David R HoggPROFESSIONAL PROFILE
.01

ABOUT

PERSONAL DETAILS
Isle of Arran, Scotland
mapiconimg
david@ruralgp.com
Dr David R Hogg BSc(MedSci) MBChB DCH MRCGP :: GMC 612 8595

BIO

I am a rural GP on the Isle of Arran in Scotland. I normally work three days a week as a GP Principal of Arran Medical Group, plus regular oncall cover to our community hospital inpatients, A&E and out-of-hours GP service. I recently became Chair of the Rural GP Association of Scotland.

After looking at various networking sites to share my interests & work to date, and seek opportunities for collaboration, I ended up creating this profile website as the others didn't quite match what I wanted them to do: this is a kind of fusion between LinkedIn, ResearchGate, a blog and Google Scholar. I have various interests around rural healthcare and am keen to expand my academic experience.

Calendar

It's always a challenge to work out when best to contact someone/arrange VC meetings etc. If it's helpful, you can see my availability here - the yellow slots are times that I can schedule calls/VC meetings.

Twitter Timeline

Contact Details

davidrhogg

@davidrhogg

david@ruralgp.com ::general::
david.hogg@glasgow.ac.uk ::academic::
david.hogg@nhs.net ::NHS::

Arran Medical Group, Lamlash, Isle of Arran, KA27 8NS

01770 600 516 ::for Arran Medical Group queries only::

david.hogg@vc.scot.nhs.uk ::Jabber NHS Scotland VC::

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RESUME

EDUCATION
  • 2002
    2003
    Glasgow

    BSc (Med Sci) - Developmental Medicine

    UNIVERSITY OF GLASGOW

    Intercalated degree. Research project was on the stereologic analysis of the distribution of myosin and elastin in placentas from smoking and non-smoking mothers.
  • 1999
    2005
    Glasgow

    MBChB - Medicine

    UNIVERSITY OF GLASGOW

    Medical degree at Glasgow University. Included electives at Great Ormond Street Hospital London, and Kanti Children's Hospital, Kathmandu.
  • 2005
    2007
    Stirling & Glasgow

    Foundation Training

    NHS Education for Scotland

    FY1: Surgery and medicine at Stirling Royal Infirmary. FY2: Oncology (Beatson Unit, Glasgow), General Surgery (Western Infirmary/Gartnavel), Paediatric Endocrinology (Royal Hospital for Sick Children, Glasgow)
  • 2009

    DCH: Diploma of Child Health

    Royal College of Paediatrics & Child Health

  • 2007
    2010
    Ayrshire

    MRCGP: GP Training

    NHS Ayrshire & Arran

    Based with London Road Medical Practice, Kilmarnock. Rotations included A&E and Medicine (Ayr Hospital), Psychiatry, Obstetrics & Gynaecology and Paediatrics (Crosshouse Hospital).
General Practice
  • 2010
    2011
    Isle of Arran

    GP Rural Fellowship

    NHS Education for Scotland / Arran

  • 2011
    2013
    Isle of Arran

    Salaried GP

    Arran Medical Group

  • 2013
    present
    Isle of Arran

    GP Principal

    Arran Medical Group

    Ten-GP practice providing full range of rural medical services - from core general practice to A&E and inpatient care at Arran War Memorial Hospital. In addition, we provide out-of-hours, forensic medical services, prehospital 'BASICS' care and more. I have specific responsibilities in the practice for IT, patient access, emergency care, respiratory medicine, the rural fellowship and undergraduate teaching.
ACADEMIC POSITIONS
  • 2011
    Present
    Royal College of GPs

    Peer Reviewer

    InnovAiT Journal (RCGP)

    Occasional reviewer for the RCGP journal for GP trainees.
  • 2014
    Present
    Glasgow

    Honorary Clinical Senior Lecturer (Remote & Rural Medicine)

    University of Glasgow

  • 2016
    Present
    Dundee

    Honorary Senior Clinical Teacher (Medicine)

    University of Dundee

Committee & Representation Work
  • 2008
    2010
    London

    Trainee Representative

    RCGP Associates in Training Committee

    Representing West of Scotland Trainees. I also organised the Trainees' stream of the RCGP Annual Conference, held in Glasgow in 2009.
  • 2011
    2014
    Aberuthven

    Co-Director / Company Secretary

    BASICS Scotland

    Initially co-opted to BASICS Scotland Board in 2011, and a Director from September 2012 to December 2014.
  • 2012
    Present
    Edinburgh

    Member

    RCGP Scottish Council

    Including a focus on input regarding First5 and rural issues. I have also been media trained to work with TV, radio and print journalists.
  • 2012
    Present

    Clinical Governance Co-Lead

    BASICS Scotland

    Since 2012 we have developed a system for clinical governance - including regular VC meetings - for responders across Scotland.
  • 2013
    2016

    Undergraduate Liaison

    Rural GP Association of Scotland

    Oversee undergraduate student input to the annual conference, and set up the RGPAS Student & Travel Scholarship programme in 2015.
  • 2016
    Present

    Chair

    Rural GP Association of Scotland

    Representing the needs and views of rural GPs across Scotland. There's lots of fantastic work going on in rural practice, and RGPAS aims to showcase some of this. There are also challenges, including a need to ensure that the forthcoming new GP contract (2018) is rural-proofed, so 2016/17 looks set to be a busy year.
Other roles
  • 2010
    Present
    Isle of Arran

    Co-ordinator

    Arran Resilience

    Co-ordinator to the Arran Resilience group, which brings together the emergency teams on Arran. In 2013, Arran Resilience was awarded the UK Resilience Team of the Year award by the UK Emergency Planning Society.
  • 2013
    Present
    Isle of Arran

    Team Member

    Arran Mountain Rescue Team

  • 2015
    Present
    RNLI Lamlash

    Deputy Lifeboat Medical Adviser

    Royal National Lifeboat Institution

    Providing on-shore input, particularly in the provision of RNLI medical examinations for current and prospective crew.
  • 2015
    Present
    Isle of Arran

    Founder & Past Chair

    ConnectArran

    ::ConnectArran:: was set up to catalyse development and innovation on Arran, to achieve world class connectivity in line with the Scottish Government's promise to achieve this across Scotland by 2020. Arran presently has poor connectivity - both mobile 3G/4G and fixed cable broadband. Despite the HIE plan to roll-out fibre across the island, there is concern that this just won't meet the number of properties intended. Other technologies are being piloted - including Dynamic Spectrum 'superwifi', as well as community-owned 4G masts in Lamlash and Kilmory.

    ConnectArran aims to act as a helpful conduit between the local population & business, and industry, regulators & connectivity pioneers, to facilitate far-reaching connectivity across the island. Local business, tourist services, health & social services and participative education will absolutely depend on better connectivity being delivered to Arran as soon as possible.

.03

TEACHING

CURRENT
  • 2009
    Present

    PBSGL Facilitator

    NHS Education for Scotland

    I completed facilitator training for the Practice Based Small Group Learning programme in 2009, and we continue to run occasional PBSGL sessions on Arran.
  • 2011
    Present
    Isle of Arran

    Undergraduate GP Tutor

    University of Dundee

    Regular hosting of GP student attachments to our GP practice. Includes supervising students, devising appropriate timetables, providing tutorials and giving feedback.
  • 2011
    Present

    Clinical Simulation Facilitation

    Scottish Centre for Simulation

    Since completing the Scottish Simulation Centre course in facilitation in 2011, and hosting a visit from the mobile skills unit in the same year, I have developed my skills in providing clinical simulation with low- and mid-fidelity technology. Latterly, we have benefited from Sandpiper Trust funding to provide mid-fidelity simulators on Arran, and we have been using these in both our GP practice and community hospital context to provide training on cardiac arrest and peri-arrest scenarios.
  • 2014
    Present
    Isle of Arran

    Undergraduate GP Tutor

    University of Glasgow

    Regular hosting of GP student attachments to our GP practice. Includes supervising students, devising appropriate timetables, providing tutorials and giving feedback.
  • 2014
    Present
    Isle of Arran

    GP Rural Fellowship Supervisor

    Arran Medical Group

    Providing supervision and mentoring to our GP Rural Fellows - and some wider input to the NHS Education for Scotland Rural Fellowship scheme.
TEACHING HISTORY
  • 2014
    2014
    Crosshouse Hospital, Kilmarnock

    Generic Instructor Course

    Advanced Life Support Group

    Completed this course in 2014 after being IP'd for PreHospital Paediatric Life Support. Currently going through further IC training for PHPLS.
  • 2014
    2016
    Isle of Arran

    Undergraduate GP Tutor

    Kings College London

    Overseeing KCL GP placements to Arran.
  • 2016
    2017
    Dundee

    Module Developer - Certificate in Acute & Urgent Care

    University of Dundee

    Six month project to deliver a series of online-learning modules for a postgraduate GP qualification in acute & urgent care. 200 hours of distance-learning Masters-level learning material and activity was developed on unscheduled care, and another 200 hours of similar material was developed on intermediate care.
.04

