Surgery Admin Flashcards
You receive a call from a pharmacist. Your morphine script says 56 capsules in words but not in numbers. What is the best way to amend this?
Ask the pharmacist to amend
- Pharmacists can amend schedule 2 and 3 drugs if total quantity is missing one of either words or figures, providing that it is clear the pharmacist has amended
What is a DS1500 form?
The old name for the new SR1 form
(benefits at the end of life)
Your patient has expected less than 12 months to live, what should you advise them RE benefits?
Doctor should fill SR1 form in
If your doctor or a medical professional has told you that you might have 12 months or less to live, you might be able to:
- get benefits at a higher rate or get extra money
- start getting payments quicker than usual
How does an eligible patient gain a medical exemption certificate for diabetes and how long do they last?
Apply through the surgery on form - MEDEX form
We sign form
patient sends off and gets certificate
Usually last 5 years then need renewing
(Prescriptions free over 60 anyway)G
Give an example of 5 conditions covered by MEDEX exemption certificate for free prescriptions?
1) Permanent fistula (for example, caecostomy, colostomy, laryngostomy or ileostomy) which needs continuous surgical dressing or an appliance
2) Hypoadrenalism (for example, Addison’s Disease)
3) Diabetes insipidus and other forms of hypopituitarism
4) Diabetes mellitus, except where treatment is by diet alone
5) Hypoparathyroidism
6) Myasthenia gravis
7) Hypothyroidism which needs thyroid hormone replacement)
8) Epilepsy which needs continuous anticonvulsive therapy
9) Continuing physical disability - cannot go out without the help of another person
10) Cancer and are undergoing treatment for either (or for effects of tx)
What are the flying rules post MI?
Uncomplicated - not for 7 days
Complicated MI - not for 4-6 weeks
What are the flying rules post a) Open abdominal surgery b) Laproscopic abdominal surgery and c) Colonoscopy
a) 10 days
b) 24 hours
c) 24 hours
(Intestinal gas volume expands by up to 30% at 8000 feet)
What are the flying rules with plaster cast on?
Flights under 2 hours - 24 hours post cast
Flights over 2 hours - 48 hours post cast
What are the group 1 driving rules for a patient on a sulphonylurea drug?
(Risk of hypos)
Doesn’t need to inform DVLA as long as no more than 1 severe hypo in last 12 months and more than 3 months ago
What are the DVLA group one rules for driving post angioplasty?
1 week if successful angioplasty
4 weeks if MI and unsuccessful angioplasty
4 weeks for MI’s where no angioplasty done
What is allowed by section 2 of the MHA?
Compulsory admission for up to 28 days
What is allowed by section 3 of the MHA?
Compulsory admission for up to 6 months
What is allowed by section 4 of the MHA?
Compulsory admission for up to 72 hours
What is section 136 of the mental health act?
llows police to take people from a public place to a place of safety
What are the 5 ‘schedules’ of drugs?
Schedule 1 - Not used medically (LSD etc)
Schedule 2 - Full controlled drugs (opiates, methodone etc)
Schedule 3- CD’s like diazepam, tramadol etc
Schedule 4- Minimal control CD’s (Zopiclone)
Schedule 5- Low strength CD’s (Codeine, low dose morphone)
What are the general fitness to fly rules in pregnancy?
Single pregnancy - Should not fly after 36 weeks
Multiple pregnancy - Should not fly after 32 weeks
What are the DVLA driving rules for:
a) Established epilepsy
b) First seizure
a) 12 months fit free to be able to drive again
b) After first seizure must surrender license, can apply again when seizure free for 6 months (as long as complication free)
What are the DVLA driving rules for:
a) Stroke/ TIA
b) Multiple TIA’s
c) Narcolepsy/ cataplexy
a) 1 month off
b) 3 months off
c) Stop driving, restart when good symptom control
What groups of patients are entitled to free prescriptions? (5)
Children < 16
Age 16/17/18 if in full time education
Age 60 or over
Medical exemption
If on income support/ jobseekers
What is a PPC for prescriptions?
Pre-payment certificate
For those not entitled to free prescriptions
Works out cheapest if pays for more than 11 prescriptions per year
What is Roger Neighbor’s five point checklist for a GP consultation?
Connecting, summarizing
handing over
safety netting housekeeping
The MHA 2007 requires two doctors and an approved mental health professional when arranging compulsory admissions. Who can’t act as an approved mental health professional?
Registered medical practitioner (Doctors)
AMHPs are mental health professionals who have been approved by a local social services authority to carry out certain duties under the Mental Health Act - can be nurses, social workers, OT’s, psychologists etc.
What is a super partnership?
As a business model, a super partnership
describes a situation where multiple practices have agreed to merge and/or work together
whilst retaining the traditional partnership model.
The Equality Act 2010 defines a disabled person as ‘someone who has a physical or mental impairment which has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities’.
Which ONE of the following correctly defines ‘long-term’ (i.e. the duration of the effects of the impairment(s))?
The Equality Act 2010 defines ‘long term’ as being likely to last for at least 12 months
At what stage of pregnancy can a doctor or registered midwife issue a maternity certificate?
