Orkney is an archipelago composed of a large central island (the Orkney mainland) and approximately 70 surrounding smaller islands, 17 of which are inhabited. The total population of Orkney is around 20,000 of which 3,300 live on islands without land access to Kirkwall. The Balfour Hospital is situated in Kirkwall, which is the main centre of population. Providing efficient and effective medical services to these island communities is a challenge faced by NHS Orkney.
In 2010 NHS Orkney had the opportunity to re-design the way primary care services are provided to the outer isles. The Isles Network of Care is the result of this work and has been created to achieve the following criteria:
- Be clinically safe with a strong clinical governance structure that avoids clinicians working in isolation.
- Provide continuity of care to the individual island communities.
- Be a model that can be recruited to and sustained.
- Provide the communities with the opportunity for input into the way their services are delivered.
- Provide efficient and effective use of clinical time.
- Be affordable within the budget of Orkney Health and Care.
Individual practitioners are appointed to island practices to be the principle providers of care to each community. When on leave they are backfilled by another practitioner, including Rural Fellows, employed by NHS Orkney. In order to provide continuity of care the aspiration is that the same individual will provide cover to the same island for most of the time.