ePulse V12 number 09

Tuesday 16 February 2010

News

• Quality Symposium highlights
• Quality and Safety Improvement Commission
• Call for College Conference Abstracts
• Praise for CORNERSTONE
• Call for RHM nominations
• Pregnancy Care Training Funds Available for GPs
• Kieran Sweeney
• Research Grants
• Journal Watch

Consultation

Representation

Research

Vacancies and advertisements

CME

Conferences

News

Quality Symposium highlights
The 2010 RNZCGP Quality Symposium in Wellington over the weekend was attended by more than 220 key primary care stakeholders. Work led by the College on the development of a quality framework and indicators for New Zealand primary care was showcased. This work was supported by British Kings’ Fund experts Nick Goodwin and Candace Imison and Royal Australian College of GPs President Dr Chris Mitchell who usefully compared with, and discussed, the local quality work with what is being done in Australia and the UK. Goodwin and Imison pointed out that New Zealand can be very proud of its record: “New Zealand already punches above its weight in delivering high quality primary care services with limited resources.” The value of the development of Quality indicators by and for clinical leaders committed to quality improvement was also underscored by Goodwin: “You can’t improve what you can’t measure,” he said. Past RNZCGP president Jim Vause led a lively, wideranging workshop on the Ministerial proposal for Integrated Family Health Centres (IFHCs), asking participants to work in groups on how to use existing structures to work towards setting up an IFHC in a fictional New Zealand community. Papatoetoe (and ProCare) GP Karl Cole also gave an excellent presentation on employing technology in general practice. For more on the Symposium (including speaker presentations) see the College website http://www.rnzcgp.org.nz/quality-symposium/ and the March issue of GPPulse.

Quality and Safety Improvement Commission
Health Minister Tony Ryall opened the Quality Symposium with a presentation on the future direction of quality in the New Zealand health system, and announced the establishment of a Quality and Safety Improvement Commission, a seven-member clinician-led agency independent of the Ministry of Health. “We’re delighted the Minister is focussed on clinician-led quality care for patients,” College President Harry Pert enthused. The new members, with appointments up to three years, will provide input into developing the role and functions of the new Commission. Nominations should be forwarded by 8 March to joyce-anne_raihania@moh.govt.nz. The College will make a nomination and is currently compiling a short-list of potential candidates. If you would like to be considered for inclusion on this list, please email your CV and a brief statement covering your relevant experience to Annie.Fleetwood@rnzcgp.org.nz. Appointments will be announced early April with the Commission formally established (and the existing body QIC disestablished) 12 April.

Call for College Conference Abstracts
Our 2010 Conference, Doing the Right Thing, takes place 2-5 September 2010 at the Christchurch Convention Centre. Abstracts are now being accepted! Full details are on the Conference website: www.rnzcgpconference.org.nz.

Praise for CORNERSTONE
Health Minister Tony Ryall also thanked the College, general practices and GPs for their leadership in improving public healthcare quality and safety through CORNERSTONE. “Gaining CORNERSTONE accreditation was an empowering process for all the staff at my Rotorua general practice,” College President Harry Pert chimed in. “It certainly helped us improve the quality of care we are able to provide for our patients.” With Dunedin North Medical Centre’s recent assessment, 500 practices have now had CORNERSTONE assessment.

Call for RHM nominations
Nominations are requested for members of the Division of Rural Hospital Medicine Council. Further details of the roles may be obtained by requesting a copy of the job descriptions from the administrator of the division, email lana.henderson@rnzcgp.org.nz or phone 04 4965999. Nominations close 5pm Friday 19 February 2010. Nominations must: include a brief curriculum vitae; be proposed, seconded and signed by two Fellows and/or Members of the Division; and be signed by the nominee. The successful nominees will take office for two-year terms at the 2010 Division of Rural Hospital Medicine NZ Annual General Meeting. This will be held 4-5.30pm 11 March at the Christchurch Convention Centre.

