7 - 13 July 2007

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

Professional Clinical England Wales
Scotland Northern Ireland


Word Version

Headlines...


  • RCGP London Faculties Response to NHS Review
  • Online Learning Modules Support GP Curriculum
  • Applicants Sought for Scientific Foundation Board Grants
  • Updated Guidance for Doctors on Identifying and Supporting Carers

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


Professional

News

RCGP London Faculties Response to NHS Review

 

Sir Ara Darzi, Parliamentary Under Secretary of State for Health, has published a report on the future of London’s NHS services. The report proposes to shift patient care from district hospitals to "polyclinics" - community-based facilities incorporating GPs and hospital services – and deploy doctors so they can move easily between hospital and community settings.

 

RCGP London Faculties issued a joint statement in response to these proposals, agreeing with attempts to tackle fragmentation of care and improve healthcare in London, whilst highlighting that it is possible to deliver improvements using a variety of models. Dr Surendra Deo (Chair, North East London), Professor Paul Thomas (Chair, North & West London) and Dr John Spicer (Chair, South London) said, “We caution against the development of “super surgeries” or disease-focused “polyclinics”, which may simply co-locate individuals without an underpinning philosophy or vision. General practice is not something that can be "tagged on" to other specialist services. The cardinal values of general practice such as interpersonal care and continuity of care must prevail. Evidence shows that patients want local personal care rather than being treated as a number - they want to see a GP they know and who knows them. It is essential to engage and involve GPs in future discussions. We commend the value of co-ordination and integration of care led by primary health care teams and of practices working together in federated models. We therefore urge London GPs to show constructive leadership and use this as an opportunity for promoting their own ambitions for improving patient care.“

 

Online Learning Modules Support GP Curriculum

 

The RCGP, in partnership with E-learning for Healthcare, is developing online learning modules to support GP Registrars and trainers using the new GP training curriculum. The interactive tools will initially focus on key areas where trainees need additional help and will then be extended to cover the entire curriculum. The first modules should be available by August 2008. Commenting on the project, Dr Bill Reith, Chair of the RCGP Postgraduate Training Board, said that the modules support training by offering a flexible resource that can be accessed anywhere, at any time, and be followed at the learner’s own pace.

 

Online Learning Modules (RCGP Website)

 

Applicants Sought for Scientific Foundation Board Grants

 

The College’s Scientific Foundation Board (SFB) is seeking applicants for its research awards, offered to people undertaking research projects on the care of patients in the general practice. The Board recently partnered with Heart Research UK and Roche Products Limited, and is particularly keen to support work in the field of cardiovascular disease; chronic kidney disease (CKD); the management of obesity; and osteoporosis. The closing date for the latest round of submissions is 31 July 2007. Grants awarded will not exceed £10,000.

 

Scientific Foundation Board (RCGP Website)

 

GPs Awards for Supporting Unpaid Carers

 

The Princess Royal Trust for Carers and Simplyhealth are seeking applicants for the Simplyhealth Caring Awards, which recognise work by GPs, surgeries and PCTs that support unpaid carers across the UK. GPs can be nominated or enter themselves and prizes include a Gold Award of £2,000, a Silver Award of £1,000 and Bronze Award of £750. Winners are expected to put half of the money into carer’s support initiatives. The closing date for applications is 24 September 2007.

 

Simplyhealth Caring Surgery Award (Princess Royal Trust for Carers Website)

 

Code of Practice to Tackle Fraud in the NHS

 

The Government is consulting on a new code of practice to combat financial loss in the NHS through fraud. The code outlines how counter fraud and security specialists should obtain information for use in investigating fraud and security breaches. NHS workers and contractors who fail to provide documentation or give misleading information could receive a prison sentence or fine. Fraud experts are instructed to ensure patient care is not disrupted during their investigation, and that information is stored securely and not misused. Comments on the draft code should be sent to counterfraudconsultation@cfsms.nhs.uk by the 4 October 2007.

