Hoy and Walls living and working as a GP Welcome

We are delighted that you are considering applying for a post on Hoy. The likelihood IN THIS BOOKLET is that you are already strongly attracted • WORKING AS A GP ON HOY by the prospect of working in a beautiful • HOY & WALLS? and unique area of Scotland, You probably • ISLAND INDUSTRIES also relish the prospect of working in a • SCHOOLS situation that offers time to ’do the job • ISLAND LIVING properly’.

• ENVIRONMENT This leaflet has been prepared with the • PRACTICALITIES intention of providing more detailed infor- • ISLAND CONNECTIONS mation about our particular island, and about some of the attractions and realities of living and working here.

Included in our leaflet you will find infor- mation about aspects of life on Hoy, in- cluding what we see as the significant strengths of our community, and the asso- ciated benefits for ourselves and our fami- lies. Our community and practice websites complement the material in this leaflet and are well worth a visit. Be sure to catch the most recent copy of The Blether.

If you have children of school age, you will be pleased to know that the schools in Orkney are excellent. Do take a look at our island school‘s website, and the websites of Stromness Academy and Kirkwall Grammar School Welcome Finally, the Hoy Trust website is also worth a look for anyone interested in local natural and social history.

WEBSITES

www.hoydoc.co.uk

www.hoyorkney.com

www.hoyheritage.wordpress.com

www.rspb.co.uk (Hoy pages)

www.undiscoveredscotland.co.uk/hoy

www.visitscotland.com It is very important for us to recruit skilled and committed practitioners who feel enthusiastic at www.loganair.co.uk

the prospect of bringing their professional skills www.orkneyferries.co.uk to this small, vibrant island community. www.pentlandferries.co.uk

We hope that you might be such a person and www.northlinkferries.co.uk that what you read about Hoy & Walls in this leaflet will reinforce your interest. Working as a GP on Hoy

The surgery is in a purpose-built Health Centre in Longhope. This has a consulting room, a treatment room, a nurse’s consulting room/office, a reception/admin area and a dispensary. The building also contains rooms used by social services for weekly lunches and meetings. NHS Orkney also owns Bayview—the former doctor’s house and surgery combined. This is currently occupied by the resident GP. However, GPs usually purchase properties on the island once they become established. Bayview is then available for locums and students

So what’s the work like?

The pathology is pretty much the same as anywhere else in Scotland. But the organisa- tion is different. Fifteen minute appointments are our minimum.. We try to deal with everything at one sitting—reducing the bewildering array of repeat visits that have become the norm elsewhere. After a short time, you can put a name to most patients’ faces and be familiar with their past and current medical situations, which is rewarding for doctor and patient alike. You’ll do more home visits than usual because we have an elderly population and mini- mal public transport. But there are no queues, traffic jams or parking problems and the scenery is wonderful. The need for 24/7 cover restricts you to the island, and means no long walks in the hills. But there’s still plenty to do, and plenty of time in which to do it—patients rarely call unless they really do need a doctor. You do all the emergency care. Major trauma is uncommon but if you are called your other patients will understand if you are busy for a few hours. Minor trauma is more usual—farming, fishing and building being the main culprits. In fact you do pretty much everything—proper general practice! Except intra-partum obstetrics— mothers go to the mainland for delivery. The professional isolation that island GPs traditionally endured has been largely banished by the internet. We have excellent video-conferencing facilities and ’meet’ with the other island practices weekly. We share stories, exper- tise and ideas as the Isles Network of Care. Our team of one 24/7 GP, one full-time nurse and one part-time ad- ministrator and her relief, is close knit, capable and mutually suppor- tive. As the relief GP you’ll provide important continuity of care and will be involved in all the clinical work—and as much of the bu- reaucracy and paperwork as you would like. ...proper You will also be involved in medical student teaching and in audit, both important elements of appraisal and revali- general practice! dation. The pay is above average for a GP nationally and reflects the on call commitment. The paid study leave allowance is excellent value and allows attendance at courses on the mainland and South.

It’s significant that most GPs who have come to the island have chosen to remain after retiring. You do become quickly enmeshed in the life of the island and the lives of your patients. After all, you are not caring for your patients but for your fellow islanders, and after a while, for your friends.

The relief GP can live elsewhere and visit, or live here and use Hoy as the base for a portfolio career. The island is a safe and civilised place to live and work, and a wonderful place to bring up children. Working as a GP on Hoy

A key element in the working environment is the support given by fellow practitio- ners on neighbouring islands at weekly video conference sessions which routinely involve discussion of admissions and emergencies, shared clinical guidelines, organisa- tional issues, etc. The success of this collaboration has led to the recent decision to join the seven island surgeries into one virtual practice. The aim of this is to further improve patient care through sharing good clinical and administrative practice (and perhaps to reduce paperwork!). The sheer variety of the work is refreshing and stimulating. Chronic disease, mental health problems and social problems are as prevalent as anywhere but are often met with a stoic practicality unusual in modern Britain. You have the opportunity to take your involvement in care further than in mainland practice. Sometimes because resources are fewer and distances greater but often sim- ply because sick patients want to stay on the island. Access to basic investigations is good, but more rarefied imaging will involve a 300km round trip, 2 ferries, 2 flights and a night away from home.

