NEWSLETTER FOR THE GENERAL PRACTICE LINK OFFICE
AUGUST 1998 ISSUE 52
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 Practice Nurse Group need to know the Yellow Fever GP Centres in Croydon. Please phone your Practice Name, Telephone number and appointment availability to Lorna at the GPLO who will publish this information in Link News
CONTENTS
IMPORTANT CHANGES IN CERVICAL CYTOLOGY PROCEDURES
CROYDON PRACTICE NURSE EVENING MEETINGS
VOCATIONAL TRAINING SCHEME SUMMER 1998 NEWS
CROYDON CARNIVAL - SATURDAY 4th JULY
PURLEY PRIMARY CARE GROUP AWAYDAY
Are you interested in saving lives, time, energy and money? If so, read on. This article is about a tool designed to make your health promotion much easier and more effective. It's about my new book - Stop that heart attack! This book has been struggling to get out of me for years. 300,000 people have a heart attack every year in the U.K. Many are struck down in their prime, and so much of this is preventable. We don't have to put statins in the water supply: people can change their lifestyles, but they need to be shown how. My book would show them. But how could I find the time to write this book? The LIZ Education Incentives scheme came to my rescue - although I've also had to recruit all my spare time for the past couple of years. My wife, Heather, has been a great support (and, incidentally, typed the book). Do you want to see the health of your practice population improve at the same time as curbing expenditure on statins and antihypertensives? If enough of your patients take my book to heart, you will. OK, we all have patients with heart disease who aren't taking a statin yet and ought to start. There are many others who can be liberated by learning how to change the way they eat and live. We all spend a lot of time and energy trying to get our patients to: l Eat properly balanced diets l Lose weight l Lower blood cholesterol levels l Take regular exercise l Stop smoking l Beat stress l Lower blood pressure l Keep to sensible alcohol limits Recommending Stop that heart attack! will help them to achieve these goals. The text is evidence-based and endorsed by authorities such as Professor Paul Durrington. Mind you, while closeted in our study for a couple of years, I did wonder whether anyone would ever want to read all this stuff. But I have been overwhelmed by the response of non-medical readers saying that they find it easy and enjoyable to read, and that it answers all their questions. The Croydon Advertiser are very excited about the book and want to feature it in a new health series in September. Stop that heart attack! is available now from all good bookshops (in Croydon: WH Smith, Books etc and Waterstones - all in the Whitgift Centre). It's helpful to jot down the title and author for your patients, and tell them to ask if it's not on the shelf. If you'd like some leaflets for your surgery, please let me know!
Dr Derrick Cutting
| STOP THAT HEART ATTACK! Paperback ISBN 1 872362 85 0 £14.99 By Dr Derrick Cutting, Class Publishing Hardback ISBN 1 872362 30 3 £29.99 |
Please find "Dispelling The Myths" Cervical Cytology/Colposcopy sheet enclosed with this month's Link News. Please feel free to photocopy this data ensuring that all smear takers have a copy. Welcome to: The colposcopy unit would like to welcome Diane Murley who has recently joined us as our colposcopy administrator. Watch this space for a direct line to the colposcopy unit.
Marianne Wood, Colposcopy Specialist Nurse
Colposcopy Unit Mayday Hospital
IMPORTANT CHANGES IN CERVICAL CYTOLOGY PROCEDURES
Martin Welch, Pathology Services Manager at Mayday has requested that when, on the rare occasion a spatula and a brush have been used to take a cervical smear then two slides must be used - one slide for the spatula sample and the other for the brush sample. Both the slides and the form must be distinctly numbered for clear identification.
Sally Walters
Locality Development Nurse
CROYDON PRACTICE NURSE EVENING MEETINGS - Starting soon
Due to the development of Primary Care Groups and the opportunity for Practice Nurse involvement, we feel it important to resume regular meetings to provide information, update and feedback. As we are awaiting important direction from the government during the summer regarding nurse involvement in the Primary Care Groups, we have planned the first meeting for September. Exact details will be forwarded to you towards the end of August Prior to this meeting we aim to keep you up-to-date with any relevant information via "Link News".
