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Welcome News


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Welcome to your


AFTER three challenging years, I have finally completed GP training and now find myself negotiating my way through the world of locum work. Coming to the end of training can be a daunting time for doctors as we face various financial and professional issues from tax returns and pensions to deciding what kind of medicine we want to practise. My article on page 4 looks back over my experiences and offers some advice for those who are due to complete their training soon. One challenge that all GP


trainees must face is the Clinical Skills Assessment of the MRCGP. GP and medical author Dr Milan Mehta shares some valuable tips on how to pass this vital test in his article on page 5. Making decisions on issues of consent in children can be complicated but on page 6 MDDUS medical adviser Dr Gail Gilmartin highlights some key points to consider. Intimate examinations can be


a distressing experience for patients which makes it all the more important for doctors to be professional and respectful. On page 12, MDDUS medical adviser Dr Susan Gibson-Smith discusses how to handle these sensitive situations to help minimise patient complaints. On page 14 misdiagnosed leg pain and a delayed referral leads to amputation for one patient in our case study which highlights the need for good record keeping among other things. In our careers article on page 8, we look at the opportunities for GPs to work within the criminal justice system in the field of forensic medicine. And on page 10, GP and media


doctor Jonty Heaversedge talks about bringing a positive health message to millions of TV viewers as well as his preparations for the planned overhaul of the NHS.


• Dr Peter Livingstone Editor


GREATER PATIENT CHOICE


MAY CREATE GREATER RISK A GOVERNMENT pilot scheme to remove practice boundaries in a bid to increase patient choice raises serious concerns for doctors over accountability and continuity of patient care, MDDUS has warned. Patients with complex health


problems could face difficulties under the plans to allow patients to choose a GP in a location remote from their home address. The pilot scheme is being launched in England in April 2012 and will operate in parts of London, Manchester and Nottingham. MDDUS medical adviser Dr


Barry Parker said: “The proposal would work well for patients who normally enjoy good health and those looking for short-term intervention for something straightforward, such as an ear infection. “However, patients with complex


health problems undoubtedly benefit from having a single source of care provided by a dedicated practice team that knows them well. The government proposals


raise concerns which could jeopardise the quality of that care given to patients.” Under the initiative, patients


could remain registered at a practice near their home and have consultations as a ‘day’ patient at another practice. Another option would be to register as an ‘out-of-area’ patient, meaning they would rely on their local PCT cluster for care at home or out of hours. Where care is split between


two sources, Dr Parker said communication channels must be very efficient and comprehensive – particularly for drug prescribing, treatment plans and referrals. The Department of Health said


it expects those who take advantage of the new boundary rules “will typically be working-age adults without complex health problems, who are less likely to require home visits.” They added: “All PCT clusters


will need to ensure they have arrangements in place to meet these needs.”


GMC ANNOUNCES


EDITOR: Dr Peter Livingstone


ASSOCIATE EDITOR: Joanne Curran


DESIGN:


CMYK Design www.cmyk-design.co.uk


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CORRESPONDENCE: GPst Editor MDDUS Mackintosh House 120 Blythswood Street Glasgow G2 4EA


t: e: 0845 270 2034 jcurran@mddus.com w: www.mddus.com


GPst is published by The Medical and Dental Defence Union of Scotland, Registered in Scotland No 5093 at Mackintosh House, 120 Blythswood Street, Glasgow G2 4EA. The MDDUS is not an insurance company. All the benefits of membership of MDDUS are discretionary as set out in the Memorandum and Articles of Association.


PLAB REVIEW THE GMC has announced a review of the PLAB test for doctors from outside Europe who wish to register to practise in the UK. The Professional and Linguistic Assessments Board (PLAB) test is the


main route through which doctors who qualified outside the UK or EEA demonstrate their clinical skills before they join the UK medical register. The two-part test is set at the level of skill and knowledge expected of a UK graduate after their first year of training – the end of Foundation Year 1. An independent expert group will oversee the review process over


the next year and is seeking the views of all interested parties. The GMC will also be commissioning research to support the review alongside a literature review on best practice in comparable examinations. GMC chief executive Niall Dickson said: “The NHS has long relied on the skills and professionalism of doctors who trained outside the UK, and of course it is vital that every doctor coming to work here has the skills to treat patients safely and effectively.” Last year, 4,068 doctors sat the first part of the PLAB test with a 35


per cent pass rate, and 2,637 sat part two with 70 per cent passing and becoming eligible to apply for UK medical registration. Further information on the PLAB review is at www.gmc-uk.org.


PHOTOS: PAUL GRAHAM


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