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Welcome News
GP TRIAGE SERVICE FOR A&E
NHS England aims to have GP walk-in triage services in all hospital A&Es by next Christmas to address overstretched demand, according to chief executive Simon Stevens. Funding of £100 million has been made available to support the
initiative which was discussed at a recent House of Commons Public Accounts Committee inquiry into GP access. In the meeting Stevens also stated that by next March it is intended
Welcome to your
FUTURE gazing is always a bit of a risk – think of the hoverboard envisaged for 2015 in the film Back to the Future II. But much of the technology discussed by digital innovator Dr Keith Grimes in our profile on page 10 is already in use – the promise lies in applying it to healthcare in clever ways. Who would have thought virtual reality would have a place in the GP surgery? The technology theme in this
issue is continued on page 12 in Joanne Curran’s survey of useful medical apps. Her article also provides advice on quality markers and a few words to the wise before relying on any app. On page 4 Dr Greg Dollman
offers some helpful insights on reflective practice – what does it entail and how can you ensure it’s not just another box-ticking exercise? Not unrelated to this is the need for doctors to monitor their own wellbeing and on page 5 we highlight a new guide
by the RMBF encouraging GPs to be sensitive to signs of stress and potential burnout. New revised GMC guidance on
confidentiality has recently come into effect and on page 6 we look at some of the changes, while on page 7 Dr Gail Gilmartin provides practical advice for doctors called to attend at court or inquests as a factual witness. Our career article on page 8 looks at opportunities for GPs with a special interest in mental health – an area of growing need with as many as a third of GP consultations now involving a mental health component and 61 million antidepressant prescriptions having been handed out in England in 2015. And our case study on page
14 involves some distressing withdrawal symptoms for a patient on opiate patches.
• Dr Susan Gibson-Smith Editor
that “half the country” will be covered by GPs “who are able to offer evening and weekend bookable appointments” and this will be expanded to the whole of the country by March 2019. But Professor Helen Stokes-Lampard, chair of the Royal College of
GPs, has warned against imposing services: “We’re pleased that Simon Stevens recognises that nearly 90 per cent of GP practices are already offering some form of extended access for patients, as this is often overlooked. However, it remains important that the services we do provide are not imposed, but are based on local need. “We have a chronic shortage of GPs and if we are siphoned off to do triage in emergency departments or required to keep open our surgeries for longer, it will inevitably have a serious knock-on effect...”
ADVICE LINE THERE
TO BE USED MDDUS is keen to dispel the myth that contacting its advice line impacts on the subscription rates members pay. Members are encouraged to seek advice from our team of
experienced medico-legal advisers at the earliest opportunity – and are not penalised for doing so. MDDUS chief executive Chris Kenny said: “As we have repeatedly made clear to the BMA and a number of LMCs who raise this issue, we can give a categorical assurance that the underwriting and pricing decisions of MDDUS are not affected by the number of times members contact the organisation for advice. “Indeed, MDDUS positively encourages members to make use of the 24-hour advice line that is available to them as a benefit of membership. We believe seeking our advice will assist the member in adopting safer clinical practice and we would never penalise them for contacting us for advice.” Contact MDDUS on 0333 043 4444 or at
advice@mddus.com
TREAT SEVERE SEPSIS EDITOR: Dr Susan Gibson-Smith
ASSOCIATE EDITORS: Joanne Curran Jim Killgore
DESIGN: Connect Communications
connectcommunications.co.uk
PRINT: Printwell
www.printwell-ltd.co.uk
CORRESPONDENCE: GPst Editor MDDUS Mackintosh House 120 Blythswood Street Glasgow G2 4EA
t: e: 0333 043 4444
jcurran@mddus.com w:
www.mddus.com
WITHIN ONE HOUR PATIENTS showing symptoms of severe sepsis should be treated within one hour, according to a new draft quality standard from NICE.
The quality standard highlights areas from NICE’s 2016 sepsis guideline and stresses that staff in any setting, from GPs to paramedics, should check patients for specific signs that show symptoms are life-threatening. These include temperature and heart rate, and checking for rashes or skin discolouration. NICE says that high-risk sepsis patients should get antibiotics and IV fluid treatment within the hour. If it will take more than an hour to get someone to hospital, GPs or ambulance staff can also administer antibiotics. Professor Gillian Leng, NICE deputy chief executive, said: “Severe
symptoms can develop in sepsis very quickly. If high-risk patients are not identified and treated promptly, people can be left with debilitating problems. In the worst cases, they may die. “This quality standard highlights priorities in the continued fight
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 Articles of Association. The opinions, beliefs and viewpoints expressed by the various authors in GPst are those of the authors alone and do not necessarily reflect the opinions or policies of the Medical and Dental Defence Union of Scotland.
to improve sepsis care. We know from recent case reviews that there are inconsistencies in how people’s symptoms are assessed in different settings. More can be done to provide rapid treatment.” Access the new draft sepsis standard at
www.nice.org.uk
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