CALL LOG


Manager Practice


Call log


These cases are based on actual calls made to MDDUS advisers and are published here to highlight common challenges within practice management. Details have been changed to maintain confidentiality.


ANTENATAL CARE AS SICK LEAVE Q


A part-time member of our practice staff is pregnant and all of her antenatal appointments are on a day that she is at work. We are setting up our regular rota to cover the busy Christmas period and would prefer her to work on regular “in” days. Is it a reasonable request to ask that she rearrange her antenatal appointment for another day? We always give such appointments for staff as paid leave. Is this standard practice or should it be classed as sick leave?


A


In general terms an


antenatal


appointment should be paid and would not be classed as sick leave. You can ask for evidence of the


appointment and whether it can be


rescheduled but you should make it clear that if


rescheduling is not possible then the original time and date will be honoured and she will have the right to take the time off when it suits


GAP IN GDC REGISTRATION Q A


Our dental practice recently hired a dental nurse who has only just completed her training. She has applied to the GDC register. Is it possible for her to work in the practice before her registration is in place?


The GDC has confirmed that a dental nurse in this situation can continue to work, provided the same supervision is in place as that which existed during training. GDC guidance states: “A named GDC supervising registrant must take full responsibility for providing direct supervision of the individual trainee. However, according to the ability and progress of the trainee, supervision may be delegated (if appropriate) to other GDC registrants. The named supervising registrant will continue to be accountable overall for the trainee. The employer must ensure that the individual trainee keeps a log book of training they receive (including induction), which is regularly signed off by the designated supervisor.”


RETAIN RECORD REQUESTS?


Q A


Is our medical practice required to keep/scan requests from solicitors for copies of patient records and from insurance companies for reports?


A patient’s medical records should contain only relevant information for the ongoing care of that patient. Administrative requests can be stored separately, with reference to such documentation in the medical records in the unlikely event they may be required in future.


NON-MEDICAL MEDICINES MANAGER


Q 04


Our practice has a non-medical member of staff who processes all repeat prescriptions. Would she be allowed to add or make changes to medication following recommendations received from hospital letters, if done under adequate supervision from a practice GP?


A


In approaching such a decision you should be mindful of GMC guidance on


delegation (Good Medical Practice), which reminds doctors that when delegating the care of patients to a colleague they must be satisfied that this person has the appropriate qualifications, skills and experience to provide safe ongoing care for that patient. It is therefore important that clinicians are satisfied that the medicines manager is competent to undertake this role. The GMC also states that doctors must prescribe medicines, including repeat prescriptions, only when they have adequate knowledge of the patient’s health and are satisfied that the medications serve the patient’s needs. They must also undertake a careful review to ensure that any amendments to a patient’s treatment are appropriate. It is understandable that the practice would wish to review how it actions correspondence from secondary care in order to improve both efficiency and ongoing patient care, but the focus must remain on patient safety. A medicines manager simply undertaking the administrative task of uploading information that has been actioned by a clinical member of staff would be fine, as long as it does not involve any clinical decisions. The practice should regularly review the approach and ensure that systems are in place to monitor the changes. You might also consider asking your local medical committee (LMC) how other practices in the area have approached the same issue.


RADIOGRAPHIC SELFIE Q A


A dental patient has requested to be allowed to use his iPhone to take a photograph of his own radiograph in order to show the image to another practice for an opinion on the potential viability of an implant. Would this be okay or should he be allowed to take the original radiograph?


The patient is entitled to a copy of his dental records under the Data Protection Act and you are obliged to provide it on request. Original records and radiographs should always be retained. On this basis it would be entirely reasonable to


SPRING 2019  ISSUE 20


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