2017: Reaching a peak in Scottish rural practice

Today we launch the new RGPAS website – redesigned with the aim of providing an improved showcase of Scottish rural general practice, as well as being a solid platform from which to keep our members, and others interested in Scottish rural GP – informed.

Please take a moment to explore.  We are very happy to receive feedback and suggestions on ways that we can develop the site further.

2017 brings a number of key topics to the fore, including some challenges and an importance to ensuring that the healthcare provision to Scotland’s rural communities is well represented to decision-makers.  Ongoing development of the new GP contract, along with seeing increasing health and social care integration, are two particularly prominent issues for which we are keen to represent Scotland’s rural GPs – who deliver a significant chunk of rural healthcare provision, including expanded service settings such as out-of-hours, the community hospital setting and supporting wider team colleagues such as in emergency prehospital care.

One of the present frustrations is reconciling the demands of the job (with increased expectations, a more complex and elderly population, medicolegal pressures and non-rural-proofed policy decisions) with the fact that the ability to practice rural general practice… the bit about providing comprehensive and quality care… can be incredibly stimulating and enjoyable as a career.

Recruitment & retention of rural GPs remains an ever pressing issue, and to some extents we are seeing the specific challenges of recruiting to remote & rural diluted by increasing challenges on GP recruitment in a wider sense.  With unrelenting pressure on the healthcare system and the difficulties experienced in standing up to cuts and hostile management, there is a real risk that GPs – in particularly those who practice in more isolated settings – experience pressures and stressors that become unmanageable.  RGPAS is a small, amicable association and we are keen to identify if there are specific approaches that we can foster within the association to assist any members who are feeling particular difficulties in this regard.  Watch this space, or please get in touch with your thoughts on this.

In 2015 Scotland’s Chief Medical Officer published her report entitled ‘Realistic Medicine’.  The sentiments of the report resonated particularly well with those of us who practice in resource-limited and generalist settings, and indeed remote & rural settings are arguably where some of the best examples of realistic medicine are to be found.  We believe that to deliver the aims of Realistic Medicine, we also need to see realistic management, realistic funding and realistic expectations from both the public and government – and this is a theme that we intend to develop over the coming year.

There is no doubt that some of the most impressive – and effective – innovation in healthcare has been developed in rural settings.  It is widely recognised that Dewar’s report of 1912 laid the blueprint for the NHS, and there are repeated examples worldwide of where great ideas originating in rural practice have gone on to be adopted in general healthcare settings.  For this reason, one are of this site that we are particularly excited to be launching is the Great Ideas section which we aim to grow, in order to share good practice – in a spirit of collaboration and helping each other out.  Similarly, if you have a great idea but not the solution yet, you can submit this for our RGPAS Wish List which we will use to capture aspect of practice – small or large – that could be improved with small or large intervention.

We are also keen to support learning and research related to rural practice.  Today we also launch our RGPAS Travel & Student Scholarships – please consider applying as to date these have been undersubscribed, and we are keen to grow this support to reach as many students and RGPAS members as possible.  Quality improvement is evident in many different guises across rural practice, and we are keen to support links being made to international confreres, as well as fostering improved engagement with rural academic practice in Scotland.  Rural GPs carry a significant range of responsibilities in their practice, and this often squeezes out aspects of medical care that are deemed more desirable, and less essential.  Academic evaluation of new and existing practices is often a casualty of this, but we know that academic practice is a strong factor in recruiting and retaining GPs, therefore we hope to assist in links being forged with existing academic support organisations – the Centre for Rural Health, and potentially the Scottish School of Primary Care – where appropriate and relevant… as well as assisting members to learn and present findings in national and international settings.

One specific opportunity that we hope to see effective work with, is the Scottish Rural Medicine Collaborative.  Setup several months ago, with funding from the Scottish Government GP Recruitment Fund, it has been allocated resource to improve the state of recruitment and retention – building on previous work, and allowing new work to kindle too.  RGPAS is represented on the Board of the SRMC, and we really hope that this will prove to deliver what Scottish rural practice really needs – direct action, implementation and fruitful consideration of all the holistic aspects that require to be taken into account when retaining and attracting GPs to rural communities.

RGPAS is a member-focussed organisation, and we hope to stimulate increasing involvement of our members in shaping debate, showcasing great practice and fostering improved collective identity across Scottish rural practice.  Please be welcome to be part of it, and encourage colleagues to join – full details on this website.  We hope that you feel as positive (with appropriate caution) as we do about going into 2017.

David Hogg

Chair, RGPAS – on behalf of the RGPAS Committee

Comments can be emailed to hello@ruralgp.scot

(Main pic: Cir Mhor, Isle of Arran)