INTERESTS

INFORMATION TECHNOLOGY
WEBSITE DEVELOPMENT > Experience with core HTML and subsequently WordPress-hosted sites, including RuralGP.com and Arran Medical Group. Challenges included linking up with social media platforms such as Twitter and Facebook, and training staff to add articles. I do most of my own photography too to avoid licensing restrictions.
LEVEL : ADVANCED EXPERIENCE : SEE PORTFOLIO
WORDPRESS APACHE SERVER API DEVELOPMENT GRAPHICS
INTRANET DEVELOPMENT > We required to set up an intranet site for Arran Medical Group, which operates from several sites. Space on an existing Sharepoint server was identified, from which the sub-intranet was created. Challenges included devising filing architecture, multiple databases, dynamic viewing options and keeping user-focussed.
LEVEL : ADVANCED EXPERIENCE : 5 YEARS
SHAREPOINT INFORMATION GOVERNANCE
RURAL CONNECTIVITY >

Through work with ConnectArran, and the problems that our community has in accessing connectivity on Arran, I have developed a wider awareness of some innovative methods of providing connectivity to rural areas. I have also become more aware of the political and industry barriers that need to be surmounted to achieve equity of access. I wrote about this :: 'Inverse Connectivity Rule' on RuralGP.com ::

Technologies such as Dynamic Spectrum/Whitespace offer great potential to rural communities, and we have facilitated trials of this in the Machrie and surrounding area on Arran. Community engagement has also been an important aspect of this work.

LEVEL : PRAGMATIC EXPERIENCE : 4 YEARS COMMUNITY BROADBAND DYNAMIC SPECTRUM INTERNET OF THINGS RURAL INEQUALITIES
Technology Enhanced Care >

Driven by moves to integrate health & social care, and the increasing challenges of an ageing and medically-complex population (generally, and on Arran), innovations in wearable technology and tech-enhanced care offer very important potential for sustaining and improving good quality care to patients.

This is an important developing field, and one which we are engaged with a number of germinating projects on Arran. I am involved with some project work with the Digital Health & Social Care Institute of Scotland, and helping to look at how connectivity can be improved on Arran to facilitate these developments.

LEVEL : LEARNING EXPERIENCE : DEVELOPING GPS POSITIONING TELEHEALTH REMOTE MONITORING SKYPE CONSULTING
RURAL HEALTH
PREHOSPITAL CARE > Active BASICS Scotland/Sandpiper responder - over 100 calls since August 2010
  • current PHPLS and PHECC certificates
  • previous courses include ALS, ATLS, EPLS, SCOTTIE, MIMMS, IMC1
  • holder of Institute of Advanced Motoring certificate and AIRWAVE radio
  • experience in rural and mountain rescue settings
  • LEVEL : ADVANCED / EXPERIENCED PHECC EXPERIENCE : 5 years
    PHECC PHPLS
    EXTENDED GP SKILLS > In addition to core GP work, I am respiratory lead for our practice. I have a number of other clinical interests that like to maintain.
    LEVEL : N/A EXPERIENCE : N/A MENTAL HEALTH CHILD HEALTH MINOR SURGERY SLEEP MEDICINE ASTHMA
    COMMUNITY HOSPITAL CARE >

    I adapted our local ACS Guidelines to take into account new developments in delivering primary PCI. Since then, I have kept these updated and liaised with our local cardiology team, along with the regional PCI receiving centre. Our ACS pathway takes into account availability of air transfer, in order to decide whether thrombolysis is a more appropriate treatment or not.

    I have also developed - with assistance of Dr Linda Dykes in Bangor Hospital - a community hospital pathway for major trauma. Transfer decision-making is another aspect of rural health care that potentially has loads of research potential, and I have formed some great links with conferes in Nunavut and Australia on this topic. I'm hoping to find some time to explore this aspect of clinical care in more detail.

    LEVEL : RURAL GP EXPERIENCE : 5 YEARS THROMBOLYSIS PPCI TRANSFER DECISIONS MAJOR TRAUMA INTERMEDIATE CARE AEROMEDICAL RETRIEVAL FOR THE RURAL GP NEAR PATIENT TESTING
    AWARDS/FUNDING
    • 2014
      2016
      Isle of Arran

      Project Acorn

      Primary Care, The Scottish Government

      Grant to a number of 'Acorn' GP practices across Scotland to free up GP Leadership time to focus on projects that would be of benefit to our patients. We have carried out a number of projects over the last few years; latterly we focussed on work to improve connectivity and raise the profile of poor rural connectivity. Specifically, this allowed me time to co-found and develop the local group ::ConnectArran::.

      On an annual basis, Project Acorn practices met up to share their learning and experience, which built up a helpful picture of some of the more pragmatic issues facing Scottish general practice. Unfortunately this funding stopped in April 2016 but it has allowed us to develop useful work on connectivity - a rate-limiting step to developing some aspects of patient care in Arran Medical Group.

    • 2015
      Dubrovnik, Croatia

      WONCA WORLD RURAL HEALTH CONFERENCE 2015

      RCGP Scotland

      Funded by RCGP Scotland to attend the WONCA World Rural Health Conference in Dubrovnik, Croatia - in April 2015. This allowed multiple connections to be built with confreres from across the world.

      Specifically, it triggered the development of the RRHEAL Rural GP VC Education sessions, to help build VC-literacy and share good practice across Scotland's rural GP/community hospital sites. This 'test for change' has recently been concluded, with the intention that these sessions will continue after summer 2016. Conversations also resulted in developments about sharing acute-care pathways across Scotland's rural sites, and the use of simulation and ultrasound in the rural setting - areas of development that have informed local innovation then.

    • 2015
      Fort William

      Best Rural-Themed Poster Submission

      Belford 50:150 Conference

      For Arran Resilience poster.
    • 2016
      National Centre for Rural Medicine, Tromso, Norway

      Travel Scholarship

      Rural GP Association of Scotland

      To facilitate attendance at an invitational mini-symposium to advance research in rural healthcare. This is being held in September 2016.
    • 2017
      WONCA World Rural Health Conference, Cairns, Australia

      Travel Scholarship

      Rural GP Association of Scotland

      To assist with attendance at the WONCA / ACRRM 'World of Rural Health' Conference in Cairns, and subsequent travel to Adelaide and the Clare Valley to understand delivery of rural healthcare in these settings.
    .05

    COLLABORATION

    PUBLICATIONS LIST
    01 Nov 2017

    PBSGL: Life Threatening Problems in Children

    PBSGL Module: NHS Education for Scotland

    A collaborative effort amongst clinicians to produce a module for the Practice Based Small Group Learning (PBSGL) network on the management of serious illness in children. Publication date TBC

    Learning Resource

    PBSGL: Life Threatening Problems in Children

    Learning Resource
    About The Publication

    A collaborative effort amongst clinicians to produce a module for the Practice Based Small Group Learning (PBSGL) network on the management of serious illness in children.

    11 Sep 2017

    Should nightshift work mean an earlier age of retirement?

    Pulse Magazine

    Now here’s a potentially controversial idea. In return for doing nightshifts, should NHS staff be entitled to an earlier retirement? This idea came to me during a 4am callout. A recent general recommendation from our accountants to check for any gaps in national insurance contributions, took me to the HMRC website. It informed me - cheerfully, I felt - that I had contributed 14 full years of national insurance, and I had another 32 to go until retirement. The 10-minute car journey to the hospital presented an opportune moment to reflect on whether this makes me feel young, or depressed.

    Pulse Articles Hogg D

    Should nightshift work mean an earlier age of retirement?

    Hogg D
    Pulse Articles
    About The Publication

    Now here’s a potentially controversial idea. In return for doing nightshifts, should NHS staff be entitled to an earlier retirement?

    This idea came to me during a 4am callout. A recent general recommendation from our accountants to check for any gaps in national insurance contributions, took me to the HMRC website. It informed me – cheerfully, I felt – that I had contributed 14 full years of national insurance, and I had another 32 to go until retirement. The 10-minute car journey to the hospital presented an opportune moment to reflect on whether this makes me feel young, or depressed.

    Click the link button to read more…

    09 Sep 2017

    Up a Track Without a Speculum: Case Presentation

    BASICS Scotland Annual Conference: Carnoustie, Scotland

    Case Presentation to the BASICS Scotland Conference in Carnoustie, about a prehospital BASICS callout for premature labour.

    Oral Presentation Hogg D

    Up a Track Without a Speculum: Case Presentation

    Hogg D
    Oral Presentation
    About The Publication

    Case Presentation to the BASICS Scotland Conference in Carnoustie, about a prehospital BASICS callout for premature labour.

