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Working as an Out of Hours GP in the Scottish Highlands

It's 5am and the phone rings...

I wake up and answer- a child with a headache, vomiting and a petechial rash is inbound to the base so that I can assess him, in case he needs a blue light ambulance or the helicopter retrieval service.

I met the child and his mother at the health centre. I had a large amount of kit with me, including IM antibiotics to manage potential meningococcal sepsis. Luckily in this case, the patient was relatively well and it seemed more likely to be a case of a facial petechial rash secondary to cough and a viral illness.

The nearest hospital in Inverness was 90 minutes away, and as you can see in the picture below, it was important to have enough kit to manage an acutely unwell adult or child for a prolonged period of time if needed.

I was also given a Sandpiper Bag, issued by BASICs Scotland, to manage any potential trauma or patients requiring urgent medical care in the pre-hospital setting. The video below highlights the contents of the bag, which is also used in the Diploma of Immediate Medical Care exams run by the Faculty of Pre-Hospital Care Edinburgh.

Overall I saw a typical mix of GP cases, including acutely breathless patients, rashes, palliative care, minor trauma and abnormal blood results. Many patients were tourists and only passing through the town overnight prior to heading further into the highlands and further away from healthcare, so it was important to be mindful of this when agreeing suitable management plans and safety netting.

As I was covering the out of hours shifts there was ample time to explore the surroundings, and sample the local fish and chips. I was lucky to be blessed with glorious sunshine whilst the views were pretty beautiful as well.

Overall, despite the drive up from South Wales to the highlands, this was a great opportunity to experience rural general practice in a different part of the UK and I would recommend it to any GPs looking for a change of scenery or to try something different. The Highlands and Islands are often looking for both short and long-term locum cover and jobs are often advertised in the BMJ, GP online and on social media.


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