Knowledgebase

Our extensive library available to members, covering everything from clinical practice and risk to wellbeing and money. With expert guidance from specialist partners.

e-learning | Hypertension in pregnancy

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

Obstetrics

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.

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.

Working  until i’m 67

Many of us are looking down the barrel of our ‘normal retirement age’ being 67. A chilling thought. One that drops to freezing when you think about how you’re going to finance the gap between when you want to retire and when you can actually afford to retire.

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.

Career & wellbeing

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.

Paediatrics

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.

Cardiology

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.

Judith Harvey

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.

Risk management

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.

Cardiology

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.

e-learning | Diagnosis and management of pneumonia

The most useful additional information from this is how long to use antibiotics for (i.e. most patients will need a five day course, but some will need longer).

Respiratory

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.

Endocrinology

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.

Diabetes

e-learning | Investigating patients with a raised ferritin

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

Haematology

e-learning | Managing abnormal liver function tests

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.

Hepatology

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

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.

Neurology

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.

Risk management

Making stress your friend

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

Career & wellbeing

Processing your evidence for NHS appraisal

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

Appraisal

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.

Respiratory

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.

Burnout and how  to avoid it

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.

Risk management

e-Learning | Management of Polycythaemia Vera

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

Haematology

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.

Gynaecology

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.

Career & wellbeing

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.

Risk management

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).

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 | Ectopic pregnancy and miscarriage

This is an updated guideline on ectopic pregnancy and miscarriage from NICE (published Apr 19). It was last updated in 2012 when I originally wrote this blog post.

Gynaecology

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).

Five taxing days; what a locum GP can claim for tax

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).

e-Learning | Lower urinary tract infection (UTI)

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

Urology

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.

Career & wellbeing

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.

e-learning | Hypertension in pregnancy

Parental benefits

My journey to life as a locum

Have yourself a merry risk-free Christmas

Working until i’m 67

Breaking the rumination trap

e-learning – Fever in under 5s

e-learning | Rivaroxaban for preventing atherothrombotic events

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

Off duty dilemmas

e-learning | Hypertension in adults

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

e-learning | Diagnosis and management of pneumonia

Dapagliflozin with insulin for patients with Type 1 Diabetes

e-learning | Management of hyperparathyroidism and high calcium

Locums as educators – every day is a learning day

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

e-learning | Investigating patients with a raised ferritin

e-learning | Managing abnormal liver function tests

Planning for university fees

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

Stroke and TIA – initial management

Being mindful of medical hierarchy

Making stress your friend

Processing your evidence for NHS appraisal

Tax FAQs for salaried GPs and GP locums

Meet the locum GP specialist

e-Learning | COPD diagnosis and management

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

Burnout and how to avoid it

e-Learning | Management of Polycythaemia Vera

Intrauterine ball – a new copper intrauterine device

Staying safe: easy steps to avert a personal crisis

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

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

Mortgage tips for GP locums

e-Learning | Ectopic pregnancy and miscarriage

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

Five taxing days; what a locum GP can claim for tax

e-Learning | Lower urinary tract infection (UTI)

Get strong, stay strong

Systems to improve continuity of care

Help

Contact

Have yourself a merry  risk-free Christmas

Working  until i’m 67

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

Planning for  university fees

Being mindful of  medical hierarchy

Burnout and how  to avoid it

Mortgage tips for  GP locums

Systems to  improve continuity of care