    29 Aug 2017

    Protected learning time is not a luxury

    Pulse Magazine

    The value placed on staff development is often a useful barometer to the culture and outlook of an organisation. An engaged and valued workforce tends to be a happy, productive and effective workforce. Of course, in the NHS, numerous pressures mean that it can be difficult to achieve the Zen approach to staff happiness that big multinationals like Google and Apple are often cited as being able to achieve. However, whilst recognising the frustrations, limitations and sometimes downright atrocious decision-making to be found in our NHS, most of us still manage to find professional satisfaction with the patient contact that is part-and-parcel of daily GP-ing, fixing unwellness, reducing suffering and the privilege of fostering therapeutic rapport.

    Pulse Articles Hogg D

    Protected learning time is not a luxury

    Hogg D
    Pulse Articles
    About The Publication

    The value placed on staff development is often a useful barometer to the culture and outlook of an organisation. An engaged and valued workforce tends to be a happy, productive and effective workforce.

    Of course, in the NHS, numerous pressures mean that it can be difficult to achieve the Zen approach to staff happiness that big multinationals like Google and Apple are often cited as being able to achieve.

    However, whilst recognising the frustrations, limitations and sometimes downright atrocious decision-making to be found in our NHS, most of us still manage to find professional satisfaction with the patient contact that is part-and-parcel of daily GP-ing, fixing unwellness, reducing suffering and the privilege of fostering therapeutic rapport.

    Click the link button to read more…

    19 Jul 2017

    That déjà vu feeling

    Pulse Magazine

    I remember the frustration of reading this article in the BBC News back in 2014, when Scottish GPs were being criticised by Reform Scotland for not embracing online appointment booking and prescriptions. The Scottish Government was quoted as saying ‘online services are currently available to all GP practices in Scotland’ and that it was 'continuing to work to promote and encourage practices to use these services’. As IT lead for our practice, my jaw dropped somewhat.

    Pulse Articles Hogg D

    That déjà vu feeling

    Hogg D
    Pulse Articles
    About The Publication

    I remember the frustration of reading this article in the BBC News back in 2014, when Scottish GPs were being criticised by Reform Scotland for not embracing online appointment booking and prescriptions.

    The Scottish Government was quoted as saying ‘online services are currently available to all GP practices in Scotland’ and that it was ‘continuing to work to promote and encourage practices to use these services’. As IT lead for our practice, my jaw dropped somewhat.

    Click the link button to read more…

    05 Jul 2017

    Are we relying on Huldufolk to give us rural integrated care?

    Pulse Magazine

    According to Icelandic folklore, when scrambling over volcanic rockscape it is not uncommon to experience the sensation that you are being joined by groups of people behind you. And yet, when you turn around, no one is there. The Icelandic term for the mysterious and unseen individuals responsible for this, is Huldufolk (yes, pronounced hool-de-foke), or ‘the hidden people’. I sometimes get the same feeling when hearing promises of what the ‘wider primary care team’ will offer us in the next version of the Scottish GP contract; especially in rural areas.

    Pulse Articles Hogg D

    Are we relying on Huldufolk to give us rural integrated care?

    Hogg D
    Pulse Articles
    About The Publication

    According to Icelandic folklore, when scrambling over volcanic rockscape it is not uncommon to experience the sensation that you are being joined by groups of people behind you. And yet, when you turn around, no one is there. The Icelandic term for the mysterious and unseen individuals responsible for this, is Huldufolk (yes, pronounced hool-de-foke), or ‘the hidden people’.

    I sometimes get the same feeling when hearing promises of what the ‘wider primary care team’ will offer us in the next version of the Scottish GP contract; especially in rural areas.

    Click the link button to read more…

    16 Jun 2017

    When should GPs participate in emergency teams, and what is their contribution? 

    20th Nordic Congress of General Practice: Reykjavik, Iceland

    Together with fellow GPs we explored aspects of  GP participation in emergency teams.  We presented research on the GPs’ key contributions, how decisions are made and how leadership is enacted.  Our ambition is to strengthen the awareness of the GP’s role as a primary care emergency team member.

    Workshop Halvorsen P, Rørtveit S, Holte-Ambjornsen O, Brandstorp H, Hogg D, Hjortdahl M

    When should GPs participate in emergency teams, and what is their contribution? 

    Halvorsen P, Rørtveit S, Holte-Ambjornsen O, Brandstorp H, Hogg D, Hjortdahl M
    Workshop
    About The Publication

    Objectives: Together with fellow GPs we want to explore aspects of  GP participation in emergency teams.  We present research on the GPs’ key contributions, how decisions are made and how leadership is enacted.  Our ambition is to strengthen the awareness of the GP’s role as a primary care emergency team member.

    Background: In 2010 a Norwegian study found that GPs are alerted in less than half or pre-hospital emergency incidents.  Furthermore, when alerted, the GPs choose to participate in less than half of the call-outs (Zakariassen & Hunskår 2010). White papers have called for increased GP participation in such incidents. Others, however, have questioned the utility of GP participation and suggested that patients may be better served by emergency medical technicians alone (Kindt et al 2013). Consistent with this view Norwegian GPs have reported lack of experience with common emergency procedures (Wisborg & Brattebø 2001).  However, recent focus group studies suggest that although their role may have changed, GPs still have an important role in the pre-hospital emergency incidents. (Hjortdahl et al 2014, 2016). For our workshop this will be the point of departure, as we share research and experiences relevant to the GP’s role as a team member. Based on a complete sample of emergency incidents in the island community Austevoll, Norway, Sverre Rørtveit was able to study the GP’s contribution in terms of practical skills and an overall ability to assess the seriousness of the situation.  In the municipality of Alta, Norway, Helen Brandstorp explored leadership and learning processes in team training sessions based on simulated emergency incidents. On the Island Arran on the west coast of Scotland numerous holidaymakers get injured during outdoor activities along the coast and in the high mountains.  Arran Resilience was formed to bring the coastguard, mountain rescue, police, fire and ambulance together for joint exercises, aiming to improve communication and teamwork (Hogg 2015).

    Session Content:  We will start with a short onsite survey regarding the GPs’ role in emergency incidents, confidence in emergency medicine procedures and whether the GP would participate in hypothetical emergency call outs. We proceed with four short presentations:

    – Triage during pre-hospital, emergencies – how do GPs decide? (Rørtveit)

    – Confidence in emergency medicine procedures among GPs (Holte-Ambjørnsen)
    – Leadership in the course of pre-hospital emergencies – what does it look like? (Brandstorp)
    – Arran Resilience: Networking island emergency responders. (Hogg)

    The session ends with feedback from the onsite survey, comparison with a recent survey of 1000 Norwegian GPs and a general discussion (Hjortdahl & Halvorsen).

    02 May 2017

    Arran Resilience: a model for integrated rural prehospital care?

    Rural WONCA 2017: Cairns, Australia

    The Arran Resilience model offers a cost-neutral, easily implemented model of immediate care delivery to rural areas. It seeks to recognise the skillbase of emergency teams, and improve co-ordination of emergency responses at high demand or in the event of a major incident or complexity.

    Oral Presentation Hogg DR

    Arran Resilience: a model for integrated rural prehospital care?

    Hogg DR
    Oral Presentation
    About The Publication

    Background

    Arran is an island community with finite – but committed – emergency medical resources.  Prior to October 2010 no mechanism existed for regular dialogue between emergency teams such as the ambulance, mountain rescue, coastguard and fire services.  We sought to change this with the aim of better networking and interagency training.

    Intervention

    We aimed to improve communication between team leaders, and sought to build a partnership based on four key principles: 1) Local ownership; 2) Can-do attitude; 3) Working within existing competences/frameworks; and 4) Cost neutrality.

    Evaluation

    We have now held twenty five liaison meetings.  In the initial stages we  ran eight island-wide workshops on casualty care, and until recently, organised three multi-agency exercises at very low cost.  Regular dialogue between teams has been facilities via a group email, and this has resulted in better understanding of each team’s skills and capabilities.  Our ‘Team Profiles Document’  summarises equipment, skills and personnel for each of our emergency teams, and is updated on an annual basis.  This is particularly helpful for new staff e.g. police officers to understand capabilities of the emergency teams.   We are now focussing on simulation training and refining the multi-agency response to cardiac arrest on Arran. There has been  interest in the Arran Resilience model of immediate care from other island and rural communities.

    In 2013 we were named the UK Resilience Team of the Year by the Emergency Planning Society

    Conclusion

    The Arran Resilience model offers a cost-neutral, easily implemented model of immediate care delivery to rural areas.  It seeks to recognise the skillbase of emergency teams, and improve co-ordination of emergency responses at high demand or in the event of a major incident or complexity.

