NEWSLETTER FOR THE GENERAL PRACTICE LINK OFFICE
MARCH 1998 ISSUE 47
The General Practice Link Office is always looking for articles to be included in Link News. If there is anyone out there involved in General Practice who would like to submit an article, please contact us with any contributions, which will be warmly welcomed.
STOP PRESS
The "Working Together Referral Guidelines Booklet" is being distributed to every GP and Practice Nurse in Croydon this week, making one available for each Consulting Room within your Practice. Further copies can be obtained from the GPLO.
CONTENTS
CLINICAL EXAMINATION OF THE BREAST
REMINDER: CARDIAC REHABILITATION
Croydon Community Health has recently been successful in a bid to take part in one of nine regional research projects which aim to implement evidence-based practice linked to audit, guidelines and standards. This project aims to evaluate the use of a multidimensional assessment package for the transfer of information about elderly people between hospital and community. The study will establish a common approach to a multidimensional assessment based on the recommendations made by the Royal College of Physicians and the British Geriatrics Society in 1993 (SAFE). The objectives are to increase information and involvement of patients and carers in care planning and decision making for discharge; increase the quality of information shared between professionals, and to provide an instrument for monitoring patient functional outcomes. It will develop knowledge about the feasibility and acceptability of the SAFE instruments. The study will also develop an evidence-based model for training and implementing a language of communication to facilitate effective discharge.
Claire has a nursing background with extensive clinical and managerial experience in the care of older people in the acute, rehabilitation and continuing care settings. Prior to this appointment and following the completion of an MSc in Advanced Clinical Practice (Care of Elderly), she was a Lecturer Practitioner in Gerontology based at the Faculty of Healthcare Sciences (Kingston University) and Queen Mary’s University Hospital in Roehampton. Claire is jointly employed by the Medical School (St. George’s) and Croydon Community Health and she has an honorary contract with the Mayday NHS Trust.
For more information regarding the STEP project, Claire can be contacted on Pager No: 01893 309040.
Claire Breslin
STEP Project Leader
Clinical Examination of the Breast
The letter from the Chief Medical Officer and Chief Nursing Officer, Department of Health, dated 2 February 1998 entitled "Clinical Examination of the Breast" discusses the role of medical and nursing staff in breast palpation as a screening procedure in a well-woman clinic, and those clinicians who should perform breast palpation in symptomatic women.
There have been a number of guidelines and advice sheets given out to general practice on breast awareness and breast palpation, the last of which was the RCN guidance in 1995 recommending that nurses should not undertake breast palpation except those who are working within specialist breast care units and who have specialist training in breast palpation.
The Advisory Committee for the Department of Health have received a number of reports claiming that Primary Care nurses are being asked to examine women’s breasts as part of a well-woman health check. They have therefore reviewed the advice and information on breast palpation and are now advising " palpation of the breast either by medical or nursing staff should not be included as part of the routine health screening for women" and that following advice from the RCN on recommendations for those nurses who can palpate breasts it is "therefore advised that clinical examination of the breasts should not be delegated to a nurse in the Primary Care setting".
The specialist training is that given to nurses who work in specialist units and are by specialist courses run by hospitals such as the Marsden, so those nurses who have undertaken Marie Curie Breast, Cervical Course or the ENB Breast, Cervical & Testicular Screening course are not eligible to do breast palpation. For those wishing to read the guidance in more detail, please contact me and I will be happy to send you a copy.
Ruth Lawler, Practice Nurse Adviser
The Quality Assurance Scheme (QA) for Near Patients Testing, i.e. blood glucose monitoring of patients in General Practice setting, is approaching the point of piloting. This is planned for April 1998.
Practices who originally expressed interest in the scheme have already been approached for information to form the necessary database, which will be held at the Link Office.
During April these Practices will receive a vial of medium to be used for testing together with a pro forma to record their results. The medium will require cold storage upon receipt through the ‘grey bag’ postal system. Participating practice staff need to perform their individual testing within seven days.
The Link Office together with Dr Collinson will be co-ordinating the pilot and collection of the result forms. Dr Collinson will be analysing results and producing a report for each practice.
The QA scheme in its entirety consists:
So far it seems only Practice Nurses and Treatment Room staff will be involved in all parts of the scheme. However General Practitioners who are performing blood glucose monitoring are also welcome to take advantage of the scheme. Community Trust staff already take part in most of the scheme but we are exploring extending the part - testing of skill using a medium - to Community Trust staff also.
If you or your practice would like to join the piloting of the scheme please contact either your Locality Development Nurse or myself at the Link Office.
Cheryl Roper – Primary Care Quality Co-ordinator
It’s good to talk!
Quite right too. For co-ordination of services to families it is essential.
Following three child deaths from child abuse in Croydon in the early 1990s, guidelines for good communication between General Practitioners and Health Visitors were set out and implemented in October 1993. This was to encourage exchanges of information to help plan appropriately for families in need of support. Gaps in communication between professionals were identified following the enquiries into the child deaths in Croydon and, sadly, in 1998 child death enquiries throughout Great Britain still throw up similar problems in communication between professionals.