It’s important to note that MAT B1s are issued not more than 20 weeks before the expected week of confinement.
When should antenatal screening for haemoglobinopathies take place antenatally? How is a definitive diagnosis made if screening is positive?
Ideally before 10 weeks
Amniocentesis is used to make a definitive diagnosis if screening tests prove positive
Who can report a drug on the yellow card scheme?
Health professionals and patients
What type of treatments can be reported on the yellow card scheme?
All medicines including:
- vaccines
- blood factors and immunoglobulins
- herbal medicines
- homeopathic remedies
- All medical devices
- Nicotine containing e-cigarettes
In what circumstances can the medical records be ammended?
To correct incorrect factual information only
Which of the following has shown evidence for improving patient understanding of info given in consultations?
‘Ask me three’ technique / ‘SPIKES’ technique / Calgary–Cambridge model / ‘Elicit-provide-elicit’ technique / Active listening
‘Ask me three’ technique
Name 4 documents/ logistical aspects that you need to consider when a patient is coming towards end of life?
DNACPR - Can have review date or no review date
Statment of intent - lasts 28 days
Drug authorization form - For anticipatory meds
EMIS prescription of above meds
The Advisory Committee on Borderline Substances (ACBS) advises as to the circumstances in which some foods and toilet preparations may be regarded as drugs. When may suncream be prescribed?
SPF 50 and over only
if abnormal photosensativity
(i.e. vitiligo and those resulting from radiotherapy)
Under the yellow card scheme - what can you make a report for? (Name at leat 5)
Any medicine, vaccine, blood factors, immunoglobulin, complementary medicine
All medical devices
Fake or counterfit medicines
Nicotine containing cigarettes and e-liquids
What is the ‘black triangle’ with regards to drugs?
A system to identify medicines being monitored more closely (usually because they are new)
A 36-year-old man from Nigeria is in the UK for business. Prior to returning home he has developed groin pain which you confirm is consistent with an uncomfortable but reducible right indirect inguinal hernia.
Which is the SINGLE MOST appropriate NHS body to decide whether he is eligible for a hernia repair in the UK?
The secondary care provider
In UK all primary care is free. All secondary care is on a residence basis and the legal duty to assess eligability sits with the secondary care organisation who will provide the care (most hospitals have a team for this)
Who makes the final decision on a patient’s fitness to fly? What are the rules around letters for this?
Airline makes final decision
Pt’s often request letters- this is outside of NHS remit and is chargable/ private service
What is the difference berween primary, secondary and tertiary prevention?
Primary - Stop a disease happening (vaccines, bisphonates if on steroids)
Secondary - Detect and/ or treat pre-symptomatic disease (Childhood surveilance
Tertiary - Reduce morbidity from existing issues (pulmonary rehab, epilepsy checks)
Drug users should be advised to get which vaccinations?
Hep A and B
Tetanus
Some also recommend annual flu
Who is eligable for a pneumoccal vaccine, what type is given to adults?
Pneumococcal polysaccharide vaccine (PPV)
Anyone over 65
Anyone with LTC
Who is eligeable for the shingles vaccine?
Healthy people aged 70 to 79 years who have not yet been vaccinated OR who turn 65 after 1st sept 2023
People aged 50 years and over with a severely weakened immune system
Eligable up to age 80
What are exercise guidance for adults in the UK? (minimum)
Each week, adults should be encouraged to increase their level of physical activity to
- At least 150 minutes (2 1/2 hours) of moderate intensity activity (such as brisk walking or cycling);
- OR 75 minutes of vigorous intensity activity (such as running)
What is the AAA screening programme?
All men at age 65
If aorta <3cm never get called back, otherwise get followed up
Which form is used to register temporary patients, how long can they be registered for?
A GMS 3 or ‘temporary resident’ form is used to register patients temporarily in the practice area for medical services for up to three months.
What form is used to register patients at the surgery on a permenant basis?
GMS 1 form is used to register a patient on a permanent basis.
What is the role of a HSA1 form?
An HSA 1 form is used to certify requirements of termination of pregnancy
What is an RM7 form used for?
Now obselete since 2010
Previously used for sickness certification
What is a SAR? How long do the surgery have to respond?
Patients have a right to request access to their own medical records and can also provide consent for disclosure to third parties. This is called a SAR (subject access request)
Must be provided within 28 days of reciept
How does the equality act define long term with regard to disability?
The Equality Act 2010 defines ‘long term’ as being likely to last for at least 12 months.
What are the eligability criteria for carer’s allowance? (3)
- The carer must be aged 16 years or over, and spend at least 35 hours per week caring for a person
- Patient must be in reciept of attendance or disability living allowance
- Lived in UK 2 of last 3 years
(don’t need to live together)
What makes lasting power of attourney for health and welfare legally enforaceable?
Once registered with the Office of the Public Guardian
Two daughters with lasting power of attourney for their 74 year old father (who doesn’t have capacity) disagree on an emergency decision. Who should make the final decision?
The Court of Protection (for emergency application out of hours)
Daughters have power of attourney so are decision makers, but if don’t agree go to court
What is the maximum amount of shared parental leave allowed, split between partners?
Share up to 50 weeks of leave and up to 37 weeks of pay