    01 May 2017

    Initial success of internet based video conferencing for prehospital care clinical governance meetings

    Rural WONCA 2017: Cairns, Australia

    BASICS (Scotland) provides education and support in prehospital emergency care to healthcare providers throughout remote and rural Scotland. Nationally, the organisation enables 176 healthcare providers who respond to prehospital emergency calls in their locality in support of the Scottish Ambulance Service. Given the geographical challenges faced by rural responders wishing to attend such meetings, a specific issue we faced was how to enable these meetings to be provided on a virtual platform which would allow participation in group discussion. This presentation considered the development of regular 'virtual' meetings whereby responders are able to discuss cases, be informed of latest service developments and obtain peer support for rural prehospital care in Scotland.

    Oral Presentation Price R, Hogg DR, Stewart S

    Initial success of internet based video conferencing for prehospital care clinical governance meetings

    Price R, Hogg DR, Stewart S
    Oral Presentation
    About The Publication

    BASICS (Scotland) provides education and support in prehospital emergency care to healthcare providers throughout remote and rural Scotland. Nationally, the organisation enables 176 healthcare providers who respond to prehospital emergency calls in their locality in support of the Scottish Ambulance Service. Given the geographical challenges faced by rural responders wishing to attend such meetings, a specific issue we faced was how to enable these meetings to be provided on a virtual platform which would allow participation in group discussion.

    This presentation considered the development of regular ‘virtual’ meetings whereby responders are able to discuss cases, be informed of latest service developments and obtain peer support for rural prehospital care in Scotland.

    01 May 2017

    The Visible Rural GP: Developing an image bank for modern rural practice

    Rural WONCA 2017: Cairns, Australia

    In this session, I aimed to summarise the important contribution of seminal works (such as A Fortunate Man, A Country Doctor and Single Handed), and consider how to share effective images that provide insight to the modern rural practitioner, and consider social media streams available to share this work. Find out more by searching for #RuralGPframed on twitter

    Oral PresentationProfiling Rural GP Hogg DR

    The Visible Rural GP: Developing an image bank for modern rural practice

    Hogg DR
    Oral PresentationProfiling Rural GP
    About The Publication

    In this session, I aimed to summarise the important contribution of seminal works (such as A Fortunate Man, A Country Doctor and Single Handed), and consider how to share effective images that provide insight to the modern rural practitioner, and consider social media streams available to share this work.

    Find out more by searching for #RuralGPframed on twitter

    Learning goals:

    • Derive inspiration to develop your own photography of rural practice
    • Consider technical aspects of effective photo-journalism
    • Consider how to share images effectively to inspire potential recruits to rural practice.
    01 May 2017

    Remote Pre-hospital Emergency Care Education: An analysis of online tele-education courses

    Rural WONCA 2017: Cairns, Australia

    I was privileged to present data from this recent report on behalf of BASICS Scotland. 'It is possible to provide tele-education, at scale, to rural primary care staff; this requires relevant course content, good technical support and appropriate contextual setting. Online delivery saves resource, and fits the way modern primary care practitioners are asked to work. The participants used the online supporting materials extensively, the potential benefits of this type of learning are as yet unknown, further work continues to find optimal modes of delivery, and to increase participation in live sessions.'

    Oral Presentation Laird C, Heaney D, Mair F, Hogg DR

    Remote Pre-hospital Emergency Care Education: An analysis of online tele-education courses

    Laird C, Heaney D, Mair F, Hogg DR
    Oral Presentation
    About The Publication

    I was privileged to present data from this recent report on behalf of BASICS Scotland.

    ‘It is possible to provide tele-education, at scale, to rural primary care staff; this requires relevant course content, good technical support and appropriate contextual setting. Online delivery saves resource, and fits the way modern primary care practitioners are asked to work. The participants used the online supporting materials extensively, the potential benefits of this type of learning are as yet unknown, further work continues to find optimal modes of delivery, and to increase participation in live sessions.’

    30 Mar 2017

    Head for the hills! Rural practice, intermediate care and realistic medicine

    BGS Scottish Trainees' Conference: Perth, Scotland

    Presentation to the annual Scottish Trainees' conference of the British Geriatric Society - background, case scenarios and workshop to introduce some of the challenges of providing complex care of the elderly and intermediate care in remote & rural settings. Delivered with Deena Deans, physiotherapist at Arran War Memorial Hospital. Lots of discussion and enthusiasm for #RealisticMedicine was evident from the participants!

    Oral PresentationWorkshop Hogg DR, Deans D

    Head for the hills! Rural practice, intermediate care and realistic medicine

    Hogg DR, Deans D
    Oral PresentationWorkshop
    About The Publication

    Presentation to the annual Scottish Trainees’ conference of the British Geriatric Society – background, case scenarios and workshop to introduce some of the challenges of providing complex care of the elderly and intermediate care in remote & rural settings.  Delivered with Deena Deans, physiotherapist at Arran War Memorial Hospital.  Lots of discussion and enthusiasm for #RealisticMedicine was evident from the participants!

    12 Mar 2017

    LGBTQ+ Factsheets

    Rural GP Association of Scotland

    Following Dr Thom O'Neill's presentation to the RGPAS Annual Conference in November 2016, we were keen to develop factsheets and materials to assist rural GPs in Scotland develop their services and approach to LGBTQ+ patients. Dr O'Neill was instrumental in developing the content for three resulting factsheets: LGBTQ+ Youth, Trans Youth and LGBTQ+ Elderly, with a strong emphasis on the challenges and specifics of rural communities. Since these factsheets were launched, we've had international interest including Canada, New Zealand and Australia, and individual practices in Scotland have reported various activities to improve local awareness of the issues highlighted in the factsheets.

    Miscellaneous O'Neill T, Hogg DR, Dawson K, MacTaggart A

    LGBTQ+ Factsheets

    O'Neill T, Hogg DR, Dawson K, MacTaggart A
    Miscellaneous
    About The Publication

    Following Dr Thom O’Neill’s presentation to the RGPAS Annual Conference in November 2016, we were keen to develop factsheets and materials to assist rural GPs in Scotland develop their services and approach to LGBTQ+ patients.  Dr O’Neill was instrumental in developing the content for three resulting factsheets: LGBTQ+ Youth, Trans Youth and LGBTQ+ Elderly, with a strong emphasis on the challenges and specifics of rural communities.

    Since these factsheets were launched, we’ve had international interest including Canada, New Zealand and Australia, and individual practices in Scotland have reported various activities to improve local awareness of the issues highlighted in the factsheets.

    02 Mar 2017

    Spectacular Horizons…Opportunities for CPD Innovation for Rural Health Professionals

    NES CPD Connect Showcase: Stirling

    This workshop was run for NHS Education for Scotland at their CPD Connect showcase event to plan future CPD strategy in Scotland. The workshop aimed to give some perspective of the challenges of delivering CPD, some of the opportunities including recent work on videoconferencing as an enabler, and also to introduce the concept of 'Clinical Courage' and its place in the learning cycle.

    Workshop Hogg DR

    Spectacular Horizons…Opportunities for CPD Innovation for Rural Health Professionals

    Hogg DR
    Workshop
    About The Publication

    This workshop was run for NHS Education for Scotland at their CPD Connect showcase event to plan future CPD strategy in Scotland.  The workshop aimed to give some perspective of the challenges of delivering CPD, some of the opportunities including recent work on videoconferencing as an enabler, and also to introduce the concept of ‘Clinical Courage’ and its place in the learning cycle.

    02 Nov 2016

    (re)Finding your Teaching Mojo

    uTCGP Conference: Dundee

    'A chance for some less-suspecting individuals to tell their story of inspiration derived from the generalism required from studying or working in a rural practice environment. There will be some cross-generational benefit from networking and story-sharing both during and after this workshop.'

    Workshop Hogg D, Lockwood P

    (re)Finding your Teaching Mojo

    Hogg D, Lockwood P
    Workshop
    About The Publication

    ‘A chance for some less-suspecting individuals to tell their story of inspiration derived from the generalism required from studying or working in a rural practice environment. There will be some cross-generational benefit from networking and story-sharing both during and after this workshop.’

    01 Nov 2016

    Evidence to the Health & Sport Committee

    Scottish Parliament: Edinburgh

    I was invited to give evidence to the Health & Sport Committee on behalf of the Royal College of GPs Scotland, about the challenges surrounding recruitment & retention to rural areas. I joined a relatively large panel, and a lively discussion ensued. You can watch the proceedings in the video clip attached to this entry.

    Evidence Given

    Evidence to the Health & Sport Committee

    Evidence Given
    About The Publication

    I was invited to give evidence to the Health & Sport Committee on behalf of the Royal College of GPs Scotland, about the challenges surrounding recruitment & retention to rural areas.

    I joined a relatively large panel, and a lively discussion ensued.  You can watch the proceedings in the video clip attached to this entry.

    15 Oct 2016

    Student Workshop: So You Want to Work in PreHospital Care?

    BASICS Annual Conference: Leamington Spa

    Student workshop run for around 30 student participants attending the BASICS England & Wales Conference, on career considerations and opportunities for developing interests in critical, retrieval and prehospital care in Scotland. We covered the spectrum from retrieval medicine and hospital specialty training, to rural medicine and opportunities in general practice.

