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Newsletter March 2002Appraisal for GP principals in England Health at Work in Primary Care EditorialThe 1st April comes ever closer and yet another major change in the organisation of the Health Service. Yet again rushed in, this time rushed in without the legislation in place to deliver the service in the intended way. Legislation to pass more powers to the Primary Care Trusts and for the formation of Strategic Health Authorities will not be in place until later in the year. Until then, Health Authorities and PCTs have had to devise methods to allow themselves to work in the intended way. Change to the organisation, inevitably brings with it the loss of some of the personnel and expertise which has been built up over the preceding years and this, of course, may lead to problems for those working in the service. Please let the committee know of any problems practices have following this re-organisation. New ContractThe GPC has now completed the first stage of its negotiations over a New Contract for General Practice. Some of the details about this have already appeared in the medical press. LMC officers have been invited to a meeting in London on 19th April to receive more details of the “New Contract”. The GPC will then be holding meetings throughout the country to which all GPs will be invited. The nearest ones locally are likely to be in Birmingham, Manchester and Chester. The LMC has arranged with Bernie Shevlin to make a presentation and receive feedback on this issue at a lunchtime meeting at Britannia Stadium on 30th April. We hope to be able to circulate more details after the 19th April meeting, although no doubt these will also appear in the press. Supplementary ListsRegulations came into effect on 14 December 2002 that introduce new powers to health authorities in the way they manage lists of GPs. The main changes include: From April 1 2002 the introduction of supplementary lists for non-
principal GPs Please note that as from 1st April GMS principals cannot employ another doctor unless he/she is on the supplementary list and there is an obligation to check this detail. There is also an obligation to check references before employment. The Health Authority will also be seeking references for applicants to the supplementary lists. In respect of this is it important to be objective in the giving of a reference. A "clinical reference" is actually a report on someone's clinical performance it is a serious matter and if not done properly can bring your own registration into question. The GMC booklet on “Good Medical Practice” states: You must be honest and objective when appraising or assessing the performance of any doctor including those you have supervised or trained. Patients may be put at risk if you describe as competent someone who has not reached or maintained a satisfactory standard of practice. You must provide only honest and justifiable comments when giving references for, or writing reports about, colleagues. When providing references you must include all relevant information which has any bearing on your colleague's competence, performance, and conduct. Further advice about the introduction of Supplementary lists can be found on the GPC website. Appraisal for GP principals in EnglandFollowing a long process of negotiation between the
GPC negotiating team and the English Department of Health, the GPC has
voted in favour of accepting the Department's proposals on GP appraisal. Appraisals should occur during normal hours, and GPs should be reimbursed for providing locums or covering for a colleague if no locum can be found. The wording of the change to our Terms of Service is such that legal opinion has concluded that if the local appraisal scheme does not comply with these requirements, there will be no requirement for a GP to participate in appraisal. Disability Discrimination ActPCOs have now received the reports they commissioned on GP premises. The requirement under the act is for practice to implement changes that can be “reasonably” carried out. A lot of the suggested requirements are clearly “pie in the sky” and unaffordable. Practice should look at other less expensive procedures, guidelines and ways of achieving a similar objective. Hepatitis B VaccineRequests for the administration of this vaccine often cause confusion has to whether it is or is not appropriate and whether or not it should be carried out by the patient’s occupational health service. Margaret Jones, in her role as Medical Advisor to the Health Authority has drawn up some practical advice on this which gives a sensible viewpoint on this difficult issue. A copy of this is being circulated to practices. A copy is also available on the LMC website at: www.staffslmcs.freeserve.co.uk I have recently written to Combined Healthcare about Hepatitis B immunisation for new employees. They do recognise that the responsibility for immunisation lies with themselves, although they were suggesting members of staff should contact their GP if they wished the immunisation to be given at their own surgery. Staffordshire Police have also agreed that they should take responsibility for immunising new recruits to the force. This was agreed by their Health & Safety Committee in December after a considerable amount of correspondence with them by both North and South Staffs LMCs. OFSTED - Childminder formsFrom September 2001 responsibility for the regulation
of childminding and day care for children under eight transferred from
local authorities to the Office for Standards in Education (OFSTED), who
have been undertaking registration since July. NHS Performance indicators.
The DOH has recently issued a further set of NHS performance indicators. These show that North Staffordshire has one of the lowest number of GPs per 100,000 population in the country, 49 compared to an average of 57.4. This is the 10th lowest in the country. This leaves us 40 GPs short of average and 95 GPs short compared to North Yorkshire. Yet despite this we have delivered very well on childhood immunisation (95.2% aver 90.9% 7th best) and flu vaccination (73.6%, aver 65.5% 4th highest). We are also above average with cervical cytology screening rates. Interestingly despite having a high morbidity in the area, emergency admission rates are only just above average. MTRACA vacancy exists on this important committee whose aim is to: provide a review system to identify the clinical value, safety and suitability for use of pharmaceutical products in primary care and to enable and encourage their optimum introduction in the West Midlands Region, including proposed transfers and requests from secondary care. Meetings are held monthly usually on the fourth Thursday at Birmingham Medical Institute from 12.30 – 15.00. Donna Louise Trust(Article by Dr Gordon Carpenter) The Donna Louise Trust is, as many of you know, a local charity with the aim of providing a Hospice for children with life limiting illnesses which will be built in the near future on the Trentham Lakes site. It will also provide support for these children in their own homes, and to that end, I am pleased to say that we have now acquired funding for the Community Nurse Team and they are in place. Already we have had referrals to this nursing team for several children with severe life limiting illnesses but we are sure there are other children out there who would benefit from the service. If any of our colleagues has a family who they think may benefit from this sort of support, then please contact the Head of Care, Margaret Harvey at c/o Lovatt Engineering, Bournes Bank, Burslem, Stoke-on-Trent, ST6 3DW. Tel: 01782 811911. Muscle Tone Sessions.GPs are increasingly being approached to sign forms for patients who wish to take various forms of exercise. Among these are the muscle tone sessions which are held at Dimensions and Shelton Pool. These were established years ago in partnership with physiotherapists from the Haywood hospital. The sessions are specifically for people recovering from injuries, ailments such as arthritis and obesity who would benefit from the therapeutic benefits of hydrotherapy. These sessions have always been restricted to people referred by a GP. However, patients appear to self refer to these sessions and then present their GP with a form to sign to allow them to undertake these sessions. The reason for the form is not clearly explained either to patient or doctor. I have written to the City Council suggesting that this is no doubt an example of unnecessary paperwork for GPs. If the sessions are held under the supervision of a trained physiotherapist, they should be capable of assessing the risks involved and this “referral” process puts unnecessary obstacles in the way. Health at Work in Primary CareThe Health Development Agency has produced two publications addressing issues of workplace health in GP practices.
Copies of these documents can be obtained by email to Vivienne.rangecroft@had-online.org.uk. The document is also available on their website at www.hda-online.org.uk/ DR P GOLIK (Secretary)
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