Appraisal toolkit

Significant events and Swiss cheese

There is a scientific discipline called human factors and ergonomics (HF&E) which recognises the absolute certainty that human beings will make mistakes, and so seeks to design working systems and environments that work around our human nature to reduce the risk of error as far as possible. Many safety-critical industries like aviation have wholeheartedly adopted…
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Two-week referrals a cocktail for complaints

Time-dependent, stressful and often scary, 2-week referrals can be a cocktail for complaints. Dr Rachel Birch from MPS presents a roundup of useful advice on two week referrals for an all too regular clinical presentation. Many patients are likely to be aware of the NICE guidelines for the recognition and referral of suspected cancer. Certainly,…
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Speaking up

As a sessional GP you may not feel comfortable raising concerns about a colleague, but patient safety comes first so it is important that you speak up, writes Charlotte Hudson, Content Editor at MPS. You are a salaried GP in a busy practice. After three months you start to notice that the quality of care…
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Raising concerns about poor prescribing

MPS Medicolegal Consultant Dr Rachel Birch shares a case scenario involving a locum GP who was working in a practice with poor prescribing issues Dr L was working three days a week as a maternity locum at a busy medical practice. Every day she was asked to manage the acute prescription requests, even though she…
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Enjoy your appraisal….

Two years after the formal introduction of NHS revalidation, NASGP appraisal and revalidation lead and locum GP Sara Chambers recounts her experience of appraisal, and how this has fed into the development of NASGP's AppraisalAid. Over one fifth of licensed doctors will now have been revalidated, and on the surface all seems to be running…
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Locum complaints

There are many reasons why doctors working as locums may be more at risk of receiving a complaint. Sara Chambers, NASGP’s appraisal and revalidation lead, and Charlotte Hudson, writer at MPS, provide tips on protecting yourself from complaints and the current complaints process. The key to most complaints is how they are handled early on…
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Fit note GP guidance for urgent forms and letters

Dr Rachel Birch, MPS medicolegal adviser and sessional GP, presents two case scenarios highlighting fit note GP guidance on how to handle patient requests for fit notes (GANFYD) and letters Fit note scenario 1 You are doing a one-day locum. You see Mr H, a 32-year-old patient with a six-week history of low back pain.…
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When a locum cancels a session

No matter what the reason, the sudden unavailability of a doctor or nurse is at the very least upsetting for patients, and in some cases can have serious adverse consequences on patient care. Practice staff go frantic having to rearrange appointments or find alternative cover. We all get ill Cancellation at short notice is always…
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Unwelcome patient attention

Sessional GP and MPS medicolegal consultant Dr Rachel Birch shares a case scenario about a patient who stalked her GP  Dr L worked as a locum GP in Manchester, doing maternity and other long-term locum jobs within the city practices. Five years ago he saw a female patient, Miss X, with mental health symptoms. He…
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Creating a patient-friendly surgery

Simple changes and feedback can improve relationships with patients, says Dr Judith Harvey The NHS's patient and public involvement scheme is about doctor and patient partnership. Sustainable patient involvement cannot be one sided and practices should aim to improve procedures that are a problem for both patients and staff. Acknowledging a shared problem and a…
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GP locums need dedicated training

Dr Judith Harvey explains why it is vital to devise a support system for the freelance GP workforce. Today around 100,000 patients will consult a locum GP. Locums keep the show on the road. At any one time a quarter of the GPs at work will be locums. Yet the RCGP curriculum has little to…
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