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Flashcards in The Team Around the Patient Deck (49)
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1

GPs play what role?

GPs play a role as ‘gatekeepers’ to secondary healthcare as well as managing many health problems within primary healthcar

2

What does PHCT stand for?

Primary health care team

3

Who does the traditional primary health care team consist of?

  • GP partners
  • GP assistants and other salaried doctors
  • GP registrars
  • Practice nurses
  • Practice managers
  • Receptionists
  • Community nurses
    • District nurses
    • Macmillan nurse
  • Midwives
  • Health visitors
  • Nurse practitioners
  • Allied health professionals
    • Physiotherapist
    • Occupational therapy
    • Dietetics
    • Podiatry
    • Pharmacist
    • Counselling
  • Care manager
  • Complimentary therapists
    • Acupuncture
    • Homeopathy
  • Social services
    • Social workers
    • Health care workers
  • Health promotion
    • Gyms
    • Education

4

What are examples of community nurses?

District nurse

Macmillan nurse

5

Where do district nurses visit patients?

There own homes

6

What are Macmilllan nurses specialists in?

  • Specialise in cancer and palliative care, giving support to people with cancer

7

What do Macmillan nurses offer?

  • Specialised pain and symptoms control
  • Emotional support both for patient and family
  • Care in a variety of settings (hospital, home or local clinic)
  • Information about cancer treatments and side effects
  • Advice to other team members of the caring team
  • Co-ordinate care between hospital and the patient’s home
  • Advice on other forms of support, including financial help

8

Who do midwives provide care to?

  • Provides care during all stages of pregnancy, labour and early postnatal care

9

What do health visitors do?

  • Lead and deliver child and family health services (pregnancy though to 5 years)
  • Provide ongoing additional services for vulnerable children
  • Contribute to MDT services in safeguarding and protecting children

10

What ages do health visitors care for?

Pregnancy through to 5 years

11

What are examples of allied health professionals?

Physiotherapist

Occupational therapy

Dietetics

Podiatry

Pharmacist

Counselling

12

What do physiotherapists do?

  • Teat people with physical problems caused by illness, accident or ageing
  • Identify and maximise movement through health promotion, preventative healthcare, treatment and rehabilitation

13

What are some core skills of physiotherapists?

  • Manual therapy
  • Therapeutic exercise
  • Application of electro-physical modalities

14

What do occupational therapists do?

  • Assessment and treatment of physical and psychiatric conditions using specific activity to prevent disability and promote independent functions in all aspects of daily life
  • Work with people of all ages to overcome effects of disability caused by physical or psychological illness, ageing or an accident

15

Who do occupational therapists typically care for?

  • Can work with young children, adolescents, adults and other people in these areas
    • Physical rehabilitation
    • Mental health services
    • Learning disability
    • Primary care
    • Paediatrics
    • Environmental adaptation
    • Care management
    • Equipment for daily living

16

What do dietetics do?

  • Communication of nutritional science to enable people to make informed choices about their food and lifestyle in health and disease

17

Who are most dietetics employed by?

  • Most are employed by the HS but some work in the food industry, education, research and on freelance basis

18

What are some responsibilities of dietetics?

  • Working with people with special dietary needs
  • Informing the general public about nutrition
  • Offering unbiased advice
  • Evaluating and improving treatments
  • Educating patients/clients and other healthcare professionals and community groups

19

Where can pharmacists work?

  • Work in hospital, community or primary care pharmacy

20

What do pharmacists do?

  • Expert on medicines and there uses
  • Advice medical and nursing staff on selection of appropriate use of medicines
  • Prove information to patients on how to manage their medicines
  • Can undertake additional training to allow them to prescribe medicines for specific conditions

21

What do care managers do?

  • Experts in working with individuals to identify their goals and locate the specific support services that enhance well  being
  • Are highly trained social workers who work with patients to advice on social and financial support services

22

What are examples of complimentary therapists?

  • Acupuncture
  • Homeopathy

23

What are examples of roles in social services?

  • Social workers
  • Social care workers

24

What kind of contract do most GPs have?

Most GPs are independent contractors to the NHS, so are responsible for providing adequate premises from which to practice and employ other staff

25

What kind of nurse is found in GPs?

Practice nurses

26

What are some roles of practice nurses?

  • Obtaining blood samples
  • ECGs
  • Minor and complex wound management including leg ulcers
  • Travel health advice and vaccinations
  • Child immunisations and advice
  • Family planning and woman’s health including cervical smears
  • Men’s health screening
  • Sexual health services
  • Smoking cessation

27

Changes affect what aspects of the PHCT?

  • Which professional groups are part of the PHCT
  • Which groups wok alongside the PHCT
  • Working relations between these different professional groups

28

What are some examples of things that can cause changes to the PHCT?

  • Economic factors
    • Big impact on development of healthcare premises, which affects PHCT beause
      • 60% of primary healthcare premises are still owned by GPs
      • Many existing premises are too small or unfit for purpose and growing numbers of new GPs needs accommodated
      • Trend, moving away from small doctor owned practices towards private company owned large buildings that can offer wider ranges of services
        • Introduction of new servives
  • Political pressure
    • Political pressures to
      • Reduce the cost of treatments
      • Provide more treatment closer to where patients live
  • Development of new and extended professional roles
    • Development of healthcare assistants
    • Extended role of pharmacists
    • Develop of nurse prescribing and triage
  • Growing number of ageing patients
    • More long term conditions (largely managed in primary care)
    • Greater demand for healthcare generally (managed largely in primary care)

29

What is the current trend in relation to GPs premises?

