Knowledgebase

e-learning | Hypertension in pregnancy

Louise Hudman introduces the latest guideline on hypertension in pregnancy from NICE.

Parental benefits

The New Year seems an appropriate time to think about new babies, so here we consider some money matters you might need to think about.

Life after VTS: my journey to life as a jobbing GP locum

Like many highly skilled professions, a career in general practice can be a journey with obstacles to overcome, barriers to navigate and choices to make. NASGP member Tina Sumner describes how she came to be working as a GP locum and how NASGP has helped her in that journey.

Have yourself a merry 
risk-free Christmas

Dr Rachel Birch, Medicolegal Consultant at Medical Protection, offers practical advice on how to make this year as safe and enjoyable as possible.

Podcast | The Sessional GP Magazine December 2019

When can I retire?

Many of us are looking down the barrel of our ‘normal retirement age’ being 67. A chilling thought.

Breaking the rumination trap

Have you ever been stuck in a swirl of negative thoughts, rehashing things that you should or shouldn’t have said or done? Most of us will recognise this circular self-battering, a process known as rumination.

e-learning – Fever in under 5s

The main update this year is around Kawasaki disease. It used to be that Kawasaki disease was diagnosed if children had 4 out of 5 features.

e-learning | Rivaroxaban for preventing atherothrombotic events

This is a new guideline from NICE advising that rivaroxaban plus aspirin can be used in the prevention of atherothrombotic events, under certain circumstances. It was published in Oct 2019. This is quite a big change in practice.

Podcast | Social prescribing – I’ve seen the future of 
general practice…

A partner in a North London practice was feeling burned out. The crushing target-chasing workload was no longer offset by the reward of helping patients. The BNF had no remedy for the distresses of modern life which patients were bringing into her consulting room. She, like her patients, was ground down.

Off duty dilemmas

As doctors, we may sometimes feel that we are never off duty. Even when we are not at work, those close to us may seek our advice on medical matters, or even request for emergency medical assistance.

e-learning | Hypertension in adults

The biggest difference is that NICE encourage us to have much more of a discussion with patients about whether to start medication and what to start. Helpfully, they have provided some patient decision aids, which are really good.

Can someone who is paid through their own limited company be a worker or employee?

An Employment Appeals Tribunal (EAT) agrees that out of hours GP paid through her own company was a worker.

Podcast | October 2019 magazine out now

Alacoque describes a legal case where a locum's tax status was different to their legal status, Rachel's being a Good Samaritan, Judith's been looking at therapeutic spaces, Louise has summarised the Nice hypertension guidelines for us, plus much more.

Dapagliflozin with insulin for patients with Type 1 Diabetes

This is a new guideline from NICE on using dapagliflozin in patients with Type 1 diabetes.

e-learning | Management of hyperparathyroidism and high calcium

This is a new guideline from NICE on managing high calcium (Ca) levels and hyperparathyroidism published in May 2019.

Locums as educators – every day is a learning day

Every day is a learning day in general practice. We are constantly learning from patients, members of the primary care team, and our secondary care colleagues.

e-learning | Ertugliflozin in type 2 diabetes and the other SGLT-2 inhibitors

This is a new guideline from NICE giving advice on ertugliflozin, published in April 2019. I am also doing a quick reminder about the other SGLT-2 inhibitors.

Investigating patients with a raised ferritin (BSH, 2018)

This is a guideline from the BSH on investigating and managing a raised ferritin  published in 2018

Podcast | Quiet please

Managing abnormal liver function tests (BSG, 2019)

This is a guideline on managing abnormal LFT that was published in 2017 by the British Society of Gastroenterology, but as it so useful I thought it worth summarising it.

Planning for
 university fees

Are university fees looming in your household? Maybe your teenager is already collecting their belongings together ready to start their next chapter in life as a student.

Setting up your tax and legal status as a new GP locum

NASGP's specialist medical accountant explains how newly-qualified GPs can set up a watertight system for managing their accounts when they undertake GP locum sessions, from managing rates to recording expenses

Podcast | The Sessional GP magazine August 2019

In our 108th edition, Judith makes a noise about being quiet, Liz summarises everything a newly qualified GP needs to know about getting their tax in order, Nigel helps us plan for when our offspring go off to university, Louise has been making sense of LFTs and Rachel has something to teach us about learning.

