GP TechLead

Details have come out about a new fellowship scheme which will be available to all newly qualified GPs (and nurses) working in Primary Care. It will be offered to all newly qualified GPs in a fellowship scheme which will provide at least 1 hour of mentor-ship every 4 weeks and at least 6 sessions of coaching over the 2 years. Locums cannot apply, it is aimed for salaried GPs though partners can apply. It is also offered to nurses interested in primary care but I will not cover that here. You would sign up to a 2 year scheme   and participants receive funded mentor-ship and funded CPD opportunities of one session per week (pro rata), and rotational placements within or across PCNs to develop experience and support transition into the workforce. To allow this to happen, the NHS will pay £10,200 to the practice to release their GP fellow out for a session a week for their CPD and also mentor-ship. Over the 2 years, it will form a sort of curriculum which I assume will make th

Doctors have to make difficult decisions. GPs generally don’t have to do so as much but occasionally a hard one comes our way. On my ward round at the nursing home, an old 110 year old man was nearing the end of his life. He lived a storied and interesting life, in the army, seen the wars and was an actual rocket scientist. He had seen better days however. He had many comorbidities and had a poor quality of life for several months now. We were treating him for a chest infection, and he had 4 days worth of his second course of antibiotics. His daughter, herself an elderly woman, was concerned about his well-being, he looked unwell, barely conscious and breathless. She asked what we should do once the antibiotic course was finished. I explained that we could either try a third course of antibiotics which may clear up his chest or we could decide that antibiotics aren’t working for this infection and let nature take its course.

Part of being a GP is unfortunately thinking of the bigger picture. We get guidance and directives from our big brother NICE, who make sure we give the most effective therapies clinically but also from a cost-effective point of view. Sadly this occasionally conflicts with the patient’s agenda and can lead to disagreements between doctors and patients. One such disagreement occurred when I had a telephone consult with a newly diagnosed type 2 diabetic lady. Diabetes is a condition where the body can’t control the sugar levels in the blood, and it becomes too high. There are two types of diabetes; type 1 where the body doesn’t produce enough insulin and type 2 where your body doesn’t respond well to insulin. Insulin is the hormone that lowers the sugars in your blood. We treat it with a combination of diet, medication and sometimes synthetic insulin. However the problem with the treatments are that they can flip the blood sugars the wrong way, and you end up going too

Part of my duties is doing rounds of a local nursing home. I do it weekly and I enjoy the continuity I get with the patients. The nursing home gives me a list of patients whom they want reviewed and I spend a morning going round the home seeing everyone. I therefore get to know most of them well, but I see one resident a lot more. Dear old Marge is a very anxious lady who is relatively healthy, bar some mild cognitive deficits. She is put on my list almost every week due to her health anxiety, she always feels something is going wrong with her, and every time we check her over and examine her, nothing can ever be found. She is always grateful to be checked over though, so I never mind seeing her. This time though, we get an odd note on our list – “Pill in the poo?”. Saying hello, she tells me that her antidepressant she is on, has magicked its way through her digestive system intact and come out whole the other side. I have my doubts but lo and behold, upon looking in h

GPs can earn extra money through many different means. One of the most popular ways is to work in Out Of Hours (OOH) or UCC in your local area. These are usually run by groups of GPs or private healthcare companies (Care UK). Most new GP trainees will have done an OOH shift when training but here I'll try breakdown what working life is like for OOH/UCC. OOH is operational when the GP surgeries close (usually 1830) until they reopen again on 08:00 on a weekday. Over the weekend that is 18:30 Friday until 08:00 Monday. Patient's call 111 and if they get triaged for a GP call, they will put onto a central list on the GP's computer screen. They are then called back by the GP who will then try manage the patient - either on the phone, bring them down for face-to-face consultation, schedule a home visit or refer them to A+E. The GP may be the one who is doing the face-to-face consultation or do the home visit. GPs working OOH may be done in a section of a hospital or a