David McLaughlin

1
David McLaughlin

• GP Waverley Practice Coatbridge
• PA supervisor

2
Initial Induction

• Layout of practice
• Meet the staff
• Computer system
• Pharmacy visit
• Discussion of planned role in practice
• Discussion of GP role within NHS

3
Early weeks

• Sitting in with most of the GPs in the practice
• Housecalls with GP
• Time with Practice Nurses
• Being observed history taking, examination,
  suggested treatments
• Introduction to the BNF

4
Language lessons !

• Oakster
• Dry boke
• Girney

5
Feedback

• After leading a few surgeries
• Discussion between Jane and I
• Many patients older, multiple pathology,
  polypharmacy
• Jane felt not appropriate for her to manage
• Agreed to try and refine patients that could book
  appointment with Jane

6
List made

• Any child
• Adults 15-50 with
• Abdo pain/ GI upset
• Asthma
• Chest infection
• Coughs and colds
• Constipation
• Depression

7
List

• Earache
• Flu like symptoms
• Hypertension
• Rashes
• Sore throat
• UTI
• Womens health issues

8
Supervision

• Able to consult alone but prescriptions need to
  be signed by GP
• Arrangements made for GP opinion if necessary
• Day to day supervision done on rota basis
• Overall responsibility for supervision mine

9
Scope of practice agreement

• Outlining what Janes responsibilities are
• Consulting
• Reviewing results
• Routine radiology
• Recommending treatment as per BNF
• Vaccination
• Supervision level specified

10
Initial surgeries

• Patients booked 15 min appts
• 20 patients per day
• Receptionists using list to book appropriately

11
Issues

• Computer quickly up to speed
• Drug names
• Getting prescriptions signed
• Referrals handful returned

12
Now

• Seeing extra patients
• Many return patients
• Largely on time
• Reviewing own bloods

13
Ongoing supervision

• Official meeting monthly
• Part of evaluation programme commissioned by Scot
  Executive
• Few issues large chunk time lost chasing
  signatures
• Other less formal as and when meetings often
  patient related

14
Benefits for practice

• Huge
• Valued team member accepted by all staff
• Extensive experience
• Different perspective
• At present 22 patients per day
• Patients positive in feedback
• Willingness to contribute more over busy winter
  period