PUNs and DENs: Discovering Learning Needs in General Practice (Radcliffe Professional Development)

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Take into account prescribing in special conditions such as with patients who are pregnant, breastfeeding, have renal or hepatic impairment or palliative care needs

Crossing the Quality Chasm: A New Health System for the 21st Century, The Institute of Medicine, 2001 The most important part of this document is the when column. This provides the internal discipline for the learning process. Relevance – what relevance does the learning need identified to the learner’s current role in the current workplace. Organisations must consider in advance - as well as respond to - present needs of disabled patients, so reasonable adjustments for the patient can be made. This could include:

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Feelings and intuition strongly affect the consultation behaviour of both the doctor and the patient. These less transparent thinking processes bring benefits and risks to the consultation. For example, while they can help you to establish rapport, it is also important to be aware of the potential impact of conscious and unconscious biases on shared decision-making The GMC Generic Capabilities Framework (2017) included the domain of 'Capabilities in Leadership and Team working'. This requires doctors in training to demonstrate that they can lead and work effectively in teams by: When risks to safety happen, immediate action must be taken (for example, an error in patient diagnosis, inadequate resources or a colleague who is not fit to practice and is putting patients at risk). Where appropriate: Many learners find it more engaging to practice critical appraisal skills within a team context (for example, appraising and debating a guideline or research paper within a journal club). Similarly, many of your best learning opportunities may come from team discussions relating to significant event audits, audits performed in the practice or from audit data collected around the locality and used as a benchmarking tool to compare practice performance.

In 'Developing People - Improving Care' the National Improvement and Leadership Development Board (2016) provided a national framework for action on improvement and leadership development in NHS-funded services. It identifies 'Five Conditions' for improving care: Drug switching may be externally recommended (for example, by specialists or Clinical Commissioning Groups) for quality reasons such as efficacy or efficiency. Consider the impact of drug switching in the patient's best interest and the impact of cost saving on the wider system As a GP, you share responsibility for the health of your local population and should understand fundamental concepts in epidemiology. These include:Health beliefs, preferences, ethnic and cultural differences have an impact on the way that patients present with illness, their willingness to engage with health services, and their management Book and web resources relevant to the GP consultation can be found in the curriculum section "Being a General Practitioner". Balint groups

The responsible officers have been advised to ensure additional flexibility for appraisees should deferral or adjustments be required. This hopefully means that if further COVID-19 spikes were to occur this would be taken into account with regards to our appraisal timing/preparation. A comprehensive understanding of local services and patient pathways, to enable timely and appropriate referrals Inform the patient's general practitioner if prescribing for a patient but you are not their general practitioner

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Be responsible for all prescriptions signed and for decisions and actions when prescribing, including if prescribing at the recommendation of another healthcare professional patient factors requiring both quantitative and qualitative analysis (for example, concordance with treatment); and Gender reassignment; this includes a person proposing to undergo, is undergoing or has undergone a process of changing their physiological or other attribute of sex Equality and diversity encourages the promotion of inclusion as well as protects employment rights. It is important to be able to raise issues and challenge colleagues should any behaviour lead to discrimination.