Welcome to the March 2010 edition of
our monthly e-bulletin which is sent to all members of
Wessex Faculty at their registered email address. If you
would like to opt out or change your contact email address, please
visit the membership area of the RCGP website via the following
link https://integra.rcgp.org.uk/membersarea.
Faculty Board Meeting, 24th February
2010.
The Board meeting was held at Andover War
Memorial Hospital with Graham Archard in the chair. A minute of
silence was observed in memory of Dr Anna Wilson FRCGP, who died on
26th January 2010. The minutes of the previous meeting
in November were accepted. The following items were among the
business discussed:
The Framework for the annual Faculty Plan has
been designed by Kevin Sharpe (FSM). This incorporates a statement
of Objectives for 2010/11 and a spreadsheet for budgeting the
expected costs and revenue for each activity. Chairman urged the
leaders of each objective to ‘populate’ the spreadsheet with the
activities which their objective encompasses, and an email exercise
to complete this was agreed. He also encouraged board members to
put forward suggestions for additional objectives or activities
which could be incorporated within the main five (Baseline
activities, Supporting members, Education, Communications and
Quality improvement). Tony Kendrick proposed an objective of
supporting research (which has been somewhat dormant in the faculty
during the last two years). It was agreed that Research could be
grouped under ‘Supporting members’ along with AiTs, First Five
years, Fellowship and iMAP. Budgets for individual educational
activities were set down according to the historic costs and
revenue for courses in the previous year, but will clearly be
subject to modification as the current year’s programme
unfolds.
The Treasurer, Kim Daniels, presented the
interim Profit and Loss account for the faculty for the year to
date, which shows that we are on course to make a satisfactory
profit this year, following the unexpected loss which was
experienced last year. The Board agreed that a prepaid debit card
should be purchased for the office to use in place of petty cash.
Formal contracts were reviewed and agreed for the Education
Director (Mark Coombe), his deputy (Jenny Allinson) and the
Communications Lead (Peter Burrows).
A resume of forthcoming Council agenda was
presented by Chris Barry (who will be deputising for John Dracass)
and Sunil Bhanot. The Board indicated their support for a motion
from Mary Selby, requesting that the College should take
responsibility for the training and accreditation of family
planning, including IUCD and implant insertion. This is currently
held by the RCOG, although 75% of the work is done in general
practice. The Board was alarmed to hear that within the College’s
‘election manifesto’, it was stated that we wish to regain
responsibility for the provision of out-of-hours care. This was
felt to be unrepresentative of members and a political hostage to
fortune which might rebound on us.
We were dismayed to hear that the proposal for
the extension of GP training to five years had been rejected by the
Medical Programme Board because they felt that the educational case
for change had not been made. Undoubtedly, however, this is not the
end of the story.
A new award is proposed, jointly between the
College and the Princess Royal Trust for Carers; this is for a
practice which has made innovative developments in the
organisation, accessibility or delivery of care to disabled people.
The Board suggested that we might ask for this to be associated
with the name of Anna Wilson, in recognition of her seminal work on
the needs of carers. We are also considering organising a memorial
concert to be held this summer in Winchester to commemorate her
life. Tony Kendrick asked for support for a motion from the South
Midlands Faculty regarding replenishing the funds of the Scientific
Foundation Board which awards research grants to members, from a
0.5% levy on the annual subscription fee. The Board was in favour
but the motion has to go to the Trustee Board first.
Forthcoming Faculty events were discussed,
including the Awards Evening which has unfortunately had to be
postponed (see below). The Summer Symposium will take place in
Portsmouth on 10th June and the speaker is Gavin Wells,
who will be able to enlighten us on the inside story of the banks
and the crash in the economy, under the title ‘Too big to fail?’.
We are inviting a very eminent speaker to give the George Swift
lecture in September, and may move away from our traditional venue
in Winchester, following the death last year of George’s daughter
who suffered from multiple sclerosis, and for whom the venue
provided convenient access.
Reports were received from various officers
and subcommittees and the succession of provost and chairman, both
of whom reach the end of their terms of office in November was
discussed. A small project for producing leaflets to help
Alzheimers sufferers to explain their difficulties to people they
meet, was proposed and accepted. The next meeting of the faculty
board will be on Monday 7th June 2010.
Peter
Burrows
Communications
Lead
My
Friend Anna
I first met Anna Wilson 15 years ago when I
joined the Wessex Faculty as Faculty Support Manager. It soon
became apparent that Anna was a person of great energy and
enthusiasm. Whilst my relationship started out as a
professional one, it soon became a personal one.
