NEWSLETTER FOR THE GENERAL PRACTICE LINK OFFICE
NOVEMBER 1998 ISSUE 55
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
As from Monday 16 November the GPLO will be located in the Croydon Postgraduate Medical Centre
"Mary Clarke has neither emigrated NOR retired - she is now based at … Drs Spicer, Allan and Clarke Woodside Health Centre Enmore Road South Norwood London SE25 5NT Tel: 0181 656 5790 Fax: 0181 656 7984 She will still be pleased to hear from anyone in connection with LIZ Education or Croydoc: so keep in touch."
CONTENTS
CROYDON COLORECTAL CANCER CHARITY
PHARMACIES BECOME LOCAL HEALTHY CROYDON INFORMATION CENTRES
ADDITIONS TO YELLOW FEVER LIST
The GPLO is moving to the Postgraduate Medical Centre on 16 November 1998.
This move coincides with the Link Office examining how its role should change given the development of the Primary Care Groups. Initial discussions have been held with representatives of the North, South and Central groups to try and identify what support and resources the GPLO could offer them in their work.
We are optimistic that the move to the Postgraduate Medical Centre will reflect the focus the Link Office places on GP education and training issues and will enable closer working between the GP Tutor and Clinical Tutor. It will also provide a focus for all primary care staff and Practice GPs to meet various Mayday staff formally and informally.
General Practice Link Office Croydon Postgraduate Medical Centre Mayday University Hospital London Road Croydon Surrey CR7 7YE Telephone No: 0181 401 3990 Fax No: 0181 401 3989
ANGELA BURGON Assistant Director of Primary Care & Community Commissioning
Croydon Colorectal Cancer Charity
On a cold wet Monday night, on 5th October, the Croydon Colorectal Cancer Charity (CCCC) had its public launch at the refurbished Addington Palace.
Over seventy guests were invited including the Mayor of Croydon and Peter Wood (of Direct Line fame) who is the chairman of the trustees. Croydon Health and the Trust were represented and the LMC chairman was also present. Mr Wood opened the evening. His interest arose when he had a personal encounter with Mr Swift armed with one of his funny looking telescopes! He noticed the inadequacies of the service, which could not provide rapid diagnosis of colorectal conditions or to give patients time to fully discuss concerns. The ideal would be for the consultation and investigations to occur in a "one-stop" clinic setting, where every patient would have results of flexible sigmoidoscopy test performed that day, with time and privacy for discussion afterwards. Mr Swift and Mr Abulafi's vision for the future is a dedicated colorectal unit for the early diagnosis and treatment of colon cancer. Such a unit would be unique, with no other in the country. Flexible sigmoidoscopy would be offered to all outpatients presenting to fast track colorectal clinics. This would allow the left side of the colon to be examined which is where 70% of colon cancers occur. Other investigations may also be planned such as endoscopic ultrasonography and high speed dynamic MRI scanning.
Obviously this high level of service and technology would not come cheap. The Charity is looking to raise £3 million. The Government's cancer initiative would give Croydon a budget of only £64,000 to be spent on colorectal cancer, hardly enough to buy two funny telescopes! This service would put Croydon on the map and it would also generate an accurate database on which quality research would be based. This ambitious plan and project has the full backing of the Trust and Croydon Health. The launch of the CCCC coincides with the national "Mooney Bear" campaign on the early recognition of colon cancer symptoms.
Although colon cancer is the second most common cancer in the UK, killing 50% of its sufferers, there exists the potential to totally cure it. The condition starts as a benign polyp, which after three to five years may turn malignant. If this polyp can be identified a simple snaring of it will cure the condition and prevent cancer. There may be a future screening programme for those with a first degree relative of colon cancer, as their likelihood of developing it over a lifetime is greatly increased compared to the general population. This initiative for a first class service is just what Croydon and Mayday Hospital need. GPs will benefit from a fast track one-stop clinic and ultimately patients' lives will be saved.
Dr Peter Campbell
DIET UPDATE - Interested?
Asian especially Sri Lankan, and Afro Caribbean population residing in Croydon is on the increase, as is the incidence of Diabetes and Heart Disease. Would you and your staff like an input/update on dietary habits and cultural and religious norms (which has an influence) from an experienced Asian Dietician? For information please contact me, Parul Patel on 0181-640 3250 or pager 01523418555.