    Workshop Hogg DR, Price R

    Student Workshop: So You Want to Work in PreHospital Care?

    Hogg DR, Price R
    Workshop
    About The Publication

    Student workshop run for around 30 student participants attending the BASICS England & Wales Conference, on career considerations and opportunities for developing interests in critical, retrieval and prehospital care in Scotland.  We covered the spectrum from retrieval medicine and hospital specialty training, to rural medicine and opportunities in general practice.

    15 Oct 2016

    Rural PreHospital Care in Scotland

    BASICS Annual Conference: Leamington Spa

    In this presentation, we provided a perspective of rural prehospital care in Scotland. We outlined the structure and function of BASICS Scotland, how this is supported by the Sandpiper Trust, and some recent work into the efficacy of videoconferencing for clinical governance purposes.

    Oral Presentation Price R, Hogg DR

    Rural PreHospital Care in Scotland

    Price R, Hogg DR
    Oral Presentation
    About The Publication

    In this presentation, we provided a perspective of rural prehospital care in Scotland.  We outlined the structure and function of BASICS Scotland, how this is supported by the Sandpiper Trust, and some recent work into the efficacy of videoconferencing for clinical governance purposes.

    06 Sep 2016

    Is academic prowess the best predictor of a future GP?

    Pulse Magazine

    It’s the time of year when school pupils find out their exam grades, on which their life trajectories seem - at least at this time of year - mapped out as a result. Cue the usual debates about whether this year’s exams were more easy or difficult, and for us medic folks, whether academic prowess (as measured by our exam system) is the best means by which to initially select students for medicine.

    Pulse Articles Hogg DR

    Is academic prowess the best predictor of a future GP?

    Hogg DR
    Pulse Articles
    About The Publication

    It’s the time of year when school pupils find out their exam grades, on which their life trajectories seem – at least at this time of year – mapped out as a result. Cue the usual debates about whether this year’s exams were more easy or difficult, and for us medic folks, whether academic prowess (as measured by our exam system) is the best means by which to initially select students for medicine.

    Click the link to read more…

    01 Sep 2016

    Generalism in Rural Medicine: International Research Symposium

    Tromso University, Norway

    Approximately 60 researchers with a special interest in generalism in rural medicine met in Tromsø, Northern Norway, for this mini-symposium. The intention was to create a place to share knowledge, plans and ideas; get an overview of what is going on around the world; a chance to revisit and clarify goals; thinking of the values we really want to define; do research that captures what makes rural generalism so different & important; and finally, do some initial collaborative work.

    Collaboration

    Generalism in Rural Medicine: International Research Symposium

    Collaboration
    About The Publication

    Approximately 60 researchers with a special interest in generalism in rural medicine met in Tromsø, Northern Norway, for this mini-symposium.  The intention was to create a place to share knowledge, plans and ideas; get an overview of what is going on around the world; a chance to revisit and clarify goals; thinking of the values we really want to define; do research that captures what makes rural generalism so different & important; and finally, do some initial collaborative work.

    I participated in four workshops covering Clinical Courage, Telemedicine and Curriculum Development for Rural Practice.  At least two articles are in the pipeline as a result of attending this symposium, along with additional research links and new collaborative opportunities.

    27 Jul 2016

    The inspiring and stimulating work of rural general practice

    Pulse Magazine

    'All you need now is for someone to give birth!' And at that moment, we highlighted to Brendan - one of our elective students - that there was indeed someone in labour upstairs in our maternity suite. Click the link to read more...

    Pulse Articles Hogg DR

    The inspiring and stimulating work of rural general practice

    Hogg DR
    Pulse Articles
    About The Publication

    ‘All you need now is for someone to give birth!’

    And at that moment, we highlighted to Brendan – one of our elective students – that there was indeed someone in labour upstairs in our maternity suite.

    Click the link to read more…

    20 Jul 2016

    It’s not all doom and gloom

    Pulse Magazine

    I am angry. I am burnt out. I am overpaid. I am set for a gold-plated pension. I am the reason why A&Es are too busy. I am a failed specialist. Apparently, when I read the papers. I still feel a glow when teaching, describing and doing my trade There is a problem universally acknowledged that GPs have an image problem. Students are telling us this. Patients are telling us this. The media is spinning this. Click the link to read more...

    Pulse Articles Hogg DR

    It’s not all doom and gloom

    Hogg DR
    Pulse Articles
    About The Publication

    I am angry. I am burnt out. I am overpaid. I am set for a gold-plated pension. I am the reason why A&Es are too busy. I am a failed specialist.

    Apparently, when I read the papers.

    There is a problem universally acknowledged that GPs have an image problem. Students are telling us this. Patients are telling us this. The media is spinning this.

    Click the link to read more…

    06 Jul 2016

    Book Review: WONCA Rural Medical Education Guidebook

    Education for Primary Care

    Review of the WONCA Rural Medical Education Guidebook - a great resource for all clinicians involved in teaching rural and remote healthcare. Full article only available behind journal paywall, sorry.

    Journal Paper Hogg DR

    Book Review: WONCA Rural Medical Education Guidebook

    Hogg DR
    Journal Paper
    About The Publication

    Review of the WONCA Rural Medical Education Guidebook – a great resource for all clinicians involved in teaching rural and remote healthcare.

    29 Jun 2016

    The answers are out there! Developing an inclusive approach to collaboration

    Journal of Rural & Remote Health

    This review article was published in the Journal of Rural & Remote Health following my presentation to Rethinking Remote 2016, held in Inverness. It highlights the opportunities now available for international collaboration, particularly in order to share good practice from a range (and often similar) settings of remote healthcare.

    Journal Paper Hogg DR

    The answers are out there! Developing an inclusive approach to collaboration

    Hogg DR
    Journal Paper
    About The Publication

    Professional isolation is a recurring issue in the delivery of rural and remote health care. However, collaboration is now more feasible with developments in technology and connectivity. At an international scale, collaboration offers clear opportunities for good ideas and great work to be shared across distances and boundaries that previously precluded this. This article reflects a presentation given to the Rethinking Remote conference in Inverness (Scotland) in May 2016. A number of factors with regard to infrastructure and engagement are considered, along with ways in which the opportunities of collaboration between individuals and large centres can be optimised. Social media and increased connectivity pave the way for easier access to great practice across international sites that share similar challenges.

    24 May 2016

    The Answers are Out There! Finding Solutions in International Collaboration

    Rethinking Remote 2016: Inverness

    This talk was given to the Rethinking Remote 2016 conference, held in Inverness on May 23-24. I was asked (and delighted to try!) to explore some of the opportunities and challenges around international collaborative working. We also managed to successfully conduct a live Skype discussion with Prof Phil Cotton and two of his colleagues in Rwanda.

    Oral PresentationVideo Clips Hogg DR

    The Answers are Out There! Finding Solutions in International Collaboration

    Hogg DR
    Oral PresentationVideo Clips
    About The Publication

    This talk was given to the Rethinking Remote 2016 conference, held in Inverness on May 23-24.  I was asked (and delighted to try!) to explore some of the opportunities and challenges around international collaborative working.  We also managed to successfully conduct a live Skype discussion with Prof Phil Cotton and two of his colleagues in Rwanda.

    This video was taken by a team from Armchair Medical ( armchairmedical.tv ) who have kindly made this recording available for public consumption. I’ve taken a look at their other videos and would recommend having a look at what they have on offer (I have no conflict of interest).

    23 May 2016

    Connectivity: The key to innovative solutions

    Rethinking Remote 2016, Inverness

    Connectivity is a vital component to allow innovative solutions to be considered in the rural environment. This workshop will explore ways in which rural connectivity can be delivered effectively, and consider some of the benefits of connected healthcare.

    Oral Presentation Hogg DR, Inglis A, Stirling A

    Connectivity: The key to innovative solutions

    Hogg DR, Inglis A, Stirling A
    Oral Presentation
    About The Publication

    Introduction

    New cloud-based services enable delivery of high quality care whether in the field or in a well-equipped city-centre hospital. Health workers can use a range of mobile devices, to suit the situation and enable flexibility. In this new ICT-enabled healthcare it is possible to reach high levels of operating efficiency without sacrificing standards of care and the experience of service users (patients).
    However, use of cloud services assumes that devices will have internet access where and when they are used. This degree of connectivity cannot unfortunately be taken for granted across much of Scotland´s landmass. Delivering connectivity suitable for mobile devices is not trivial in remote rural areas, however new technologies and approaches are bringing down the costs.

