year Award for outstanding standards of patient care.  This prestigious annual award generates significant press interest and is a huge boost to the GP and practice who receive it.

We would be very grateful if you could help us promote this year’s award by displaying the enclosed poster and also to have a supply of nomination forms available for patients if requested.

Nomination forms are also available online at http://www.rcgp.org.uk/about-us/rcgp-awards/rcgp-scotland-awards.aspx or by contacting euan.bailey@rcgp.org.uk on 020 3188 7750.

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GP Update – one day update for GPs, Registrars & Practice Nurses

team 13 cu wRed Whale runs a number of courses across the country, including their flagship ‘GP Update’.  Each year they try to coincide the timing of their Inverness course with the RPAS Conference, which this year runs on 6th-8th November 2014: GP Update will run on the day (Wednesday) before, so that if you’re booking travel and locums, hopefully this makes the course slightly more accessible.

Provided by the Red Whale team (new name, same team, same format – for the GP Update team), they aim to bring all the relevant and useful updates for GPs to one day – and with plenty of entertainment thrown in too!

A range of supporting elements are made available to course participants too: including the GP Update handbook, an online handbook, CPD recording area on the GP Update website, and a range of suggested focussed learning activities.

RPAS enjoys a friendly link with the GP Update Course providers (not financial) and hopes that the teamwork in coinciding the dates of their conference with the course, is helpful to rural & remote GPs across Scotland.

For more details, you can visit the GP update course website or watch the video below.

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RPAS Conference 2014 – Programme now available

Craigmonie Hotel, Inverness

Craigmonie Hotel, Inverness

The annual RPAS (Remote Practitioners’ Association of Scotland) conference will be held on Thursday 6th to Saturday 8th November 2014.  As with tradition, it will once again be held at the Craigmonie Hotel in Inverness.

The programme includes a keynote speech from Mr Alex Neil MSP, and Scottish Cabinet Secretary for Health & Wellbeing, on the Thursday afternoon at 2pm.

Also speaking are Mr Quentin Cox on orthopaedic injuries in rural practice, and an update from the Scottish Ambulance Service by Dr James Ward, SAS Medical Director.  There will be an intriguing talk from Dr Martin Wilson on ‘Square Pegs and Round Holes’ and a Drama Triangle workshop by Dr Andrew Tressider, who will come all the way up from Somerset.

In line with previous years, RPAS has managed to coincide the conference to fit with the GP Update course, which takes place on Wednesday 5th November.  We’ve featured what GP Update can offer in a separate post – you can also take a look at their website where you can find out more info about rates and course content.

For booking form and programme, see the links below.  Hope to see you there!

Conference Programme    Booking Form

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RCGP Scotland Rural Strategy – a personal view

RCGP Scotland has today published its Rural Strategy report, written by GPs Miles Mack, Hal Maxwell, John Gillies and David Hogg.  Here, one of the authors, David, provides his personal thoughts on the paper…

See the press coverage featured in The Herald here: Article, Editorial, Case Example

rural-1-2Being a rural GP can be great.  In 2005 I delighted in experiencing my first student surgery whilst on a GP placement with Dr Bob Dickie in Stornoway.  Little did I realise the impact that this would have on my future career.  Dr Gordon Baird deserves the credit (or blame!) for kindling my subsequent interests in rural practice, with plenty other icons of rural practice involved in influencing my career choice – which ultimately took me to a GP Rural Fellowship on Arran in 2010.  I have remained here since.

Since my student days, I have been lucky to get involved with various national groups; latterly these have included BASICS Scotland and RCGP Scotland.  Throughout, I have been intrigued by the challenge faced by our profession’s leaders of how to put the ‘day job’ in the context of decisions that need to be made on a macro or national level.  However, I have witnessed a consistent level of personal conviction in those ‘at the top’ which is largely due to one reason: the majority of GPs who take part in these decision-making activities  continue to consult with patients at least once or twice a week – and normally more.  It’s probably an essential tenet of maintaining credibility.   And so you’d expect decisions to be taken with pragmatism and ‘grass-roots’ insight.

rural-6

So why is rural practice in its present situation?  Report upon report has highlighted, detailed and warned of the challenges facing rural practice – the biggies such as recruitment & retention, as well as the downright perplexing such as threats to dispensing practices and policies without any thought to rural-proofing.  Since Dewar 1912 (and before) we have known that geography, communication, housing and professional resilience are the areas that continue to be problematic in delivering sustainable rural healthcare.