Repeat prescriptions are dispensed in town and shipped across for us to deliver. But we hold a good stock of drugs for immediate use and emergencies. You are not alone! Our nurse is both practice nurse and district nurse and sees patients wherever it is best. Between us we keep an eye on patients when they are well, not just after they become ill. Volunteers man our ambulance and will transport patients to the mainland on the ferry or to our helicopter landing ground. Everyone of working age has more than one job, sometimes three or four. So don’t be too surprised if, once in a while, you find yourself acting as policeman, undertaker or vet. it’s unusual not to go home for lunch And on Hoy, uniquely among the islands, there is the lifeboat. It is difficult to overstate how important the Longhope Lifeboat is to the community. She lies literally and metaphorically at the centre of the village. For most callouts the doctor is not required, but if called, you go. Hoy residents seem to appreciate their good fortune in receiving the kind of close, personal attention that we can offer. But they don’t abuse the system. They look after doctor & nurse just as much as the doctor & nurse look after them. Coupled with the courtesy and common sense that are the norm, this means that the out-of-hours work is infrequent. But when called, it’s usu- ally important. We advise against using NHS 24 as it simply wastes time. There’s time for patients and time too for teaching. We are an under- graduate teaching practice for Dundee University and take their final year students for 4 week attachments. time for excellence

The practice is generally well equipped and includes:- A 4-wheel drive vehicle, essential for carrying emergency equip- ment and dealing with farm tracks. Bleeps and mobile phones for doctor and nurse. The current IT system is Vision—we aim to move to a unified sys- tem across the islands in 2015. Widescreen video conferencing, for education, for discussions and meetings and for remote consultation with specialist services. Emergency equipment to the BASICS standard suitable for dealing with major injury. ECG, Spirometer, INR machine SAS ambulance used about twice a month for patient transport. Equipped with stretchers, splints, vacuum mattress etc Hoy and Walls?

According to the maps we live on Hoy. But Hoy is the big, high island, with the parish of Hoy at its north end forming a distinct community that has greater historic links with Graemsay and Stromness than with Longhope to the south. The MV Graemsay runs back and forth from Stromness several times a day, maintaining this connection and bringing thousands of walkers in the summer. Along the longest uninhabited stretch of road in Orkney lies Hoy’s southern parish, North Walls, hence our North Walls Community School. This also contains our ro-ro port Lyness, from where MV Hoy Head links us to Flotta and the mainland. Most southerly of all is South Walls. This is almost an island (and at high tide in a south- easterly gale is still effectively separate). It looks much like the rest of Orkney, low, green and fertile and very different from north Hoy. Most of the population lives in South Walls, and most of it in the village of Longhope. So that’s why we are based in Longhope, and why we occupy the Hoy & Walls Health Centre. Given that Hoy is 20 miles away from Longhope both doctor and nurse have regular clinics in the Outdoor Centre in Hoy. Island Industries

The principal industries in Hoy, as they have been for several thousand years, are farming and fishing. Or both—there are a number of fish farms in the bays and along the coast of Scapa Flow.

After that comes tourism. Thousands of visitors come every summer, some for the day: to walk to the Old Man or to visit the Lyness museum or the Martello Tower and some to stay, to do all those things and more besides. There is plenty of summer work and a substantial B&B and holiday let market. And there is a small but steady stream of visitors to the Health Centre.

In recent years the Golden Quay at Lyness has been made into a large deepwater dock and has become the maintenance base for experimental wave energy machines. Although the transition from trials to production is stuttering at the moment there are great prospects for future employ- ment at Lyness in the electricity generation industry .

Schools

North Walls Community School is mod- virtually unique in the UK in providing ern and purpose built and is co-located specialist teaching in Art, Music and P.E. with the swimming pool and fitness cen- for all Primary school pupils. That level of tre. Although built to cater for children specialist provision also makes an impor- from 4-14 it now has pupils from 4-11 (3- tant contribution to the breadth of cur- 11 if you count the associated pre-school riculum offered to pupils in the secondary nursery) department. The facilities are outstanding and the edu- This contributes to Orkney’s enviable cation excellent. Small class sizes and per- reputation as a producer of graduates, sonal attention for all are the norm. sportspeople and particularly musicians. Uniquely in Orkney children from Hoy can Above all though, our schools generally go to either of the two superb secondary produce confident, articulate and mature schools—because this is a big island, close young men and women. to the mainland and with a boat at each end. So for S1 they can opt to go to Kirkwall Grammar School, where they weekly board in the hostel with children from the other islands. Or they can go to Strom- more to do ness Academy as day pupils, travelling over and back on the MV Graemsay. than time Educational provision throughout Orkney is excellent: school buildings and gener- to do it! ously-sized grounds are maintained to a level which would be envied elsewhere in the country; and the county must now be Island Living

Hoy’s inhabitants enjoy a fundamentally tranquil lifestyle but the community is an active and dynamic one, whose clubs and groups offer a wide range of social, artistic and physical activities, all underpinned by hard-working enthu- siasts. Apart from the fitness suite and pool there is regular badminton. You can walk, run and cycle—on the flat or in the hills. If you’d rather be in the warm you can dance weekly in the YM and if you’d rather be active sitting down then try sailing or kayaking.

