Things to discuss: The Practice & The Clinical

THE PRACTICE
 The local geography
 The demography
 Out of area patients
 Personal safety
 Our educational philosophy - why we train
 Exchange contact numbers

DAILY ROUTINE
 Telling someone when you arrive and leave
 Contacting you when you are not in surgery (mobile no. needed)
 Daily routine
- paper intray (pigeon hole),
- letters, blood results & tests,
- email (internal & external),
- visits
 Telephone Consultations
 Visits System - triaging, how to log on, assigning doctors
 Leaving the surgery
– clear desk system
– closing windows, locking up etc. (don’t get locked in)

HOW THINGS WORK IN THE PRACTICE

 Who's who & who does what (doctors, nurses, admin, PM, assistant PM)
 Patient call system
 Panic button
 Mobile phone (On Call for the Surgery)
 Leaving messages on patient’s phones
 Chaperones – when to use, who.

OTHER BITS n BOBS

 Caution about who you leave alone in your room (security of personal effects)
 FEES: crem fees (and any other private fees) – who they go to
 Partners Meetings & Confidentiality
 Insurance forms & HGV medicals – expected to do, if unsure -ask.
 Letters of support
 Personalising your room
CLINICAL MATTERS
 Clinical system - SystmOne & Ardens
 Protocols on surgery website, GP notebook, CKS, Ardens
 Blood tests (ICE), other investigations
 Repeat Prescribing System & Prescriptions – eBNF, Ardens, CKS,
GP Notebook. 1m vs 2m vs 3m repeat prescriptions. HRT and the
Pill.
 Referrals – ASSIST, Fasttrack, acute admission letters
 Patient information leaflets – NHS website, patient.info
 Patient follow-up (esp. if you’re doing tests)
 Clinical letters & scanning system
 Face-Face consultations vs Telephone consultations.
 ON-CALL: Daytime On-Call, Extended Hours, OOH
 Acute Admissions: - Ring FY/SHO on call for specialty. If ambulance needed – phone (will
be asked degree of urgency). Write letter on practice notepaper (and enclose summary visit
printout sheet). If patient seriously ill consider staying until ambulance arrives.
 Special groups of patients – drug misuers, homeless people, travellers, asylum seekers,
LGBTQ community
 GP Trainee’s attitude to requests for TOPs and emergency contraception
 Emergency Drugs & Equipment
 Death Certs & Crem Forms

EQUIPMENT
 Check doctor's bag and drugs (drug stock & dates check)
 List of available equipment in GP Trainee’s room
– auroscope, ophthalmoscope, tendon hammer, tuning fork, sphyg, stethoscope,
fluorosciene, Snellen chart, PEFR meter, dermatome chart, weight scales, height
measure, tongue depressors, urinalysis sticks, glucometer, speculum
 Housekeeping
– discarding clinical waste in correct bins
– sharps bins: close when 2/3 full, keep out of reach of children, high up all times.
– keep desks, sinks, other surfaces free of clinical specimens (esp tongue depressors)
 Clinical room
- keep locked when not occupied even for 5-10 mins
- remove smart card when out of room
- video camera/tapes/ipod – trainee responsibility – keep locked when not in use, do
not leave alone, it is the patient information that we need to protect (not about the cost
of the equipment). Fines can be upto £10,000. Imagine the consequences.
ADMINISTRATIVE MATTERS

 Check signing of work contract

 Sign Educational contract
 Discuss leave - yours and mine
 Discuss maternity, paternity and parental leave
 Hep B immunity status (check) and other
Occupational Health matters. (mainly for PM to do)

IT & COMMUNICATION
some things are repeated here to ensure you have covered them.

 Record Keeping & the clinical computer system

 Disease coding – our coder
 Pathlinks, results. keeping on top of it.
 E-mail (internal and Internet based); use of computer at work
 Important telephone numbers - hospital, partners, GP Trainee's; SystmOne directory. Trainer
& Trainee exchange mobile phone numbers
 Pigeon holes and In-trays - yours, others, outgoing mail etc
 Web resources: www.bradfordvts.co.uk , www.rcgp.org.uk, www.gpnotebook.co.uk ,
www.patient.co.uk , CKS
 Dictating letters - tape plus paper list of names on envelope - take care with patients' identity.
Where to put signed letters.
 Referrals: Antenatal, Self-referral Counselling, Crisis team, Hospital, Locality GPSI clinics;
attitude to requests for TOPs and emergency contraception , Domicillary requests
 Private Referrals, Private Letters, Letters of support, list of fees
 Read protocols on our website – esp child & adult safeguarding
 Keyboard skills - Mavis Beacon Teaches Typing software if they need to improve
 DISCUSS GP TRAINEE's FEARS - reassure.