 

A Code of Practice for the Use of Powers to Counter NHS Fraud and Security Incidents (DH Consultation)

 

College Member is New Medical Director of Choose and Book

 

Dr Stephen Miller MRCGP has been appointed as the new Medical Director for the national Choose and Book programme. He is a founding member of the initiative and will work with clinicians and front-line staff to ensure Choose and Book is used as the everyday method for referring NHS patients.

 

New Medical Director for Choose and Book Programme (Connecting for Health Press Release)

 

Appointment of Pharmacy Regulation and Leadership Oversight Group

 

The DH has announced the establishment of a Professional Regulation and Leadership Oversight Group, which will advise and work with Health Ministers to establish the new pharmacy regulator - the General Pharmaceutical Council (GPhC).

 

Pharmacy Regulation and Leadership Oversight Group (DH Press Release)

 

Universities to Train Physician Assistants

 

The Universities of Wolverhampton, Birmingham and Warwick with Coventry are to run a new postgraduate diploma in Physician Assistant Studies. The course compresses three academic years into two calendar years, and will cover many of the elements contained in the standard four or five-year medical programme. It will focus on general medicine in the General Practice and Hospital settings rather than specialty care. Physician Assistants will be trained to take medical histories, perform examinations, diagnose illnesses, and analyse test results under the direct supervision of a doctor.

 

Training Programme for Physician Assistants (University of Birmingham Press Release)

Guidance

Updated Guidance for Doctors on Identifying and Supporting Carers

 

Updated guidance to assist doctors in identifying and supporting carers has been published by the BMA’s Community Care Committee. It outlines carers’ basic rights (in relation to legislation and government guidance); describes their needs (such as a break from caring); and outlines the doctor’s role in providing care (such as signposting to local support services). It suggests that creating a register for carers and setting up a formal carer strategy would benefit GPs by reducing appointment times and decreasing GP prescription costs (such as antidepressants).

 

Working with Carers: guidelines for good practice (BMA Guidance)


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Clinical

Announcements

College Response to Two-Week Breast Cancer Referral Rates

 

A study published in the BMJ has shown that the ‘two-week wait rule’ – implemented to improve access to specialist services for patients with suspected breast cancer – has disadvantaged patients that are referred routinely. 

 

The findings show that while the percentage of patients referred under the rule has steadily increased between 1999 and 2005, the percentage of patients actually diagnosed with cancer has significantly decreased (from 12.8% in 1999 to 7.7% in 2005). Meanwhile, the proportion of cancers diagnosed in the group referred routinely – where breast cancer is not suspected but a consultant's opinion is still needed - has significantly increased (from 2.5% in 1999 to 5.3% in 2005). Patients in the latter group are not subject to the two-week rule and are therefore disadvantaged by longer clinic waits and delays in diagnosis. Simon Cawthorn, lead researcher on the study, called for everyone to be seen within two weeks.

 

Two-Week Breast Cancer Referral Rates (BMJ Article)

 

Being able to refer a patient with suspected cancer, who can then be seen within two weeks, has been one of the most important advances in the NHS in recent times, according to Professor Mayur Lakhani, Chair of the RCGP. He added, “The two-week scheme can sometimes be too rigid. Every patient is different and they do not fit ‘neat’ criteria. GPs are experts at tailoring and judging referrals but can be hampered by referral schemes which act as ‘straightjackets’. Problems arise because the voice of GPs is sometimes ignored in designing clinics. For the future, GPs want a two-week scheme that is more flexible and responsive, where they are able to readily refer patients to senior consultants."


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England

Announcements

Consultation on the Future of Stroke Services

 

A consultation document outlining the first steps in the development of a National Stroke Strategy has been published by Professor Roger Boyle, National Director for Heart Disease and Stroke. The document examines the prevention of stroke though faster treatment for transient ischaemic attacks (TIAs); urges clinicians to take the earliest signs of strokes seriously; and improve post-hospital care. It reports that GPs are in a position to encourage people to change their lifestyle to reduce the risk of ill-health, and urges all staff in contact with patients (such as GP Receptionists) to be able to recognise the symptoms of stroke or TIA, even when they cannot see the individual. The consultation will shape the final Stroke Strategy to be published later this year. Comments should be sent to MB-Stroke-Ideas@dh.gsi.gov.uk by 12 October 2007.

