31 July - 3 August 2007

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A Weekly Bulletin of Professional News, Guidance and Policy for Primary Care

Professional Clinical England Wales
Scotland Northern Ireland


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Headlines...


  • Findings Show GPs Spend 40% Longer on Each Patient Consultation .....
  • Clinical Lead Sought for NICE Work Programme .....
  • Yellow Card Centre Wales Launches Website for Reporting Suspected Adverse Drug Reactions .....
  • Measuring Quality in Primary Medical Services in Scotland .....

Guidance featured in Seven Days is uploaded weekly to the RCGP Non-Clinical Guidance Database for General Practice.


Professional

News

Findings Show GPs Spend 40% Longer on Each Patient Consultation

 

The RCGP has welcomed the findings of the new GP workload survey but has been disappointed by claims that GPs are working less for more money and refutes these. RCGP Chair Professor Mayur Lakhani said, “GPs are working harder and more intensely at dealing with complex and complicated clinical problems. Independent analyses show UK GPs to be the ‘best-in-class’ internationally. GP teams have delivered outstanding results in the quality and outcomes framework year on year. Instead of attacking hardworking GPs we should be asking questions about the extraordinary amounts of money that have been spent on endless reorganisations in the NHS and external management consultancy costs which have amounted to £500 million pounds in recent years. GPs are on the side of patients and are determined to improve care even further. We would urge local NHS organisations to work constructively with their GPs to develop plans for improving patient care.”

 

The College response comes in the wake of two surveys on GP workload and consultation rates published this week. The first provided an overview of the entire workload and skill-mix of general practices in the UK in 2006/2007 and revealed that:

  • The average length of surgery consultations with GP Partners has increased from 8.4 minutes in 1992/1993 to 11.7 minutes in 2006/2007.
  • GP Partners worked an average 44.4 hours per week (full-time) and 38.2 hours per week (part-time); while salaried GPs worked an average 39.6 hours per week (full-time) and 23.8 hours per week (part-time).
  • The average number of hours worked by all GPs decreased with practice size. However, GMS GPs worked longer hours on average than PMS GPs regardless of surgery size.
  • 60% of the total patient contacts in practices were covered by GPs and family practitioners estimated they spent 72% of their time on essential services and 10% on additional services.
  • 76% of non-consultation work time was covered by non-clinical staff.
  • Reception staff spent 47% of the total time on repeat prescriptions.
  • Choose and Book accounted for 36% of the total time spent on arranging referrals.

GP Workload Survey (IC Report)

The second survey examined trends in consultation rates in general practice (1995–2006) and the findings for 2006 showed:

  • The overall number of GP consultations in England increased to 29,446.
  • 62% of consultations were undertaken by GPs, 34% by nurses and 4% by other clinicians.
  • 84% of GP consultations were conducted in surgery premises, 10% on the telephone, 4% were home visits and 3% were conducted at other locations.

Trends in Consultation Rates in General Practice 1995–2006 (IC Report)

 

Workplace Based Assessment (WPBA) Training for Senior GP Educators
 
The RCGP is running a workshop for those people responsible for the implementation of WPBA in the deaneries. It will be held at the RCGP’s Clinical Skills Assessment Centre in Croydon on Wednesday 5 September 2007. The day will enable GP educators to increase their familiarity with the assessment tools and explore ideas about training others in their use. There will be opportunities to share experiences and raise issues for which the College may need to resolve. Deaneries may nominate as many people as they wish to attend but if the event is oversubscribed the College will ensure that each deanery has one place. Although the workshop is aimed at senior educators, GPs who have missed out on local training or who would like more information are also eligible to attend this free workshop. To book places, please contact the College at jphillips@rcgp.org.uk or on 020 7344 3196. 

 

Register Online for the RCGP’s AKT and CSA

GP trainees can now register online for the RCGP’s Applied Knowledge Test (AKT) and Clinical Skills Assessment (CSA).

 

Specialist Library on Patient and Public Involvement in Health
 
A comprehensive collection of current knowledge and evidence about patient and public involvement (PPI) in health care has been launched by the PPI Specialist Library. The free resource is run by the King’s Fund on behalf of the National Library for Health and covers policy development, self-care, and strengthening NHS accountability to patients and local communities. It aims to support the implementation of patient, user, carer and public involvement in health care.
 
Patient and Public Involvement (PPI) Specialist Library (King’s Fund Website)


Guide to Recent College Activities
 
The RCGP has published its Autumn edition of the bi-annual publication “At a Glance”. It lists the major College activities since January 2007, and includes updates from Primary Care initiatives that the College is involved in. This issue contains items on the appointment of Professor Stephen Field as Chairman Elect of the RCGP and new College guidance on the management of Hepatitis C.
 
At a Glance – August 2007 (RCGP Publication)

Guidance

Healthcare Rights of LGB People
 
The General Medical Council (GMC) and Stonewall - the equality organisation for lesbian, gay and bisexual (LGB) people across Britain - have produced a leaflet informing LGB people of their right to complain if they feel discriminated against by their doctor. 
 
Protecting Patients: your rights as lesbian, gay and bisexual people (GMC and Stonewall Leaflet)
 
Consultation on Personal Beliefs and Medical Practice
 
The GMC is consulting on its guidance “Personal Beliefs and Medical Practice”. The document provides extra information on the doctors’ obligation to provide equitable access to care for all patients as outlined in the publication “Good Medical Practice”. Topics in this consultation document include refusal of blood products by Jehovah’s Witnesses; circumcision of male children; care of patients pre- and post- termination of pregnancy; clothing and other expressions of religious belief or culture; and completion of cremation forms. Register online to take part in the consultation. The closing date for comments is the 21 September 2007.
 
