Thanks Dinesh, will look at this. Have already asked them re an
alternative and am waiting for a response. Not prepared to do anything
until they confirm they will accept it. Did the prospective audit
below and asked if this was suitable (with a further prospective audit
now, but the response is no). I suppose the terminology I should have
used fr it in retrospect is 'Respiratory Tract infection and not URTI,
as I meant those who felt they were presenting with a chest infection.
I assumed that this with a prospective audit could have been a Quality
Improvement (but waht of my antibiotic prescribing in these patients
was higher??)

Thanks Paul

A prospective study of those presenting with a diagnosis of 'URTI' and
how many were given antibiotics.

As  a locum it is difficult to do audits on patient populations. I
therefore did a prospective audit over a 3 week period covering 22
sessions and 348 patients.

Audit of those presenting in surgery with a diagnosis of 'URTI' and
number of these with antibiotics given.


Prospectively I did a count over a 3 week period of 22 sessions and
348 patients of those presenting with symptoms of a typical 'URTI' and
noted how many I issued advice to, and antibiotic or an antibiotic
with a rider of 'benefit of the doubt'.



Number of patients seen = 348


Total with a diagnosis of URTI = 70 (20%)

NO antibiotics given = 47 (67%)

Antibiotics given  = 14 (20%)

Antibiotics given with a 'rider' of 'Benefit of the doubt'  = 9 (13%)


I advise patients that I am giving the 'benefit of the doubt', when I
think there is a 'possibility' of a bacterial infection, BUT I advise
that if things do not improve with them, a further course of
antibiotics will not help.


It has confirmed my belief that I try hard only to prescribe
antibiotics when they are required. It has also confirmed my belief
that 'URTIs' do form a substantial workload. Advising patients that
they DO NOT require an antibiotic can take a substantial amount of
time, and can take far longer than if an antibiotic is prescribed.
This was carried out in March during a period when it was televised
that GPs should not prescribe an antibiotic when a virus is considered
to be the causative organism to avoid resistance. It surprised me that
more did not know about this

On 15 October 2014 19:17, Dinesh Patel <[log in to unmask]> wrote:
> Paul
>
> You can use quality improvement activity instead of audit. Further, your
> appraiser should have
> confirmed in his summary that this was acceptable evidence of quality
> improvement.
>
> Have a look attached document. This may help support your case.
>
> http://www.rcgp.org.uk/revalidation-and-cpd/~/media/370F452EA9E44CBB9D1BB02CD84FA95F.ashx
>
> Dinesh
>
>
>
> On 15 Oct 2014, at 18:22, Paul Bromley <[log in to unmask]> wrote:
>
> Thanks all for the help & support. Am getting nowhere with this
> locally & no support to tick the box easily - they are still asking
> for a full audit cycle with re-audit (within a month!!??).  Will keep
> you posted how it goes. Was retiring within next 3 years anyway so may
> wait for a deferral, work the 6 months and then pack it all in. They
> will then have lost a local locum in an area where they cannot recruit
> partners at the moment. Their loss!!
>
> Best wishes
>
> Paul Bromley
>
> On 15 October 2014 18:01, kupton <[log in to unmask]> wrote:
>
> Just thought. If you are on doctors net there is a forum on there for non
> principals which has threads about revalidation. I did not need it as yet so
> have not looked through as yet. I only left partnership last July waited
> until after revalidation just in case.
>
>
> Karen U
>
>
> On 14 Oct 2014, at 23:05, Michael Leuty <[log in to unmask]> wrote:
>
>
> On 14 October 2014 22:08, Ian Trimble <[log in to unmask]> wrote:
>
> Unless the government has a serious rethink I'm afraid UK general practice
>
> is finished.
>
>
> What Trims said. The only question is whether NHS GP collapses before
>
> Australia and Canada fill all their posts.
>
>
> None of the requirements of revalidation reliably check whether the
>
> subject is fit to practice, they only appear to do so. If they don't
>
> take much extra time, then fair enough. But a token audit is a waste
>
> of a doctor's time energy and enthusiasm, and thus makes his practice
>
> slightly worse that it would otherwise have been.
>
>
> Quel tas de merde !
>
>
> Mike
>
>
> N.B. I am not on the Medical Register and all my opinions are those of
>
> a layman with an interest in medicine. If you are in any doubt you
>
> should consult your GP.
>
>
> --
>
> Michael Leuty
>
> Nottingham, UK
>
>
>
>
> --
> Best Wishes
>
> Paul Bromley
>
> www.informatiks.com
> Custom EMIS LV Software.
> vuE | GPLabels | GPDocs | eGFRChecker



-- 
Best Wishes

Paul Bromley

www.informatiks.com
Custom EMIS LV Software.
vuE | GPLabels | GPDocs | eGFRChecker