    Objectives

    This presentation will consider:

    • Advanced services that can be delivered where connectivity allows, and the positive impact they can bring to remote communities – including remote monitoring and telecare
    • The connectivity challenges faced in remote areas and the factors contributing to the issue
    • Ad-hoc requirements (e.g. for a summer tourist festival or emergency incident)
    • Emerging connectivity technologies, showing how a connectivity strategy could be evolved to meet remote requirements
    • Examples of remote areas (including international examples) where emerging technologies enable a revolution in service delivery

    Conclusions

    Connectivity is a vital component to allow innovative solutions to be considered in the rural environment. This workshop will explore ways in which rural connectivity can be delivered effectively, and consider some of the benefits of connected healthcare.

    23 May 2016

    Scotland’s GP Rural Fellowship: what is it and where are they now?

    Rethinking Remote 2016, Inverness

    Scotland´s GP Rural Fellowship is an initiative that positively impacts on rural recruitment and retention.

    Oral PresentationProfiling Rural GP MacVicar R, Clarke G, Hogg DR

    Scotland’s GP Rural Fellowship: what is it and where are they now?

    MacVicar R, Clarke G, Hogg DR
    Oral PresentationProfiling Rural GP
    About The Publication

    Background

    In Scotland 20% of the population live in a remote or rural area spread across 94% of the land mass that is defined as remote and rural. The Scottish Government has, in its Quality Strategy outlined the need for equitable access to high quality healthcare services for all patients regardless of personal characteristics including geographic location.
    NES works in partnership with territorial Health Boards and medical schools to address rural recruitment and retention through a variety of initiatives and the longest established of these is the GP Rural Fellowship, which has been in place since 2002.The current model involves co-funding arrangements between NES and participating Boards supporting a maximum of 12 fellows per year.

    Summary of work

    A survey of all previous rural fellows was undertaken in the first quarter of 2014 including all fellows that had undertaken the fellowship in the 11 academic years from 2002/03 to 2012/13. A total of 69 GPs were recruited to the fellowship in this period with a response rate of 98%.

    Summary of results

    A total of 46 graduates are working in rural areas or accessible small towns (71%), 39 in substantive general practice roles (60%).

    Conclusions

    Scotland’s GP Rural Fellowship programme is an example of successful collaboration between education and service and the results of this survey suggest that approximately three quarters of graduates are retained in important roles in rural Scotland.

    Take-home message

    Scotland´s GP Rural Fellowship is an initiative that positively impacts on rural recruitment and retention.

    12 May 2016

    Clinical guidelines need input from ‘disinterested’ GPs

    Pulse Magazine

    On why clinical guidelines need to reflect the range of expertise and time available to address health concerns, in the context of busy surgeries and patients with complex health needs. See link to article.

    Pulse Articles Hogg DR

    Clinical guidelines need input from ‘disinterested’ GPs

    Hogg DR
    Pulse Articles
    About The Publication

    On why clinical guidelines need to reflect the range of expertise and time available to address health concerns, in the context of busy surgeries and patients with complex health needs.  See link to article.

    28 Apr 2016

    We need to recognise the need for holistic recruitment

    Pulse Magazine

    Let’s stop for a second to think how much we could gain if all those involved - particularly HR departments - could work more effectively to value our future colleagues - and their partners and families - to take up positions that we are spending so much energy trying to advertise. There are of course other factors affecting the recruitment crisis within general practice, but for those who are up for the challenge - and who have recognised it as a stimulating career - we should be doing everything possible to make their move a feasible and fair prospect. See link for article.

    Pulse Articles Hogg DR

    We need to recognise the need for holistic recruitment

    Hogg DR
    Pulse Articles
    About The Publication

    Let’s stop for a second to think how much we could gain if all those involved – particularly HR departments – could work more effectively to value our future colleagues – and their partners and families – to take up positions that we are spending so much energy trying to advertise. There are of course other factors affecting the recruitment crisis within general practice, but for those who are up for the challenge – and who have recognised it as a stimulating career – we should be doing everything possible to make their move a feasible and fair prospect.  See link for article.

    16 Apr 2016

    Rural Generalism: A presentation to Glasgow University GP Society

    Glasgow

    Presentation to Glasgow University GP Society about the attractions and challenges of rural practice.

    Oral PresentationProfiling Rural GP

    Rural Generalism: A presentation to Glasgow University GP Society

    Oral PresentationProfiling Rural GP
    About The Publication

    Presentation to Glasgow University GP Society about the attractions and challenges of rural practice.

    04 Apr 2016

    Five IT fixes we desperately need

    Pulse Magazine

    Poor progress in harnessing advances in IT is holding back innovation and the ability to provide patients with modern health care. See link for article.

    Pulse Articles Hogg DR

    Five IT fixes we desperately need

    Hogg DR
    Pulse Articles
    About The Publication

    Poor progress in harnessing advances in IT is holding back innovation and the ability to provide patients with modern health care.  See link for article.

    08 Feb 2016

    We need to do more to inspire the next generation of GPs

    Pulse Magazine

    Thinking back to my own student days, I found myself repeating advice that I had received whilst a student in Stornoway: ‘Seize every opportunity. And never lose sight of the diagnostic power contained within your patient’s story combined with sound clinical examination.’  Inspiring the next generation with generalism. See link to article.

    Profiling Rural GPPulse Articles Hogg DR

    We need to do more to inspire the next generation of GPs

    Hogg DR
    Profiling Rural GPPulse Articles
    About The Publication

    Thinking back to my own student days, I found myself repeating advice that I had received whilst a student in Stornoway: ‘Seize every opportunity. And never lose sight of the diagnostic power contained within your patient’s story combined with sound clinical examination.’  Inspiring the next generation with generalism.

    See link to article.

    28 Jan 2016

    Why consider Rural GP as a career?

    University of Glasgow

    In January 2016 three Glasgow University medical students - Zeyar MyoTin, Lara Kelly and Faseeha Farid - came to Arran to find out more about a career in rural practice. Here's their video.

    Media WorkProfiling Rural GPVideo Clips

    Why consider Rural GP as a career?

    Media WorkProfiling Rural GPVideo Clips
    About The Publication

    15 Jan 2016

    Scotland’s GP Rural Fellowship: an initiative that has impacted on rural recruitment and retention

    Journal of Rural & Remote Health

    A review of ten years operation of the NHS Scotland GP Rural Fellowship programme.

    Journal PaperProfiling Rural GP MacVicar R, Clarke G, Hogg DR

    Scotland’s GP Rural Fellowship: an initiative that has impacted on rural recruitment and retention

    MacVicar R, Clarke G, Hogg DR
    Journal PaperProfiling Rural GP
    About The Publication

    Context:  In Scotland 20% of the population live in a remote or rural area spread across 94% of the land mass that is defined as remote and rural. NHS Education for Scotland (NES), NHS Scotland’s training and education body, works in partnership with territorial health boards and medical schools to address rural recruitment and retention through a variety of initiatives. The longest established of these is the GP Rural Fellowship, which has been in place since 2002. This article describes this program and reports on a survey of the output of the Fellowship from 2002 to 2013.

    The Rural Fellowship program:  The Fellowship is aimed at newly qualified GPs, who are offered a further year of training in and exposure to rural medicine. The Fellowship has grown and undergone several modifications since its inception. The current model involves co-funding arrangements between NES and participating boards, supporting a maximum of 12 fellows per year. The Health Boards’ investment in the Fellowship is returned through the service commitment that the Fellows provide, and the funding share from NES allows Fellows to have protected educational time to meet their educational needs in relation to rural medicine. Given this level of funding support it is important that the outcome of the Fellowship experience is understood, in particular its influence on recruitment to and retention in general practice in rural Scotland. To address this need a survey of all previous rural Fellows was undertaken in the first quarter of 2014, including all Fellows that had undertaken the Fellowship between 2002–03 and 2012–13. A total of 69 GPs were recruited to the Fellowship in this period, of which 66 were able to be included in the survey. There was a response rate of 98% to the survey and 63 of those that responded (97%) were working currently in general practice, 53 of whom were doing so in Scotland. A total of 46 graduates of the Fellowship in the period surveyed (71%) were working in rural areas or accessible small towns in Scotland, 39 in substantive general practice roles (60%).

    Lessons learned: Scotland’s GP Rural Fellowship program represents a successful collaboration between education and service, and the results of the survey reported in this article underline previously unpublished data that suggest that approximately three-quarters of graduates are retained in important roles in rural Scotland. It is unclear however whether the Fellowship confirms a prior intention to work in rural practice, or whether it provides a new opportunity through protected exposure. This will form the basis of further evaluation.

    11 Jan 2016

    My anti-burnout strategy for the next five years

    Pulse Magazine

    The realisation that I have now surpassed my First5 years as a GP has been rather more significant than I anticipated. Concluding my first revalidation a few months ago seemed an anticlimax, with no ceremony, brownie points or free pens involved. Instead came the prospect of completing a new round of PSQs and MSFs, with the resetting of the revalidation clock. It didn’t feel the same as the other five-year milestones of a ‘typical’ GP career - qualifying MRCGP, and five years previous to that, qualifying in medicine.