Moving away from small doctor owned practices towards private company owned large buildings that can offer a range of services

30

What are the political pressures that impacts the PHCT?

  • Reduce the cost of treatments
  • Provide more treatment closer to where patients live

31

What are examples of development of new and extended professional roles?

  • Development of healthcare assistants
  • Extended role of pharmacists
  • Develop of nurse prescribing and triage

32

What are complications of growing numbers of ageing patients?

  • More long term conditions (largely managed in primary care)
  • Greater demand for healthcare generally (managed largely in primary care)

33

What are the principles of good teamworking described by?

Forum on Teamworking in Primary Healthcare

34

What is the Forum on Teamworking in Primary Healthcare?

Forum on Teamworking in Primary Healthcare was convenes as result of joint initiative between Royal Pharmaceutical Society, the BMA, Royal College of Nursing, the National Pharmaceutical Association and the Royal College of General Practitioners

35

What groups of people came together to create the Forum on Teamworking in Primary Healthcare?

Royal pharmaceutical society

BMA

Royal College of Nursing

National Pharmaceutical Association

Royal College of General Practitioners

36

What are the recommendations from the Forum on Teamworking in Primary Healthcare to establish a successful PHCT?

  • Recognise and include the patient, carer or their representative as an essential member of the primary healthcare team
  • Establish a common agreed purpose (share understanding of team working)
  • Agree set objectives and monitor towards them
  • Agree teamworking conditions, including a process for resolving conflict
  • Ensure that each team member understands and acknowledges the skills and knowledge of team colleagues
  • Pay particular attention to importance of communication between its members, including the patient
  • Take active steps to ensure that the practice population understands and accepts the way in which the team works within the community
  • Select the leader of the team for his or her leadership skills (rather than basis of status, hierarchy or availability) and include in the membership of the team all the relevant professions serving a practice population
  • Promote teamwork across health and social care
  • Evaluate all its teamworking initiatives on the basis of sound evidence
  • Ensure that the sharing of patient information within the team is in accordance with current legal and professional requirements
  • Take active steps to facilitates inter-professional collaboration and undertaking through joint conferences, education and training initiatives
  • Be are of other measures involving national organisations, educational measures, research and general guidance which impact on teamworking

37

What people who are not 'professionals' are considered to be apart of the PHCT?

Patient

Carers

38

What programme has the government recently lauched to simplify care?

Program to integrate health and social care

39

What is the PHCT often now refered to as a result of merging health and social care?

Multi-professional or the Health and Social Care Team

40

What is the aim of the health and social care team?

  • Aim of integration is to reduce unnecessary admissions to hospital and delayed discharges
  • Integration is more efficient and effective use of limited recourses to improve outcomes for patients

41

The plan to integrate health and social care is underwritten in what law?

  • This plan is within The Public Bodies (Joint Working) Act 2014

42

What are the goals of The Public Bodies (Joint Working) Act 2014?

  • Improve quality and consistency of services for patients
  • Provide seamless, joined up quality health and social care services to care for people in their homes or a homely setting
  • Ensure recourses are used effectively to deliver services that meet the increasing number of people with longer term and often complex needs
  • Created a number of new organisations known as integration authorities that act to break down barriers between NHS boards and local authorities
    • Places requirement on both to integrate health and social care budgets, governance, planning and resources of adult social care, adult primary care and community health services and some hospital services
  • Intended to achieve the National Health and Wellbeing Outcomes by Scottish government

43

What do integration authorities act as?

  • Act to break down barriers between NHS boards and local authorities

44

Integration authorities place requirements on both NHS boards and local authorities to do what?

  • Places requirement on both to integrate health and social care budgets, governance, planning and resources of adult social care, adult primary care and community health services and some hospital services

45

The Public Bodies (Joint Working) Act 2014 is intended to achieve what?

  • Intended to achieve the National Health and Wellbeing Outcomes by Scottish government

46

What are the 2 ways to set out a framework for creating integration authorities

Integrated joint board (body corporate) model

Lead agency model

47

What does IJB stand for?

Integrated joint board

48

Describe the integrated joint board (body corporate) model to create integration authorities?

  • Integration Joint  Board (IJB) set up and the NHS board and local authorities delegate the responsibility for planning and resourcing services for delegated adult health and social care services to the IJB
  • NHS boards and local authorities delegate budgets to the IJB which then decides how to use the resources
  • Number of representatives on IJB from local authority and NHS board is specified in the integration scheme
    • Must nominate at least 3 members each but may nominate more as long as the same number is nominated by each group
      • Local authorities nominate councillors and the NHS board will nominate non-executive directors
      • Must also include a carer representative, GP representative, nurse representative, secondary medical care practitioner, service user representative, staff-side representative, third sector representative, an officer responsible for financial administration, the chief officer and the chief social worker

49

How is the people on the IJB determined?

  • Number of representatives on IJB from local authority and NHS board is specified in the integration scheme
    • Must nominate at least 3 members each but may nominate more as long as the same number is nominated by each group
      • Local authorities nominate councillors and the NHS board will nominate non-executive directors
      • Must also include a carer representative, GP representative, nurse representative, secondary medical care practitioner, service user representative, staff-side representative, third sector representative, an officer responsible for financial administration, the chief officer and the chief social worker