Have yourself a merry 
risk-free Christmas

With seasonal cheer building and the countdown to the holidays drawing near, it is important that sessional GPs are well-prepared for possible challenges during Christmas and New Year. Dr Rachel Birch, Medicolegal Consultant at Medical Protection, offers practical advice on how to make this year as safe and enjoyable as possible.

“Let it snow! Let it snow! Let snow!......”

You may all be dreaming of a White Christmas, but this can present a challenge for sessional GPs. Snow and ice on the roads can cause significant travel disruption and, in the worst scenario, may prevent you from getting to work.

  • When driving to an unfamiliar practice, ensure that you know where you are going and plan any alternative routes in advance.
  • Leave plenty of time for travel.
  • Ensure that you have the practice direct dial number, so that you can let them know if you are going to be late.
  • Always keep your mobile phone fully charged.
  • Keep a snow shovel in the car.

“We three kings of Orient are.....”

You may not be expecting gold, frankincense and myrrh, but boxes of chocolates, fruit baskets and wine are sometimes gifted to doctors by appreciative patients. It is important that you know, in advance, what to do if you are given a festive token of their gratitude.

  • Ensure that you keep your own personal register of all gifts received.
    Familiarise yourself with the practice’s gift policy and always let the practice manager know if you have received a gift.
    Inform NHS England if you receive any presents over the value of £100.
    Do not leave wine bottles in doctors’ rooms- this could give patients the wrong impression.

The GMC advises doctors that they “must not ask for or accept – from patients, colleagues or others – any inducement, gift or hospitality that may affect or be seen to affect the way you prescribe for, treat or refer patients or commission services for patients.” Doctors should always be mindful of this guidance and ensure that accepting a gift could not be misinterpreted by others.

“I wish it could be Christmas every day......”

Whilst time spent with family and friends is precious over the Christmas and New Year bank holidays, general practice can be a busy place in the days following these long breaks, with many patients saving up their concerns for their own GP practice, rather than attending OOH.

Between Christmas and New Year many NHS services may be reduced, including outpatient clinics, laboratory services and pharmacies.

  • Clarify these arrangements with practices in advance, as well as what will be expected of you, as a locum, as there may be fewer staff than at other times.
  • Will you be responsible for triage telephone appointments or repeat prescriptions? Ensure you are clear with what is being asked of you.
  • Consider coming in a few minutes earlier than you usually would, to ensure that you start the day running to time.
  • Check the OOH contact sheets early, so that home visits and review appointments are pencilled in early in the day.
  • Request essential tests urgently, so that results come back in a timely manner.
  • Bring a packed lunch and ensure you have time for coffee.
  • Be understanding and try not to get frustrated! It is a busy time of year for everyone.

“I’ll be home for Christmas….”

Vulnerable patients, such as the elderly, housebound and homeless populations, may feel isolated during the festivities. With winter bringing its own set of illnesses, coupled with the possibility of inclement weather, there may be more requests than usual for home visits.

  • Ensure you have adequate time for home visits.
  • Liaise with district nurses, social services or crisis teams if you are concerned about a patient- these services may be restricted, but will still be available over the festive period.

The holiday season is also a time when signs and symptoms may be dismissed as harmless typical festive ailments, such as those caused by alcohol and food excess. These issues can get more complicated if patients attend as temporary residents, without access to their medical records, for example if they are visiting from abroad or out of area.

  • Always remain vigilant to the possibility of serious illnesses, such as heart attacks, and avoid the potential pitfall of assuming a patient is suffering from festive excess.

“Have yourself a merry little Christmas.....”

Everyone working in primary care tends to work extra hard in the run up to Christmas and New Year. This, coupled with seasonal social events, can place extra demands on health and resilience.

  • If you have not already done so, consider arranging to have an influenza vaccination- remember you are in the front line and need to keep healthy!
  • Try not to organise late nights prior to a working day so that you don’t look or feel tired the next day.
  • Ensure that you act professionally at all times, even when out with friends locally.
  • Make time for some emotional “down time” over the long holiday period when you are not working.
  • If you become unwell, remember to visit your own GP- you cannot help other people if you are unwell yourself.
  • Beware the inevitable chocolate boxes at reception…

You may or may not feel that it is the most wonderful time of the year, but with a little planning and awareness of what to expect, you can make a success of working over this festive season.

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