    Pulse Articles Hogg D

    My anti-burnout strategy for the next five years

    Hogg D
    Pulse Articles
    About The Publication

    The realisation that I have now surpassed my First5 years as a GP has been rather more significant than I anticipated.

    Concluding my first revalidation a few months ago seemed an anticlimax, with no ceremony, brownie points or free pens involved. Instead came the prospect of completing a new round of PSQs and MSFs, with the resetting of the revalidation clock. It didn’t feel the same as the other five-year milestones of a ‘typical’ GP career – qualifying MRCGP, and five years previous to that, qualifying in medicine.

    Click the link button to read more…

    22 Oct 2015

    Being Rural: Exploring sustainable solutions for remote and rural healthcare.

    Belford 50:150 Conference, Fort William

    Recruitment to remote and rural areas is dependent on the factors outlined above. RCGP Scotland has outlined its strategic plan to address them with stakeholders who include Scottish Government, the British Medical Association, Health Boards, and NHS Education for Scotland. Actions include advocacy with Government on the urgent need to improve connectivity, buddying for practices between urban and rural areas and development of a novel education package for GPs who wish to move from urban to rural practice.

    Poster Presentation Mack M, Maxwell M, Hogg DR, Gillies J

    Being Rural: Exploring sustainable solutions for remote and rural healthcare.

    Mack M, Maxwell M, Hogg DR, Gillies J
    Poster Presentation
    About The Publication

    (Poster presentation of previously published RCGP Scotland policy paper).

    Introduction

    Remote and rural healthcare in Scotland has reached a crisis with problems with recruitment & retention for general practices throughout the whole country. The causes of the crisis are complex and multi-factorial and have the potential to adversely impact on safe and effective patient care. Within Scotland, significant initiatives have already been taken by NHS Education for Scotland and others. These include a Schools programme, remote & rural training track for GP trainees and a longstanding rural fellows scheme by NHS Education for Scotland. However, problems remain and Royal College of General Practitioners (Scotland) felt that a fresh strategic approach was needed.

    Methodology

    The RCGP Scotland Remote & Rural Strategy Group was formed in 2013 to stratify RCGP Scotland’s work on rural & remote matters. Representation was sought from rural GPs, as well as NHS Education for Scotland, NHS Highland and the RCGP Rural Forum. The work of the 2012 Dewar Group was helpful in stimulating initial discussion that led to the production of a ‘Being Here’ mindmap produced by Miles Mack, which subsequently informed the wider view taken towards factors that have an impact on GP recruitment & retention in remote and rural areas, such as connectivity and professional isolation.

    Several meetings have been held between 2013 and 2015, with ongoing email communication to advance priority areas which we have identified as being most pertinent to the ongoing challenge of the recruitment and retention of rural GPs in Scotland.

    Results & Discussion

    Discussion with remote and rural GPs and many other stakeholders identified the following factors. These constitute a particularly challenging set of circumstances in which to recruit and retain both GPs and other healthcare professionals to remote and rural environments.

    • Connectivity (mobile phone/broadband)
    • Transport
    • Fragility of support services
    • Workload (including the 24 hour commitment)
    • Professional development
    • Education & Training
    • Professional and social isolation

    In 2014 RCGP Scotland developed and published a major policy document with stakeholders, Being Rural, to highlight these issues and to ensure focussed action to address them. All are important but the issue of poor mobile phone and broadband connectivity is a major deterring factor for young GPs and other health professionals.
    http://www.rcgp.org.uk/rcgp-near-you/~/media/Files/Policy/A-Z-policy/RCGP-Being-Rural-policy-paper-and-appendix-2014.ashx

    Since then, the ‘Being Rural’ paper has informed media inputs from RCGP Scotland, helped to galvanise understanding of some of the less obvious factors involved in GP retention, and stimulated discussion with other key stakeholders, such as public and private organisations contributing to the Scottish Government’s 2020 digital vision for world-class connectivity.

    With regard to rural recruitment, our work has been further informed by reflecting on the concept of a ‘rural medical workforce pipeline approach’, an overview of which was described by Norris (1). The pipeline conceptualizes a joined-up approach from provision of effective school-based work experience, through to attractive fellowship and other postgraduate opportunities within rural practice.

    Conclusion

    Recruitment to remote and rural areas is dependent on the factors outlined above. RCGP Scotland has outlined its strategic plan to address them with stakeholders who include Scottish Government, the British Medical Association, Health Boards, and NHS Education for Scotland. Actions include advocacy with Government on the urgent need to improve connectivity, buddying for practices between urban and rural areas and development of a novel education package for GPs who wish to move from urban to rural practice. Furthermore, we believe that there would be benefit in achieving a more integrated approach to the longitudinal aspects of training for, and recruitment to, rural practice, by learning from international experiences of the ‘pipeline approach’.

    Norris TE (2014). Addressing rural health workforce shortages: The pipeline concept. Chapter 1.2.3; WONCA Rural Medical Education Guidebook. http://www.globalfamilydoctor.com/groups/WorkingParties/RuralPractice/ruralguidebook.aspx [accessed 27th August 2015].

    22 Oct 2015

    Arran Resilience: Networking island emergency responders

    Belford 50:150 Conference, Fort William

    Arran Resilience offers a cost-neutral, easily implemented model of immediate care delivery to rural areas. It seeks to recognise the skillbase of emergency teams, and improve co-ordination of emergency responses at high demand or in the event of a major incident or complexity.

    Poster Presentation Hogg DR

    Arran Resilience: Networking island emergency responders

    Hogg DR
    Poster Presentation
    About The Publication

    Aim

    Arran is an island community with finite – but committed – emergency medical resources. Prior to October 2010 no mechanism existed for regular dialogue between emergency teams such as the ambulance, mountain rescue, coastguard and fire services. We sought to change this with the aim of better networking and interagency training.

    Methodology

    We aimed to improve communication between team leaders, and sought to build a partnership based on four key principles: 1) Local ownership; 2) Can-do attitude; 3) Working within existing competences/frameworks; and 4) Cost neutrality.

    Twenty five liaison meetings involving team leaders have now been held. We have identified core educational opportunities, run eight island wide workshops for 57 responders, and are carrying out some original work on designated rendez-vous points. All emergency teams have had the opportunity to refresh their skills in CPR and triage, and we have had useful discussion about major and multiple incident responses on the island.

    Results & Discussion

    We have now held twenty five liaison meetings. In the initial stages we ran eight island-wide workshops on casualty care, and until recently, organised three multi-agency exercises at very low cost. Regular dialogue between teams has been facilities via a group email, and this has resulted in better understanding of each team’s skills and capabilities. Our ‘Team Profiles Document’ summarises equipment, skills and personnel for each of our emergency teams, and is updated on an annual basis. This is particularly helpful for new staff e.g. police officers to understand capabilities of the emergency teams. We are now focussing on simulation training and refining the multi-agency response to cardiac arrest on Arran. There has been interest in the Arran Resilience model of immediate care from other island and rural communities.

    In 2013 we were named the UK Resilience Team of the Year by the Emergency Planning Society. Also nominated in this category were London Fire Brigade, and the Metropolitan Police team responsible for the 2012 London Olympics.

    Since then we have been able to focus on the sustainability and relevance of Arran Resilience activities.

    Conclusion

    Arran Resilience offers a cost-neutral, easily implemented model of immediate care delivery to rural areas. It seeks to recognise the skillbase of emergency teams, and improve co-ordination of emergency responses at high demand or in the event of a major incident or complexity.

    03 Oct 2015

    Tackling Inequalities – A Rural Perspective

    RCGP Annual Conference, Glasgow

    A rural perspective on the rising challenges of inequalities and complexity in medicine.

    Oral Presentation Hogg DR

    Tackling Inequalities – A Rural Perspective

    Hogg DR
    Oral Presentation
    About The Publication

    The challenge of providing rural healthcare is exacerbated by inequalities that are often subtle and indirect. Complexity is the result of intrinsic and extrinsic factors, which can be more explicit when faced with provision of healthcare within the domain of generalist and isolated practice. These pressures often result in ‘inevitable innovation’ and rural practice continues to offer novel and effective means of addressing the rising tide of complexity in general practice.

    I shall consider several scenarios from his experience as a rural GP, and present examples of where he has found and shared innovation which may be replicated in other areas of practice.

    30 Sep 2015

    Be the doctor you wanted to be

    MDDUS GPST Magazine

    An insight into the varied life of a rural GP on the Scottish isle of Arran.

