www.mddus.com GMC GUIDANCE ON


REFLECTIVE PRACTICE REFLECTIVE notes do not need to capture full factual details of an experience but should focus on learning or actions taken from a case or situation, says GMC guidance published to reassure registrants in light of the Bawa-Garba case. The new guidance has been developed jointly by the GMC, the


Academy of Medical Royal Colleges (AoMRC), the Conference of Postgraduate Medical Deans (COPMeD) and the Medical Schools Council. It confirms the importance of reflection for personal development and learning and highlights how reflection can help maintain and improve standards of professional practice, helping to drive improvements in patient safety.


WALES TO GETNEW


GENDER IDENTITY SERVICE TRANSGENDER patients in Wales will be able to access care services closer to home, health secretary Vaughan Gething has announced. Currently all patients who


present with gender dysphoria are referred to the London Gender Identity Clinic, where they are assessed and provided with a treatment plan. But from the end of October


2018, a new Welsh Gender Team will begin seeing patients, considerably reducing travel time and costs. In the meantime, a specialist GP will be available from


next month to help patients in the Cardiff and Vale area who have experienced difficulty in accessing medicines recommended for them by the London clinic. Mr Gething said there had been


increased demand for transgender health services in Wales in recent years, prompting an annual investment of £500,000 to improve gender identity services in the country.


He said: “This announcement


is a positive step towards the fully integrated service I expect to be in place next year.”


NICE GUIDANCE ON ANTIBIOTIC TREATMENT


OF COUGH ANTIBIOTICS should not be administered as first-line treatment for cough, according to new draft guidance by NICE and Public Health England. Patients should be advised to take honey or


over-the-counter cough medicines and consult their GP if the cough persists for longer than three weeks. The reasons for not giving an antibiotic should be clearly explained and advice given to the patient on appropriate self-care. An antibiotic may be necessary for acute


cough when a person has been identified as being systematically unwell or if they are at risk of further complications, for example people with a pre-existing condition such as lung disease, immunosuppression or cystic fibrosis. The draft guidance provides information about the


most appropriate choice of antibiotic and duration of the course. Professor Mark Baker, director of the centre for guidelines at NICE said: “When prescribing antibiotics, it is essential to take into account the benefit to the patient and wider implications of antimicrobial resistance, only offering them to people who really need them.”


Key advice also includes: • Reflection is personal and there is no one way to reflect.


• Having time to reflect on both positive and negative experiences is important.


• Group reflection often leads to ideas that can improve patient care.


• Tutors, supervisors, appraisers and employers should support individual and group reflection.


The guidance acknowledges that recorded reflections, such as in learning portfolios or for revalidation or continuing professional development purposes, are not subject to legal privilege and disclosure might be requested by a court if considered relevant. But it states that the GMC does not ask a doctor to provide reflective notes in order to investigate concerns, as the focus in fitness to practise investigations is on “facts and evidence relating to a serious allegation”. It adds: “Following a significant event or a serious incident, factual


details should not be recorded in reflective discussions but elsewhere, in accordance with each organisation’s relevant policies.”


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