Anna was a fantastic advocate for all those
that she worked with and cared about, whether they were patients,
carers, doctors that she helped through training, GPs returning to
practice after career breaks, vulnerable people in the community
and most of all her family and friends.
Networking was one of Anna’s biggest strengths
- she seemed to know just about everyone. I remember the
Summer Symposia at Sarum Road where she had negotiated the free use
of a marquee, Pimms, a buffet and the biggest heap of fresh
strawberries I had ever seen!
Anna had vision and time has shown that she
was often before her time – her work on Carers was at least 10
years before current developments, as was her work with Brenda
Sawyer on management training for trainees.
The RCGP and Wessex Faculty in particular,
were very important to Anna and her award of Fellowship in 1998 was
something she was very proud of. Carol (White) and I went
along to “granny” sit while Max, Anna and their respective mothers
had a wonderful day out (complete with us) to receive the
award.
Anna was a much respected GP and patients at
Gratton Surgery would wait as long as was necessary just to see
Anna. (I often met them in the waiting room). On my numerous
travels with Anna, she would often take phone calls from patients
seeking advice.
Over the years, Anna became as much attached
to my own family as I did to hers whether this was aqua aerobics
with my sister and I, or visiting my mum when she was ill in
hospital. I in turn celebrated her children’s successes with
her.
News of Anna’s illness was a shock but she
tackled this with typical drive to fit in as much as she could into
her remaining time. She never complained and focussed very
much on achieving personal milestones – firstly Anya’s
qualification from medical school, Nina’s and then Crispian’s
weddings. She travelled extensively and typically made huge
efforts to help others who she felt were more disadvantaged than
she was. She was even skiing just a few weeks before her
death.
Anna was vibrant, caring, funny and had so
much energy - an inspiration to everyone who knew her. I believe
our friendship was as important to her as it was to me and I value
that. Anna has left a huge legacy and will be remembered by
everyone, from whatever background, who she helped in their lives.
Anna was, however, first and foremost a dedicated wife and mother
and her spirit and values live on through her husband Max and three
children, Anya, Nina and Crispian.
Anna was unique and the world will be a sadder
place without her. I have so many Anna memories and I hope this
article reflects just a few of them. I will miss Anna but
will certainly not forget her.
Frances
Cloyne
Head of
Faculties
Caring for Victims of Sexual Assault
Who undertakes it?
This work is interesting, challenging and
intense and requires the doctor involved in it to develop a new set
of skills not usually needed in regular clinical practice. It
is a part of Clinical Forensic Medicine which traditionally has had
a rather shabby image – the old Police Surgeon who stumbles out of
bed in their night clothes is mostly long gone. Today’s Forensic
Physicians are very different; they are often Portfolio doctors who
have a wide skills set and knowledge base in several related areas.
Sexual Offence Examiners form part of this group of Forensic
Physicians and they may undertake Sexual Offence examinations only
or may be involved in general Clinical Forensic Medicine (CFM) as
well. The Faculty of Forensic and Legal Medicine (FFLM) is part of
the Royal College of Physicians and is committed to raising the
standards in CFM. http://www.fflm.ac.uk/
Sexual Assault Referral Centres
(SARCs)
SARCs were developed to help and support
victims of sexual assault, they are all client focussed and offer
clients access to the SARC either through the Police route (90%) or
as a Self Referral (10%). Both routes allow the victim to have a
Forensic medical exam where appropriate, and to have immediate
aftercare (PCC, PEP, Preg Test, any acute onward medical referral)
and immediate crisis support from the Crisis workers. Further
support is available – this may be by referral to Rape Crisis
services, Genito-Urinary Medicine and Independent Sexual Violence
Advocates.
.
Is this work for me?
Working as a FP is an intense but rewarding
job. The people that we see are in a highly vulnerable state,
perhaps mentally shocked, and they need a doctor with warmth and
humanity, who is a good listener and who can remain impartial but
be supportive. Forensic Physicians are agents of the court
and their role is to gather evidence impartially for the benefit of
the court. They must be able to document carefully (and legibly)
their findings, assess the medical needs of the victim and
carefully collect the relevant forensic evidence. It is a
highly responsible task since failure to do any of these may result
in a case being dropped or a Not Guilty verdict in court.
Specialist Skills
This work is very different from that in other
areas of medical practice. Whilst in every case that a doctor sees
in other areas of medicine there is the remote possibility
that it may result in a court action (usually Civil), in CFM the
aim is that the case will go to court (usually Criminal
Court). The doctor, therefore, will be required to provide a
statement and possibly appear as a witness. This requires good
initial training in the examination process, statement writing and
courtroom skills. Careful examination and documentation with good
statement writing will ensure that court appearances are rare.
