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
Q

What are essential services?

A

Ones that all practices must provide

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26
Q

What are examples of essential services?

A

Management of unwell patients

Chronic disease management

Palliative care

Health promotion

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27
Q

What are additional services?

A

All practices are expected to provide these but can opt out

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28
Q

What are examples of additional services?

A

Contraception

Childhood immunisation

Cervical screening

Maternal services

Child health surveillance

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29
Q

What are enhanced services?

A

Ones commisioned locally by the NHS board on the basis of patient need

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30
Q

What are examples of enhanced services?

A

Specialised sexual health services

Minor surgery

Care of MS patients

Anticipatory care plans

Polypharmacy reviews

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31
Q

Where does a general practices income come from?

A

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

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32
Q

What is the global sum proportionate to?

A

Number of patients and their ages

33
Q

What are things that a practices income is used to pay for?

A

Premises

Staff wages

Insurance

Utility bills

Indemnity for staff

Drugs (not prescriptions)

Blood tubes and needles

34
Q

What happens to the left over money after outgoings have been paid for?

A

GP partners get paid an agreed percentage of what is left

35
Q

Who are beds in community hospitals run by?

A

Local practice

36
Q

What do community hospitals act as?

A

Rehabillitation between acute care and home

37
Q

What kinds of things might community hospitals have?

A

Minor injury units or daytime casualty units

Consultants inpur from care of the eldery

Additional diagnostic facilities such as X-ray and ultrasound

38
Q

What do some rural practices do in regards to medicine?

A

Dispense their own, one of their staff is trained up to be a despenser

39
Q

What does HSCP stand for?

A

Health and Social Care Partnership

40
Q

What are Health and Social Care Partnership (HSCP) involved with?

A

Strategic planning of care based on local needs and delivering service to patients

41
Q

Who are Health and Social Care Parternships led by?

A

Integrated Joint Boards

42
Q

Who composed Integrated Joint Boards?

A

Health and social care members

43
Q

What does OOH stand for?

A

Out of hours

44
Q

When is out of hours primary care?

A

From 6pm to 8am Monday to Friday

From 6pm Friday to 8am Monday

45
Q

How many hours a week are out of hours?

A

118

46
Q

How do patients access care out of hours?

A

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
Q

What is the timescale of out of hours services?

A

1, 2 or 4 hours

48
Q

What are the primary care emegency centres out of hours team composed of?

A

General practitioners and nurse practitioners

49
Q

What happens to OOH notes?

A

Passed back electronically in the morning to the practice, handovers are essential for good patient care

50
Q

Who does the primary care healthcare team consist of?

A

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
Q

What is the practice manager responsible for?

A

Human recources

Finance

Health and safety

Contract management

Medical rota

52
Q

Why are practice managers used?

A

Frees up GPs time for patient care

53
Q

What do administrative, clerical and reception staff do?

A

Make appointments and deal with phone calls

54
Q

What additional things can practice nurses do?

A

Undergo additional training in management of things like asthma, COPD, hypertension and diabetes

Trained as non-medical prescribers

55
Q

What do healthcare assistants and phlebotomists do?

A

Routine work such as BP checks, ECGs, new patient health checks and data collection

56
Q

Who are district nurses employed by?

A

Health board rather than the practice

57
Q

What do district nurses do?

A

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
Q

How do you qualify as a health visitor?

A

Qualify as a registered nurse or midwife and then take an approved programme in specialist community public health nursing

59
Q

What do health visitors do?

A

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
Q

What training do Macmillan nurses have?

A

Registered nurse with 5 years experience, including 2 or more in cancer or palliative care

61
Q

Who are Macmillan nurses employed by?

A

NHS with post funded by Macmillan for a set time, usually the first 3 years

62
Q

What do Macmillan nurses do?

A

Work in hospitals and the community

Caseload management

Advisory consultancy

Education and research

63
Q

Where do community midwives work?

A

Across geographic area rather than attached to specific practices

64
Q

Who are community nurses the first point of contact for?

A

Any women who is pregnant

65
Q

What does CPN stand for?

A

Community psychiatric nurse

66
Q

What do community psychiatric nurses work within?

A

Community Mental Health Team (CMHT)

67
Q

What does CMHT stand for?

A

Community mental health team

68
Q

Who are members of the community mental health team?

A

Community psychiatric nurse

Consultant psychiatrist

Junior medical staff

Social work

Psychologist

69
Q

What do community psychiatric nurses do?

A

Assessment of patients

Monitoring compliance

Counselling

70
Q

What does CPNA stand for?

A

Specialist Substance Misuse Nursing

71
Q

What do specialist sibstance misuse nursing do?

A

Work with adults with drug and alcohol problems

72
Q

What do primary care mental health worker service do?

A

Available for patients who would benefit from additional input with the management of anxiety and depression

73
Q

What contract do community pharmacists work within?

A

Community pharmacist contract

74
Q

What are the 4 core areas of the community pharmacist contract?

A

Minor ailments service

Chronic medication service

Acute medication service

Public health service

75
Q

What do practice pharmacists do?

A

Ensure medicine is safe, appropriate and cost effective

Advices on stock control and drug storage practice

76
Q

Who are physiotherpists employed by?

A

NHS rather than practice

77
Q

What does OT stand for?

A

Occupational therapy

78
Q

What do occupational therapists do?

A

Concerned with the assessment and treatment of individuals with physical, mental or social problems

79
Q

What do social work and home care do?

A

Form relationships with people and assist them to live more successfully within their local communities by helping them to find solutions to their problems