Admin Flashcards
Which form should be filled out for a temporary resident ?
GMS3
Which form is used to register a patient on a permanent basis?
GMS1
Which essential services must be provided under the General Medical Services (GMS) contract?
- management of chronic disease
- non specialist care of terminally ill patients
- childhood vaccinations
- maternity medical services
Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR), puts duties on employers to report serious workplace accidents and occupational diseases including:
*Carpal tunnel syndrome
* Cramp of the hand or forearm
* Occupational dermatitis
* Hand arm vibration syndrome
* Occupational asthma
* Tendonitis or tenosynovitis
* Occupational cancer
* Exposure to a biological agent
What formula is used to adjust the global sum dependant on the demographic of the practice?
The Carr–Hill formula
When is a GP able to write a death certificate?
- If they have attended the deceased within the last 28 days AND
- are able to give a cause of death
They do not need to view the dead body.
Which deaths should be reported to the coroner? (and therefore you should not issue a death certificate)
coroner in scotland = procurator fiscal
- not seen by the ‘attending’ doctor either after death or within 28 days before death (telephone consult does not count). (attending doctor is one who saw the patient during their last illness).
- attending Dr not available <5d of death to write MCCD.
- cause of death is unknown
- the death was violent, unnatural or suspicious
- death due to poisoning
- death due to toxic substance
- death due to medical drug, or psychoactive substance (illicit drug)
- death may be due to an accident (whenever it occurred), violence, trauma, or injury.
- death may be due to self-neglect or neglect by others
- the death may be suicide or self harm
- death may be due to an industrial disease or related to employment
- the death may be due to a medical procedure or treatment (incl. delayed diagnosis leading to/hastening death)
- death occurred during or shortly after detention in custody
- death occurred when the patient was subject to MHA (DOLS incl if also in custody/detention)
What does 1a), 1b) and 2 refer to in the death certificate?
- 1a) The disease or condition that led directly to death (if two separate conditions both caused death you can write both on this line) Can have just 1a) alone.
- 1b) go back through the sequence of events or conditions that led to death on subsequent lines.
- other conditions that were not part of the main causal sequence of death but likely played a role in hastening the death.
What things should NOT be written on a death certificate?
- a ‘mode’ of death without explanation. e.g. cardiac
or respiratory arrest, syncope or shock. Do not write any ‘organ failure’ without specifying the disease or condition that led to the organ failure. It is acceptable if the cause is in 1b) - Do NOT write ‘natural causes’
- Do NOT use abbreviations
- Do not list all comorbidities in 2.
When can ‘frailty of old age’ be listed as a sole cause of death in 1a) on the death certificate?
- usually age >80
- You have personally cared for the deceased over a long period (years, or many
months) - You have observed a gradual decline in your patient’s general health and functioning
- You are not aware of any identifiable disease or injury that contributed to the death
- You are certain that there is no reason that the death should be reported to the coroner
What are the possible outcomes of a coroners referral?
- Can authorise you to issue MCCD with no further action
- Can hold a documentary inquest (ask for notes/statements)
- Can hold a formal inquest (summon you to court)
- Can hold an inquest with a jury (to help reach a verdict of who, where, how and when a person died).
- Can issue a “Regulation 28 (Report to prevent further deaths)
- Can order a post mortem (NB family cannot object to this, nor
can the deceased indicate refusal before death e.g.no advanced directive to refuse an autopsy)
When is a Certificate of Stillbirth issued?
- born after 24 weeks gestation but did not show any signs of life / did not breathe.
(if born before 24 weeks = no certificate. Unless showed signs of life = Neonatal Death certificate)
When is a Neonatal Death Certificate issued?
Any death of a live-born infant occurring within the first 28 days of life.
What is the role of the CQC? (Care Quality Commission)
To monitor, inspect and regulate health and social care services.
* “Safe, Caring, Effective, Responsive, Well-Led”
* Practices have to pay to be CQC Registered and inspected.
* Also inspect care homes, dentists, community physio clinics etc.
What is the role of the GMC?
- Maintains official register of medical practitioners
- to “protect, promote and maintain the health and safety of the public”
- by controlling entry to the register, and suspending or
removing members. - Sets standards for medical schools and postgraduate CCT
- Medical Act 1983 gives it lots of powers (also criminal offence to claim to be dr when you are not!)
- Refers to the Medical Practitioners Tribunal Service to decide if a Dr should be ‘struck off’.
What is the MPTS?
- Medical Practitioners Tribunal Service
- GMC refers doctors to this independent body for fitness to practice hearings.
- May find fitness to practice is unimpaired, issue warnings, impose a suspension, impose conditions or erase a doctor from the medical register
- Usually panel of 3 people, at least 1 a doctor and 1 a lay member
What is healthwatch?
- Independent national champion for those who use health and social care services.
What is the Health and Care Professions Council? (HCPC)
- organisation which regulates health, psychological and
care professionals in UK. - set standards, hold a register, quality assure education
and investigate complaints. - They regulate:
-Biomedical scientists
Podiatrists
Clinical scientists
dieticians
OTs
ODPs
Orthoptists
Paramedics
Physios
Psychologists
Orthotists
Radiographers
SALT
What is the LMC?