And yet, guess what?  These same issues feature in our report too.

Same old?

We’re well aware that there will be some (?many) including those already disengaged , who will look at this report and say ‘So what?’.  So many times, instead of taking ideas forward to the stage of implementation, each new project or committee seems to go back to redefining the problem, repeatedly stalling at the point of getting on with proposed solutions.  The pen may be mightier than the sword, however sometimes one just needs to implement some elbow grease to tackle the issue. I wonder if the scientific approach taken to some of these projects, has resulted in becoming naturally bogged down with definition and evidence, when in fact we really need implementation and enablement.  My biggest fear for our paper is that it becomes yet another futile addition to the library of attempts to provide ‘the solution’ to rural general practice.

Inspiration

rural-9Thankfully, we can find some inspiration in examples of where progress has been made.  The rural fellowship programme, the rural-track training pathway, the mobile clinical skills unit, Sandpiper-Trust enabling BASICS Scotland education and response, the recent change of the law regarding dispensing practice, and the Emergency Medical Retrieval Service, to name a few.  An unrelenting enthusiasm continues from undergraduate students to experience the rural life – at least for a bit – and they usually find their eyes opened wider to the concepts of core clinical skills and doctor-patient relationship.  We’re looking forward to this year’s intake being as enthusiastic as last year’s, and I’m sure we won’t be disappointed.  All these improvements should be celebrated, recognised and harnessed to drive forward our ambitions for good quality rural health care.

Crisis response

rural-4

However, rural practice is in crisis.  More than any marketing campaign, pilot project, golden handshake, first responder group, co-production initiative, helicopter service or fancy photography will alleviate.  For all that GP contracts have been media-bashed of late for being ‘private contractors’ – despite being tightly controlled and nationally negotiated – in fact there is a wide community of rural GPs who will continue to innovate, entrepreneur, lead and work together, and this needs to be enabled by avoiding putting any further bureaucratic hurdles and misinformed judgement in the way.  That creativity and local initiative is – I believe – best fostered in most cases by the current model of GPs as independent providers.  There is certainly no doubt that the last thing we need is contractual reorganisation to distract from tackling core issues.  I look to England and the increasingly piece-meal NHS sell-off to truly private contractors, and find reassurance that our Scottish Government has avoided such privatisation of our NHS.

We need to get into gear,and get sleeves rolled up.  That includes macro decision makers – on boards, committees etc. within healthcare but far wider too.  As demonstrated by Dr Miles Mack’s mind map of issues affecting rural practice, the answers are certainly not limited to decision mechanisms within our own profession.

Here’s my less official wish list:

  • recognise that the digital equivalent of the inverse care law is happening in front of us now.  The forgotten 5% (over 200,000 people) who continue to miss out on broadband and 3G cannot be forgotten any more.  When our phone line gets soggy in the rain (no joke) I can’t access our NHS24 system from home.  Access to unscheduled and emergency care is hindered in remote communities by poor mobile phone signal.
  • ensure that every national policy is truly rural proofed.  Decisions such as the STAC agreement for oncall staff including radiographers, look set to seriously threaten the viability of community hospitals and rural emergency care in the next 4-5 years.  30% of Scotland is rural, so this is not a consideration for the minority.
  • recognise that GP work IS becoming more challenging.  Sore throats are now sore throats on methotrexate.  Cellulitis is more often in the context of insulin-dependent diabetes.  Holidaymakers present between chemotherapy cycles, or are even taking it whilst they are away.  Alcohol withdrawal is accompanied by increasing polypharmacy and comorbidity.  And of course we are seeing a continual shift of work from secondary care to primary care, without the same flow of resource.
  • make it more feasible for students and rural healthcare teams to share the superb opportunities that exist in rural practice for quality learning: better substantive financial support for undergraduates (evidence based as an effective strategy for future recruitment), a GP training scheme that allows effective training for those who want to prepare early for a career in rural practice (building on the rural track programme in the North of Scotland), and development of fellowship-style supported introductions to rural practice for qualified GPs.
  • accept that GPs are usually more costly per hour/day worked, but we will (usually) see anything.  There are economies of scale that will never be realised in rural practice, and there will always be less pricier alternatives, but that does not translate into value for money.  Whilst we need to be open minded, it is probably impossible to replace a GP, trained in generalism with considerable experience over at least 10 years until qualification, with anything else – unless the focus is to change to an approach of reduced experience and generalism, and a different kind of care.
  • consider pension benefits to those who work outside the 8am-8pm window.  We need to get to grips with the real-life unhelpful barriers being placed in front of GPs.  Our latest pension reforms mean that at a level of income which many GPs are at due to full-time partner work, it simply makes no financial sense to carry out additional out-of-hours work in some areas.  In addition, those of us who do our share of unscheduled care are wondering just how feasible it is to continue in this way until the ever-increasing age of retirement.  Hundred hour weeks and disturbed sleep patterns seem (surprise surprise) to become less tolerable with time.
  • enable the ‘can do’ attitude of those rural GPs who want to innovate: good ideas need support.  GPs have a wide scope of responsibility, with local patient care the priority.  The time lost to frustrating issues such as IT/connectivity failures, lack of contextual understanding, and an absence of will from those who can make budgets and innovation happen, is not acceptable when we need to get going with the changes identified.