Personal Beliefs and Medical Practice: consultation on new supplementary guidance (GMC Document)


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Clinical

Announcements

Clinical Lead Sought for NICE Work Programme

 

A vacancy has arisen for a College member in good standing to provide clinical support to the NICE work programme. The role will involve developing clinical practice guidelines, technology appraisals and public health guidance relevant to primary care. The Clinical Lead will be expected to advise the College whether it should be involved with a particular piece of guidance; help identify potential contributors; and monitor the various written contributions generated by College Members. The position is estimated to occupy a day a month (2 sessions) and will be based in the newly established RCGP Clinical Innovation and Research Centre in London. The successful candidate will be reimbursed at the standard GP education rate of £361 for one day per month and any necessary travel expenses and locum cover will be paid. If you would like further information on this role please contact Paulomi Vyas, CIRC Manager, at CIRC@rcgp.org.uk by 31 August 2007. 


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England

Announcements

Consultation on Improving the Care Environment for Patients

 

The DH has issued a consultation document on best practice in 10 areas relating to the care environment, including ease of access to the care setting and its maintenance. The document aims to help practitioners compare, share and develop services. Each of the 10 benchmarks has been developed with input from patients, their carers, multi professional groups and health specialists, using focus groups. To ensure the views collected so far are representative of most people, the DH is calling on groups and individuals to provide feedback on the document. Comments should be emailed to j.alexander@leeds.ac.uk by 5 October 2007.

 

Essence of Care - consultation on patient care environment (DH Document)

 

Eleven More Areas Benefit from Psychological Therapies

 

Eleven new projects which will give patients with anxiety and depression better access to psychological therapies have been given the go-ahead by Mental Health Minister Ivan Lewis. The services will be specifically designed for the local communities where they are situated, with the aim of reducing the length of time that patients are ill – allowing them to regain their independence and return to work. Examples of the schemes include the development of a Healthy Minds Network (HMN) in Stoke-on-Trent, which will provide a number of services to GP practices in the area; and initiatives in Salford to help GPs send patients to an appropriate practitioner with the right skills to help them. Details of the 11 schemes are on the DH website.


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Wales

Announcements

New Health and Care Statistics Website

 

A website containing data on all aspects of health care in Wales has been launched by the Welsh Assembly. It provides access to the latest statistical releases, bulletins, publications and forthcoming datasets. Statistics are categorised into sections such as Primary and Community Health, Mental Health Services, and NHS Workforce.

 

Health and Care Statistics in Wales (Welsh Assembly Website)

 

Yellow Card Centre Wales

 

The Yellow Card Centre Wales (YCCWales) has launched a new website containing information and guidance on the importance of reporting suspected adverse drug reactions. It also allows healthcare professionals and patients to report adverse reactions online. Staff at the centre are available to offer advice and training on reporting and can be contacted at yccwales@cardiffandvale.wales.nhs.uk or on 02920 744181.

 

Yellow Card Centre Wales (YCCWales Website)


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Scotland

Announcements

Measuring Quality in Primary Medical Services

 

A report examining quality in primary medical services has been published by the Clinical Indicators Support Team (CIST), part of NHS Scotland. The document analyses data collected via the Scottish Programme for Improving Clinical Effectiveness in Primary Care (SPICE) to examine the effect of the GMS contract on the treatment of chronic conditions; compare measurements assessing changes in quality of service provision; evaluate the treatment of disadvantaged individuals in affluent and deprived practices; and review the use of innovative data presentation in comparing quality between practices. It concludes by making a number of recommendations on the future uses of SPICE data, such as linking it with morbidity and prescribing statistics.

 

Measuring Quality in Primary Medical Services Using Data from SPICE (NHS Scotland)

 

Fall in Cervical Screening Uptake

 

Uptake rates for cervical screening have continued to fall in almost all age groups according to statistics published by ISD Scotland. As at 31 March 2007, 76.5% of women had been screened for cervical cancer in the previous 3.5 years, compared with 81.7% as at 31 March 2002 (excludes Lothian). Overall 401,700 smears were processed in 2006/2007, of which approximately 3.5% showed some degree of pre-cancerous change. The number of unsatisfactory smears fell from 8.8% five years ago to 2.4% in 2006/2007, mainly due to the introduction of Liquid Based Cytology (LBC) as a method of taking samples.

 

Statistics on the Cervical Screening Programme for 2006/2007 (ISD Scotland)

 

Update of the Guideline on the Management of Asthma

 

The guideline on the management of asthma - first published in 2003 by the British Thoracic Society (BTS) and the Scottish Intercollegiate Guidelines Network (SIGN) – has been updated for 2007 to incorporate the results of the latest research. The document is a comprehensive resource for those caring for asthmatics in hospital or the community. Changes to the update include a suggested dose of inhaled steroid treatment for children and the need to consider prescribing higher doses of inhaled steroids for smokers/ex-smokers. No specific recommendations have been provided on the use of ciclesonide; anti IgE monoclonal antibody “omalizumab”; or adjusting the dose of a combination inhaler budesonide/formoterol according to symptoms. A revised copy of the entire guideline is due to be published in early 2008 following a major review.

 

Update to the British Guideline on the Management of Asthma (SIGN Website)

 

No Major Rise in GP Consultations for Flu-Related Illness

 

Statistics published by ISD Scotland show no major rise in GP consultations for flu-related illness during winter 2006/2007. The uptake rate of the vaccine in patients aged 65 plus was just over 75% - well over the 70% target - and more than 1.1 million vaccines were dispensed overall. The figures, which examined flu related activity in primary care, showed that practice nurses administered the majority of the flu vaccinations.

 

Influenza Statistics for Winter 2006/2007 (ISD Scotland)


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Northern Ireland

Announcements

No announcements.

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