We are aware that many HBs have contacted practices to state that all persons involved in performing spirometry and reading spirometry are to undertake specific ARTP accredited training in order to continue offering this service within general practice. This has come about following release of the All Wales Respiratory Plan.
Whilst we acknowledge the good intentions of the All Wales Respiratory Health Implementation Group’s efforts to improve respiratory care, we are concerned that the unintended consequences of these proposals have not been considered. As well as the ongoing actual monetary costs of ongoing training, the practical implications for these proposals on General Practice and actual contractual requirements for GPs with respect to spirometry assessments have not been fully appreciated or realised.
That aside, the following issues have come to our attention:
· To date, no clarity or evidence base has been provided to GPs to explain why practice nurses need to attend this specific training course. Therefore, at present, we fail to see the value or merit to this proposal, over and above what training general practice staff have already done.
· Whilst initial costs are intended to be met by Welsh Government/Local Health Boards, there has been no consideration for providing resources for the ongoing training, which we understand is required every 3 years, nor the costs of renewal of accreditation or essential backfill to cover practice staff undertaking training. From reviewing this course it appears to require attendance at a 2 day course followed by around 250 hours of coursework. We are aware that some HBs have offered to fund the fees of the 2 day course but not for time / locum backfill for this training.
· The GMS contract does not require practices to perform spirometry. It simply requires practices to ensure patients can access the investigation. Given that GPs are operating at critical capacity, if this decision is not reconsidered, there is a very real risk that practices will disinvest in performing spirometry and will simply refer all patients requiring this test to secondary care.
· In terms of continuity of care, the reality is that there will be an expectation that patients will have ongoing monitoring of spirometry changes undertaken within the practice. However, this will not be possible if all practices are required to have completed ARTP training.
We hope the above clarifies the national position and can confirm that at no point have GPC Wales been consulted. We have raised this with representatives of the All Wales Respiratory Plan and will be in touch once these discussions have been concluded.
Dr Charlotte Jones
LMC are to convene a meeting between members of the directorate, ABHUB primary care team staff and LMC this is following the discussion at LMC as reported last month.
We are keen to ascertain whether the current annual review letters from secondary care for the super six patients– cover the nine point holistic review of diabetic patients monitored by the audit office. The letters should include consideration of Blood pressure; Body mass index; Cholesterol; Creatinine; Eye screening; Foot examination; HbA1c level; Micro-albuminuria; Smoking advice)
To inform this meeting we are asking for any practices to forward information to LMC directly using the audit template on the website – even if only one - two patients per practice could be reviewed in the next 2 weeks this will give us evidence on the quality of the correspondence.
GMC produced guidance for prescribing entitled ‘Guidance for doctors treating transgender patients ‘‘which appears to be undermining the principles of the GMC good medical practice .
GPC has made us aware of their concerns around shared care prescribing principles and issuing bridging prescriptions, and are in communication with the GMC.
The LMC has been invited to be part of ABUHB task group around this issue.
The advice at present is that the decision to prescribe must be down to individual clinical judgement that the treatment provided is within the GP’s personal competence.
With the increasing use of email advice lines to hospital specialties, there can be a need to attach documents to the email as attachments e.g. ECGs to Cardiology etc.
This is a guide to attaching images from Docman to Outlook email.
Emails to advice lines can be found in ABUHB website
With effect from the 1st April 2016 Health Boards have been asked to establish a working arrangement for the management, coordination and provision of occupational health services to General Practitioners (GPs).
The service is available for GPs only; to include all partners, salaried GPs and any other GP employed directly by your practice. The service will not be accessible to other staff employed by your practice.
Service provision will include advice on wellbeing, attendance management and ill health retirement but will not include pre-placement screening, health surveillance and inoculation injuries.
The Health Board will aim to provide appropriate and timely occupational health services from the following three departments:
Nevill Hall Hospital, Abergavenny
Location: Cartrefle House (to the left of the Conference Centre)
Opening hours: 08.30am to 16.30pm Monday to Friday
Contact number: 01873 732849
Ysbyty Ystrad Fawr, Ystrad Mynach
Location: Level 3 (near stairwell 3)
Opening hours: 08.30am to 16.30pm Monday to Friday
Contact number: 01443 802442
St Woolos Hospital, Newport
Location Top floor B block (opposite chapel)
Opening hours 08.30am to 16.30pm Monday to Friday
Contact number 01633 238349
Should you require to use the service then you may self refer by contacting your nearest Occupational Health Department.
Any queries and bookings should be directed to the clerical staff at the relevant site.
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