LMC Conference 2016

There was an LMC Conference on Saturday 31st of January, which was a chance for  all the local medical committees to speak up about their concerns and issues with general practice. They spoke, debated and demanded, and came to the conclusion that government was not providing a solution, but we need to find one immediately.

 

One topic of conversation was talking about trying to find a solution to the spending issues around recruitment. And one thing that kept coming up was restrictions on agencies supplying staff.

 

Our Managing Director, Tawhid Juneja, commented on this in saying, “the government is saying they just want to use agencies who are on national frameworks. But the national frameworks are only secondary care, not primary care.

Therefore, we have clients not wanting to use us because we are not on the frameworks, which means us (alongside other agencies) cannot provide skilled Primary Care clinicians. But that will only create further issues when our clients do not have the nurses they need.”

 

Not only that, the government is also saying those nurses should be employed by what band they are on. Which we know by experience that if a nurse has the right skillset they can really benefit in certain healthcare environments that are struggling.

 

He went on to say “we propose that Urgent Care Centres should be treated separately to other practices and centres, and have no pigeon hole of band nurses. Because otherwise the UCC’s job of relieving A&E will not be able to function. And nurses will no skills would be there instead.”

 

We believe this because UCC’s need an affective team to perform its function. We recognise this first-hand from when we told the UCC’s that we could cost them a more effective solution of using Nurse Practitioners and Practice Nurses with minor injury skills.

 

We feel this is just another example of a system gone wrong and not thought through.

 

Please let us know your thoughts on this.

Or any thoughts you may have had from the day.

 

Email: work@primarycarepeople.co.uk

Happy 2016!

Now we enter the new year we want to wish everyone a Happy New Year, and let clients and candidates alike know what exciting things we have to look forward to this year.

Primary Care People will be holding our first annual Summer charity ball for our charity partner Sense. This will kick-off with a volunteer day we have booked in with them soon at the Stables, where we get to meet our rescue donkeys, Bonnie and Clyde!

Our sponsorship is also in place with The RCGP so we will be assisting them in working with Practice Manager’s in their workshops on running your own practice. We will also be presenting and sponsoring this years 20th Research Paper; RCGP and Primary Care People Research Paper of the Year Award.

We will be attending a lot more events this year so you shall expect to see us there! We will also be running for more awards, moving into another new office, and growing evermore as a company.

Christmas Time with General Practice

As we are entering the Christmas month, we are filled with festive cheer and busy days and nights running around headless in the cold! Although it is ‘the most wonderful time of the year’, we must be aware it is also the most busiest in every aspect!

To make sure everyone is aware of how their GP Practices will be available, we have put together some important information for patients and Practice managers.

We are all aware of ‘winter pressures’, which put a strain on all Primary Care services. So to ensure patients can get the best services;

Practices should ensure that:

  • patients are aware of any closures in advance by using surgery notices, and including messages on repeat prescriptions
  • arrangements are in place to ensure that repeat prescriptions are ordered and collected in a timely matter to avoid requests over the period of practice closure
  • answer phone messages should be changed at 18:30 on the afternoons of early closure – in particular – for opted out practices where there is a change from the sub-contracted provider to NHS 111

 

Helpful tips to prepare for the holiday period

In addition to the contractual guidance below, the following are suggestions for actions practices might consider to ensure your patients’ reasonable needs and your practices’ contractual obligations are met.

Following these tips will help to promote the smooth running of out of hours services and to ease pressures on your practice on days when the practice is open:

  • Minimise or avoid pre-booking advance appointments, particularly for non-essential services, from 23 December to 6 January
  • Minimise or avoid appointments for routine consultations, i.e. non-essential services from 23 December to 6 January
  • Ensure on any half day closing that a GP from the practice is contactable by the covering out of hours or other service in case of unforeseen queries
  • Advertise practice half day closing arrangements well in advance on prescription counterfoils, posters and other media at the practice, commencing as soon as possible if you have not already done so
  • Extend repeat prescriptions so they do not fall due during the period 23 December to 6 January
  • Ensure pharmacists collect “collection and delivery” prescriptions before the practice closes
  • Ensure patients on opiate substitution prescriptions have enough to cover practice closure periods and collect their prescriptions before closing
  • Ensure urgent lab tests carried out during this period have the clinical condition and phone number of the patient clearly on the form
  • Ensure special notes are sent to the out of hours organisation on vulnerable patients e.g. those without mental capacity, those with complex or terminal conditions and those where special arrangements are in place (e.g. GP to be informed during the out of hours period if patient dies)
  • Ensure residential and nursing home patients have repeat prescriptions, know the opening times and any sick patients have been reviewed before closing the practice [1]

We hope this helps you, and allows patients to know what to expect during this time of year.

