Knowledgebase

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?

e-Learning | Alcohol exposure prenatally and its effects on children and young people

This is a guideline on Fetal Alcohol Spectrum Disorder from SIGN outlining the assessment and management of children who have had prenatal alcohol exposure (PAE).

What expenses can a GP locum claim?

Jess is a sessional GP on a budget, saving for her wedding so she’s recording every single penny she spends – let’s look at what she can get tax relief for (and why or why not).

Podcast | The Sessional GP magazine April 2019

In our 106th edition, Liz takes us through five taxing days, Nigel has some top tips for locums on getting a mortgage, Louise reviews the latest SIGN guidance on alcohol in pregnancy, Sara highlights the roles of locums in quality improvement, Rachel looks at the risks around burnout, Kate on mental health safety, Judith rounds off with singing in the brain, all interspersed with some beautiful paintings by Claire.

e-Learning | Lower urinary tract infection (UTI)

NICE released new guidelines in Oct 18 on antimicrobial prescribing in lower urinary tract infection (UTI).

Get strong, stay strong

Evidence suggests that there are strong associations in middle and older age between poor balance, poor strength or poor physical function and mortality, and that lower strength in late adolescence and early adulthood link with increased vascular risk in later life.

Systems to 
improve continuity of care

Following on from her previous article Dis-continuity; putting care into context, Dr Sara Chambers explores the idea that sometimes continuity of care is deployed to paper over the cracks where 'continuity of management' and 'information' is lacking or even absent, and why the locum's perspective needs to be part of a future solution.

Podcast | I’m a GeriGP

NASGP member Eva Kalmus describes how she became co-chair of the new GeriGP group of the British Geriatrics Society (BGS), and why being a portfolio GP has never been boring.

Kyleena intrauterine system

Kyleena is an IUS. It contains levonorgestrel, like Mirena does.

Levosert – a levonorgestrel intrauterine device (LNG-IUS)

This is a new product review from the FSRH. Levosert is an LNG-IUS,  which is the same as Mirena.

e-Learning | Renal and ureteric kidney stones

This is a new guideline from NICE on managing renal and ureteric stones, published in Jan 19.

Podcast | Eating people is wrong: Kuru and cannibalism

Recently, in Tromsø, the Arctic capital of Norway, I came across the name Carleton Gajdusek. That name took me back many years and halfway round the globe to a village in the Fore district of Papua New Guinea.

State-backed indemnity – 
what it means for sessional GPs

There's still some uncertainty about the new state-backed indemnity scheme for England and Wales, and Rachel Birch from the MPS has the answers.

Combined hormonal contraception guidelines (FSRH, 2019)

A really useful aspect of this guideline is that there are numerous tables which summarise starting and switching routines, efficacy of various contraceptive methods etc.

Confused by Type 2 Self Assessment forms?

Our specialist medical accountant answers Type 2 FAQs.

Podcast | The Sessional GP magazine February 2019

In this 105th edition, Sara concludes her article on a fresh pair of eyes; Judith would rather we didn't eat each other; Rachel has some news on medical indemnity; Liz answers your Type-2 queries; Eva and Nicky have both explored specialties outside of primary care that have enhanced their enjoyment of general practice; Kate wants us to get physical, and Louise has summarised Nice's latest on ureteric and renal stones.

Dis-continuity – putting 
care into context

Much is made of continuity of care, but little time is spent examining its weaknesses and exploring the alternatives. In the first of a two-part series, Dr Sara Chambers helps put continuity into context.

e-Learning | Post-traumatic stress disorder (PTSD)

I don't think this really changes our management much (i.e. watch and wait for 1 month and then refer for most patients), but I will summarise the symptoms we should be looking out for and also the management.

Podcast | Saying farewell to social media

Scroll down to the bottom of the page to listen to our podcast with  Zoe in conversation with Richard Fieldhouse on her journey to a destination that's almost completely free of social media.

Should GP locums use WhatsApp to book sessions or jobs?

What you gain in convenience, you lose in the ability to control significant aspects of your practice

Bronchial thermoplasty for severe asthma

This is a new guideline on bronchial thermoplasty from NICE on bronchial thermoplasty for severe asthma.

Podcast | Getting under your skin; a visit to Body Worlds and the art of plastination

How do you react to seeing a man standing, flayed of his skin, his internal organs on view, his muscles brick red, his blue eyes staring out at you? Or what about the trio posed round a table playing poker?

Podcast | Oh, you’re a GP locum; the rise of the portfolio GP

e-Learning | Contraception in the over 40s

This was an updated guideline from the FSRH on contraception in the over 40s.

Podcast | The Sessional GP magazine December 2018

iFuse for chronic sacroiliac pain

It is worth being aware of as we may have patients affected by this condition.

e-Learning | Chronic Heart Failure in adults

They have pulled several different guidelines together to make this more comprehensive. There are a few new things which I'll lay out, then I'll give a brief summary of management.

Locuming; it takes skill, needs training

Over 2,000 doctors will have qualified as GPs in the last 12 months, each having spent in the region of two years working in at least one, possibly several, GP surgeries, but including training on how to be a GP locum?

Wounded healers; what makes GPs so vulnerable to mental ill-health?

Doctors experience more mental ill-health and addiction than other professional groups, and there are higher rates of suicide in doctors than other professionals, especially in young women, who are two to four times more likely to kill themselves than other women.

Management of pancreatitis

This is a new guideline from NICE on pancreatitis from Sep 2018. Most of it is aimed at secondary care, but there are a few things that are useful for us.

Transurethral steam ablation for lower urinary tract symptoms in men

This is a new guideline from NICE recommending that transurethral water vapour ablation can be used for treating lower urinary tract symptoms (LUTS) in men.

Taking account – is having an accountant a luxury or a necessity?

Are you confident that you can keep up to date with all the changes in tax law, practice, tax tribunals etc?

Valproate – contraindicated in women of childbearing potential

You have probably heard about this on the news, or seen it in other forms, but in case you have missed it, I felt it important to do an update.

Does the NHS pension scheme still represent good value for money?

Just how good is the NHS pension scheme, anyway? Our advice on why GP locums should take a closer look at the 2015 scheme

e-Learning | Management of dementia

This is a new guideline from NICE on the management of dementia.

Elementary my dear doctor

Fed up of the world seeing GPs as the honest but dim-witted Watson, I took it upon myself to change our image in the public arena.