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21 - 28 August 2007
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A Weekly Bulletin of Professional News, Guidance and Policy for Primary Care
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Word Version
Headlines...
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RCGP Search for External Assessors .....
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Members Sought to Chair New College Committees .....
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Inclusion of the Civil Standard of Proof at Fitness to Practise
Panel Hearings .....
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GMS Contract Review in Wales .....
Guidance featured in Seven Days is uploaded weekly to the
RCGP Non-Clinical Guidance Database for General Practice.
Professional
News
RCGP Search for External
Assessors
The RCGP wishes to appoint External
Assessors to act as College representatives on the Specialty
Training Committees (or equivalent) of all UK deaneries. The
successful applicants will provide College input to training within
the deaneries and sit on panels which evaluate GP Specialty
Registrars’ progress at the end of the training year. Candidates
should be currently or recently active in clinical family practice
have experience as a GP trainer, and be familiar with the
principles of education in general practice. A job description and
person specification is available from Mona Lindsay at mlindsay@rcgp.org.uk.
The closing date for applications is 14 September 2007 and
interviews will be held during October 2007.
New Online Forum for
Medical Undergraduates
Medical students around the UK will
be able to access a wealth of information about becoming a GP by
logging on to the new RCGP Online Student Forum. It is designed to
support students through their time at medical school and onto the
Foundation programme. Registration allows users to access online
publications, news bulletins, the College library and discounts
when purchasing items from the RCGP bookshop.
Student Forum (RCGP Website)
Members Sought to Chair New
College Committees
The College is seeking three
Members to chair three newly established College committees. The
first will be responsible for the effective delivery of the nMRCGP
assessment (Assessment Committee); the second accountable for work
on the RCGP curriculum (Curriculum Committee); and the third will
lead and coordinate work relating to standards for GP specialty
training and certification of doctors (Quality Management and
Training Standards Committee). The closing date for applications is
11 September 2007 and interviews will be held on 24 September 2007.
Role descriptions and person specifications are available from Kate
Tunnicliffe, PDB Administrator, on 01925 242167 or at ktunnicliffe@rcgp.org.uk.
RCGP Recruits for
Leadership Programme
Enrol now for next Leadership
Programme starting in October 2007. The one year programme aims to
help GPs develop leadership skills and provides a unique learning
opportunity to focus on the issues that matter most to grassroots
doctors. Participants are required to attend four residential
weekends and three tutorial days, and will receive around four
hours additional learning per week. A personal online tutor will be
assigned to each person for confidential feedback and support. For
more information and to obtain an application form please email
leadershipprogramme@rcgp.org.uk.
RCGP Leadership Programme (RCGP
Website)
Inclusion of the Civil
Standard of Proof at Fitness to Practise Panel
Hearings
The GMC is consulting on proposals
to introduce the civil standard of proof at its Fitness to Practise
panel hearings. Standards of proof represent the level of certainty
and the degree of evidence necessary to persuade a reasonable
person that a particular fact is true - and different cases require
different standards of proof depending on the circumstances. The
new GMC system would lower the amount of evidence required by
panellists making decisions on disputed facts from "beyond all
reasonable doubt” used in criminal cases to "on a balance of
probabilities" used in civil courts. The consultation runs from 20
August to 31 October 2007 and comments should be emailed to
ftpconsultation@gmc-uk.org.
Standard
of Proof Consultation (GMC Document)
Improving Access to Primary
Care – Free Webcast
A live webcast to encourage staff
to consider issues on improving access to primary care will take
place on 19 September at 13:00. The free 45 minute session,
presented by Dr Tom Debenham, will look at the challenges and
opportunities of access and new ways of working. Register
online to view the session by 12
September.
Access: thinking beyond the
boundaries (Improvement Foundation Live
Webcast)
Reduction in GP Vacancies
Rates
Results from the third annual GP
practice vacancy survey show a reduction in the number of unfilled
posts per 100,000 patients in England (from 0.7 in 2006 to 0.5 in
2007) and Wales (from 1.1 to 0.6). Findings also revealed a
decrease in the estimated number of practice nurse vacancies in
England (from 0.6 to 0.5) and an increase for Wales (from 0.2 to
0.4). While vacancy rates per 100,000 patients for practice staff
in England remained unchanged (at 1.0) but increased in Wales (from
0.6 to 0.8).
