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Handbook for General Practice Flashcards

1
Q

What is the first point of contact for most people to access healthcare?

A

Primary care

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2
Q

What two specialties deal with patients who are unsorted?

A

Primary care

Accident and emergency

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3
Q

What do GPs act as?

A

Gatekeeper, assessing patient patients and referring selected ones onto secondary services

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4
Q

What medical college oversees GP training?

A

Royal College of General Practitioner

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5
Q

What is the Royal College of General Practitioners?

A

Medical college responsible for overseeing GP training

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6
Q

What the 5 areas of capability set out by the RCGP?

A

1) Knowing yourself and relating to others
2) Applying clinical knowledge and skill
3) Managing complex and long term care
4) Working well in organisations and systems of care
5) Caring for the whole person and the wider community

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7
Q

What does RCGP stand for?

A

Royal College of General Practitioners

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8
Q

What aspects are undering ‘knowning yourself and relating to others’?

A

Medical ethics

Fitness to practice

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9
Q

What aspects are under ‘applying clinical knowledge and skill’?

A

Data gathering and interpretation

Decision making and management

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10
Q

What aspects are under ‘managing complex and long term care’?

A

Working in a team to ensure optimal care

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11
Q

What aspects are under ‘working well in organisations and systems of care’?

A

Leadership and organisation skills

Personal learning, teaching and competence

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12
Q

What aspects are under ‘caring for the whole person and wider community’?

A

Holistic approach to patients

Building relationships with the community

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13
Q

What are 3 general essential features of you as a doctor?

A

Contextual features

Attitudinal features

Scientific features

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14
Q

What are contextual features?

A

Understanding own context as a doctor and how it may influence the quality of your care

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15
Q

What are attitudinal features?

A

Personal capabilities, values, feelings and ethics

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16
Q

What are important factors for contextual features of a doctor?

A

Environment you work

Community

Culture

Financial and regulatory frameworks

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17
Q

What are scientific features?

A

Need to adopt a critical and evidence based approach to your work

Lifelong learning

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18
Q

When does applications for GP training take place?

A

FY2

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19
Q

How long is GP training?

A

3 years of specialty training

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20
Q

What do GPs have to undertake each year to keep their lisence?

A

Annual appraisal with an external GP appraiser

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21
Q

What do GPs have to undertake each 5 years to keep their lisence?

A

Revalidation

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22
Q

How often does revalidation of GPs take place?

A

Every 5 years

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23
Q

How is general practice also an academic specialty?

A

Some people will wngage in active research based in primary care

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24
Q

What are the 3 categories of the services provided by GPs?

