At 15:45 24/11/2007, you wrote:
>On Nov 24, 2007 3:02 PM, Fay Wilson <[log in to unmask]> wrote:
> > "Is venesection for analysis part of GMS?"
> >
> > It depends
> >
> > * whether you have a specific contract for it, usually an enhanced
> > service
> > * whether you have by custom ad practice been doing it without
> > specific contract in which case you have arguably agreed to do it
> > under essential services
> > * whether you are prescribing the warfarin in which case you are
> > responsible for ensuring the monitoring is carried out.
> >
> > Of course a more expert person may be along at any minute with
> another opinion!
> > Fay
> >
> >
>It was the last of these that meant I did it, the INR was already 1
>week overdue due to the bickering. I do know that one neigbouring
>practice is talking of sending all housebound patients to hospital
>using hospital transport!
>
>Cheers Geoff
The evidence of benefit for Warfarin in Atrial Fibrillation is
generally good, but NOT as far as I know in the housebound elderly.
Because of the increased risk they present it is probably not only
medically reasonable, but possibly medically essential that they be
referred for specialist care.
Just a point of view of course, and I haven't looked at the
literature for a year or so, but I suspect your neighbouring practice is right.
Julian
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