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NICE guidance watchNew Good Medical Practice for GPs

Good Medical Practice, the core guidance for doctors, has been revamped and the new version came into effect in April. There are no longer seven core areas, but instead four domains:

  • Knowledge, skills and performance 
  • Safety and quality 
  • Communication, partnership and teamwork 
  • Maintaining trust.

GMP booklet 2013The domains are being used in the new appraisal forms, for revalidation. In addition there are extra areas of explanatory guidance covering social media, ending professional relationships with patients and maintaining professional boundaries.

Following the publication of the guidance GPs should:

Don't miss the views of GMC’s Sir Peter Rubin and new GP Dr Laura Davison on the GMC’s new guidance regarding social media. We have also highlighted two cases where the GMC has expanded its guidance.

Prescribing update

The British Medical Association has updated its guidance on prescribing. Prescribing in General Practice replaces the previous version Information and Guidance for Prescribing in General Practice published in 2004. It includes new and updated guidance on medicine shortages, the transcribing of medication directions and supplementary and independent prescribers. The Committee has also published an updated version of its Focus on Excessive Prescribing Guidance. [Source: BMA]

Useful links

NHS England has published a Guide to Good Handling of Complaints for CCGs. It provides advice for CCGs on responding to complaints about the services they commission on behalf of their populations, or about the exercise of any of their own functions.

It is intended as a guide to good practice and will help CCGs to ensure they comply with the legal requirements of the 2009 complaints regulations. The document also highlights the importance of monitoring trends and learning from complaints and makes suggestions for CCGs on how to do this. [Source: NHS England]

Top ten calls to GPs

BLOG: Was the GMS contract to blame for A&E increase?

BlogPressures on emergency departments have dominated the news, with blame being heavily apportioned to the changes introduced by the GP contract in 2004. An interesting blog by the King’s Fund, authored by James Thompson and John Appleby, explored the facts about emergency attendances and identified that the media hype was far from the complete picture.

According to the authors, the facts show that for 15 years – from 1987/8 to 2002/3 – attendances were unchanged at around 14 million per year, but in 2003/4 they jumped – by nearly 18% – to 16.5 million, and rose to 21.7 million by 2012/13. The health secretary said these changes were largely due to GPs opting out of providing out-of-hours care. However, the bloggers argue that when the large increase in attendances started, there was a change in the data series.

Until 2003/4, stats on emergency attendances included ‘major’ emergency units only, but around this time smaller units – including walk-in centres (WiCs) and minor injuries units (MIUs), were introduced. The statistical collection was changed to record attendances separately for ‘type 1, 2 and 3’ units. Type 1 reflecting major emergency units and types 2 and 3 defined as the smaller WiCs and MIUs.

They attribute much of the increase to previously unrecorded attendances now being collected, and also additional – less serious – work being carried out in the new units. From 2003/4 to 2012/13, attendances in type 1 units have remained more or less unchanged, whereas admissions to type 2 and 3 units account for all the increase.

In summary, the blog argues that over the past decade there has been a huge increase in work, but this is partly attributable to the changes in statistical collection and a degree of ‘supply induced demand’ as new routes into emergency care (WiCs, MIUs) opened.

In addition, the possible substitution of some types of care (a visit to the GP) by others (a visit to a MIU) may have increased emergency attendance statistics, but given that WiCs and MIUs are generally not open out-of-hours, it is not easy to see how the rising workload of these services is linked to changes in GP outof- hours arrangements. Read the full blog here >>

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