Practice Management Flashcards
Which form is used to register patients permanently?
GMS1
Which form is used to register patients temporarily
GMS3
When a patient submits a request for access to their health records (or gives consent for a 3rd party e.g solicitor to have access to their health records on their behalf) how long does the practice have to supply the information?
28 days
What are the eligibility criteria to apply for Industrial injuries disablement benefit for occupational deafness?
Hearing loss must be *sensorineural hearing loss of at least 50db bilaterally * be related to occupational exposure in at least one ear and * the average of losses at 1, 2 and 3 kHz frequencies (main speech frequencies)
How many weeks of combined leave and pay are parents entitled to under Shared Parental Leave?
Shared parental leave (SPL)
= entitled to upto a combined total of 50 weeks of leave and upto 37 weeks of pay
This leave and pay can be shared between parents in the first year of a child’s life (biological, surrogate, adopted or fostered)
If the parents choose to take shared parental leave, then the amount taken must be deducted from the woman’s maternity leave and pay
(Woman is entitled to 52 weeks of maternity leave and 39 weeks of maternity pay / maternity allowance)
What is the minimum mandatory maternity leave that a woman MUST take after having a baby?
Must take at least 2 weeks off (or 4 weeks off if working in a factory)
For how long is a woman entitled to statutory maternity pay and how much does she receive?
Statutory maternity pay = paid for 39 weeks. Must have been in continuous employment with your employer for at least 26 weeks prior to the 15th week before the baby is due.
Initial 6 weeks is 90% of your weekly earnings, and then £184 per week or 90% of your weekly earnings (whichever is lower) for the remaining 33 weeks
If not eligible for SMP, then may be eligible for maternity allowance
For how long is a woman entitled to statutory maternity leave?
52 weeks
Which are the 8 conditions that should be reported as occupational diseases to the The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR)?
Occupational dermatitis
Occupational Asthma
Occupational cancer
Cramps of the forearm or hand
Carpal tunnel syndrome
Hand arm vibration syndrome
Tendonitis or tenosynovitis
Exposure to biological agent
What changes did the 2022 Health and Care Act make to the death certification process?
It made mandatory that any cause of death could only be reported after either scrutiny by a medical examiner or investigation by a coroner?
Applies to England and Wales
What is the role of the medical examiner?
Medical examiner should scrutinise every death that is not investigated by the coroner - their role is to answer 3 questions:
1. What caused the death of the deceased
2. Does the coroner need to be notified of the death
3. Was the care before death appropriate
They should answer these Qs by reviewing the medical notes, interacting with bereaved relatives and the doctor who completed the Medical Certificate of Death (MCCD). The doctor should send the provisional MCCD to the ME to confirm they are happy, in which case the MCCD can be sent electronically to the ME who will send it to the registrar’s office. The death must then be registered within 5 days of the registrar receiving the MCCD.
The death can be registered by a relative or by anyone that was there at the time of the death
Medical examiners can be GPs that have undergone further training. They must have had at least 5x years of full GMC training
If MEs identify an issue with care before death they should normally raise this with the GP practice directly
Who are medical examiner officers and what is their role?
Medical examiner officers assist medical officers by liaising with bereaved relatives and obtaining the medical notes
What are the criteria needed for the doctor that signs the medical certificate of cause of death?
Any doctor who knows the cause of death and has EVER seen the patient in their lifetime can complete the MCCD
(Medical examiners can complete the MCCD but this would only be in exceptional circumstances e.g if no doctor that knows the patient available)
(definition of having ‘seen’ the patient includes video consultations but NOT telephone consultations)
MCCD can be completed by GP registrars OR F2s
They do NOT have to have seen the patient in the last 28 days of life
They do NOT have to have seen the patient in their final illness
What new additions to the MCCD were added with the new regulations in Sep 2024.
Now the MCCD a 1d line (for further antecedents to death), ethnicity, if pregnant or if within 1 year postpartum, presence of hazardous medical devices eg pacemakers
There is also no more cremation form 4 - the GP doesn’t need to have physically seen the body so long as someone verified the death
What rules are present for when filling out cause of death in the MCCD?
No abbreviations
As specific as possible (e.g include site and histolgoy of cancer if known)
Frailty of old age is allowed if > 80
Cannot write probable or possible
Them mode of dying e.g cachexia or cardiac arrest can be in 1a but ONLY if supported by an underlying cause of death in the further sections in 1
Organ failure CANNOT be used independently as 1a with the exceptions of congestive cardiac failure, heart failure or cardiac failure which are classed as medical conditions and so can be used alone if needed
Under what circumstances should the GP refer directly to the coroner?
- Anyone in custody / state detention
- Death related to poisoning or intake of a toxic substance or non-toxic substance taken in excess e.g salt
- Death related to trauma violence or injury self-harm or self-neglect
- Death related to a medical procedure
- An injury or death related to current or past employment at any time
- Cause of death is unknown or agreement cannot be reached between GP and ME
- Identify of the patient is unknown
- other unnatural circumstances
True or false - patients and relatives cannot opt out of medical examiners getting access to their notes?
