GP clinical leads

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GP clinical leads

Post by Lesley Williams on Tue Oct 27, 2015 2:57 pm

Hiya
Reading up about CQC they like to have named GPs for chronic conditions with evidence of audit cycles to show that you are trying to improve your clinical area. I would like to be diabetes lead if everyone iss happy with this. We will be able to do an audit cycle prior to CQC coming in as we have managed to hit targets for diabetes for the first time in years so this should show how our changes have improved patient care already. Yay!!

I think alison was going to do CKD. She has already done an audit and will be able to show to CQC that she plans to re-audit next year to ensure that her recommendations have helped to improve patient care.

This leaves asthma and COPD and heart disease up for grabs. So I was wondering if Rachel and Tom could decide which they would prefer.

I also thought it would be a good idea to have a named GP for dementia and mental health. I dont mind doing dementia but is there any takers for mental health?

The aim would be that the nurses utilise the named GPs for any patients that they are struggling with and we can have regular discussions about the people that are not being brought under control with their condition. For instance those with COPD going to hosp regularly should be discussed with a goal to try and help prevent this as one example and this discussion recorded in patients notes on emis as proof it has been done

The dementia care plans are currently in the process of being completed. It is a template that Alex has put on and will be saved in care history so the goals for that year with the patient are obvious and then reviewed the following year to see if they have been achieved with further goals created for the subsequent year.

Tom could you show me where the mental health care plans are? Are these up for review? We need to ensure all Gps are accessing the care plans reviewing and updating them when these patients are seen and the same with dementia care plans as CQC will want to see how it is benifiting patients and how we are acting on them.

With this in mind also can we try and allocate some time to have a discussion about who is going to be coded as vulnerable adults. Is it those without support who are struggling and under social work review or eg if someone has full blown dementia with no short term memory but they live with their spouse who is caring for them well and coping would he still be classed as vulnerable? We all need to be firm in Silverdales definition of this in case CQC ask. Currently I am only coding those I am worried about from a social point of view and those who are under social work review. It is important we remove these codes into history if the situation changes. We can show CQC we do this because we are now having our monthly meeting about our vulnerable adults. We should also ensure that all vulnerable adults and children have a named GP which appears as a screen alert so reception can try and book them in with their own GP each time to promote continuity. To this effect Alex can you review the current list and see which GP is facilitating their care the most and add screen alerts and update the list with the named GP next to them. You could delegate this to a member of reception to do once you have generated the full list.

Lesley Williams

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Re: GP clinical leads

Post by Lesley Williams on Tue Oct 27, 2015 3:54 pm

Yes good idea re chronic diseases shall I take heart disease then as doing an AF audit and happy with this area. I will have been through all pts with AF on ASPIRIN now so will write this up. Will at some point look at other groups such as those DM and CVA on aspirin but so many so will do this post CQC.

Rachel

Lesley Williams

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