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 mak...

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...

When GP's qualify, they have a possible decision to make. Do I try find a salaried post or do I locum (work ad hoc)? Nowadays with Covid19, a lot of GP work has shriveled up and there is a shortage of locum and salaried jobs, with news that some have had to go on benefits ... however in this discussion I'll be assuming a pre-covid time when locum jobs were abundant and there was a shortage of GPs. I'll be mainly looking at these roles from a financial stand point in a GP surgery, there are numerous other pros and cons to these roles which are outside the scope of just the money however.

Part of creating this website was to document my forage into making an app, and publishing it to the Android Play store or Apple App Store. I have never programmed and know no coding language. The idea came from a random youtube video, where it was talking about programming, and it talked about Flutter, the new coding language from Google. It supports cross platform meaning I can code it once and it should work on both Android, Apple and even Windows.

There is a useful shortcut to allow you to prepare pieces of text in advance when writing consultations. This can speed up typing up your notes, especially if you normally usually repeat the same information to the patient. In the consultation tab, go to CR config button found above.  Select the 'Quick codes and text' tab on the menu that pops up. Press the 'Add..' button.

Inside EMIS there are very basic macro functions you can do to help speed things up. I'll go through a very basic one which may help you speed up certain tasks and procedures. First of all, go to the top right-hand corner of EMIS where you can find the menu button. Click on the EMIS logo and go to Configuration -> Template Manager.

Following on from my guide on how to install EMIS at home , here is a short guide on how to install other useful programs on your home computer. Best to be on the VPN when installing and running these programs. AccuRx Download and  Install AccuRx installer from here . Log in with normal password, should just work as normal.If not, you can follow the guide here . You will need to open it when you have EMIS open for it to sync with your selected patient. Alternatively you can use the standalone web site which has all the features in the browser - Fleming . However if is a bit more time consuming and it also doesn't save into the notes automatically nor automatically select the correct patient. 

Following on from my last post , an article from GP Online  has suggested that there may be hidden costs for GP practices. An accountant that was interviewed has said that there may be issues if the new partner was to leave or change his hours, and that if NHS England would claw that money back from the surgery.  'If someone leaves or reduces their working hours then there is a clawback off the practice contract. So it’s tricky in that practices are expected to pay over the full amount to the new partner but they may then need to recover money if they leave.' He also feels there would be thousands of pounds that needed to be spent on the partnership agreement to add a new partner and avoid this issue. 

A new scheme came out earlier this year to try encourage more GPs to take on partnership roles. In it, it promised up to £20,000 for new GP partners who signed up after April 1st 2020. Things slowed down due to Covid19 but details about the scheme have just been released which can be found  here but below is the breakdown. Starting from 1st July, new to partnership GPs will be eligible for a sum of up to £20,000 for a full-time GP (37.5 hours a week). Also included will be 20% to go towards tax and national insurance. Participants must be new to partnership, and be joined as a profit sharing partner.    The hours to sessions are in the table above. It appears full time is equivalent to 9 sessions (4.5 days).  The amount given will be pro-rota depending on many hours you do. Participants must deliver a minimum of two clinical sessions per week (4hr 10 mins each) in their general practice partnership setting (other than when on annual leave or on short-term sickness...

With Covid19, we're trying to reduce footfall into the surgery and trying to send things out to patients. Sick notes are a big administrative reason why patient's come into the surgery. One way of reducing foot-fall is send them the sick notes electronically.  Here is a guide on how to sign and send sick notes electronically on Emis Web but the same will apply to most patient management software like Vision and System1.  Creating the Sick Note Once inside the patient's record, create your sick note as you normal would. Before you print, you must press 'Preview'. When it comes to printing, change the printer to 'Print to PDF' which is an option in Windows 10. If you don't have this option, you will have to install another Print to PDF option, I recommend  Cute PDF  which does this as well and is easy to set up.  The reason why you must press preview is that EMIS can crash if you just print it straight away without previewing it first. The preview screen...

Due to Covid19, a lot of GPs have had to do more home working / remote access. A few GPs got given laptops with all the software included, but in my experience, the laptops can be a bit hit-and-miss. I thought I'd do a guide on how to setup home working on either your PC or Mac. I'm assuming you have set up Windows Bootcamp on your Mac, but if you haven't I will post another guide on how to Bootcamp your Mac. You will need: -           Certain files contained in here . -           Card reader or keyboard with card reader - the one below is very commonly used (affiliate link): -           Smartphone (optional) -           Windows 10 (may work on earlier windows though haven’t tried) -         ...