GMS contract 2014/15

The General Medical Services (GMS) contract for 2014/15 has now been published.  This contains all the relevant guidance about the new contract changes agreed between the Government and GPs.  For those of you in General Practice over the next year you may well come across concepts such as the “Named GPs for over 75s” and Quality and Outcomes Framework (QOF) changes.

Prescribing Safety Indicators

The latest British Journal of General Practice (BJGP) contains an interesting article about medicines safety.  The authors identify a list of potentially dangerous medication situations (e186 and e187).  We felt that this sort of list may offer itself towards an audit or two!  The pdf can be found here (and is currently free online).

Patient Participation

Thank you to Helen (and Bob!) for an illuminating session on Patient Participation. Hopefully observing the Patient Participation Group (PPG) in action gave you some food for thought.  The discussion afterwards showed that there are varying views as to how PPGs should be formed.  Helen’s presentation can be found here.  The actual NHS England guidance for the 2013/14 DES can be found here  More information can be found at the National Association for Patient Participation website.

CRB or “Disclosure and Barring Service” checks

There have been a number of queries about Disclosure and Barring Service (DBS) checks (or what used to be CRB checks).  It does appear that it is the responsibility of individuals to pay for their own DBS checks (See Slide 6 of this presentation from Health Education West Midlands) where as in the past this was paid for by the Employer.  More information about DBS checks for Doctors in training can be found on the NHS Employers website.  It looks as though you may update your DBS check rather than repeat the process of applying for a new check and this can be done via the gov.uk website (thank you Matt).

Trainee Trajectory for GP Trainees

Health Education Yorkshire and the Humber have produced an extremely useful document (Trainee Trajectory) which charts what it is you should be doing during the three years you spend as a GP trainee.  We realise when you first start that being aware of when it is you should be doing the various Work Based Placed Assessments (WBPAs) etc can be difficult – I think this document summarises it well.

Communication skills and Improv

Thank you to Ryan Offutt who came to do a session on how the art of Improvisation can highlight communication skills and hopefully improve them too.  Ryan helps organise and run a group called MB Improv (based in Sheffield) and it struck me at the recent South Yorkshire GP Conference earlier this year what a fresh and innovative method improvisation was for teaching communications skills.

 

Improvisation is steadily gathering an evidence base to support its use in medical education (see the following link from pubmed) and hopefully the feedback from today’s session will further support our decision to include it as part of the GP training programme.

 

This clip is of one of Ryan’s warm up games – enjoy!

Neutropaenic Sepsis

The topic of neutropaenic sepsis was central to one of the SEAs we covered today at the half-day release session.  For those trainees who would like to read and learn a bit more about this potentially fatal condition I have attached the following links.

 

Although NICE guidance on the condition with regards management in Primary Care is limited to just four lines the advice is quite succinct and easy to follow:

 

“suspect neutropaenic sepsis in patients having anticancer treatment who become unwell…refer immediately for assessment in secondary or tertiary care.”

 

The Map of Medicine pathway highlights clinical signs that patients with neutropaenic sepsis may present with and once again stresses the importance of immediate referral to hospital.  Finally, the following YouTube clip (North West London Cancer Network) offers a patient’s first hand experience of neutropaenic sepsis and other good clinical advice.