Pregnancy Care Training Funds Available for GPs
As part of the additional funding allocated for maternity services in the 2009 budget, the Ministry of Health is making funds available to GPs wishing to undertake additional training in pregnancy care beginning from March this year. The courses covered include the Postgraduate Diploma in Obstetrics and Medical Gynaecology (PGDipOMG) and certain tertiary level papers available via distance learning. For further details of the funding available and how to apply, please contact Cindy Farquhar - c.farquhar@auckland.ac.nz.

Kieran Sweeney
Professor Kieran Sweeney, an Exeter GP who presented superbly at the 2005 College Conference, has died aged 58. Domhnall Macauley has written a moving tribute: http://blogs.bmj.com/bmj/2010/02/08/domhnall-macauley-lasting-memories. “I watched the course of his life and career with great interest and admiration; his commitment to patients, creativity, courage of his convictions, his use of language, innovation, intellectual dexterity. But, above all, his humility… at the centre of everything was his care for people. Dedicated to patients, he once took time out of practice because he could not face another one of his patients dying. Part of him suffered with every loss.” The College expresses its condolences to Kieran’s family and friends.

Research Grants
Applications for the next round of Wellington Medical Research Foundation grant applications close on Tuesday 16 March 2010. Referee’s reports are due by Tuesday 30 March 2010. Further details of the grant application process at www.wmrf.co.nz.

Journal Watch
• Lower car CO emissions, decreased suicide by exhaust gas correlated
• Erectile dysfunction strongly predictive of atherosclerotic cardiovascular events
• Identification of antigens which may advance malaria vaccine development
• Exposure to food, drinks packaging chemical associated with heart disease

Consultation

Thank you to those members who found time to provide comment on the issues in the previous edition of ePulse.

Prioritisation Meeting
The Ministry of Health is holding a meeting of DHB GP liaisons on the 19th of March in Wellington, and there is the opportunity for a few additional GPs interested in issues such as prioritising access to secondary care advice and diagnostic services such as colonoscopy and echocardiograms, to also attend. Register your interest at policy@rnzcgp.org.nz.

GPEP OWL flying
On Friday the Royal New Zealand College of General Practitioners launched OWL for GPEP1 2010. OWL is the Online Web Learning site for the general practice vocational training pathway we operate. OWL was developed for Registrars and their Educators involved in GPEP1 for 2010. By the end of the year it is envisaged that it will also be a learning tool for those moving into GPEP2. GPEP2 facilitators will be able to log on by Friday. And in time for all College members undertaking professional development.GPEP1 Registrars and their Educators will have access to all programme, curriculum and seminar details, and the resources required to complete their learning. OWL has interactive components and enables all users to participate in forums and surveys regionally and nationally. We look forward to delivering GPEP1 through OWL. Any, comments, queries or feedback? Contact sue.domanski@rnzcgp.org.nz.

Day surgery definition
The Ministry of Health is consulting on a proposed definition of day surgery that can be used for regulatory purposes. This will affect general practices and GPs that provide day surgical procedures outside of hospital settings. They want a definition that will include high risk procedures while avoiding inadvertent inclusion of low risk procedures. An expert working group, which had Dr Hans Raetz as our representative, came up with the following proposed definitions: 1.Day surgery is the same day admission and discharge of a consumer to a facility or service for a planned surgical and/or diagnostic procedure by a registered health practitioner. 2.Day surgery is the admission and discharge, within 24 hours, of a consumer to a facility or service for a planned surgical and/or diagnostic procedure by a registered health practitioner. Please let us know at cathy.webber@rnzcgp.org.nz which definition you prefer by Thursday 25 February 2010.

Regulation of Health professions: MOH discussion document
The MOH have released a discussion document How do we determine if statutory regulation is the most appropriate way to regulate health professions? The Health Practitioners Competence Assurance Act 2003 (the Act) provides a framework for regulating health professions to ensure the public is protected from harm when receiving health services. This discussion document discusses the criteria for regulating health professions and seeks comment on proposed revised criteria. Please email your views to contribute to the College submission by 22 February to policy@rnzcgp.org.nz.

