Previews – PPR

Pathology | Practice Management | Research Review

Kristian BowlesAbnormal blood results
Kristian Bowles (Consultant Haematologist)

Kristian Bowles is a consultant haematologist and clinical director for haematology at the Norfolk and Norwich University Hospital. He qualified from Guy's and St Thomas' Medical School, London in 1995 and undertook his medical training in London, Kent and Southern Africa. Dr Bowles trained in haematology in Cambridge and Norwich. He has worked as a consultant in Norwich since 2006 covering all aspects of blood disorders with a particular focus on cancers of the blood.

Kristian Bowles has written book chapters on general haematology and the management of lymphoma and contributed to national guidelines on lymphoma. His lecture takes us on a whirlwind tour of haematology, taking the FBC report as it's template. Everything is here, and the answers to any questions you might have to the interpretation of abnormal blood test results will be forthcoming.

This lecture is full of facts and covers all of the haematological pathologies of the anaemias, polycythaemias, lymphoproliferative disorders, and ends with a discussion on MGUS.

This lecture will be one of those that you will bring up on screen regularly during the day when you just want to remind yourself about how to manage an abnormal result.

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Garry JohnLaboratory Diagnosis Diabetes
Garry John (Consultant Clinical Biochemist)

Professor Garry John is a Consultant and Honorary Professor of Clinical Biochemistry and was Chairman of the IFCC Working Group for HbA1c Standardisation.
The accepted glucose cut-off values for diagnosis have changed a number of times. In 1979 the WHO criteria included the measurement of glucose tolerance using 7.8 mmol/L as a fasting cut-off and 11.1 mmol/L as the cut-off two hours post glucose load. The fasting value was revised down to 7.0 mmol/L in 1997 along with inclusion ofsymptoms in the criteria and the introduction of impaired fasting glucose.
The use of HbA1c for the diagnosis of diabetes is the next development, albeit seemingly changing the definition of diabetes from hyperglycaemia to hyperglycation.

An HbA1c of 48 mmol/mol (6.5%) or greater is considered to be diagnostic of diabetes.
What has precipitated this development? And what does it all mean?
Professor John explains the biochemistry and and the application of the Hba1c test to clinical diagnosis. A perfect diagnostic algorithm , he states, has not yet been perfected, but may be possible. This is understandable once you have digested this lecture; Hba1c can mis-diagnose some individuals, and on a population basis, some diagnoses may be delayed. It is a simple to perform test, but not so simple to understand what it actually means. A definite must-attend lecture for any GP.

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Practice Management

clinical4Explaining the Clinical Audit Process
Stephen Ashmore & Tracy Ruthven (The Clinical Audit Support Centre)

The Clinical Audit Support Centre is the brainchild of Tracy Ruthven and Stephen Ashmore. Tracy and Stephen formerly managed Leicestershire Primary Care Audit Group (PCAG) and collectively have over 20 years experience in clinical audit and quality assurance across all sectors of the NHS.

The Clinical Audit Support Centre was founded in September 2006 and is a Private Limited Company. Tracy and Stephen are the founders, owners and directors of the business.

The main aim of the centre is to provide bespoke support and training to healthcare professionals across a range of quality improvement fields. The work of the centre is quality assured and all staff that work for the organisation must have an academic qualification in clinical audit or clinical governance. In addition, staff who deliver training must possess a nationally recognised teaching qualification

In this detailed lecture Stephen and Tracey explain how to perform clinical audit. This is an essential lecture for GPs and their staff who conduct audits.

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clinical2An Introduction to Clinical Audit
Stephen Ashmore & Tracy Ruthven (The Clinical Audit Support Centre)

Stephen Ashmore and Tracey Ruthven run the Clinical Audit Support service and have provided this lecture, an Introduction to the Clinical Audit Process.
Audit is an essential part of everyday clinical practice and this lecture will refresh your skills and enable your auditing to become more effective.
After discussing the audit process and reviewing the terminology and concepts involved Stephen and Tracey discuss a series of hot tips.

