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An island practice

Jim Killgore travels to the Isle of Arran for a perspective on the challenges of remote and rural primary care

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HE SEA is calm the day I make the short ferry crossing to the Isle of Arran from the North Ayrshire port of Ardrossan. Standing on deck I am even lucky enough to see a dolphin break the placid

surface as the granite peak of Goatfell comes into view above the low cloud. Lying only 40 miles southwest of Glasgow as the crow flies and only 14 miles from the Scottish mainland the island does not seem as remote as I had imagined. Less than an hour later I sit in the meeting room of the local GP

surgery in the small village of Shiskine. I have come to meet the practice manager of the Arran Medical Group (AMG) – Ruth Betley. The Arran Medical Group was formed in 2012 with the merger of the three main practices on the island. It serves a resident population of over 5,000 people but that can increase fourfold in the summer months when the island is swamped by holidaymakers. Ruth explains that, even with its close proximity to the populous central belt of Scotland, Arran faces the same challenges typical of

remote and rural practices across the UK. Not least recruiting and keeping staff with a skill set to serve the broad needs of an isolated population. “When you have lots of water between you and the mainland, GPs

here will do many things that other GPs would send on to secondary care,” she says. Ruth is responsible for the overall management of three base

surgeries (at Brodick, Lamlash and Shiskine) and three branch surgeries with 30 staff – all part-time – in addition to six GP partners, two salaried GPs and one rural fellow. She is supported by three team leaders for on-site management of the base surgeries and also a business manager. In addition to delivering primary healthcare on the island, AMG also provides a range of additional services including out- of-hours care, medical input to the local Arran War Memorial Hospital, accident and emergency cover, BASICS prehospital care and police surgeon work. “It’s quite a large area, geographically. You are 56 miles all around the island,” says Ruth. “I actually work in each of the main sites. I move around a lot. That’s the only way you can do it. You need to be there and see how people are getting on.”

A NEW PROJECT Ruth is originally from Yorkshire and moved to Arran nine years ago. She and her husband had been coming to the island for holidays and decided to make a lifestyle change. She had worked in health administration all her career, first in hospitals and then as a director of a primary care trust near Halifax. “The director’s job was quite long hours and difficult. And then an opportunity came up in Arran,” she says. “The existing surgery in

SUMMER 2015  ISSUE 12

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