Tis’ the season to be jolly after all!

[1] Bma.org.uk, (2015). BMA – GP Services During Holiday Period | British Medical Association. [online] Available at: http://bma.org.uk/support-at-work/gp-practices/service-provision/gp-services-during-holiday-period [Accessed 3 Dec. 2015].

 

Pharmacists Could Improve GP Surgeries

We were skeptical when we heard about the pharmacists to help out GP surgeries; could it be just another rouse to throw over a problem?

However after considering the benefits that could be reaped, and understanding the direction GP surgeries will be taking, this step could have been inevitable. And, quite possibly, maybe the only choice the NHS has right now.

Although, despite all of this, pharmacists could also truly improve GP surgeries with their expertise.

Ravi Sharma spoke about her assistance as a pharmacist within a GP surgery. The article discusses the numerous benefits pharmacists can bring towards helping in these surgeries.

They say that the move will improve patient safety and care and, crucially, reduce waiting times for GP appointments.

GP surgeries will be expanding in the future as A&E needs to have stress taken off of their services. However, since there has now been a shortage in GP’s there needs to be an incentive for studying doctors to pursue primary care. There also needs to be extra help in the surgeries, WIC, and UCC’s. One realistic first step is to have pharmacists help out. Most pharmacists are located next to/near a GP surgery, therefore this seems like an idea that could potentially have a long term success.

It is believed that practice based pharmacists could relieve pressures and make a real difference to patient care.

Currently with an over-stretched GP workforce, this could be a solution that would benefit those who seek medical remedies and monitoring of long term illnesses.

“Pharmacists can also work with GPs to resolve day-to-day medicine issues and with practice teams to provide advice on medicines to care homes, as well as visiting patients in their own homes when needed…It’s a win-win situation for everyone concerned. The NHS simply can’t afford to wait any longer to create capacity in the system. We must be more strategic and change the services on offer to make best use of the NHS workforce.” [1]

A consensus that has been reached seems to be that patients could start receiving high quality care through the help of Pharmacists. Therefore perhaps this really is the correct step to take at this point for the sake of patients.

A lot of patients already use A&E as their go-to, but really most patients could be seen by a GP, and more often-than-not, a Nurse, and now also a Pharmacist.

In regards to the shortages of General Practitioners, The RCGP is calling for an increase in the NHS budget for general practice to be increased to 11% by 2017 – it is currently just over 8% – and for 8,000 more GP’s in England by the end of the next parliament.

Please let us know your thoughts.

[1] Medical News Today, (2015). Pharmacists set to work in GP surgeries in radical move to ease pressures on general practice and improve patient care, UK. [online] Available at: http://www.medicalnewstoday.com/releases/290999.php 

A&E’s Given Rules For Safe Nurses

By now, we are all fully aware of the crisis A&E departments are in. Another proposed action has been put in place for nurses; a strict guideline on how many staff is ‘really’ needed on the ward, and per patient.

The main guidelines that have been put in place are:

– One nurse for every four cubicles

–  For major trauma or cardiac arrest patients there should be two nurses per patient

– Senior nurses are to look out for red flags that may show something is wrong in the wards

The BBC ran this news and had a spokesman Prof Mark Baker, from NICE, explained they wanted to;

“[Ensure] there are enough available nursing staff with the right skills helps to make sure people in need of immediate medical help will get safe care whatever time of day or night.” [1]

These rules may help the A&E situation, however at the present time, they have not specifically acknoweldged all A&E departments to understand how much help and restructuring is needed. Therefore we started to think, are these actions the right ones to take? With the severity of A&E issues, is it down to monitoring nurses? And, do nurses feel this strain?

It has been said the these plans were meant to be put in place before the winter issues, however we could argue that it will benefit the NHS to implement these now, since the A&E has reached breaking point. But if they have not monitored who needs help, and this may be a trial, then how are they to know which actions are best to take?

However, a Department of Health spokeswoman said there were now more nurses in the NHS than when the current government came to power.

“This NICE guidance will give the NHS evidence to make sure it has the right number of staff, improving patient care,” [2]

The growth in nurses means that these new requirements may run smoothly, and staffs may need be overrun, and patients will be attended to correctly.

However, Primary Care People also wanted to add – if you are a junior Nurse who wants to reach higher levels, we can provide you with the correct environment to help you be where you truly want to be in this profession. Whether it be attending A&E yourself, or in surgeries, we want to help too.

Please get in touch should you wish to know more. And please let us know your thoughts on this news.