Although many doctors are apprehensive about court appearances good
preparation can make this a much less worrying event.
Training
This varies from area to area depending on the
local provision for dealing with Sexual Offence examinations. There
is “In House” training and shadowing in all areas prior to a doctor
working unsupervised on the Sexual Offences rota.
Further training is available from St Marys’
Hospital in Manchester and the Havens in London. Courses lasting 2
or 3 days are run at regular intervals – details are on the
websites. These courses may be taken after “In House” training to
reinforce knowledge or prior to any local training. At present it
is not essential to have attended one of these courses before
starting this work.
St Marys’ also runs a more in-depth course on
Sexual Assault in conjunction with the University of Manchester.
(The Forensic and Medical Aspects of Rape and Sexual Assault - for
details see http://www.stmaryscentre.org/
). For established Sexual Offence Examiners there are postgraduate
courses run by universities at Preston and Ulster which will give a
higher qualification in Forensic Medicine.
Treetops
This is the SARC for Hampshire and IOW,
situated in Cosham near the QA Hospital. It has been operational
since 11/06. All victims of sexual assault have the opportunity to
be seen here – the service runs 24/7 for anyone over 16yrs and in
the OOH period, 13–15yr olds can be seen for an acute assault. The
service is provided by female doctors and female crisis workers who
work together and with Hampshire Constabulary to provide a
forensically sound examination and sample collection whilst being
supportive and empathic. The female workforce situation is common
in most SARCs, however in some areas male doctors are available on
the rota but this is dependent on local arrangements. A Young
Person’s Worker is available to support and offer follow up to
cases in the ages 13 -18yrs.
Approximately 450 cases are seen at Treetops
each year from all over Hampshire and the Isle of Wight, and most
of these require a Forensic examination. The majority of cases are
young women aged 16 -24yrs, and this reflects national figures that
show that the greatest risk for being sexually assaulted is in that
age group. Historical cases are also seen, and they may be there
for a Police interview or for referral by the Crisis Workers to
other services, eg Rape Crisis or Victim Support. Further
information about the services at Treetops is available on the
website - http://www.treetopscentre.co.uk/
Dr Sandy
Fielding
Clinical Director
Treetops
Member of the
Faculty of Forensic and Legal Medicine
Wessex Faculty Case Cards
If you haven’t heard of CASE (Communicate,
Articulate, Simplify and Explain) cards yet, we’re clearly not
working hard enough at promotion! This is how they came
about:
We’re all recently qualified GPs (or in
Lizzie’s case very soon to qualify) and we all took the CSA at the
end of 2008. Working in a small study group to prepare for
the CSA was very helpful. While doing the role plays that many CSA
study groups focus on, we realised that the part of the
consultation we really struggled with was explaining simple
concepts about diagnoses, drugs and other medical information in a
patient-friendly and easily understandable manner, without being
tainted by jargon or ‘medicalisation’. Hearing how each of us
did it differently, using different phrases, analogies and body
language was incredibly helpful. We started writing diagnoses
onto small scraps of paper, putting them into a teacup, pulling one
out at random, and having to do that explanation there and then.
And it worked brilliantly. The game developed and we
started playing it like Radio 4’s Just a Minute – we were allowed
repetitions and hesitation but deviation and, worse, medicalisation
were right out (although, to be fair, we all struggled with the
minute!). It was always meant to be a bit of fun to break up
the ‘more serious’ role-playing, but we all found it extremely
helpful.
It was complete serendipity that Lois
mentioned it to Mark Coombe, her trainer, and he thought it was an
idea worth publishing as a box of ‘revision’ cards. With his
experience of examining for the CSA and developing the CSA videos,
he encouraged us to approach the faculty for funding and guided us
throughout the project; as well as introducing us to Peter Tate,
who gave us his own words of wisdom to help direct us and went on
to write the foreword for us too!
We linked the topics on each card to the
curriculum so that by mapping them we could try and get the
coverage even. We accepted that we’d never be able to cover
the whole curriculum, but tried to work out the explanations we had
really struggled with and included them in the box. We met
most weeks over 2009, writing the cards individually and then
editing them as a group (and this despite two babies being born,
one further pregnancy, two house moves and four job changes between
us!). Although time consuming, this worked well:
we each brought our own perspectives, styles and turns of phrase to
the cards and could share our analogies and own experiences.