By July 1996 the Patients’ Charter Standards for Community Nurses again brought our attention to sharing information.
Each Health Visitor in Croydon is charged with the responsibility to establish a system to identify removals into the area. This would ensure that families with a child under five would receive a visit within five working days after registering with a new GP. This system also helps to locate missing families of concern and identify vulnerable children early.
Unfortunately this system has not been entirely successful. Health Visitors are asking that GP practice staff realise the importance of keeping Health Visitors informed promptly of new registrations, so they may regularly update their caseloads and visit according to the standard.
It’s good to talk! For the co-ordination of services to families it is essential. Can I suggest though that we talk face to face, so we can get to know each other, and leave the telephone to Bob Hoskins.
Briony Ladbury
Child Protection Advisor, Croydon Health Authority
Usually contracted by eating contaminated food or drink. Avoidance includes paying strict attention to food, drink and general hygiene. If in doubt about drinking water, then it does need to be boiled or sterlilised. Avoid using ice cubes and ice cream unless absolutely sure that they are made from clean water. Remember that salads may have been washed in unclean water.
Taken in part from Traveller World Wide Health Information Service and brought to you by the Croydon Practice Nurse Group Committee.
'Working Together' Referral Guidelines Booklet
The above booklet is being distributed to every GP and Practice Nurse in Croydon this week, making one available for each Consulting Room within your Practice.
If you require further copies, please contact Lorna at the General Practice Link Office on 0181 - 401 3990.
Reminder: Cardiac Rehabilitation
Woodside Health Centre
Monday afternoons 3pm – 5pm
for any patient discharged after M.I. or surgery or patients who have I.H.D. and want more information.
Jo Torring 0385 561 604
Sally Walters, Locality Development Nurse
Advert
Mature person, must have knowledge of WP & general computer skills. Also experienced in Secretarial /Reception work/good telephone manner. Applicant must be flexible regarding MORNING OR EVENING shifts. 15 hrs (three evenings and one morning) we are mainly looking for. Further details please contact the Practice Manager on 0181-653 0635.
The GPLO does not necessarily endorse or support any of the positions, products or people advertised herein
Medical Secretary required for busy surgery in Thornton Heath (6 hours per week) to start in April. Please contact Alison Fowler, London Road Medical Centre, 515 London Road, Thornton Heath, Surrey CR7 6AR. Tel: 0181-239 9002.Practice Nurse (G grade) required for friendly doctor’s surgery. 16 hours per week, one Saturday morning in three. Please apply in writing with CV to Jean McPhail, Practice Manager, Parkside Group Practice, 27 Wyche Grove, South Croydon, CR2 6EX. Closing date for applications 13 March.
Retired GP (early retirement) available from April or May to join Group Practice as Assistant, part or full time. Fax 0181-765 1560.
Receptionist/Admin Clerk required 18 hours a week on a rota basis for a small but very busy surgery in Croydon. Must be fully conversant in all matters of finance and computerisation. Please contact Angela Arcus on 0181-683 1255.
GP Assistant required. Initially April – June 1998 (18 hours per week) with prospects. Contact Practice Manager on fax: 0181-777 9532.
Secretary/Receptionist required (2 vacancies available) for four doctor practice in Crystal Palace 18-24 hrs p/wk. Administrative and computer skills required. Reply to Dr Sivathasan, 60 Central Hill, Upper Norwood, London SE19 1DT. Tel: 0181 670 7117.
Full Time Partner required due to retirement. Four GP practice in Crystal Palace area. Above average income. Fully computerised. Eligibility for CHS and minor surgery advantageous. Out of hours Co-op. Apply to Dr Diver & Partners, 60 Central Hill, Upper Norwood, London SE19 1DT. Tel: 0181 670 7117.
Three Part Time Medical Receptionists required to work in busy computerised fundholding practice in Croydon. Hours range from 15 – 22 per week with a 1 in 7 Saturday rota working 8:30 – 11:30am. The rate of pay is �5.10 per hour depending upon experience. Previous experience preferred. Handwritten applications and C.V. to the Practice Director, Friends Road Medical Practice, 49 Friends Road, Croydon, CR0 1ED. Previous applicants need not apply.
Book-Keeper required to work in busy GP Practice in Croydon 6 – 8 hours per week (flexible). You will have knowledge of both manual and computer based payroll and accounts. Experience of General Practice finance systems would be an advantage. For further information/informal enquiries, please contact the Practice Manager on 0181 681 1114.
Receptionist required for busy surgery in Coulsdon. 30 hrs per week. Some medical knowledge required. Typing essential. Please telephone 0181-660 0193 and speak to the Practice Manager.
LIZ Assistant required from 9.3.98 or soon after. Full time for three months initially with a view to becoming a salaried GP. Please contact Catrine Paddon or Dr Ford on 0181-776 2055 or write to 2 South Way, Shirley, Croydon, CR0 8RP.