Call: 0203 137 2114

Email: applications@primarycare-jobs.co.uk

[1] BBC News, (2015). A&Es given safe nurse staffing rules. Available at: http://www.bbc.co.uk/news/health-30829555

[2] Ibid

Cuts Have Been Made To Cancer Treatments

New cuts to cancer treatments have been warned to cause severe problems for future patients. However, there is a flip-side to consider; health spokesmen say it’s to make room for new and improved drugs to be funded.

These cuts are coming from the decision of the NHS as they over-funded the cancer treatment budget by £100m.

Patients currently using the drugs will still be allowed to use them, but the restrictions will be put in place from the 12th of March. However new treatments have already been discussed, and are set to be put in place from April.

Fund chair Professor Peter Clark said the review – carried out by doctors, pharmacists and patients’ representatives – had prioritized the treatments with the “best clinical benefit” to get the most out of “every pound…There were drugs that did not offer sufficient clinical benefit so we simply cannot go on funding those,” [1]

He went on to say that pharmaceutical firms over the country has worked with the NHS in decisions to lower some prices of medicine in order to save money further. Therefore although this may seem extreme for a lot of patients,  this potentially could make room for cancer treatments to be more advanced in the long run.

The fund will also increase again to £340m next year, even though the cuts will save £80m a year.

However, executives of charities have commented on this decision, and feel this is a bad move on behalf of the NHS.

Owen Sharp, chief executive of Prostate Cancer UK, said the announcement was “just another symptom of a drug appraisal system in meltdown”. While Mark Flannagan, chief executive of the charity Beating Bowel Cancer, said “It’s likely that 65% of patients with advanced bowel cancer face the probability of an earlier death by being refused innovative treatments that were available before,”. And Stephen Whitehead, of the Association of the British Pharmaceutical Industry, said the move was “extremely disappointing”. [2]

However if some patients extremely still need the drugs, they can apply as an ‘exceptional case’. And it has been stated that the raise in funding next year is to ensure all patients are receiving the most beneficial drugs they need.

Therefore the question must be, is it worth a year to hold back, to earn years of potentially ‘better’ drugs? Or is this another saving tactic for the NHS, with a danger for patients?

[1] BBC News, (2015). Cuts to cancer treatments announced. Available at: http://www.bbc.co.uk/news/health-30787132

[2]

Could the Paralyzed Walk Again?

There have been trials and errors with this study. Many researchers and scientists have attempted to cure the paralyzed to walk again. Trials have not lasted very long, but now scientists have hit a milestone in their research in a new study that allowed rats to walk for up-to two months.

Research has been done previously on implants, however they proved to be inflexible as they would rub, which would cause inflammation, and would not work properly.

However, this new study is a renovated implant, one that has been designed to move with the body which thus provides a chemical and electrical stimulation. Once tested on the rats, they were able to move again. Although only for two months, this is a huge breakthrough for the area of study. Not only has it lasted longer than other tests, but it has sustained in an animal which gives a small hope that the process could perhaps one day be progressed onto human trials, and succeed.

To explain the spinal process;

The spinal cord is like a motorway with electrical signals rushing up and down it instead of cars…Injury to the spinal cord leads to paralysis when the electrical signals are stuck in a jam and can no longer get from the brain to the legs. [1]

This implant has worked due to the movement , and using the elastic affect it is soft and flexible. The scientists explained the wiring used is made of “microcracked” gold. This means that tiny cuts in the wiring surface has made it flexible.

Dr Dusko Ilic, from King’s College London, said: “This is quite remarkable, until now, the most advanced prostheses in intimate contact with the spinal cord caused quite substantial damage to tissue in just one week due to their stiffness…The work described here is a groundbreaking achievement of technology, which could open a door to a new era in treatment of neuronal damage. [2]

We consider this amazing news to hear to end our weekend! What do you think of the new breakthrough?

[1] BBC News, (2015). Elastic implant ‘reverses paralysis’. Available at: http://www.bbc.co.uk/news/health-30725899

[2] Ibid

Can Labour Solve The A&E Problems?

It has been announced this week that A&E targets are at their worst for the last ten years. Despite warnings to only go to A&E if you truly need emergency services, and putting targets in place, they have simply not been met by the hospitals in England. With a target of 95%, they have dropped to 92.6%. This has been a progressive issue for the last few months, and one that quite clearly needs to be addressed.

The Labour party has suggested that a co-operative solution be made. However shadow health secretary Andy Burnham had reasons to blame the issue on them.

“You will know that I have repeatedly warned throughout this Parliament that severe cuts to social care could end up dragging down the NHS…This is exactly what is happening now. Increasing numbers of very frail, elderly people are ending up in A&E and then becoming trapped in hospital because the care they need to be discharged is not available. This comes on top of pressures arising from the fact that people are finding it harder to see a GP, and pressures within the NHS from the shortage of nurses and GPs.” [1]

However, labour have made it clear that although targets are important, and met, we must remember the most prominent importance is the patients and their treatment.