Aiming for Excellence: Fourth Edition
In preparation for the fourth edition of Aiming for Excellence, Royal New Zealand College of General Practitioners seeks your views on its third edition by the end of April 2010. Your advice will help us understand whether Aiming for Excellence still measures what it was intended to measure. Our full consultation document can be found here. Contact Maureen.Gillon@rnzcgp.org.nz with feedback.

Defining the role of the GP
Dr Jo Scott-Jones, College rep on the then Primary Healthcare Advisory council (PHCAC), has put considerable thought into the issues around the role of the GP in current and future primary care teamwork. The result is a paper, mentioned in a recent edition of NZ Doctor, ‘Defining the Role of the GP in a primary health care team: The GP genome and phenotype 2009-2020’. Jo and the College are keen to hear feedback which can be sent to policy@rnzcgp.org.nz. Jo’s paper is available here.

Access to high-cost, highly-specialised medicines in New Zealand
The three person panel Review of Access to High-Cost, Highly-Specialised Medicines in New Zealand has released a preliminary report intended to promote discussion and elicit feedback. The report is available here. Members’ thoughts on this issue would be appreciated and can be sent to policy@rnzcgp.org.nz.

PHARMAC altering funding and access arrangements for special foods
The College will be making a submission on this consultation. It includes the proposal that vocationally registered general practitioners become eligible to authorise Special Food Special Authorities. Members comments on this and other recommendations can be sent to policy@rnzcgp.org.nz by Wed March 3rd, to inform the College response. The consultation document is available at:

• Consultation on altering subsidies for Special Foods. Closes Friday 19 March 2010

PHARMAC (Three further consultations)
Members wishing to comment on the proposals below can click on the link for further information and respond directly to PHARMAC by the closing date indicated. If you consider that this proposal requires a formal RNZCGP response please let us know by emailing policy@rnzcgp.org.nz.

• Proposal to fund bisacodyl suppositories (Dulcolax). Closes 5pm, Friday 26 February 2010

• Proposal to reference price risperidone. Closes Friday 5 March 2010.

• Proposal relating to provisional agreement with Allergan Australia Pty Ltd for various products. Closes Friday 26 February 2010

Opioid Substitution Treatment: draft service specifications
The Ministry of Health and DHBNZ have released two draft service specifications around Opioid Substitution therapy- (methadone). The first outlines arrangements for specialist services and the second concerns arrangements for care shared involving primary care and specialists in Opioid substitution, Those wishing to provide feedback on the draft can request a copy by sending an email with Opioid Substitution in the subject line to policy@rnzcgp.org.nz prior to 18 February.

ACC: Revised Clinical Guideline Recommendations for MRI use in diagnosing soft tissue knee injuries
ACC have provided the following information for e-Pulse: ACC seeks your feedback on updated clinical guideline recommendations about the use of MRI for diagnosing internal derangements of the knee. ACC is consulting with professional organisations/associations/colleges, and their members, who have an interest in the diagnosis and treatment of knee injuries. You are a valued provider of services to ACC and as such we would like to hear your views on the revised recommendations. We would like to hear from both groups and individuals. Please go to http://www.acc.co.nz/news/PRD_CTRB132893 to access the consultation document and feedback form. On the same weblink you will also find the evidence-based report that informed the revised recommendations. Your feedback will be considered by the group of experts who developed the draft recommendations, and any necessary changes will be made before the recommendations are finalised. We will inform you of the final recommendations and seek formal endorsement from your professional group. ACC will do a final dissemination to the sector using several approaches, including a publication in ‘ACC Reviews’. If you have any queries related to this consultation please feel free to contact me by email at sarah.clark@acc.co.nz.

Consultation on the competencies and standards for education programmes for the revised enrolled nurse scope of practice
The Nursing Council will be introducing a revised scope of enrolled nurse practice for all second level nurses and has revised the competencies and the standards for education programmes. The consultation documents can be downloaded from http://www.nursingcouncil.org.nz. Responses are required by March 15.

Representation

RNZCGP Representatives are required:

Medsafe statutory advisory committees
Medsafe requires GP representatives for the following committees:

    1. Medicines Assessment Advisory Committee
    2. Medicines Adverse Reactions Committee – Chair of this committee.
    3. Medicines Review Committee

Terms of reference are available. The appointments are for a three year term. Closing date: 22 February for RNZCGP endorsement

If you are interested in these following committees please contact Annie.Fleetwood@rnzcgp.org.nz for further information.

