Action Points: Clinical Management

Action Points for the Competency Rating Scales

  • Choose some (2-3) logs in which you focus especially on competences like providing continuity of care for the patient rather than the problem (should be possible in Pall Care) and review of drug interactions and side effects.
  • You need to look at the word statements here ( Clinical management) and demonstrate them on routine cases to demonstrate the subsets of this competency.
  • Improve your knowledge of the management of minor illnesses in GP. demonstrate this in entries looking at natural history and how you used this too.
  • Consider how you can demonstrate using time as a diagnostic tool. Write up some cases when you have done this.
  • On e-P write about how you might demonstrate being competent in dealing with the uncertainty you can have in General Practice and the challenges this can bring with sharing management options with the patient.
  • As stated in your CSR – attend more out-patient clinics to give you exposure to the type of patient you are likely to see in the community and demonstrate you have developed skills to make decisions independently.
  • You need to demonstrate you can independently manage all types of patients and conditions you are able to see in GP though a good choice of Clinical Encounters and through your choice of CbD and COTS.
  • Continue to expand your knowledge as this will help with management decisions. Use NICE pathways as quick reference. Provide learning log entries (Clinical encounters and SEAs) that demonstrate logical thought processes when determining appropriate management plans for patients. Learning Log entries need to demonstrate you can manage patients independently without seeking senior advice (but of course still ask if patient safety needs this).
  • When you ask for advice always make sure that you have written down your thoughts and plans before you get advice. Write LLE comparing the plan you had and that the senior person had.
  • More log diary linkable entries which will be easier to do where the simple expectant approach is easier in the GP setting, as will be variation of options when slightly less constrained by hospital protocols. So time to rehearse options and possibilities and being appropriately flexible within the bounds of good care.
  • Take up learning opportunities in your next post to learn GP relevant management Document the learning of this in your log.
  • Consider in your e-P the difference in management in the GP setting. More use of time and clinical management of chronic conditions over multiple consultations.
  • Lots of Paediatrics management is slightly different to adult medicine. Reflect on how this happens and how this might impact upon your career in GP.
  • You will need to consider how GP management differs from the hospital posts that you have been used to.
  • It would be good to see more evidence of follow up and provision of continuity of care when in a more permanent GP role. You should prepare evidence of your follow up for your first GP principal appraisal.
  • get some different conditions that you feel are important to know about in Paediatrics e.g. asthma, DKA etc. and write up some management plans describing also how you would adjust these to changing circumstances.
  • Document cases where continuity of care and follow up has been needed. Aim to reflect not only on your own clinical management decisions but on implications for the services offered by the practice and on future resource development for example.

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