Local Medical Committee
* Statutory body representing GPs and general practice as a whole
(predates the NHS).
GP practices pay a levy per patient
What body regulates nurses and midwives?
Nursing and Midwifery Council
What body regulates Pharmacists?
General Pharmaceutical Council
How often must a doctor revalidate?
- every 5 years - including doctors in training
- appraisals should be done annually
There are six types of supporting information you must collect, refect on and discuss at your appraisal ad revalidation, what are these?
They are:
a Continuing professional development
b Quality improvement activity
c Signifcant events or serious incidents
d Feedback from patients or those you provide medical services to
e Feedback from colleagues
f Compliments and complaints
Which registrations are ESSENTIAL to work as a GP in the NHS in the UK?
- Must be on the GMC GP Register
- Must be licensed by the GMC
- Must be included on an NHS performers list.
When can patient confidentiality be breached?
- when a patient consents
- When it is required by** Law** (statutory/court/tribunal requirement)
- Patient lacks capacity and it is in their best interest e.g. patient with dementia
- In an emergency if seeking consent to break confidentiality would put you/ others at serious harm - can do so without consent e.g violent person, child protection
- If seeking consent would undermine the prevention/ detection/prosecution of a** serious crime.** - in the public interest.
- Public health reporting of notifiable diseases (statutory duty)
- Adverse drug reactions reporting to MHRA
- **complaints **- as part of GMC performance procedures involving doctors.
Children <16 - disclosure can be authorised by parent.
- if mature enough to understand, they can refuse parental access to their record.
Deceased -if there is no legal claim - there is no right of access to information.
Do you need consent to refer a child or adult to the safeguarding team?
- ideally should obtain consent, but not always needed.
- e.g. can just tell the patients you are referring to safeguarding (don’t need their consent) - for example when child witnessing domestic abuse.
- FGM - report without consent. Report to police and social services.
What are the 5 statutory Principles of The Mental Capacity Act ?
applies to those aged 16 and over
- A person must be assumed to have capacity unless it is established that they lack capacity. (all adults >18 are assumed to have capacity)
- A person is not to be treated as unable to make a decision unless all practicable steps to help him to do so have been taken without success.
- A person is not to be treated as unable to make a decision merely
because he makes an** unwise decision.** - An act done, or decision made, under this Act for or on behalf of a
person who lacks capacity must be done, or made, in his best interests. - We should act in the** way that is less restrictive **of the person’s rights and freedom of action.
What is the Stage 1 of the 2-stage test of capacity?
- Stage 1: Does the person have an impairment of, or a disturbance in the
functioning of, their mind or brain?
Stage 1 requires proof that the person has an impairment of the mind or brain. If a person does not have such an impairment or disturbance of the mind or brain, they will not lack capacity under the Act.
e.g. - conditions associated with some forms of mental illness
- dementia
- significant learning disabilities
- the long-term effects of brain damage
- physical or medical conditions that cause confusion, drowsiness or loss of consciousness
- delirium
- concussion following a head injury
- symptoms of alcohol or drug use.
What is stage 2 of the 2-stage test of capacity?
Stage 2: Does the impairment or disturbance mean that the person is unable to make a specific decision when they need to?
A person is unable to make a decision if they cannot do any of the following:
1. Understand the relevant information
2. Retain that information long enough to make the decision
3. use or weigh that information
4. Communicate the decision by any means.
At what age can children (in law a minor is age <18) consent to treatments?
- Age 16-18 consent can be gained from the parent or child. Consent from the child is valid, and it is not necessary to obtain consent from the parent/guardian.
- Children <16 may be competent “Gillick Competent” to consent to treatments.
- a competent child can understand the nature, purpose, possible consequences of proceeding or not proceeding with a treatment.
- they can therefore consent to treatment
- however if they refuse treatment, a parent or court can authorize procedures in their best interests. (they do not have this power to overule a competent child in Scotland)
- Children <16 who are not competent - only those with parental responsibility can authorise/refuse treatments.
What are the Fraser Guidelines for giving contraception to the under 16s?
- A doctor can give contraceptive advice and treatment to a girl aged <16 without parental consent if it is in her best interests that contraceptive advice /treatment is given AND she:
- is mature enough to understand moral, social and emotional implications
- cannot be persuaded to inform her parents/carers
- is likely to begin /continue intercourse with or without contraception
- is likely to suffer (mental/physical) if no contraceptive is given
What are the Caldicott principles for disclosure of patient information?
- disclosure should be relevant, purposeful, necessary
- use the minimum patient idetifiable information
- access on a strict ‘need-to-know’ basis.
What is the age of sexual consent in the UK and when should the police be informed?
- Age 16
- There is no intention to prosecute if age <16, where both agree, consent, and similar age.
- Sex with a child age <13 is rape and must be reported
- Offence if a person >=18 has any sexual activity with a person <18 if the older person holds a position of TRUST e.g a teacher.
What does this symbol mean?
Controlled Drug Schedule 1
What does this symbol mean?
Prescription only medicine
What does this symbol mean?
pharmacy only medicine
What does this symbol mean?
- Newly licenced drug under special monitoring.
- The MHRA requests that all suspected adverse reactions should be reported
What is the exclusion time for scabies?
Can return after first treatment.
