Having time with patients lets you be a caring GP

She arrived off the NorthLink ferry from Aberdeen on a cold New Year’s Eve morning with her husband Alex Armitage – a consultant paediatrician at the Gilbert Bain Hospital and an elected member of Shetland Islands Council – and their son Ayanda, who was 7 at the time.

Shetland was far from unchartered territory as Deepa’s mother-in-law Marian Armitage, co-founder of the Shetland Food & Drink group, grew up here. They visited Alex’s grandparents most summers while going through medical school, and also married in Gulberwick 12 years ago.

Back then, Deepa says, she would “never have contemplated” living in Shetland. She would have worried about living far from her family, about the long, dark winter nights and the strong gales.

But over time she came to see more and more special things about the islands: its nurturing communities, its “incredible” natural landscape and wildlife and thriving traditional music and craft scenes.

She and Alex had “spoken about moving here from our very first trip, but in the end it was me that really pushed us to relocate, as I started to think about the kind of environment I wanted us and Ayanda to grow older in”.

Deepa had three jobs in London. In addition to working at a busy GP practice in Hackney, she wrote medicolegal reports for refugees who had survived torture, and was a clinical lecturer in primary care at Queen Mary University of London. The latter saw her run a project teaching students about the social and political determinants of health.

She relished working in such a multicultural setting and “wasn’t sure that I would find the same sense of purpose in Shetland”, but happily the reality of being a GP in the islands has “surpassed all my expectations”.

Deepa works as a GP at the Levenwick Medical Practice, which serves 2,800 patients in the south of the Shetland mainland. The area is also home to an international airport and a globally significant nature reserve – not to mention prime puffin-spotting location – in Sumburgh, at the mainland’s southernmost tip.

“Providing primary care as part of a rural community allows you to get to know patients, their families and gain a deeper understanding of the context in which they are living,” says the 40-year-old.

“I really enjoy the continuity of care that you can experience working here and the feeling of being a respected and cared-for person in the community.

“My working days are busy, but much more humane than that experienced by many of my colleagues on the UK mainland. I leave for work after seeing my son off on the school bus [now aged 9, he attends Dunrossness Primary School] and usually get home in time to have dinner with my family.

“I also have the time to spend with patients and have the kinds of consultations that make me feel like a caring GP, instead of one looking at the clock and wondering how I can bring the conversation to an end – which is often how I felt in a more time-pressured urban setting.”

Deepa has also taken on the role of chairing the local medical committee, representing all of the approximately 50 doctors in the islands at NHS Shetland’s health board.

She has embraced the opportunity to help shape the development of healthcare in Shetland, with the relatively small size of the healthcare community meaning it is “easy to form collaborative, supportive relationships with other professionals”.

Deepa, along with fellow doctor Jacqueline Gray, has founded a “greener practice” group and has been “really inspired by the energy of my colleagues and patients in helping this to grow”.

The group aims to reduce the carbon footprint of primary healthcare and find more sustainable ways of delivering care, with priority given to ensuring people can continue living well and healthily in their own communities.

Deepa also emphasises the importance of nature and social connections to improving people’s wellbeing, pointing to the proven health benefits of spending more time outdoors and at one with nature, going for walks and undertaking activities such as gardening.

She has helped set up a weekly walking group and an active gardening group that have made the Levenwick practice and the nearby Overtonlea care home grounds “a more welcoming and calming place to be”.

Deepa and her family have settled in Bigton, a few miles south of the practice on the west coast and within walking distance of the spectacular St Ninian’s Isle tombolo. It is a place that exemplifies so much of what is good about small village living, and all three of them have fairly thrown themselves into community life in the two years since relocating.

The community-run local shop – where Deepa works one morning a week – is mostly run by volunteers and serves as something of a social hub: “It has been a great way to meet and get to know people locally outside my role as a GP, as well as supporting a project that helps to make this community a welcoming, friendly and thriving place to live.”

There are regular social events at the country hall, while there is a real buzz about the burgeoning Hymhus project. Based in a converted kirk, the building was the subject of a community buyout in 2021 and is now run by the Bigton Collective with the aim of providing an inspirational hub for arts and wellbeing in the area.

It is already doing just that: Deepa attends a samba drumming group, a singing group and a “Friday friends” craft group at Hymhus, describing each as “real highlights of my week”.

“Shetland has so much to offer from sports to music and drama to outdoor adventure,” she says. “I have always enjoyed arts and crafts and I have loved being introduced to the world of felting and making traditional Shetland straw baskets by my colleagues and neighbours.”

She would “absolutely” recommend Shetland to GPs looking for a change of scenery and lifestyle, describing it as “a unique way of working” where you “get to know your population really well” and have the ability to influence how healthcare is delivered.

While there are always challenges on that front, she does feel morale is generally better in Shetland than in many other parts of the UK, with workloads that are “busy but much more manageable”, with a “strong network of support from colleagues to manage those pressures”.

Although she misses some aspects of her old working life, particularly working with refugees, Deepa certainly does not regret making the move: “I still wake up every day feeling so incredibly lucky to live here.”

She adds: “On beautiful midsummer days it is easy to imagine why that would be in an amazing natural environment like this. But the long dark winters, although hard in many respects, are also one of the reasons why Shetland is such a rich and welcoming place.

“The long, sometimes inhospitable nights create a camaraderie amongst Shetlanders, drawing folk together, with time to nurture artistic or musical talents. Shetland feels like a place where everyone can find their creative voice.”