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clinical1An Introduction to Significant Event Audit
Stephen Ashmore & Tracy Ruthven (The Clinical Audit Support Centre)

An Introduction to Significant Event Audit

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John BaldaroStreamlining Practice Expenditure
John Baldaro (Director, PracticeProfit)

PracticeProfit is the UK’s only firm of purchasing and cost reduction experts who work exclusively with professional practices. John Baldero\'s talk here is an introduction to cost reduction techniques. Practiceprofit offer a range of specialist services all of which help GP's practices achieve more profit.

They have experience covering most business and management disciplines so are very likely to be able to help your business strategy planning, change management, purchasing, tendering and operations management.

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Ken CraigTaxation for self-employed GPs
Ken Craig (Partner, Rawlinsons Chartered Accounts)

This talk by Ken Craig, a Partner at Rawlinsons Chartered Accountants, provides a comprehensive guide to tax affairs for a GP. Recommeneded for all newly qualified GPs and trainees, and a useful reminder to the rest of us.

The lecture is in 3 parts and deals with the basics of taxation,  single handed and locum implications, partnership basics, national insurance, pensions and finally  " dealing with the HMRC".

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Nigel MorleySetting up a Pharmacy
Nigel Morley (Surelines Limited)

Nigel Morley is an independent consultant registered pharmacist and Managing Director of Surelines Ltd. He is acknowledged as a leading consultant in Dispensing Doctor Dispensing. From Government departments to the smallest single handed practice, he is happy to advise on financial, legal and practical matters. Nigel has particular interest in improving practice finances, pharmacy applications and controlled drugs.

Nigel's lecture here is an excellent review of all of the issues a GP practice will have to consider should they decide to set up a pharmacy. If you are a GP who is considering this, then this lecture will be of great interest to you.

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Nigel MorleyControlled Drugs - The Law, Probity & Good Practice
Nigel Morley (Surelines Limited)

Nigel Morley is an independent consultant registered pharmacist and Managing Director of Surelines Ltd. He is acknowledged as a leading consultant in Dispensing Doctor Dispensing.
Nigel has particular interest in improving practice finances, pharmacy applications and controlled drugs.
This is a lecture that dispensing doctors and their dispensers will benefit from viewing at regular intervals.

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Peter WaddellManaging Change
Peter Waddell (Partner, Cherith Simmons Learning and Development)

Peter Waddell is a Lead Consultant at Cherith Simmons Learning & Development. He has worked at board level in the UKs leading marketing agencies and is a leading edge marketing, management and communication strategist.

He specialises in Change Management, Marketing, Project Management, Management Development and Tailored Customer Care courses for all levels of staff. He is a guest lecturer at Bristol Business School on Customer Loyalty & a Visiting Lecturer at the University of Greenwich.

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James WilliamsMaximising surgery income
James Williams (GP Surveyors)

James Williams is a Senior Chartered Surveyor with GPSurveyors. His talk here is an excellent discussion of (and for new GPs introduction to) the intricacies of GP premises, and how they are funded.

He begins with discussing cost and notional rent, and some basics in how these should be approached. How can you maximise income from your premises? James deals with this question and discusses a variety of common strategies used by practices. Finally he discusses the four key factors which affect value: the DDA, infection control,  internal maintenance and layout.

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Research Review

Jerome PereiraThe National Mastectomy & Breast Reconstruction Audit
Jerome Pereira (Lead Breast Surgeon)

Professor Pereira is a Consultant Surgeon with extensive experience in general and oncoplastic breast surgery, and has been working at the James Paget University Hospitals for the last eighteen years.  He has been the first Consultant General Surgeon in the East of England to provide a full range of breast reconstruction operations.  He has been a national trainer for
Consultants and Surgical Trainees on breast reconstruction operations for many years.
He is also a trainer and teacher in the Department of Education at the Royal College of Surgeons of England.

He has a special interest in the outcomes of surgery, and has been instrumental in developing and leading the national mastectomy and breast reconstruction audit programme.  This is the first study in the world looking at outcomes of breast cancer surgery, and the largest patient outcomes study ever carried out in the UK.

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