Behind the scenes with staff at Britain’s most remote hospital
As Island Medics – a new daytime series following NHS and emergency workers on Shetland – begins, the producer and some of the stars share their stories about making the show
Island Medics, a brand new series for BBC1, transports viewers behind the scenes at the UK’S most remote hospital. At the Gilbert Bain Hospital in Lerwick, Shetland, doctors and nurses work alongside GPS, paramedics, coastguard, lifeboat crews and police to provide emergency and medical care to the islands’ 23,000 residents, as well as workers from the surrounding oil and gas rigs and cruise tourists. Surrounded by the North Sea and closer to the Arctic Circle than London, Shetland throws up unique challenges for this tight-knit team.
Tom Cara – series producer Why did you choose Shetland for this programme?
We were looking for somewhere really unusual for the series, a place that had a medical set up like nowhere else in the UK – and Shetland fitted the bill perfectly. The NHS on Shetland operates in a truly unique way – from the GPS in the more isolated corners who sometimes provide their own out of hours service, meaning they’re on call 24 hours a day – to the surgeons in the Gilbert Bain Hospital, who have to perform many different types of operation (which is something that doesn’t happen in mainland hospitals). As we researched the islands’ medics, we just found more and more that was interesting and inspiring – the emergency services all work together, hand in glove, to provide an incredible level of care to the residents but also the tourists, oil workers and fishermen who work in the sea around the islands – and people really go out of their way to help each other. If someone is taken ill on one of the islands at three in the morning, the people who run the ferry will get up in the middle of the night to get the boat running so the ambulance can reach them.
The other factor was the people, Shetland is packed with characters – there’s a great sense of humour on the islands and a great sense of community – and we really wanted to show off how warm, welcoming and funny Shetlanders are.
What is different about this series in comparison to medical observation docs we’ve seen in the past?
I think it’s probably the variety – even though it’s a relatively small place with a population of around 23,000, the cases the medics see are hugely varied. In A&E you might have a helicopter evacuation from an oil rig one minute, followed by someone who’s injured their finger shearing their sheep the next – we were constantly surprised by the variety that came in through the doors of A&E.
Other than that, the star of the show is the islands themselves – it’s an amazing place full of incredible wildlife and a landscape like no other – it’s got to be one of the most beautiful places on earth. So, we’ve high drama, interesting medical stories and great characters set in a truly beautiful and magical location.
What were the filming challenges?
There’s always a challenge when filming a series like this that you’re trying to tell the stories of people who are often in quite a bad situation – if you’ve fallen and injured your spine on a fishing boat in the middle of the North Sea, and have had to be air lifted by the coastguard to safety, the last thing you’re expecting is to be confronted by a camera crew. Luckily everyone we filmed with was incredibly open to us filming and the patients were happy to be filmed in all sorts of situations in order to show off the great work done by the NHS in Shetland.
Other than that – the weather is always a challenge up there, even though it was an unusually sunny summer (there was more sunshine in Shetland than Cornwall this summer) – until you’ve experienced the wind and rain that can blast the islands it’s hard to imagine just how bad weather can get!
What were the timescales – how long did you take to film?
The crew were on the islands for nine weeks during the summer – during that time we were on call 24/7 – so if we got a call in the middle of the night to say a helicopter was coming in with a casualty, we’d have to throw on our clothes and grab the camera kit and race to the landing site to capture the action – which was really exciting, and slightly exhausting. The crew did find some time for other things when they weren’t filming – we saw orcas, pilot whales and dolphins as well as seals and puffins. What really surprised us was how much daylight there is there in the summer – we were there in July and August and it hardly got dark.
Was there a particular person or story which really struck you whilst filming?
There are so many good stories and characters, it’s really hard to pick – one is Brian – who was airlifted to the hospital after falling and injuring his neck and who had a worryingly low heart rate – we were in the coastguard HQ when the call came in – quite by chance – and were able to follow the story all the way through – from the helicopter landing through his diagnosis and treatment. Otherwise there were some stories you’d only probably find on Shetland: Eddie – who’d had a head on collision with a seagull out on his motorbike and had an injured neck. A little girl who’d fallen off her Shetland pony – and a woman with a fish hook imbedded in her arm. What’s common to all of our stories is just how stoic the Shetland natives are – they never complained, even when in quite a bit of pain – they breed them tough up there.
Dr Kushik Lalla You are originally from South Africa. How did you find your way up to Shetland and what enticed you to stay?
I came originally to do a locum contract and loved the place and people. Having worked elsewhere in the UK, I found Shetland much better. I met my wife whilst operating in theatre (she’s a theatre scrub nurse) and decided to stay.
Can you tell us a little bit about a usual shift at the hospital or what your job entails?
The job varies from day to day and no two days are the same. I can be called on to see patients in A&E, the wards, theatre, outpatients. The day starts with a review of all patients seen the previous day in A&E and a discussion around admitted patients. This is followed by a ward round where all patients who have been admitted are seen and ongoing care planned. I then go to either theatre, the outpatient clinic or A&E. Following this we usually have a teaching session for junior doctors around 2pm. Then it’s back to A&E. I’m supposed to finish at 4pm but usually end the day around 6-7pm. Then it’s home to the family.
Was it strange to be followed by cameras for the series? What did the rest of the staff and patients think?
Yes very. It somehow makes
“If we got a call in the middle of the night to say a helicopter was coming in with a casualty, we’d have to throw on our clothes and grab the camera kit and race to the landing site to capture the action”
things seem artificial. I am now aware how strange I sound on camera. The staff and patients varied in their opinions. Some were for it, others against.
Midwife Hannah Mccluskey How many babies are delivered on Shetland in a week/ month/year?
Last year we looked after 278 pregnant women in Shetland with approximately two-thirds delivering here and one-third in Aberdeen due to the need for consultant obstetric or neonatal facilities.
Tell us about a particularly challenging time you have faced at work.
I feel for me I’ve been challenged a lot recently, moving midwifery posts whilst still being newly qualified has been hard, but I’m slowly gaining in confidence again. I’m getting to know the policies for the island and what changes this presents for rural midwifery compared to
midwifery in an obstetric unit.
What is the best thing about your job?
Really getting to know the women and being with them on their journey towards becoming a family. There’s something special about being with women throughout pregnancy, birth and in the early stages of parenthood. ● Island Medics is on BBC1, Monday to Friday, 9:15am from this morning.