Category: Clinical

Clinical updates and guidelines for GP locums

Working at a flu clinic

The double whammy of the Covid-19 pandemic and flu must be tackled to avoid NHS overwhelm this winter, but GP locums must know the risks before infections rise, Dr Zoe Neill of MPS writes

Infectious diseases

First wave flu clinics cancelled as vaccine supply runs short

Practices have already been forced to cancel flu clinics for at-risk under-65s after supply of the vaccine ran short in September.

Infectious diseases

Managing insect bites

Most insect bites do not require antibiotics, and most infections in bites are secondary (and quite rare) following itching.

Dermatology

Management of back pain and sciatica

This is an updated guideline from NICE on the management of low back pain and sciatica. There is quite a bit that is new in this guideline, but it probably doesn't really add much to our current management

Orthopaedics

GP locums eligible for free seasonal flu jab from their own GP this year

GP locums are eligible for free flu jabs at GP practices according to the new DES in 2020.

e-learning – Iron deficiency in pregnancy

An October 2019 guideline from BSH on managing iron deficiency in pregnancy has a few interesting points, particularly for GP locums facing requests from midwives to prescribe iron

Obstetrics

Fremanezumab for preventing migraine

Although fremanezumab seems to be effective in episodic migraine, it hasn't been approved as it isn't felt to be cost-effective

e-learning – Long term macrolide use in respiratory conditions

Most of the time, long term macrolide therapy will be initiated in secondary care. However, we may well be the ones writing the prescription, so it is worth being aware of some of the safety concerns

MGP Guidelines

Clinical

e-learning – Abdominal Aortic Aneurysm (AAA)

NICE guidance from March 2020 advises that men over 65 should be offered routine screening for AAA

Vascular

e-learning – Tinnitus

Mental health comes to the fore in new NICE guidance, published March 2020

e-learning – Leg ulcer infection: antibiotic prescribing

A NICE update on antibiotic prescribing for leg ulcers published in February 2020 includes a good visual guide to best practice

e-learning | Sotagliflozin with insulin for type 1 diabetes

A new guideline from NICE from February 2020 advises that sotagliflozin can be used alongside insulin for type 1 diabetes

e-learning | New treatments for hyperkalaemia

New guidelines from NICE update the guidance on prescribing sodium zirconium cyclosilicate and patiromer

Venous thromboembolism (VTE) investigation and management – new NICE advice

PERC tests, anticoagulants, D-dimers, stockings and cancer investigations: a stack of new advice on VTE in guidance

Actions after incorrect use of combined hormonal contraception (ie missed pills guidance)

The FSRH provided a good summary of guidance for those advising women about what to do after a missed pill

Impetigo, antibiotic use and hydrogen peroxide 1% cream

New guidance advises GPs consider using hydrogen peroxide cream as a first line in localised non-bullous impetigo

Essential Covid-19 advice for GP locums

NASGP has produced a new template to make sure practices are able to provide them will all necessary information.

e-learning | Indoor air quality

GPs are advised to start looking for at-risk patients, signposting patients to local authority housing assessments, and giving guidance on risk reduction