Monday, 19 May 2014

Changes At The Balfour Hospital, Orkney

Due to Orkney’s geography, General Practice has always been pretty self-sufficient; used to taking on extended roles within Primary Care, dealing with emergency presentations on the single-handed  outer isles and taking on a broad spectrum of roles within the Balfour Hospital.  We also have a strong tradition of GP training both within Primary Care and the hospital.

There have been a number of changes in the Balfour Hospital over the last year.  Until last year the hospital medical service had been run by a team of Rural Hospital GPs who had developed specialist skills in acute medicine and were closely supported by the Aberdeen Consultants.  Following a redesign of our services we were fortunate to appoint Consultant Physicians Drs Izabela Bodzioch and Tomasz Waszyrowski in 2013 to run the service and work alongside the two remaining Rural Hospital GPs; Drs Charlie Siderfin and Elaine Toms. 

The anaesthetic team of Drs Colin Borland, Marek Wolanski and Aneta Sowinska have been joined by Dr Paul Cooper, Consultant Anaesthetist.  Dr Michael Dohrn and Mr Caesar Zawal, Consultant Surgeons head up the Surgical Department and Drs Sujan Sen and Andreas Laut were also appointed in 2013 as Consultant Obstetricians and Gynaecologists.

As the new model of working has settled in over the last months we have given some considerable thought as to how best deliver our GPST training in order to utilise the new skills and talents within our teams.  Drs Izabela Bodzioch and Tomasz Waszyrowski have taken on the role of Clinical Supervisors to the GPSTs, closely supported by Dr Charlie Siderfin who previously undertook this role.  Izabela and Tomasz both have previous training experience in Poland and England.  Dr Sujan Sen has taken on a newly defined role of Local Programme Lead and will have overall responsibility for organising our Postgraduate and Undergraduate teaching programmes.  Sujan has considerable training experience as well as a Diploma in Medical Education.

The Anaesthetic and Surgical Departments are keen to continue supporting the training programme.  In addition to providing day to day clinical supervision to the GPSTs they are contributing to our seminar programme and are keen to provide additional in-theatre training from both an anaesthetic and surgical perspective, to individuals interested in extending their skills.

In the last 6 months the anaesthetists have established a High Dependency Unit.  This has greatly increased our capacity to manage critically ill patients and is another useful area of training for our Rural Track GPSTs.  By the end of the summer we will have our long awaited CT scanner; this will have a considerable positive impact on our working practice. To date patients requiring CT scanning have been transferred to Aberdeen. 

The Balfour Hospital has to deal with the full range of hospital presentations.  As a GPST you will be exposed to a very broad, undifferentiated case mix. You will be working front line in managing these presentations, with close Consultant support when needed.  Having two Rural Hospital GPs working full time in the Balfour helps ensure particularly close working relationships with Primary Care and an important focus on the skills that you need to acquire as a GPST.

Training remains an important priority for Primary Care in Orkney.  Skerryvore Practice has a long history of GPST, Medical Student and Rural Fellowship training, stretching over decades. Drs Iain Craighead and Sarah Stevenson have considerable experience as GP Trainers.  Dounby Surgery has recently been accredited GP training status under the guidance of  Dr Huw Tomas.  Dounby also hosts Rural Fellows.  Drs Andy Trevett and Tony Wilkinson in Stromness Surgery have played a critical role in establishing the Orkney Rural Fellowship programme.  Their Practice also runs the hyperbaric unit, dealing with the not infrequent diving emergencies.  They are always happy to teach around this unusual extended service which the practice provides.  A number of outer isles practices in the Isles Network of Care maintain a keen interest in training medical students, GPSTs and Fellows and we have plans afoot to expand the Network’s involvement.  Dr Jonathan Clowes on Westray is a CSA examiner and is always happy to offer GPSTs practice sessions as they prepare for this exam.  For further information on the Isles Network of Care see the related article.

In May we have planned a “Learning Festival” based around a visit from the Mobile Skills Unit (  We have created a full 2-week programme of clinical skills training, delivered by local clinicians.  In addition we have a “Training the Trainers” course to expand our local faculty of Clinical Scenario Trainers so that we can develop a regular programme of scenario training using our high fidelity training manikins SIM-Man, SIM-Baby and SIM-NewB.

NHS Orkney places a high level of importance on training.  We see it as essential to maintaining high standards of care, but also in facilitating staff development and retention.  We see our involvement in the Rural Track GPST programme, the GP Rural Fellowship and Medical Student attachments as a critical part of maintaining a vibrant and relevant programme.  Training also has an important role in recruitment; it is no coincidence that 8 permanent GPs appointed in the last 7 years came through our local training programmes. Be warned, Orkney has a habit of getting its hooks into people! 

Despite Orkney’s location, just off the northern tip of Scotland, Kirkwall is less than an hour’s flight from Aberdeen, Edinburgh, Glasgow or Inverness.  There are ferry connections from Aberdeen, Scrabster, Gill’s Bay and John O’Groats.  There is an immensely wide variety of activities, places of interest and spectacular wildlife.  See last year’s article “Orkney Number 1 Island Destination” posted last year to get a fuller flavour of what is on offer.

If you are interested in becoming a Rural GP and are considering applying to the Rural Track we hope that you will consider the benefits Orkney has to offer you. Please do not hesitate to contact Dr Charlie Siderfin (Rural Hospital GP and GP Associate Advisor) if you would like any more information. or text 07900405964 and I will call or text you back to arrange a mutually convenient time to talk.

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