To each General Practice in Tayside
TAYSIDE LOCAL MEDICAL COMMITTEE LTD
Issue Number 11
CHAIRMAN
February 2013
DR ANDREW COWIE
VICE CHAIR
DR RICHARD HUMBLE
DR ANDREW THOMSON
MEDICAL SECRETARY
DR MARY O’BRIEN
MEDICAL SECRETARY
TREASURER
DR ANDREW BUIST
BUSINESS CO-ORDINATOR MRS HAZEL DONALDSON
Compulsory Treatment Order – Part 2
them within their departments or arranged via
cardiology if not.
We are aware that requests for these can be few and far
between and wanted to remind you that there is a fee
for doing this work.
This is a view supported as “best practice” by the
Medical Defence Unions.
Below is an excerpt from the SE Circular on Fees under
the Mental Health Act
Medications in short supply or unavailable
FEE FOR SECOND MEDICAL EXAMINATION FOR
A COMPULSORY TREATMENT ORDER UNDER THE
MENTAL HEALTH (CARE AND TREATMENT)
(SCOTLAND) ACT 2003
1. GPs and Approved Medical Practitioners (AMPs)
who undertake to provide the second medical
examination in relation to an application to the Mental
Health Tribunal for a Compulsory Treatment Order
(CTO) under the Mental Health (Care and Treatment)
(Scotland) Act 2003 (the ‘2003 Act’) will be entitled to
the payment of a fee of £173.37 for this work
We are all fed up with the issue of being asked to do a
replacement prescription as the medication we have
prescribed is “unavailable” when the patient has taken
the script to the pharmacy. Often it is unclear whether
this is just that that particular pharmacy does not have
it or there is a genuine supply/manufacturing problem.
In the case of Isosorbide Mononitrate it is a genuine
manufacturing problem that may not be solved for
months so Practice pharmacists have been advising GPs
to change to the nearest dose longer acting version in
many instances.
Community pharmacists have a duty to try and source
the medication for the patient as per the community
pharmacy newsletter May 2011:
The fee should be claimed from:
Heather Ford,
Clinical Support Services Officer,
Carseview Centre
4 Tom McDonald Avenue
Dundee DD2 1NH
Please remember if you are presented with a
prescription for an item you do not have in stock you
have a duty of care to help the patient source the
medication in a timely manner appropriate to the
individual patient’s needs.
Requests to carry out ECGs
Unfortunately some Specialties are still referring
patients back to the GP asking them to carry out an
ECG. Under the GMS contract practices are not
obliged to either have ECG machines nor interpret
ECGs and many GPs feel they do not have the expertise
to safely interpret ECGs in many instances i.e. in the
case of certain psychiatric medications.
We have raised this concern with NHST many times
over the last few years and a group including the NHS
Tayside Medical Director has been discussing this with
a view to a specialised ECG and monitoring service
being set up. In the meantime the view is that these
tests should either be carried out and interpreted by the
clinician if the technology and expertise is available to
Informing the patient that you do not have the
medication in stock, and sending them away with the
script may be classified as unprofessional and not
meeting patients’ needs.
See also flow chart attached.
It may be worth your admin staff having a copy of the
chart handy to ensure that the agreed steps have been
followed before they pass a request for an alternative
prescription on to you. They should also have been
informed by the Pharmacist / Pharmacists Assistant
what they do have, which is close enough to the
original prescription.
Registration Number: SC420456
There are various website that the pharmacists use and
we can access, if we wish, to get a heads up on what
may be in short supply soon:
http://www.communitypharmacyscotland.org.uk/contra
ctor_services/drug_tariff/shortages/shortages.asp
QOF AND QP Returns
http://www.isdscotland.org/Health-topics/Prescribingand-Medicines/Scottish-Drug-Tariff/ part 13.
The Black Triangle Campaign
Unfortunately these 2 websites only report genuine
shortages once they have reached a sufficiently high
level to warrant changes to community pharmacy
remuneration and so may not provide us with the
desired level of advanced notice.
This is a national problem and the powers that be,
including the Scottish Government, are aware of it.
Our Practice Pharmacists are also in discussion with
the Area Pharmaceutical Committee around ways of
communicating genuine supply problems better to
practices.
Tayside LMC Annual Conference
Thanks to the 40 or so GPs who struggled through the
blizzards and appalling road conditions to attend this.
An afternoon of lively discussion on topics such as, the
changes to the Scottish GP Contract, Anticipatory Care
Plans, Patient Safety and many soapbox topics took
place.
The AGMs of the 3 Divisions were also held and the
following GPs were elected to represent their Division at
the main LMC Committee for 2013/014
Angus
Dr Andrew Thomson
Dr Giles Ledlie
Dr Marc Jacobs/Dr Alastair Shaw – job sharing
**Dundee
Dr Andrew Cowie
Dr Mary O’Brien
Dr Julie Anderson
Dr Shawkat Hasan
Dr Brett La Hay
Dr Pascal Scanlan
** Dundee has 1 extra rep as the Chair of the LMC
comes from this Division
Perth & Kinross
Dr Andrew Buist
Dr Richard Humble
Dr Beena Raschkes
Dr David Shackles
Just a reminder that these need to be in to Primary Care
by 15th March and that there will not be flexibility in
this date this year.
Some of you may be aware of the above which is
a website for an "Anti-Defamation Campaign in
Defence of Disability Rights"
They posted letters for use on the site on 16th of Nov
last year and some Practices in other areas are reporting
patients attending with these asking for them to be
completed. In the letter they “quote” GMC guidance,
below:
“The recent GMC publication of Good Medical
Practice 2010 clearly stated that a Doctor must
(overriding duty or principle) “take prompt action if
you think that patient safety is or may be compromised
by inadequate premises, equipment, or other resources
policies or system”
These letters and in fact this “guidance” should be
ignored as the GMC guidance is quoted out of context
and in this context is without substance, relevance or
meaning.
You should follow your usual agreed practice protocols
for completing or not completing appeals letters/forms.
We would be interested to hear from any Practice
whose patients are appearing with these letters.
Dr Mary O’Brien
Medical Secretary
Tayside LMC Limited (SCR Number 420456)
King’s Cross
Clepington Road
Dundee DD3 8EA
Tel 01382 424118
Fax 01382 828825
hazeldonaldson@nhs.net
Web site: www.taysidelmc.co.uk
Tayside Local Medical Committee Limited does not provide legal or
financial advice and thereby excludes all liability howsoever arising
in circumstances where any individual, person or entity has suffered
any loss or damage arising from the use of information provided by
Tayside Local Medical Committee Limited in circumstances where
professional legal or financial advice ought reasonably to have
been obtained. Tayside Local Medical Committee Limited provides
representation, guidance and support to GPs and practices. Tayside
Local Medical Committee Limited strongly advises individuals or
practices to obtain independent legal/financial advice
Registration Number: SC420456