www.mddus.com


Q&


A


Dr Fiona Collier, GPwSI in dermatology


• What attracted you to a career as a GPwSI in dermatology? I worked as a part-time clinical assistant in dermatology while having a break from general practice and I found it a fascinating field. After returning to general practice I decided to do the Cardiff diploma in practical dermatology and was fortunate to pick up a session in dermatology at the department I had previously worked in. I then approached our local dermatology department about creating a GPwSI post. This coincided with a redesign of dermatology services, and they incorporated three posts into their plan.


services within the hospital or for contracted community dermatology services but employment contracts and financial arrangements will differ between areas. GPwSIs can choose to set up a number of different service models,


including:


 A community based service with strong links to the local dermatology department.


 A community based clinic for patients with chronic skin problems such as psoriasis, eczema or leg ulcers, all within a multidisciplinary setting.


 Specialist or enhanced skin surgery performed by trained GPs with suitable facilities.


There are a number of essential elements in providing a GPwSI dermatology service, including access to consultant dermatology support, support from a trained dermatology specialist nurse and adequate consulting rooms with good facilities for diagnosis and treatment procedures. Ideally, there would be a computer link to the hospital-based dermatology department with telemedicine facilities.


The future The changes set out in the 2010 White Paper Equity and Excellence: Liberating the NHS will, as they are implemented, have an impact on the way in which GPwSI services in England are commissioned and accredited. But while some of the details of the process will be subject to change, the principles set out in DoH guidance are expected to remain valid.


Links: • Doctors interested in becoming a GPwSI in dermatology should consider membership of the Primary Care Dermatology Society – www.pcds.org.uk


• British Association of Dermatologists – www.bad.org.uk


• Revised guidance and competences for the provision of services using GPs with Special Interests (GPwSIs) Dermatology and skin surgerywww.tinyurl.com/3o48mas


• Providing care for people with skin conditions: guidance and resources for commissioners (NHS Primary Care Commissioning 2008) www.tinyurl.com/3ukx8kz


Joanne Curran is associate editor of GPST


Tania von Hospenthal is Clinical Services Manager at the British Association of Dermatology


• What do you enjoy most about the job? It’s refreshing to be able to concentrate on one aspect of a patient's problems. I find in general practice, patients often throw in their skin problem as a third or fourth item on their list and it’s hard to do it justice. It’s also very interesting to see the health service from the secondary care viewpoint and speak to hospital colleagues who are often interested/puzzled by various aspects of primary care. The GPwSIs are very much part of the multi-disciplinary team in dermatology and I enjoy the support and exchange of ideas within the team.


• Are there any downsides? One problem with being a GPwSI is that this is a 'non-standard' post, with a locally-negotiated contract. This means that we have no automatic right to any salary increase awarded to other NHS staff and have to argue our case for any uplift in our remuneration.


• What do you find most challenging? It can be challenging to balance the demands of the two different jobs, particularly ensuring I am back in the practice on time for my commitments there. Also, I must admit that quite a lot of my GP consultations have a dermatology flavour, due to intra-practice referrals, and patients hearing by word-of-mouth that I am interested in skin conditions. I don't mind this at all, but it means that my other patients can have some difficulty in getting appointments.


• What about the role has most surprised you? I hadn't realised how much other areas of my practice would benefit from spending time getting more expertise in a particular area. It seemed to rejuvenate my enthusiasm for keeping up-to-date and improving my skills in other aspects of general practice.


• What is your most memorable experience so far? My most memorable experience was giving a talk to local GP colleagues about a particular skin disease, hidradenitis suppurativa, which I felt was a neglected and under-diagnosed condition. I was quite apprehensive about lecturing to my peers, but they were very supportive and it was a very positive experience.


• What advice would you give to a trainee GP considering a career as a GPwSI in dermatology? Sit in on some dermatology clinics to see if you enjoy it – it’s not everyone's cup of tea. Then investigate the various options for a postgraduate diploma in dermatology. Many of these are now largely distance learning, with local clinical attachments. The diploma gives you a solid knowledge base and training in the specific clinical skills of dermatology. It’s worth trying to make links with your local dermatology department, so they know your face if any opportunities arise. I think having a special interest helps maintain enthusiasm and balance in general practice and it’s something I'd recommend to any GP at any stage in their career.


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16