However, the problem still stands and labour needs to resolve the issues if there is any improvement to be made to patient treatment. And it is not just England, the whole of the UK are falling behind on their targets, some more than England.

There have been some precautions made, but only due to the severity of the situation. Mr Burnham continued to say that ‘a summit was needed to “assess the situation and put in place a coordinated plan to ensure patient safety and support the performance of A&E departments” to minimize any avoidable further major incidents being declared.’ [2]

But do we believe there is an easy solution to this mess? Please let us know your thoughts.

[1] BBC News, (2015). Labour seeks summit to find A&E ‘fix’. Available at: http://www.bbc.co.uk/news/health-30705689

[2] Ibid

Cancer really is just bad luck

A new study has shown that some cancers are down to just a bad chance rather than genetic mutations.

Dr. Bert Vogelstein and Cristian Tomasetti, PhD, publish their findings in the journal Science. Researchers claim 65% of cancer cases are a result of random DNA mutations, while the remaining 35% can be explained by a combination of these mutations and environmental and hereditary factors. [1]

However, the researchers are not denying that lifestyle does not affect the chance of some cancers. Smoking, drinking and poor diet can still progress to the disease.

Cancer research still heavily believe in warning against the remaining third chances, such as; sun exposure, being overweight, etc. We must still take care of ourselves to avoid damaging our cells even further, despite the possibilities of still simply receiving some bad luck.

The researchers explained how this ‘bad luck’ can occur:

Old tired cells in the body are constantly being replaced with new ones made by dividing stem cells. But with each division comes the risk of a dangerous mutation that moves the stem cell one step closer to being cancerous…[Researcher’s] concluded that two thirds of cancer types were “due to bad luck” from dividing stem cells picking up mutations that could not be prevented. [2]

This again would really be down to everyone’s individual body clocks. Unfortunately this cannot be measured or controlled. The body works to protect you, but in some unfortunate cases this can backfire on the body.

Due to this problem, researches suggested we should not primarily focus on the prevention of cancer – for only a third would be monitored this way. But we should start a process of how we manage early detection of the disease, in a state that is curable.
We must not diminish, nor forget those new ambitions to stay healthy. Nor should we feel disheartened, but another reminder perhaps, to live sensibly, and on the odd occasion, it really is ok to indulge ourselves.

But what are your thoughts on this new study? We want to know your thoughts.

[1] Whiteman, H. (2015). Two thirds of cancer cases down to ‘bad luck,’ new study claims. Medical News Today. Available at: http://www.medicalnewstoday.com/articles/287542.php

[2] BBC News, (2015). Most cancer types ‘just bad luck’. Available at: http://www.bbc.co.uk/news/health-30641833

No Drink Driving This New Year’s Eve!

We are always warned around this time of year of the dangers of drink driving. Here at Primary Care People, we do wish you a happy new year, but we also wish you a safe one.

Many cases are seen every year to the police and paramedics of those who still disregard the warnings to not drink and drive. It has been featured in the news this week that A&E have to deal with drunk issues more consistently, and it needs attention.

We understand the hectic and dangerous nature of drink driving cases:

– Last year 3296 failed a breathalyser test

– Deaths by drink driving had a 26% rise

– One in six road deaths last year was alcohol-related.

The local police have released a statement to remind us all of the consequences of these reckless decisions.

“The Bedfordshire, Cambridgeshire and Hertfordshire Road Policing Unit will be conducting breathalyser checks round the clock throughout December – supporting the national Christmas drink drive campaign. Motorists found to be driving while under the influence of drink or drugs face a minimum of a 12-month disqualification from driving, as well as a fine and/or imprisonment. The offence of causing death by careless driving whilst under the influence of drink or drugs now carries a maximum penalty of 14 years’ imprisonment and a disqualification of at least two years.”[1]

To prevent danger, and to ensure your safety this new years eve:

  • Assign a designated driver or pre-book a taxi
  • Buy some nice non-alcoholic beverages if you are the driver
  • Limit your alcohol intake
  • Buy your own breathalyser
  • Drink in consideration, with water and eating a meal before.

We want all emergency and medical staff to bring in their new year without any casualties, and for no one enjoying themselves to become a patient.

Let’s drink safely, and have ourselves a great way to bring in the New Year!

[1] Peterboroughtoday.co.uk, (2014). Drink drive warning for new year celebrations. Available at: http://www.peterboroughtoday.co.uk/news/local/drink-drive-warning-for-new-year-celebrations-1-6494017