The Practice Nurse Group
MONTELUKAST (Singulair)
Montelukast is a leukotriene receptor antagonist, a new class of drug for the treatment of asthma. It is licensed as add-on therapy in patients with mild to moderate asthma who are inadequately controlled on inhaled steroids and in whom "as needed" short acting Beta-agonists provide inadequate clinical control (i.e. step three of the BTS Guidelines). It is also licensed for prophylaxis of exercise-induced bronchoconstriction as add-on therapy. It is not licensed as a steroid sparing therapy. Montelukast was discussed at Croydon Prescribing Liaison Group (CPLG) in March 1998. The advice of CPLG is that montelukast is not to be recommended at the moment as it has no clear place in the treatment of asthma, but that evidence should be reviewed in six months time. The studies that have been done appear not to be in patients who are at step three of the BTS guidelines. Experience with montelukast is limited, especially in paediatric patients. As more drugs in this class become licensed, the evidence will be reviewed by Croydon Prescribing Liaison Group and a further recommendation made.
Copies of the full drug evaluation for montelukast are available from Helen Marlow or Vikki Williams, at Croydon Health Authority, on 0181 401-3798
Vikki Williams, Prescribing Adviser, CHA
VOCATIONAL TRAINING SCHEME SUMMER 1998 NEWS
Croydon VTS seems to have had a good academic year throughout 1997/98. Our syllabus has remained pretty much the same on Wednesday day release although new subjects have come in as the GP Registrars have requested, for example a lot more on child Health and somewhat less on management. There is always an ebb and flow of material depending on what seems to be required by the participants: one of the principles of adult learning, the educationalists tell us. Having not had access to Cumberland Lodge for the Residential course brought us instead to Forest Lodge in the New forest for an enjoyable few days of reflective learning. The hot news this year is of the upsurge in interest in General Practice as shown by the vast increase in applications to Croydon to train here. It is probably not the advent of Tramlines that is doing this, so it must be the appeal of the training. This pattern is reported by other course organisers around the country also. Perhaps general practice is again becoming an attractive option for young doctors again. Next academic year will bring all VTS admin. teaching materials and paperwork together at Mayday PGMC for the first time ever, making life a lot easier for all. Less driving around the suburbs for us chasing things, which no doubt will make Mr. Prescott happy.
John Spicer and Helen Lees
CROYDON CARNIVAL - SATURDAY 4th JULY
The Link Office would like to thank Dr Howard Cohen and his very patient three children who, along with Dr John Linney and his daughter (won first prize in her age group for her artwork at the CCHT stand) for spending time talking to Croydon residents at the Primary Care stand. Practice Nurses were represented by Caroline Bridgeman, Lisa Eve, Mary Hewitt, Angela Lambert, Ruth Lawler and Sally Walters, all of whom gave up most of their day off to "man" the stand. Dr. Peter Campbell arrived looking like the Kennel Club representative with his two hounds and proceeded to frighten off the non-dog lovers among us, but did attract every under five year old in Croydon who incidentally were not remotely interested in taking away any of the literature on offer - ranging from HRT update advice to Gay Men and Safe Sex. Dr. Trompetas stayed long enough to have his photograph taken on every NHS stand available! Natalie Hyde, communications manager at Mayday who masterminded the NHS stands and floats, did a spectacular job - wholly appreciated by everyone involved in the Carnival
Lorna Noble
Time for an update on the most common travellers' disease Travellers' Diarrhoea
Travellers' diarrhoea can affect two out of three travellers abroad. Diarrhoea is caused by bacteria and other parasites and is caught by eating contaminated food and water.
· E-Coli and salmonella are the two most common bacteria that cause diarrhoea.
· The disease lasts an average of about two to four days.
· It is important to replace fluid loss with oral rehydration therapy, these can be bought over the counter at most chemists.
· Anti-diarrhoea drugs can reduce symptoms but should be used with care in adults only.
· The role of antibiotic use with this condition remains unclear.
· All travellers should be advised to include oral rehydration therapy (electrolyte powder) in their first aid kit.