GP Practice Vacancy Survey 2007 (IC
Survey)
Increase in Number of
Missed Appointments
Research published by Developing
Patient Partnerships (DPP) reveals that almost 13.5 million GP
appointments and nearly 6.5 million practice nurse appointments are
missed each year, despite the availability of same day
appointments. The findings come from a survey conducted with 557 UK
GP surgeries in July 2007.
UK Statistics on Missed Appointments
(DPP Survey Statistics)
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Clinical
Announcements
Patients Sought for Kidney
Cancer Survey
The James Whale Fund for Kidney
Cancer is conducting a survey to investigate how patients discover
they have the disease and the resulting action they take. The
charity seeks to raise public awareness of kidney cancer and hopes
that survey results will inform the way in which diagnosis rates
can be improved. Details of how kidney cancer patients and their
carers can take part can be found on the charity’s website
or by calling 01799 585 033.
Help Make NICE Guidance
More Accessible to End Users
NICE has created a new project to examine how to effectively
disseminate its guidance to end users. A virtual group has been
created to enable participants to get up-to-date information on the
scheme and join regular discussions to inform decision making. NICE
is currently recruiting more front line clinicians and healthcare
staff to this online community to ensure end users’ needs are fully
represented. To enrol or obtain further information contact
Jennifer Alletson at Jennifer.Alletson@nice.org.uk
giving your full name, role, organisation details and whether you
use NICE public health guidance, technology appraisal guidance, or
both.
Electronic
Guidance Access Project (EGAP) (NICE Website)
Guidance
NICE Guidelines on Lung
Cancer, Multiple Sclerosis, Arthritis, UTI and Chronic Fatigue
Syndrome
NICE has published a number of
guidelines this week, which are listed below, along with their
recommendations:
- Pemetrexed (Alimta) has not
been recommended as treatment for locally advanced or metastatic
non-small-cell lung
cancer.
- Natalizumab has been
recommended for the treatment of rapidly evolving severe
relapsing-remitting multiple
sclerosis (RES).
- Rtumximab (Mabthera) and
adalimumab (Humira) have been approved for the treatment of
rheumatoid
arthritis and psoriatic
arthritis, respectively. The guidance states that
rituximab in combination with methotrexate should be considered as
an option for adults with severe active rheumatoid arthritis, who
have not responded to other therapies. Whilst adalimumab is
recommended for adults with active and progressive psoriatic
arthritis, where the person has three or more tender joints and
three or more swollen joints; and if there has been no response to
at least two other disease-modifying anti-rheumatic drugs
(DMARDs).
- A guideline published in
conjunction with the National Collaborating Centre for Women’s and
Children’s Health (NCC-WCH) offers advice on the diagnosis,
treatment and management of urinary tract infections
(UTI) in children aged 16 and under. It focuses
on when to consider UTI and outlines the relevant diagnosis
procedures for children at different ages.
- New guidance on improving
the diagnosis and management of chronic fatigue
syndrome/myalgic encephalomyelitis (CFS/ME) in
adults and children has been published in collaboration with the
National Collaborating Centre for Primary Care (NCC-PC). Emphasis
is placed on the importance of shared decision-making between
health professionals and people with CFS/ME; providing therapies
suitable to the individual; and the right to refuse or withdraw
from any part of the treatment plan without it affecting future
care.
Using Monitored Dose
Systems (MDS)
The Dispensing Doctors’ Association
(DDA) has issued a new
FAQ on MDS in response to confusion on their
usage. An MDS is a sealed container holding a one week supply of
medication, prescribed to patients with proven difficulty taking
their medicines from cartons and bottles. The DDA advice states
that:
- The Disability Discrimination Act
1995 places a duty on dispensers to consider what reasonable
adjustments need to be made to standard dispensing procedures to
enable a disabled patient to take their medication.
- MDS usage must be based on
clinical need and any adjustments should be reasonable and
practicable.