We have the only proper theatre outside the mainland, The Gable End, which attracts regular visits from local, national and international perform- ers, often on the back of the major festivals taking place on the mainland. It is also the home of the Hoy & Walls Entertainment Group (winners of the inter-island one-act play trophy for several years running) and the Film Club. Once a year the island hosts the Hoy Half Marathon. The most beautiful and most arduous half marathon you are ever likely to do—and always over- subscribed. It is now preceded by a 5km fun run for families. Most of the activities and entertainments are do-it-yourself. But with a bit of enthusiasm it’s amazing what a small community can achieve. Participation is the key and all ages can participate in something or other. Whether you are interested in gardening, politics, singing in the pub, or maintaining an historic lifeboat, there is always something to do. Environment

On an island the surroundings impose themselves upon you. It is impossible not to notice what’s about you. It doesn’t matter if you have no interest in birds you will still notice the hundreds of transiting pink-footed geese and the return of the bonxies in the spring. (If you are interested then much of north Hoy is an RSPB reserve with a resident RSPB war- den). It doesn’t matter that you care nothing for astronomy, you can’t ignore the thou- sands of stars and the startlingly bright planets on a clear winter evening (very little light pollution here). And even if you have no interest in archaeology you can’t fail to notice the green hills that cover old brochs or earlier tombs. But on Hoy more than anywhere else in Orkney you can’t ignore the archaeology of warfare. From pillboxes by the roadside and gun pits on the hills to the huge concrete edifice that gazes down from Wee Fea on the ferry arriving at Lyness, the legacy of the First and Second World Wars are all around. And when you look more closely and realise that the hill upon which the WWII Communication Centre stands has been hollowed out to store fuel for the Fleet….

But there is one aspect of environment that no one on Orkney ignores, and if you live on an island you pay even closer attention. To the weather. Schoolchildren can look at the waves and tell you the wind speed. Nobody goes out without a coat. And old wifies can time the hanging out and the bring- ing in of their washing to the second. Orkney, with the possible exception of the Hoy hills, is so low lying that the weather ignores it. It’s like being on a ship; the weather just passes right over you. Which brings us to... Practicalities

Hoy is an island. In fact it’s an island off an island. Although a sick patient could be in Aberdeen via helicopter 3 hours after you’ve seen them, it may take an awful lot longer. On Hoy we are more fortunate than the other islands. We may not have an airfield, but we do have a dedicated ferry. And she lives here in Longhope and is crewed entirely by islanders. So, if we need to evacuate a patient, we usually can, whatever the time of day or state of the weather. And, in ex- tremis, on the rare occasions that the Hoy Head can’t get to sea, the Helen Comrie can.

The other vital practicality is shopping. There are 2 post offices, one in Hoy and one in Longhope, and one shop. Groats in Longhope will sell you petrol and dog food, onions and light bulbs, lemons and tap washers, and everything in between. Most folk take the car to the supermarkets in Kirkwall periodically to stock up but, for the GP, the only person unable to leave the island, shopping can be awk- ward. Locums bring rucksacks full of supplies. For residents a big freezer, a tattie patch and some chickens are essential, and a poly-tunnel highly desirable. Internet shopping works fantastically well. Books are easy—the mobile library visits once a month and will bring what you ask for. And if something breaks—there is an island expert who will fix it.

Island Connections

Orkney Ferries’ ro-ro ferry MV Hoy Head runs back and forth between Houton, Flotta and Lyness several times a day (though she rests in Longhope on winter Sundays). MV Graemsay (foot passengers only) runs between Stromness and Moaness every day and does a handy late night run on Fridays Resident islanders can buy books of tickets at a discount Transport links between Orkney and the mainland of Scotland are also excellent. Flybe operates flights daily between Kirkwall Airport and Scotland’s main cities. The Air Discount Scheme gives residents a significant discount on flights within Scotland. Pentland Ferries and Northlink Ferries both run daily ferry services across to the north coast of Scotland. For those who prefer to cut down on driving time through Scotland, Northlink Ferries operates an overnight service on the Kirkwall- Aberdeen route. Patients can use these services to attend appointments on the Orkney mainland and in mainland Scotland (usually at Aberdeen Royal Infirmary) for a small contri- bution towards the fare. The Health Board bears the brunt of the expense. After a time on the island you may find that Kirkwall, pleasant though it can be, feels rather busy and hectic. You may find yourself gazing over the Flow towards Hoy wondering when the ferry will arrive. You may watch the Scottish news and wonder what relevance it has. You may watch the news from London or New York with equal dispassionate disinterest. It is then that you realise that Hoy is not remote, everywhere else is. Hoy living and working as a GP For more details, please contact Dr Iain Cromarty or Teresa Bird With thanks to Sanday Develop- on 01856 701209 or email ment Trust for the [email protected] idea and the format.