New Drugs Considered by Croydon Prescribing Liaison Group
Croydon Prescribing Liaison Group (CPLG) considers new products that are either new in their class or are likely to have an impact on primary or secondary care. An independent review of the evidence for a new drug is considered, and advice taken from local specialists. CPLG may then give advice to Croydon Health, GPs or Trusts on how the new drug should be used. Copies of the independent reviews on new drugs are available from Mike Salter or Vikki Williams, Prescribing Advisers at Croydon Health. A summary of advice issued by CPLG on new drugs in included below.
| Product | Date discussed | Recommendation |
| Montelukast (Singulair) | 3/98 & 9/98 | Insufficient evidence to support use over existing therapy at present, unclear place in therapy. Mayday undertaking an empirical trial on selected patients. To review when this is complete or in the light of new evidence. |
| Tolterodine (Detrusitol) | 3/98 | Insufficient evidence to support use over existing therapy. Oxybutynin still first line treatment. |
| Dipyridamole MR (Persantin retard) | 6/98 | Recommended for use in secondary prevention of stroke and transient ischaemic attacks. |
| Raloxifene (Evista) | 6/98 | Insufficient evidence at the moment to support its use. |
| Orlistat (Xenical) | 9/98 | Insufficient evidence to support its use, only minor weight loss achieved, significant side effects. |
| Zafirlukast (Accolate) | 9/98 | Insufficient evidence to support use over existing therapy at present - to be reviewed in conjunction with montelukast. |
| Clopidogrel (Plavix) | 9/97 & 9/98 | Recommended for use as second line to aspirin, except in aspirin intolerant patients. |
Mike Salter, Vikki Williams, Prescribing Advisers, Croydon Health Authority
Pharmacies become Local Healthy Croydon Information Centres
Twenty local pharmacies are embarking on an innovative new scheme to become local health information points. The pharmacies will be displaying and promoting a rolling programme of information which focuses on wider health issues such as how to heat homes effectively, air pollution, and welfare benefit take up. The Project is being run as part of the Healthy Croydon Initiative, a partnership between Croydon Council, Croydon Health Authority, the voluntary sector and many other organisations and agencies to reduce inequalities in health. Croydon Pharmacists and their staff have the opportunity to interact with between 170,000 and 200,000 clients per week, many of whom use the same pharmacy on a regular basis. This puts them in an ideal position to become health information points at the heart of the local community and allows them to play an important part in achieving the objectives of Healthy Croydon. The project forges an innovative new partnership between Croydon Pharmacists and the Council, who are financing the project for a one year pilot. The project is also supported by the Health Authority and many other health agencies who will be involved through providing information for, and taking referrals from, the information boards. The project will be jointly managed by the Healthy Croydon Support Unit and the Local Pharmaceutical Committee. If the scheme is successful, it is hoped that it can be expanded to GPs and other primary health care professionals. For more information about the project call Jo Bradbury on 0181 760 5773.
Update - Primary Care Groups in Croydon
Following the recent elections for GP Members of Croydon Primary Care Groups, good progress has been made on the selection of other Board Members for the three Croydon Primary Care Groups.
Two nurses have been selected for the Board of the Purley Primary Care Group, while the Selection Boards for the North and Central Croydon PCGs each agreed to recommend one Nurse Member for appointment to the PCG Boards. We will now be re-running the selection process to appoint a second Nurse Member for the Central and North Croydon PCG Boards. If you would like to know more about the appointment process for PCG Nurse Board Members, please contact Greg Cairns on 0181 401 3982. Nominations have been confirmed for Social Services representatives for the three PCG Boards. Interviews for Lay Members took place on 26 and 27 October when we were able to appoint for the Central PCG. We will be re-running the recruitment process to fill lay member vacancies on the North and Purley PCGs. Shadow Boards have now confirmed nominations for GP Chairs for the three PCGs, with appointments for Chairs and other elected Board members to be confirmed at a Health Authority meeting on 10 November. To facilitate communication between key stakeholders, a Croydon PCG Development Advisory Group has now been set up and will meet for the first time on 18 November. In addition to representatives from CHA and PCGs, there will also be representatives from local providers, Social Services, local representative committees (LMC, LPC, LDC and LOC), CVA and CHC on this group. We will also be issuing the first edition of a Croydon PCG Newsletter in the near future, so if you have any suggestions for topics to be covered, please contact Greg Cairns on the above number.
Following the appointment of PCG Boards at the Health Authority meeting on 10 November, detailed implementation plans will be developed with the three shadow PCGs to provide a framework for action between now and "going live" on 1 April 1999. Implementation plans will cover amongst other issues, management and staffing arrangements, the delegation of commissioning functions and PCG "Levels", remuneration for PCG Board members based on the recent national guidance, and information and information technology.
If you require any further information on the development of Croydon PCGs call Greg Cairns on 0181 401 3982.
