Medical highlights from 2008
Last year was full of new regulation and guidance; read through Your Practice’s comprehensive list and be fully prepared for 2009.
January
What? Department of Health: Prescribing costs in primary care.
Why? The report argued that more action should be taken to curb NHS spending on prescription drugs in England, which had more than doubled in a decade to £8.2bn a year. It suggested that GPs should prescribe more generic drugs instead of expensive, branded ones and that the cost of drugs should be printed on packets to discourage patient waste.
Links: www.publications.parliament.uk
February
What? Making experiences count: the proposed new arrangements for handling health and social care complaints – response to consultation.
Why? This report summarised responses to the 2007 consultation, and how the DH had taken them into account in its response. It makes for good background reading. In April 2009, the new complaints system will come into fruition.
Links: www.dh.gov.uk/en/Consultations
March
What? Fitness to fly guide.
Why? The guide published by the Civil Aviation Authority provided flying advice for people with respiratory or cardiovascular disease, haematological disorders, diabetes, or pregnant women, or those who had undergone recent surgery.
Links: www.caa.co.uk/fitnesstofly
April
What? GMC guidance on Personal beliefs and medical practice.
Why? Contained important advice on dealing with dilemmas like abortion, the wearing of face veils and male circumcision.
Links: Click here to see the guidance
May
What? Standards for radiological investigations of suspected non-accidental injury.
Why? The Royal College of Paediatrics and Child Health (RCPCH) and the Royal College of Radiologists (RCR) jointly published advice on working with children with suspected non-accidental injury.
Links: www.rcpch.ac.uk, www.rcr.ac.uk
June
What? Consent: doctors and patients making decisions together.
Why? This GMC guidance took into account changes in the law, in particular about making decisions when patients lacked capacity. It also reflected shifts in professional and public attitudes towards more patient-centred care.
Links: www.gmc-uk.org
July
What? GMC guidance on Expert witnesses.
Why? This advice was published following a series of high-profile cases, involving criticism of medical experts with the consequent reluctance of doctors to undertake this work. It covered the roles and responsibilities of witnesses in giving expert opinion and evidence, keeping up-to-date, information security and disclosure, and conflicts of interest.
Links: www.gmc-uk.org
August
What? Good Medical Practice for General Practitioners.
Why? It was deemed necessary by the RCGP and the BMA’s GPs Committee (GPC) to publish this document, to take account of changes in the profession, such as out-of-hours arrangements, and to support revalidation. Changes included replacing the term “excellent GP” with "exemplary GP”, introducing a new section on appraisals and taking account of increased web email communication.
Links: www.rcgp.org.uk/PDF/GMP_web.pdf
September
What? Access to healthcare for asylum seekers and refused asylum seekers.
Why? The BMA ethics team published this guidance to summarise the legal situation, it included information about healthcare for asylum seekers, registering with general practitioners, registering at hospitals, prescription charges and confidentiality.
Links: www.bma.org.uk
October
What? NPSA advice on Significant Event Audits.
Why? An MPS study that featured in Your Practice (issue 3, Winter 07/08), identified that 56% of participating practices had no formal system for dealing with significant events. The guidance details how to hold a successful significant event audit meeting, so that lessons can be learned from errors.
Links: www.npsa.nhs.uk
November
What? Mental Health Act 2007 – key documents.
Why? Since November the remaining provisions of the Mental Health Act 2007 have come into force, with the exception of deprivation of liberty safeguards, advocacy and age-appropriate environments for those under 18, which come into effect in April 09.
Links: www.dh.gov.uk
December
What? Healthcare Commission report on State of Healthcare 2008.
Why? This was the fifth and final report by the Healthcare Commission on the progress made in healthcare since 2004. The report recognised the growth in GP services and the high level of trust patients placed in their GP. But it also said that GPs were not engaging enough with commissioning, more systematic reporting by GPs was needed, patients wanted more flexible access to their GP and GPs were not receiving adequate information on patients’ medicines on discharge from a hospital.
Links: www.healthcarecommission.org.uk
A look ahead
Issues set to rank highly on the agenda during the next year
Watch out for the results of the GP Patient Survey 2009, which will summarise the views of more than five million patients in England. This year the DH is investigating whether practices get the basics right, eg, are receptionists helpful, do patients want more telephone consultations, etc. The results will be used to drive changes to general practice in the future.
MPS is hosting its second annual GP conference in Manchester on 21 May. The extensive programme will bring experts to discuss ethical dilemmas from the MPS caseload, child protection issues and much more. Email: gp@mps.org.uk.
This year will also see the introduction of Responsible Officers (ROs), following the approval of the Health and Social Care Act 2008. ROs will be senior doctors with responsibility for clinical governance, who will provide a link to the GMC by monitoring the conduct of doctors and oversee the processes that support medical revalidation. MPS envisages that ROs will be in post by late 2009. Finally, 2009 will see the introduction of the new two-stage unified NHS complaints system, which commences in April 2009 to coincide with the introduction of the Care Quality Commission. Unresolved complaints will be referred to the Health Services Ombudsman, the Healthcare Commission’s current role will be abolished.