A

Essential services

Additional services

Enhanced services

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25
What are essential services?
Ones that all practices must provide
26
What are examples of essential services?
Management of unwell patients Chronic disease management Palliative care Health promotion
27
What are additional services?
All practices are expected to provide these but can opt out
28
What are examples of additional services?
Contraception Childhood immunisation Cervical screening Maternal services Child health surveillance
29
What are enhanced services?
Ones commisioned locally by the NHS board on the basis of patient need
30
What are examples of enhanced services?
Specialised sexual health services Minor surgery Care of MS patients Anticipatory care plans Polypharmacy reviews
31
Where does a general practices income come from?
Global sum (money from NHS board based on number of patients and their ages Quality payments for enhanced services Income from private work such as medicals and insurance forms Money to train GP trainees or FY doctors or even students
32
What is the global sum proportionate to?
Number of patients and their ages
33
What are things that a practices income is used to pay for?
Premises Staff wages Insurance Utility bills Indemnity for staff Drugs (not prescriptions) Blood tubes and needles
34
What happens to the left over money after outgoings have been paid for?
GP partners get paid an agreed percentage of what is left
35
Who are beds in community hospitals run by?
Local practice
36
What do community hospitals act as?
Rehabillitation between acute care and home
37
What kinds of things might community hospitals have?
Minor injury units or daytime casualty units Consultants inpur from care of the eldery Additional diagnostic facilities such as X-ray and ultrasound
38
What do some rural practices do in regards to medicine?
Dispense their own, one of their staff is trained up to be a despenser
39
What does HSCP stand for?
Health and Social Care Partnership
40
What are Health and Social Care Partnership (HSCP) involved with?
Strategic planning of care based on local needs and delivering service to patients
41
Who are Health and Social Care Parternships led by?
Integrated Joint Boards
42
Who composed Integrated Joint Boards?
Health and social care members
43
What does OOH stand for?
Out of hours
44
When is out of hours primary care?
From 6pm to 8am Monday to Friday From 6pm Friday to 8am Monday
45
How many hours a week are out of hours?
118
46
How do patients access care out of hours?
Phoning NHS24 where calls are triggered by a nurse practitioner using computerised flowcharts and models Patients are allocated an appointment, an advice call or a home visit in a timescale of 1, 2 or 4 hours Calls are passed to primary care emergency centres where the staff on duty may be a combination of GP and nurse practitioners
47
What is the timescale of out of hours services?
1, 2 or 4 hours
48
What are the primary care emegency centres out of hours team composed of?
General practitioners and nurse practitioners
49
What happens to OOH notes?
Passed back electronically in the morning to the practice, handovers are essential for good patient care
50
Who does the primary care healthcare team consist of?
Practice manager Administrative, clerical and reception staff Practice nurses Healthcare assistancts or phlebotomists District nurses Health visitor Macmillian nurse Community midwives Community psychiatric nurse (CPN) Specialist substance misuse nurse (CPNA) Primary care mental health worker service Community pharmacist Practice pharmacist Physiotherapist Occupational therapy (OT) Social work and home care
51
What is the practice manager responsible for?
Human recources Finance Health and safety Contract management Medical rota
52
Why are practice managers used?
Frees up GPs time for patient care
53
What do administrative, clerical and reception staff do?
Make appointments and deal with phone calls
54
What additional things can practice nurses do?
Undergo additional training in management of things like asthma, COPD, hypertension and diabetes Trained as non-medical prescribers
55
What do healthcare assistants and phlebotomists do?
Routine work such as BP checks, ECGs, new patient health checks and data collection
56
Who are district nurses employed by?
Health board rather than the practice
57
What do district nurses do?
Assess and meet the nursing needs of patients in the community Important role in palliative care going into patients home once or twice a day
58
How do you qualify as a health visitor?
Qualify as a registered nurse or midwife and then take an approved programme in specialist community public health nursing
59
What do health visitors do?
Work with parents to support their needs to give their child the best possible start in life, by giving information and visits Spot vulnerable familes and can enable parents to express their needs and decide what support they need, by referring families to specialists or arranging access to support groups Trained to recognise the signs of neglect and child abuse
60
What training do Macmillan nurses have?
Registered nurse with 5 years experience, including 2 or more in cancer or palliative care
61
Who are Macmillan nurses employed by?
NHS with post funded by Macmillan for a set time, usually the first 3 years
62
What do Macmillan nurses do?
Work in hospitals and the community Caseload management Advisory consultancy Education and research
63
Where do community midwives work?
Across geographic area rather than attached to specific practices
64
Who are community nurses the first point of contact for?
Any women who is pregnant
65
What does CPN stand for?
Community psychiatric nurse
66
What do community psychiatric nurses work within?
Community Mental Health Team (CMHT)
67
What does CMHT stand for?
Community mental health team
68
Who are members of the community mental health team?
Community psychiatric nurse Consultant psychiatrist Junior medical staff Social work Psychologist
69
What do community psychiatric nurses do?
Assessment of patients Monitoring compliance Counselling
70
What does CPNA stand for?
Specialist Substance Misuse Nursing
71
What do specialist sibstance misuse nursing do?
Work with adults with drug and alcohol problems
72
What do primary care mental health worker service do?
Available for patients who would benefit from additional input with the management of anxiety and depression
73
What contract do community pharmacists work within?
Community pharmacist contract
74
What are the 4 core areas of the community pharmacist contract?
Minor ailments service Chronic medication service Acute medication service Public health service
75
What do practice pharmacists do?
Ensure medicine is safe, appropriate and cost effective Advices on stock control and drug storage practice
76
Who are physiotherpists employed by?
NHS rather than practice
77
What does OT stand for?
Occupational therapy
78
What do occupational therapists do?
Concerned with the assessment and treatment of individuals with physical, mental or social problems
79
What do social work and home care do?
Form relationships with people and assist them to live more successfully within their local communities by helping them to find solutions to their problems

FoPC (21 decks)

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