It became clear as we wrote them that they
worked best when there was a context in which to give the
explanation, so we incorporated a short scenario into each
card. We also found ourselves being distracted by all sorts
of interesting discussion around the topics – these were so
valuable that we thought it would be good if our readers could
share them. So ‘the red questions’ were born: a short series
of questions to provide some direction for personal reflection or
group discussion.
I’ve lost count of the times that we would
meet and recount how we had used the cards we’d written the
previous week in our consultations the following week!
They were clearly working for us and we hope they do for our
readers too.
We were very lucky that Paula’s husband, Andy,
is a graphic designer and created the cards for us at a much
reduced rate. Style and quality of design was important to us
– and this is very much what Andy produced!
And what have we learnt from this project? We
would certainly have approached it differently with the benefit of
hindsight, but then the cards wouldn’t have developed as they had
unless we had ‘gone through the process’. I think we would
all have wanted to be more focused in our writing and editing, we’d
have been more organised in the project management, taking
individual responsibility for tasks, rather than ‘doing them as a
group’, and have been smarter in our commissioning of the printers
– but the retrospectoscope is a wonderful thing! You live and
learn, and this has been a great learning experience for us
all.
We’re tremendously proud of what we’ve
produced and, it goes without saying, extremely grateful for Mark’s
support and encouragement (not to mention editing pen) throughout
the project. We’re also most grateful to The Wessex
Faculty, who have been extremely generous with their financial
assistance, and to Jeremy Stupple (our other editor) and Richard
Weaver (Head of School of General Practice, Wessex Deanery) for
their continued support.
If you would like to order a box of the cards (how
could we miss such a marketing opportunity!) please contact:
Michelle Spencer or Jackie James at Wessex Faculty RCGP, Suite 3
Fosse House, East Anton Court, Icknield Way, Andover, SP10 5RG Tel:
01264 355 013 or e-mail: wessex@rcgp.org.uk
Simon Tricker, Lois
Bowd, Paula Hunt & Lizzie Smiley
Postponement of Faculty Awards Evening
We regret to announce that the Faculty Awards
evening which was due to take place on Friday 5th March
has been postponed and will now be rescheduled for the early
summer.
Not enough nominations have been received to
make it viable; this may be because the publicity was delayed by
staff being unable to get to the faculty office in January during
the atrocious weather conditions.
However we think that the main reason was
because we mailed the flyers to your registered addresses rather
than by bulk delivery to your practices via the PCTs. Consequently
they did not come to the notice of practice managers and surgery
staff who have probably been the prime movers in initiating
nominations in previous years. We shall remedy this in our next
circulation, so please watch for the flyers and prepare to nominate
your excellent colleagues for an award this year.
Forthcoming events
Educational Courses
|
Date
|
Subject |
Venue |
Length |
|
| 10 Mar |
AKT Preparation for
the
MRCGP Exam Study Day
|
Langstone Campus, University
of Portsmouth
|
1 Day
|
|
| |
|
|
|
|
| 13 Apr |
Practical Alternative to
CBT
|
Hilton Hotel, Southampton |
1 Day |
|
| |
|
|
|
|
| |
|
|
|
|
Future courses planned are as
follows:-
25-27 May Child Health
3 day course - venue and flyer to be confirmed
June
Minor Surgery & Joint Injection - dates, venue and flyer to be
confirmed
September 21st, Travel
Medicine & 30th, Emergencies in General Practice
If you would like to register your interest on
the above future planned courses, please email your details and the
course(s) you would like to apply for to wessex@rcgp.org.uk. As soon
as the courses are finalised you will receive the flyer and
application form to complete.
Wessex Faculty is pleased to advise that on
most courses we can offer creche facilities to those who
request them. Please let us know if you may require creche
facilities for any of the courses you are attending however we will
need a minimum of 6 weeks notice. We will be happy to advise
of the cost should you be interested in creche facilities.
Contact us regarding educational
events
DWP Event - 20th April 2010, Southsea, Portsmouth
There are still places available for the DWP Health & Work
in General practice Workshop at the Best Western Royal Beach
Hotel in southsea, Portsmouth on the 20th April. You can find
the flyer and application form here.
Social Programme
Wessex Faculty Summer Symposium - Thursday 10th June 2010.
Please contact the office for further details.
Contact us
regarding social events
Contact us
By
phone: 01264
355005 Administration and Social events
01264 355013 Educational events
By
fax:
01264 355115
By
email:
wessex@rcgp.org.uk
By
post:
Wessex Faculty
Royal College of General Practitioners
Suite 3, Fosse House
East Anton Court
Icknield
Way
Andover, Hants, SP10 5RG
E-Bulletin Editor: Dr Peter
Burrows
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