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Q&A Dr Ewen Mcleod, full-time GP working part-time in Aberdeen Royal Infi rmary.


He is vice chair of independent charity the British Association for Immediate Care (BASICS) Scotland.


• What attracted you to a career in urgent and emergency care? I decided to get involved in emergency medicine following my personal experience of an enjoyable and worthwhile training experience as a GP VTS (vocational training scheme) in Aberdeen, particularly in the emergency department (ED) of Aberdeen Royal Infi rmary. This was followed by a further two years post-GP VTS both in the paediatric ED and adult ED. I made the move from an ATLS (advanced trauma life support) viewpoint to BASICS pre-hospital care under the guidance of the present medical director of BASICS Scotland, Dr Colville Laird. This was prior to taking up the post of rural GP 44 miles from Aberdeen.


an important bridge between primary and secondary care and are often found in the ED either working alongside or within the acute care team. This work is typically carried out for at least one session a week, in combination with their day-to-day general practice duties. Service delivery models vary but a GPwSI may be tasked with attempting to extract patients already booked into the ED in a bid to fi nd alternative treatment or care options. They may see and treat simple problems or attempt to see all walking patients including those who need hospital facilities such as X-ray. The most successful services tend to be those where strong working relationships are developed with the existing hospital staff and where multi-disciplinary team members share ideas and learn from each other to improve patient care. With this approach it is likely that GPwSIs are fully integrated into the ED, sharing a common reception and operational processes. Other hospital locations include urgent care


centres, pre-A&E urgent care centres, minor illness clinics or A&E clinical assessment units. GPwSIs in this fi eld can also be found in


community settings, manning urgent care centres, minor illness clinics, minor injury units, providing out of hours services, or working with the ambulance service aiming to treat patients in their homes. Whatever the role, it is clear that GPs pursuing a special interest in this fi eld can look forward to a challenging and exciting career.


Joanne Curran is an associate editor of GPST


• What do you enjoy most about the job? I most enjoy sharing my primary care experience and manage- ment with ED colleagues, including emergency nurse practition- ers. As well as being BASICS Scotland vice chair, I am also the Scottish Ambulance Service lead and one of the medical consultants for the Sandpiper Trust who support the provision of pre-hospital equipment to doctors and nurses via BASICS Scotland. This equipment mainly takes the form of the Sandpiper bag which was designed to be a standardised portable and eff ective immediate care medical kit for doctors and nurses in remote parts of Scotland.


• Are there any downsides? The only downside is the distance I have to travel to reach my local ED.


• What do you fi nd most challenging? The most challenging aspect is keeping abreast of departmental and specialist services policies and procedures as I only work one session per week.


• What about the role has most surprised you? I have been most surprised with the expression on the faces of both my primary care patients and ED patients when I admit to working in both areas.


• What is your most memorable experience so far? My most memorable experience was escorting an attempted hanging patient from my community with my local paramedic crew to my ED and being able to assist with his ED management through to admission to a secondary care bed. A journey very few of my GP colleagues can experience.


• What advice would you give to a trainee GP considering a career in emergency care? I would advise trainees considering a career to complete their GP VTS fi rst and then undertake further time and training within their local ED. Membership of an organisation such as BASICS/ BASICS Scotland brings many resources and contacts vital to a healthy experience of both ED and pre-hospital care.


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