Happy holiday Season The Practice Nurse Group Committee
Croydon Health Authority
Every computerised Croydon practice now has a system which is accredited for Items of Service (IOS) links. Thus, far, 78% of practices are linked with the Health Authority and are able to process all their items of service claims electronically. The guaranteed payment for IOS claims accepted via links improves practice financial planning and any uncertainty surrounding the quarterly payment. The completion of the IOS programme will have real benefits for Croydon's health services, but every practice needs to be connected before we can totally realise them. Funding is currently available to meet the entire costs of installing IOS in practices, including software, any necessary hardware, staff training and the first year's maintenance. The computer reimbursement policy is currently under review and there are no plans to continue this level of reimbursement for IOS after 31 March 1999. Dr Alex Trompetas said: "Since our practice linked we have really benefited from the system. It's nice to be able to press a button and have nothing more to do other than await the payment; we can now concentrate on other important things such as patient care and practice development". Rebecca Sparks, Director of Primary Care and Community Commissioning, said, "It is encouraging to see that so many practices have taken advantage of the re-imbursement which has been on offer for the past two years. It is important to keep moving towards linking all practices so that we reduce the amount of paperwork in the system and pave the way for future improvements in communication between practices, Croydon Heath and NHS Trusts".
For more information about reimbursement for establishing IOS Links, you should contact Matthew Willis, Primary Care Services Development Manager on 0181 401 3977, or write to him at Croydon Health.
PURLEY PRIMARY CARE GROUP AWAYDAY
On 7th July 1998 a unique experience was taking place at the newly refurbished Addington Palace. As many members of the health care teams in the south of the borough as possible joined together in anticipation of the Primary Care Groups being established on 1st April 1999. As the configuration of the Primary Care Groups had yet to be completely finalised, the aim of the day was to think about the particular health needs of our area so that when the starting gun goes, we are some way to establishing priorities. Thus a group of 51 professionals, all with their own idea of health needs including GPs, their practice staff, nurses, assorted therapists, health visitors, midwives, members of the local and health authority and Mayday spent the day deep in thought and discussion. Dr. John Shanks, Director of Public Health Medicine, proved to be an excellent and entertaining facilitator for the whole day. Firstly, with the aid of photographic diaries, we looked at some of the health issues effecting Purley, including the establishment of isolated community housing groups, traffic pollution and the large number of care homes for the elderly and handicapped. John Shanks, who already had statistics about the population, said that he had discovered fewer elderly people live in Purley and less affluent than it was generally thought to be! We were then divided into groups to examine anonymous practice profiles and had to "guess the practice". It was an interesting exercise and fascinating to see how individual practices attracted patients from different age groups, sexes, ethnic groups and even diseases. Armed with this data we then tried to establish the health needs of the individual practices. After lunch and the opportunity to admire the Palace and its grounds, we examined various sources of health information and assessed their usefulness in relation to establishing health needs. In the final group session we considered what we felt to be the needs of the patients in the borough and what should be done to meet these needs. The day ended with dinner and a chance to talk to colleagues who are usually just names or voices on the telephone. Many thanks to the Link Office and the facilitators for the day, we look forward to the challenge of the Primary Care Group for Croydon South on April Fools Day 1999.
Croydon Primary Care
The Croydon Primary Care Wound Formulary was launched on Tuesday 7th July. It has been compiled by a multi-disciplinary team of nurses, pharmacists, chiropodists, and GPs in response to an identified need within the Primary Health Care Team. The Wound Formulary has been developed in order to enhance clinical practice and achieve improved wound healing in an informed and cost effective manner. It includes suggested dressings and products for the management of wounds in Croydon. For those of you that did not have the opportunity to attend the launch, the Wound Formulary will be promoted at locality meetings over the next few months. Copies of the Wound Formulary will be issued to every GP practice, every practice nurse, every community nurse, each community pharmacy, community chiropodists and nursing homes in Croydon. General Practitioners can obtain further copies by contacting Lorna Noble at the GPLO.
Vikki Williams Prescribing Adviser, CHA
The GPLO does not necessarily endorse or support any of the positions, products or people advertised herein.
Receptionist required. Part-time 10-15 hours per week. Would need to be flexible about working evenings and afternoons as well as mornings. Start 27/7/98. Please contact Catrine (Practice Manager) on 0181 776 2055 for more details, or send your CV to Dr Ford's Surgery, 2 South Way,Croydon, Surrey CR0 8RP