 

A New Ambition for Stroke - consultation on a national strategy (DH Consultation)


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Wales

Announcements

Electronic Referral System Tested at Two Practices
 

GPs at two practices will test a new method for delivering patient referral letters to hospital consultants, replacing hand-delivered letters with electronic messages. The system, known as the Scottish Care Information Gateway, allows clinical messages to be sent securely from the GP to the hospital. Benefits of the new scheme include:

  • The use of templates to ensure a standard set of patient information is received by the hospital consultant
  • Integration of data with the GP’s IT system, minimising the amount of information that needs to be keyed in
  • Less reliance on the post for delivery of referral letters
  • Immediate updating of patient records with information from hospital discharge letters

The trial will commence in August 2007 and will be completed by the end of the year, with the aim of making e-referrals available to the entire health community shortly after.

 

Eliminating Paper Referrals for Patients Needing Hospital Care (NHS Wales)

 

Call to Support for New Gold Standards

 

A Gold Standards Framework for Primary Care Mental Health is being developed by the RCGP Wales and the Wales Mental Health in Primary Care (WaMH in PC) Network. The initiative will offer a structure for commissioning and service provision, resulting in consistent standards of care across the country. To gain support and recognition for the framework, organisers are calling on individuals to register their support either online or by contacting Lesley Hills, RCGP Wales Project Manager, on lhills@rcgp.org.uk.

 

The Welsh Declaration for Mental Health and Well-being (RCGP Wales and WaMH in PC)

 

Review of Child Protection Arrangements

 

The Healthcare Inspectorate Wales (HIW) has published a review of child protection arrangements across Wales. Findings show the protection and safeguarding of young people is taken very seriously in the NHS but areas that require improvement still exist - such as information sharing, enhanced Criminal Records Bureau checks and training. The Inspectorate reported that arrangements in primary medical services were “mostly developed”, and that Local Health Boards (LHBs) are responsible for updating GPs on their child protection responsibilities. The report outlines 20 recommendations for NHS organisations, including the requirement for LHBs to monitor the role of the lead GP for Child Protection as part of the new GP contract. Implementation of recommended improvements will be assessed by HIW and included in its 2007-2008 review programme.

 

Review of Child Protection Arrangements Across NHS Wales (HIW Report)


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Scotland

Announcements

Review of ADHD Services

 

A review of services for patients with Attention deficit and hyperkinetic disorders (ADHD) has revealed that provisions are delivered in different ways, by a range of clinicians, across the country. The evaluation examined data from all NHS Boards between September 2006 and December 2006, to determine what services are available and how they are delivered. Emerging patterns revealed that:

  • None of the Boards had a comprehensive system for collecting and storing information on the number of patients diagnosed with ADHD.
  • Half the Boards had either a formalised shared care protocol in place or informal mechanisms for delivery of shared care. (An agreement made between the specialist and GP, where the family doctor takes over responsibility for prescribing medication initially recommended by the specialist is known as Shared Care).

ADHD – Services Over Scotland (NHS Quality Improvement Scotland)

 

Improved Co-ordination When Investigating Complaints About Doctors

 

The General Medical Council (GMC) and the Scottish Public Services Ombudsman (SPSO) have formalised the process of information sharing when investigating complaints about doctors. Both organisations signed a Memorandum of Understanding (MoU), which will commit them to sharing information if it will assist or trigger an investigation into a complaint made about a doctor. The agreement also means they must collaborate on informing other organisations about their work and share knowledge on trends and issues around complaints.

 

Co-ordinating Investigations into Complaints About Doctors (GMC News)


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Northern Ireland

Announcements

Campaign to Prevent Suicide and Reduce Stigma Around Mental Health

 

A campaign aimed at reducing the stigma around mental health has been re-launched by Health Minister Michael McGimpsey. It forms part of the Suicide Prevention Strategy “Protect Life – A Shared Vision” and encourages people to seek help for their problems. A website to accompany the campaign provides information on mental health issues and contains a searchable directory of mental health services throughout the UK.

 

‘Minding Your Head’ Campaign (Northern Ireland Executive Press Release)


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