    Magazine ArticleProfiling Rural GP MDDUS

    Be the doctor you wanted to be

    MDDUS
    Magazine ArticleProfiling Rural GP
    About The Publication

    Dr David Hogg offers an insight into the varied life of a rural GP on the Scottish isle of Arran

    WHAT’S the difference between the skeleton of a seal’s flipper and a human foot? With a new-found respect for the range of anatomy required by vets (not just one species!), this is the question I found myself entering into Google at the end of a busy Saturday on call.Such is rural practice. We provide a wide spectrum of medical care on Arran. It’s hugely stimulating, often challenging and occasionally daunting. The limitations imposed by being the only doctor on-call, or by transport logistics of ferry or helicopter, are relatively blatant. However, our patients tend to be understanding – whether residents or visitors – and an acceptance of the need to find common sensibility in dealing with medical uncertainties can be a helpful element of pragmatism from which to manage patient expectation.

    [Full article available from link].

    14 Jun 2015

    A-Team Video for Arran Medical Group

    Vimeo

    In June 2015 we made this A-Team remake video to recruit another GP to join our team at Arran Medical Group.

    Profiling Rural GPVideo Clips

    A-Team Video for Arran Medical Group

    Profiling Rural GPVideo Clips
    About The Publication

    17 Apr 2015

    Being rural: exploring sustainable solutions for remote and rural healthcare in Scotland

    WONCA World Rural Health Conference, Dubrovnik, Croatia

    Oral presentation to a worldwide audience at the WONCA World Rural Health Conference.

    Oral Presentation Mack M, Maxwell H, Hogg DR, Gillies J

    Being rural: exploring sustainable solutions for remote and rural healthcare in Scotland

    Mack M, Maxwell H, Hogg DR, Gillies J
    Oral Presentation
    About The Publication

    Oral presentation to a worldwide audience at the WONCA World Rural Health Conference.

    01 Mar 2015

    Being Rural: exploring sustainable solutions for remote and rural healthcare

    Royal College of GPs Scotland

    Policy Paper written by the Rural Strategy Group of RCGP Scotland.

    Miscellaneous Mack M, Maxwell H, Hogg DR, Gillies J

    Being Rural: exploring sustainable solutions for remote and rural healthcare

    Mack M, Maxwell H, Hogg DR, Gillies J
    Miscellaneous
    About The Publication

    This paper cites the issues of poor connectivity (mobile and broadband), problems with recruitment and retention, increasing workload and fragility of support services as some of the main threats to patient care. In particular, the College in Scotland is calling for the eradication of the current inequalities in access to good primary healthcare provision by addressing these areas, and is keen to work with Scottish Government, health boards, partners and stakeholders to prevent a deepening crisis.

    Dr Miles Mack, Chair Elect of RCGP Scotland and one of the author’s of the report, told the Herald newspaper,

    “Smartphone capabilities fail in a great deal of rural areas, as there’s no data service at all. Then there’s mobile connectivity – how do you call an ambulance if your phone doesn’t work?”

    He also expressed grave concern about the difficulties in recruiting GPs to rural areas telling the newspaper that some health boards have to rely on expensive locums, who may not have the appropriate skills to run GP services, as they cannot attract permanent staff to rural locations.

    18 Jan 2015

    BBC Countryfile: Rural GP on Arran

    BBC Countryfile

    In January 2015 the BBC Countryfile team came to find out more about delivering rural healthcare on Arran - and the challenges of recruitment & retention in rural areas.

    Media WorkProfiling Rural GPVideo Clips

    BBC Countryfile: Rural GP on Arran

    Media WorkProfiling Rural GPVideo Clips
    About The Publication

    19 Sep 2014

    Medical Students & Rural Practice – what do we have to offer?

    In September 2014 I was asked to speak to Glasgow University medical students about rural practice. Unfortunately I couldn't get to Glasgow due to work commitments, so I made this video for them instead.

    Profiling Rural GPVideo Clips

    Medical Students & Rural Practice – what do we have to offer?

    Profiling Rural GPVideo Clips
    About The Publication

    01 May 2014

    Remote & Rural Medicine

    Chapter for The Good GP Guide

    Book Chapter (50) for The Good GP Guide. Published by RCGP. Edited by Matt Burkes and Alec Logan.

    Book Chapters Hogg DR, van Lieshout S

    Remote & Rural Medicine

    Hogg DR, van Lieshout S
    Book Chapters
    About The Publication

    Chapter (50) for The Good GP Guide. Published by RCGP. Edited by Matt Burkes and Alec Logan.

    22 Feb 2014

    Arran Resilience: Presentation to NHS Highland

    NHS Highland 'Being Here' Conference

    We were invited to present our experience of setting up Arran Resilience - with the aim of improving communication and training between Arran's emergency teams - to the NHS Highland 'Being Here' Conference.

    Oral PresentationVideo Clips Hogg DR, Nelson M

    Arran Resilience: Presentation to NHS Highland

    Hogg DR, Nelson M
    Oral PresentationVideo Clips
    About The Publication

    01 Aug 2013

    PBGSL: Prehospital Care of Emergencies

    PBSGL Module: NHS Education for Scotland

    A collaborative effort amongst clinicians to produce a module for the Practice Based Small Group Learning (PBSGL) network on the systematic management of prehospital emergencies that might present in general practice.

    Learning Resource Soppitt H, Hogg D, Ross L, Cuthbert D, Buchan C, O’Rourke J, Hussain P, Abel R, Curran J

    PBGSL: Prehospital Care of Emergencies

    Soppitt H, Hogg D, Ross L, Cuthbert D, Buchan C, O’Rourke J, Hussain P, Abel R, Curran J
    Learning Resource
    About The Publication

    A collaborative effort amongst clinicians to produce a module for the Practice Based Small Group Learning (PBSGL) network on the systematic management of prehospital emergencies that might present in general practice.

    03 Dec 2012

    James Bond Advert for Arran Medical Group

    Vimeo

    In December 2012 we launched a recruitment project to find a GP to join our team at Arran Medical Group. Here's the James Bond video that resulted.

    Profiling Rural GPVideo Clips

    James Bond Advert for Arran Medical Group

    Profiling Rural GPVideo Clips
    About The Publication

    01 Aug 2010

    The Medical Bag: a guide for GP registrars

    InnovAiT 3(8): 479-482

    A guide for GP Registrars on what to consider when putting together a medical bag for GP work.

    Journal Paper Hogg DR, Lunan R

    The Medical Bag: a guide for GP registrars

    Hogg DR, Lunan R
    Journal Paper
    About The Publication

    Buying the equipment for your medical bag is an important—and potentially expensive—necessity for your career in general practice. In this article we outline some of the things to consider to ensure that your kit is reliable and cost-effective. Being prepared will enable you to react to the more common medical scenarios that you will face outside your practice and stay within the guidance of the General Medical Council.

    10.1093/innovait/inq029

    .06

    PORTFOLIO

    CLINICAL PATHWAY

    Handover Proforma

    Handover Proforma

    About The Project

    This handover proforma follows an ISOBAR method of communication (identifiers, situation, observations, background, assessment, recommendations) to record transfer decision making and discussions, and pertinent information in the process of transferring unwell patients.

    Click the link button below to see a generic PDF version.  I am happy to provide a word version that can be edited for local use if necessary.

    WEBSITE DESIGN

    Arran Medical Group

    Arran Medical Group

    WEBSITE DESIGN

    Rural GP Association of Scotland

    Rural GP Association of Scotland

    WEBSITE DESIGN

    Arran Resilience

    Arran Resilience

    WEBSITE DESIGN

    WILMA – a GP Practice Intranet

    WILMA – a GP Practice Intranet

    About The Project

    Using Sharepoint, this intranet site was set up to support Arran Medical Group’s multi-site clinical and admin teams.

    WEBSITE DESIGN

    ConnectArran

    ConnectArran

    About The Project

    Created to support and communicate the work of ConnectArran – which seeks to lobby and catalyse the provision of world-class connectivity on Arran.

    WEBSITE DESIGN

    RuralGP.com

    RuralGP.com

    About The Project

    RuralGP was launched in April 2009 as a resource for remote & rural GPs, GP trainees and nurses. It aims to provide up-to-date information about key events, discussions and initiatives for UK rural general practice.

    CLINICAL PATHWAY

    Major Trauma Pathway

    Major Trauma Pathway

    About The Project

    Our major trauma pathway aims to act as a helpful ‘aide memoire’ to dealing with major trauma whilst awaiting specialist assistance/retrieval in a community hospital setting.

    Click the link button below to see a generic PDF version.  I am happy to provide a word version that can be edited for local use if necessary.

    CLINICAL PATHWAY

    Acute Coronary Syndrome Pathway

    Acute Coronary Syndrome Pathway

    About The Project

    This pathway was developed in 2013 and updated in 2016 to reflect the latest European Cardiology Society guidelines.  Our situation is that there are occasions when helicopter transfer can be achieved to convey the patient within a 70 minute timescale.  However there are also occasions when this is not feasible, and therefore thrombolysis must remain a prominent feature of the pathway.

    Click the link button below to see a generic PDF version.  I am happy to provide a word version that can be edited for local use if necessary.

    (Image: Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist.  Via Creative Commons.)

    .07

    CONTACT

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