True
There is no option to opt out of MEs or coroners accessing the medical notes of dead patients
According to the Working Times Regulations, how many hours consecutive rest are employers entitled to between working days?
11 hours
According to the working times regulations, how long a break are employers entitled to if they work a shift longer than 6 hours?
20 minutes
According to the working times regulations, what is the maximum average number of hours per week that an employer can be REQUIRED to work?
48 hours on average per week
(they can elect to work more)
According to the NHS England Standard GMS Contract, what is the threshold at which gifts should be recorded in a register?
Gifts worth £100 or more must be recorded
Which form can be filled out by the GP to expedite a patient’s application for disability benefits - PIP (if 16-65) of Attendance Allowance (if > 65) - if they are terminally ill with a life expectancy less than 12 months?
An SR1 form
What is the definition of a young carer?
A person 18 or under whose life is affected by looking after someone with a disability or a long-term illness.
How long after an adverse event may a patient make a formal complaint?
Within 12 months of the adverse event OR within 12 months of them becoming aware of the adverse event
After receiving a formal complaint, how long does the practice have to acknowledge the complaint by letter or telephone?
3 days
How long after a patient requests access to their records must the records be provided to them?
Within 28 days
According to the UK Civil Aviation Authority, which patients would require consideration for in flight oxygen on a commercial flight?
Use of 02 at ground level
Sickle cell anaemia
Congenital cyanotic heart disease
Class III or IV angina on the Canadian Cardiovascular Society scale
NYHA class III or IV congestive heart failure
Primary pulmonary hypertension
Can normally contact the airline to arrange 02 - may be a charge associated with this
The single, most practical, fitness to fly test, which has stood the test of time, is to assess whether the patient can walk 50 yards/metres at a normal pace or climb one flight of stairs without severe dyspnoea. If this can be accomplished, it is likely that the patient will tolerate the normal aircraft environment.
Which cardiovascular conditions are contraindicated to fly on a commercial flight?
MI (uncomplicated: 7 days, complicated: 4-6 wks)
CABG: 10 days
Stroke: 2 weeks
TIA: 2 days
Unstable angina
Decompensated congestive heart failure
Uncontrolled HTN
Uncontrolled cardiac arrhythmia
Severe symptomatic heart valve disease
Hb below which level should get special medical assessment prior to flying on a commercial flight?
Hb < 7.5 should have medical assessment before flight is allowed and supplemental oxygen may be required
Note those with sickle cell anaemia should travel with supplementary oxygen and should wait 10 DAYS after a sickling crisis before flying
What are the UK Civil Aviation Authority’s guidelines on flying during pregnancy?
A doctors note is required after 28 wks to report that the pregnancy is progressing normally and EDD
Singleton pregnancy - cannot travel beyond 36 weeks
Multiple pregnancy - cannot travel beyond 32 weeks
How long after a pneumothorax should a patient wait before flying?
Must wait at least 2 weeks
Pneumothorax is an ABSOLUTE contraindication to flying
According to the UK Aviation Authority, how long after surgery must the patient wait before flying?
Open abdominal surgery - 10 days
Neurosurgical interventions - 7 days
Colonoscopy or laparoscopy (where gas introduced, which could expand) - 24 hours
Intraocular procedures that involve the intraocular injection of gas: must wait 2 wks if sulphur hexfluoride or 6 weeks of perfluoropropane. For other penetrating eye injuries or intraocular procedures must wait 7 days
After orthopaedic fracture with application of a plaster cast - must wait 24 hours for flights < 2 hours or 48 hrs for flights > 2 hrs
For how long after a seizure must patients wait before flying?
24 hrs
(Any patient with uncontrolled epilepsy or new onset of seizures should get medical clearance before flying)
What is attendance allowance for?
Attendance allowance is a tax-free benefit for those over the state pension age (currently 66) who needs extra money to help with personal care due to a physical or mental disability severe enough to necessitate extra care
What does the Access to Health Records Act 1990 pertain to?
Access to Health Records Act 1990 allows for a deceased patient’s personal representative (or other person who may have a claim arising from that person’s death) to request medical information on a deceased patient.
The BMA that advices that ONLY information directly pertinent to the claim is disclosed, and no additional information
What does the Access to Medical Reports Act 1988 pertain to?
It grants patients the right to request access to any medical reports written about them for insurance or employment purposes.
They may request to see the report before it is supplied to the employer./ insurance complany and for UPTO 6 MONTHS AFTER
What does the data protection act 1998 pertain to?
It allows patients to request access to their health records, regardless of how historic they are.
What does the freedom of information act 2000 pertain to?
Freedom of information act gives individuals the right to request recorded information held by public authorities, including GP surgeries
This is in relation to general information held by the practice NOT personal health information (which is covered under the Data Protection Act)
What is the name for the criteria that defines the criteria for screening programmes?
Wilson-Jungner criteria