What can we do?

The point is this.  We know what the problems are, and have a good idea of the solutions too.  Countless reports have been written already, however our latest contribution is motivated purely by the opportunity for effective implementation.

For that implementation to happen, we need everyone with a responsibility to rural infrastructure (medical, social and otherwise) to act on that responsibility.  To resist the urge for further work on definition or scoping.  And to come up with the goods that will actually address the problems, not just describe them.  Connectivity is particularly important to address.

Rural practice still has the potential to offer a fantastic career, but its sustainability depends on implementing the tangible solutions that have been described too often.  We need a serious injection of high level attention to this, and a drive to get on with the changes we know need to happen.

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BASICS Scotland Conference 2014

BASICSlogoThe programme is now finalised for this year’s BASICS Scotland conference.

Taking place at The DoubleTree by Dunblane Hydro, from Friday 12th to Sunday 14th September 2014, this year’s conference will focus on Special Circumstances in the prehospital environment.

A great line up of speakers has been organised, from Dr James Robson, Chief Medical Officer for Scottish Rugby, to Dr Gordon Baird, stalwart rural GP, and Kenny Simpson, former Detective with Strathclyde Police.

As well as other education, the weekend will feature the BASICS Scotland annual dinner, as well as the AGM and a great chance to catch up with colleagues from across the spectrum of Scottish prehospital care.

Full details about booking your place are available on the BASICS Scotland website.

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BASICS Scotland: Paediatric & Adult Practical Skills Course

BASICSlogoBASICS Scotland is pleased to announce its brand new online Tele-Education SKILLS Course!

A first of its kind; this online course gives participants the chance to gain hands-on experience.

Similar to our Tele-Education Course, this Skills Course involves live web-conferencing teaching but has the added hands-on advantage of the specialist Equipment Pods we provide you with for the duration of the course. These equipment pods enable a more comprehensive learning experience by allowing candidates practical skills training in pre-hospital emergency care, alongside the guidance of our expert Medical Instructors.

Key Course Benefits

  • No travel/accommodation costs
  • Ability to attend the course from anywhere with access to a computer and the Internet (minimum 1MB broadband recommended)
  • IT support before and during the course
  • Use of expensive specialist equipment for the duration of the course
  • Opportunity to gain practical experience as well as refresh your knowledge
  • Certified qualification valid for 1 year from completion date

This course is available in both adult and paediatric programmes, with each course consisting of 2 half days of teaching. For more information on course dates, please see attached Flyer and Booking Form or visit our website at www.basics-scotland.org.uk.

If you wish to apply, please complete the relevant attached Booking Form and return to BASICS Scotland, Sandpiper House, Aberuthven Enterprise Park, Main Road, Aberuthven, PH3 1EL or rwatt@basics-scotland.org.uk.

If you have any questions, please feel free to contact me on 01764 663671 or rwatt@basics-scotland.org.uk.

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RPAS Conference – Date for the Diary!

Craigmonie Hotel, Inverness

Craigmonie Hotel, Inverness

The annual RPAS (Remote Practitioners’ Association of Scotland) conference will this year be held on Thursday 6th to Saturday 8th November 2014.  As with tradition, it will once again be held at the Craigmonie Hotel in Inverness.

A full programme is being worked on at present by Stuart Cairns and Catherine Todd.  Full details will be provided here in the next few weeks.

In line with previous years, RPAS has managed to coincide the conference to fit with the GP Update course, which takes place on Wednesday 5th November, also in November.  We’ll feature what GP Update can offer in a future post, but meantime take a look at their website where you can find out more info about rates and course content.

 

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