A third, successful satellite course - "Paediatric Pot Pourri" was held in September. We are now hoping to hold a further three on Gynaecology, Obstetrics and Family Planning. If you have any other suggestions for topics to be covered, please inform Lorna Noble. The non-LIZ money is now almost at an end. There is, however, plenty of LIZ money available. It all has to be spent by 31 March 1999. If you have any courses you wish to undertake, please send in a PDP to the Education Board. The I.T. training programme, available as one-to-one computer tuition for GPs, is well underway. To date fifty GPs have requested training from the seven GP trainers. If you would welcome any computer training, at any level, and have not yet let us know, please phone Lorna Noble and ask to be included on the list. Again all of this training has to be undertaken by the end of March 1999.
Alison Lawton Primary Care Adviser
ADDITIONS TO YELLOW FEVER CENTRE LIST which was included with October's Link News.
FAIRVIEW MEDICAL CENTRE,
69 FAIRVIEW ROAD
NORBURY SW16 5PX. Telephone: 0181 764 6666.
DR E O'BRIEN & PTRS,
THE MOORINGS,
VALLEY ROAD,
KENLEY, SURREY CR8 5DG. Telephone: 0181 660 6104.
DR NT DESILVA,
1 MORLAND ROAD,
CROYDON, SURREY CR0 6HA Telephone: 0181 688 0434.
The natural proteins or the chemical additives found in examination gloves are resulting in some patients or nurses developing allergies. This can vary from contact dermatitis to anaphylactic shock. Powdered latex gloves have been found to increase the risk or exacerbate the effects of an allergic reaction especially when the glove powder is in contact with mucus membrane of sensitised individuals. Latex gloves covered with modified starch powder are documented by the Medical Devices Agency (MDA SN9825) June 1998 as being a problem. This is due to the latex protein residue attaching itself to the starch powder which then acts as a carrier enabling surface or airborne transmission. Preventative Action · Aware of the potential risk of allergy from powdered latex gloves. To reduce the risk powder free gloves should be used. · If allergy present or suspected, gloves provided should be latex free. · Awareness of the possibility of patient sensitivity to latex and therefore ask patients if they are allergic to latex prior to procedure.
Always wash your hands pre and post gloving up!
Plan next Practice Nurse meeting dedicated to latex.
Ref: RCN Newsletter Autumn 1998.
This information is brought to you by the Croydon Practice Nurse Group Committee.
Have your children been affected with this condition? Sadly both my twins have. Having got over Nanobabyitis I thought things were picking up a bit, but my joy was short lived. In my day, a few children played with a bog standard yo-yo whilst others played marbles and one or two (myself included) chased the girls in the playground. But not in 1998, oh no. Most children seem to have been afflicted with this latest fad. Not content with the 1958 vintage model I used to play with, today's children are spoilt for choice. They even have a Thunderstone 4 Ball Clutch Professional Power - Yo which even lights up!
I was the subject of ridicule and humiliation when I proudly attempted to use the 1998 Yo. After a few ups and downs it went into a stall and nearly knocked our moggie unconscious. "This is how to do it daddy" were my twins reply. I then had to watch them perform a feat of pure heroics including "Double or Nothing Tough Guy", "Crazy Monkey Climbs The String". "Brain Twister Extreme" (by now I had a headache), "Super Skin The Cat" and "The Ultra Hop the Fence". Before this display was finished, Tigger (our moggie) thought his time was up, and was last seen "running out of his skin and leaping the garden fence".
Dr Nicholas Cambridge
The GPLO does not necessarily endorse or support any of the positions, products or people advertised herein.
Medical Secretary is required for two doctor practice in Thornton Heath. Approximately three hours per week. Please call Alison Fowler, London Road Medical Centre Tel: 0181-239 9002 for details.
RECEPTIONIST/SECRETARY required for friendly single handed practice in Old Coulsdon. 5 mornings per week. Call Sue Colomb Practice Manager on 01737-553660.
ASSISTANT required for 6 sessions per week in 3 partner computerised teaching practice with full PHCT. Purpose built premises. No out of hours on call. Send C.V. with hand written covering letter to Mrs. M. Taylor, Practice Manager, Violet Lane Medical Practice, 231 Violet Lane, Croydon, CR0 4HN. Informal enquiries welcome: 0181 688 8838.
RECEPTIONIST/TYPIST required for 15 hours per week for three doctor computerised teaching practice in South Croydon area. We are looking for a flexible as well as adaptable person to work within our friendly team who has both good communication and administrative skills, as well as good typing ability. Send C.V. with hand written covering letter to Mrs. M. Taylor, Practice Manager, Violet Lane Medical Practice, 231 Violet Lane, Croydon, CR0 4HN.
RECEPTIONIST required for GP surgery. Thornton Heath area. £5.89/hour. To work 23 or 28 hours/week. Sessions ranging between 8:30am and 7:30pm. Apply 684 1174.