Yell and Fetlar. - Population approx 1011 (68 resident on the island of Fetlar). See website for surgery details.
Average number of patients seen each week = 100-110
Average number of OOH calls approx 3-4/week (including weekends). Night visits which get you out of your bed are not common, but an admission in the middle of the night can be time consuming. There is a pupose built ambulance on Yell, manned by volunteers who are trained to first responder level, but are not paramedics.
We see patients each morning, Monday to Saturday, from 9 -11.30 with 15 minute appointments. Once a fortnight there is a clinic in Fetlar. We also end up seeing extra patients in the afternoon most days, but try to reserve these appointments for urgent cases. Home visits, of which there are quite a few, are done usually between clinics. Wednesday PM we are closed for staff training, but we usually use this time to do a weekly visit to Islehavn Care Centre, practice meetings etc etc. Medical as usually done on the Friday morning that GP is not in Fetlar.
The practice has a slightly higher than average elderly population (20% > 65). We also have a higher than average rate of IHD, hypertension, diabetes, asthma and cancer.
The nearest hospital is the Gilbert Bain Hospital in Lerwick. It has 3 consultant physicians, 3 consultant surgeons, 3 consultant anaesthetists, a community psychiatrist, 1 ½ public health physicians and 8 junior medical and surgical staff. The lab processes most tests. There is an X-ray, US and CT service, but the CT is not open access (consultant request only). The Lerwick GPs provide intra partum obstetric care along with midwives.
We have a podiatrist visiting most weeks. There is open access, self referral for patients to access physiotherapy based in Lerwick. The counselling service is also based in Lerwick.
The practice has previously had regular undergraduate students from Aberdeen and Imperial College, London; 4 times a year. We are sure the universities would be keen for this to continue, but none are due to come in the year 2013. We also have had the occasional elective student with us.
The practice has a video conferencing facility, which is used for educational activities, meetings and some clinical consultations.
Since we are so far from an A and E Department, we see all minor injuries and deal with most of them as they arise (suturing etc).
Yell has its own ambulance which is manned by volunteer ambulance drivers. They are not paramedics, but are trained to “First person on the Scene” training. The journey from Yell to Lerwick takes a minimum of 1 hour, with a 20 minute ferry crossing. All emergencies need to be stabilised by the GP first and then transferred. In serious cases the GP will escort the patient across on the ferry before handing over to the paramedic ambulance on the mainland of Shetland. The GP has to be competent in dealing with emergencies and will either have BASICs training or be prepared to undergo this training.
Due to the continuous on call commitment, the practice employs an "associate" for between 15-17 weeks a year to allow the principal time off, study leave etc.