The isles network of care in Orkney

During 2009 all nine single-handed GP posts on Orkney's outer islands became vacant. Attempts to recruit were unsuccessful. To establish effective clinical governance in single handed island practices and improve recruitment and retention. Following in depth discussions with individual island communities, four islands adopted a Nurse Practitioner model of care and five continued with a GP model. The Isles Network of Care was established which linked isolated practices through weekly videoconferencing to provide professional and managerial support. Recruitment in 2010 was successful. In 2015 the system was reviewed and modifications made. Six islands were amalgamated into one virtual practice to improve clinical care and administrative efficiency. A management structure with a devolved budget and increased decision making autonomy for clinicians was introduced. Recruitment in 2015/16, despite nationwide GP and Nurse Practitioner shortages, has been extremely successful. Important lessons regarding clinical governance, improved clinical standards, as well as recruitment and retention have been learnt. The presentation will review these lessons which include the creation of an overarching system of support, working with communities, empowering clinicians, clearly defining roles, targeted advertising, quality information for potential applicants, training as a long term recruitment strategy, the importance of ongoing education and the provision of mutual support mechanisms through videoconferencing.

This abstract was presented at the Innovative Solutions in Remote Healthcare - 'Rethinking Remote' conference, 23-24 May 2016, Inverness, Scotland.