Stroke and TIA – initial management

This is an updated guideline from NICE on the management of stroke and TIA in over 16s. It was first published in 2008 and this update is from May 19.

Being mindful of medical hierarchy

Medical hierarchy may present a challenge, and at times a possible reluctance, to open discussions about patients. Dr Rachel Birch, medicolegal consultant at Medical Protection, discusses possible reasons for this and provides helpful strategies to overcome this.

Making stress your friend: how to cope as a sessional GP or locum

With ever mounting workload, increasing patient complexity and rising patient expectations and complaints, work is becoming increasingly stressful in the NHS.

Processing your evidence for NHS appraisal

Sara Chambers continues her two-part article on collecting evidence for NHS appraisal on-the-go

Podcast | Now wash your hands

Presumably a reasonably successful public health campaign, although if you are trapped like a sardine in a rush-hour tube train, you may have no alternative but to sneeze into the shoulder of the person jammed in front of you.

Tax FAQs for salaried GPs and GP locums

Liz Densley from Honey Barrett runs through some commonly asked questions from GP locums on matters related to tax and national insurance.

Meet the locum GP specialist

For years, we’ve been calling for recognition that locuming involves performing in a specialised environment requiring at least a mention in formal GP training. We brought that together in a one-day GP locum masterclass with the BMJ.

e-Learning | COPD diagnosis and management

This is an updated guideline from NICE on the diagnosis and management of COPD, published in Dec 18. It's a pretty mammoth guideline, first written in 2004.

e-Learning | COPD – antibiotic prescribing in an acute exacerbation

The most interesting bit for me about this new guideline was that only 50% of COPD exacerbations are thought to be caused by bacterial infections. The rest are caused mainly by viral infections or smoking.

Podcast | June 2019 ‘The Sessional GP’ magazine

NASGP chairman Richard Fieldhouse reviews the latest edition of The Sessional GP magazine. In our 107th edition, Louise has not one but two COPD-related e-learning articles; Judith has been washing her hands, Liz has been answering your tax questions, Rachel has some advice about medical hierarchy, and Kate has been making stress her friend, all with some more beautiful paintings by Claire.

GP locum burnout and how to avoid it – MPS advice

Burnout among GPs can be an occupational hazard and is believed to be increasingly common. Dr Rachel Birch, medicolegal consultant at Medical Protection, discusses burnout and the steps that sessional GPs can take to avoid it.

Management of polycythaemia vera (BSH, 2018)

Much of this is beyond what we need, but it outlines how we should be approaching a patient with raised haematocrit, which is useful.

Intrauterine ball – a new copper intrauterine device

This is a 'New Product Review' from the FSRH on the intrauterine ball (IUB). It is otherwise known by the not so catchy title of SCu300B MIDI.

Staying safe: easy steps to avert a personal crisis

Many of us will have experienced a time of emotional crisis. It could follow a break-up of a relationship, a bereavement, a traumatic event, financial worries or an adjustment to a big change.

The story of a locum session; missing out on marginal gains

In this final article, we'll run through a hypothetical locum session (but inspired by real events!) and the typical response to errors, finally examining how a more considered, system-based approach based on the learning from psychology and Black Box thinking could promote patient safety, practice efficiency and GP morale and retention.

e-Learning | Coughs (of the acute kind) and antimicrobial prescribing

This is a new guideline  from NICE on when to prescribe antibiotics for coughs. It only covers those with acute coughs and doesn't include COPD patients (they are covered in a separate guideline).

Podcast | Singing in the brain; music for dementia

There is currently no prospect of effective medication for dementia. Reluctantly, we prescribe agitated patients chemical coshes. But does music sooth agitation – and more?

Mortgage tips for 
GP locums

Despite the weirdness that is Brexit, the traditional increase in the number of new mortgage applications in springtime continues. There are plenty of decent rates out there, particularly fixed rates. But what if you are a locum?