- It is sensible to dispense MDS at
shorter intervals than the standard 28 days if there are changes to
medication or dosage regimes. Weekly MDS prescriptions should only
be issued when clinically justified.
Diary to Improve Ovarian
Cancer Referral Rates
Ovarian cancer action has developed
a symptom diary to assist GPs in the diagnosis of ovarian cancer.
It is based on research carried out by Professor Barbara Goff at
Washington University and aims to improve decision making regarding
referrals and help GPs adopt a best practice approach to monitoring
women presenting with symptoms.
Ovarian
Cancer Symptom Diary (Ovarian Cancer Action
Publication)
The key findings of Professor
Goff’s recent paper, published in the journal Cancer earlier this
year, called on doctors to consider ovarian cancer in their
diagnosis if a woman experiences any of the following symptoms more
than 12 times during a four week period: bloating/increase in
abdominal size, pelvic/abdominal pain, difficulty eating/feeling
full quickly, and/or frequent or urgent urination.
Development of an Ovarian Cancer Symptom
Index (Article by Professor Barbara Goff)
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England
Announcements
Interactive Website to
Improve Life Expectancy
An interactive website to help
local health services improve life expectancy in spearhead areas
(those with the worst health and deprivation in England) has been
updated for August 2007. It was commissioned by the DH, and
developed by the London Health Observatory and Yorkshire and Humber
Public Health Observatory. It provides information on life
expectancy in spearhead local authorities (such as cause of death)
and enables users to estimate the improvements to life expectancy
through simple interventions such as smoking cessation. The updated
version includes charts to illustrate the life expectancy gap and
enable comparison with the England Spearhead Group as a whole;
population and deaths data has been updated from 2002-04 to
2003-05; and user friendliness has been improved.
Health Inequalities Intervention Tool
(London Health Observatory Website)
Reminder to Use Read Codes
for Choose and Book
The DH has disseminated a ‘Dear
Colleague’ letter to remind practices that signed up for the Choice
and Booking Directed Enhanced Service (DES) that they must
participate in the delivery and administration of the GP Patient
Survey. New Read Codes (the recommended national system for
recording clinical information in general practice) were released
in October 2006 to record which patients were referred by a GP for
a first consultant outpatient appointment using Choose and Book;
and practices must start to use these from 1 September 2007 if they
are not already doing so. GPs are advised to contact choice@dh.gsi.gov.uk
with any queries about the use of these codes.
Read Code for Choice and Booking (DH
Letter)
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Wales
Announcements
GMS Contract is Benefiting Patients
Findings from a Wales Audit Office
review show that while patients have benefited from the GMS
contract, changes need to be made to the way it is managed to
ensure its long-term success. The report found that the contract
has delivered better working conditions for GPs including a 10%
reduction in working hours and an average 25% increase in incomes.
Practices also had more funding for patient services – which has
improved access to provisions and the quality of care. Report
recommendations include:
- Commissioners should make full use of the new contract’s
flexibilities and provide local services based on local needs.
- Incorporating continual service improvements in the QOF
- For Local Health Boards to introduce routine, detailed
checks
Review of the GMS Contract in Wales
(Wales Audit Office Report)
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Scotland
Announcements
Views Sought on Headache Guideline
A draft guideline outlining best practice in the diagnosis and
management of headache in adults has been published by the Scottish
Intercollegiate Guidelines Network (SIGN). The remit of the
publication is to reflect the needs of the Scottish population and
the health resources available. Recommendations focus on common
disorders such as migraine, tension-type headache, and rarer
primary headaches due to recognisable features with specific
treatments. Advice on assessment tools, investigation, magnetic
resonance imaging and therapies are also covered. Comments on the
draft document should be sent to lorna.thompson2@nhs.net
by 19 September 2007.
Diagnosis
and Management of Headache in Adults (SIGN
Guideline)
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Northern Ireland
Announcements
No announcements.
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Contact Us
RCGP Information Services can be contacted at:
Email:
info@rcgp.org.uk
Tel: 020 7581 3232 ext: 240
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Disclaimer
Seven Days uses third party information and neither endorses nor guarentees the accuracy or authenticity of these sources.
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