Research

Research Dosh
The RNZCGP’s Research and Education Charitable Trust is inviting applications for research and travel grants. Please complete the application forms and either post them to the College or email it to pam.berry@rnzcgp.org.nz. The forms are available here: http://www.rnzcgp.org.nz/Research-Applications-2.

Vacancies and Advertisements

RUSSELL GP
Permanent GP partner wanted for the beautiful Bay of Islands. We both work five sessions a week but our income is close to that of a full-time GP! We have a fully equipped surgery and purpose built premises that are funded by a local community trust. The practice is fully computerised (Medtech32) and Cornerstone accredited. For more information see http://www.propertyvideosnz.com/Doctor/Business.html. Phone 09 403 7604 or email ianbirch@paradise.net.nz.

CHRISTCHURCH GP
Long term position for GP – 5/10ths. Large, established, purpose built, suburban practice in multidisciplinary centre. Friendly, supportive staff in a superb working environment. Email claireh@barringtonmc.co.nz.

King Country GP Locum – Part/Full time
Do you want to enjoy lifestyle, leisure activities, rural practice in the heart of King Country, close to Mt Ruapehu, part or full time for long term? Then it’s for you – two Doctor GP practice, located in the local hospital. Medtech, very friendly staff to work in an attractive environment. Ph: 0064 7 895 3333; email: manager.tmc@xtra.co.nz.

Clinical Leader RHM
The Clinical Leader RHM will contribute to the College’s Strategic Focus of a high performing, sustainable workforce for general practice and rural hospital medicine through providing clinical leadership for the DRHM’s training programme. It is a 3/10 position but this can be negotiated. If you have any questions regarding this role please contact Lana Henderson, Rural Hospital Medicine Administrator. Complete cover letter and CV should be emailed to lana.henderson@rnzcgp.org.nz.

Christchurch GP
Ferrymead Medical Centre has a fresh opening for a new partner (female preferred). We are a three person practice in large, purpose-built facilities, situated within the Ferrymead retail district and in a rapidly growing area of Christchurch. A great opportunity is open for a motivated and dedicated replacement for our outgoing partner. A permanent long term locum would also be considered. Contact Dr Brendan Smith at brendan.smith@ferrymead.pegasus.net.nz.

Miramar GP
Locum required for July 2010 to cover leave in a friendly four doctor family practice, 8 or 9/10ths preferred. Locum also required for July school holidays (5th to 16th) to cover leave, 4/10ths or more considered. Contact Raewyn, practice manager, on 04 388 7018 for more information on either position, or send CV to manager@miramarmedical.co.nz.

South Island – Solo GP
Available in a delightful South Island town, a solo general practice. Pleasant, well equipped premises, well managed, with excellent staff, contact joeballs@es.co.nz or phone 03 434 7697 or 021 349721.

Rotorua - Senior Registrar (GPEP 2)
Rotorua’s Ranolf Medical Centre has a vacancy for a GPEP2 Registrar to join us for a year or two. This is a busy Cornerstone accredited practice with great opportunities for further training in a very supportive, team oriented practice. Excellent conditions and remuneration. For further information talk to our current registrar, Eloise Fry at efry@rgpg.co.nz, or contact Debbie Morris, Practice Manager at dmorris@rgpg.co.nz.

Click here to go to the College website for more vacancies.

CME

Palliative Care Education Opportunity through Hospice New Zealand – free of charge
Hospice New Zealand offer free access to monthly Palliative Care Lectures. These take place on the first Thursday of every month from 7.30-8.30am. The lectures cover a range of topics and are delivered via teleconference, usually with a power point presentation that the speaker takes participants through. The last 10-15 minutes of each session is dedicated to questions, giving the opportunity to raise anything specific with the speaker. Please click here to find out more, see this year’s schedule of lectures and to register.

Culture, Health & Society (Postgraduate)
This paper develops an understanding of the cultural and societal contexts in which medicine is practised. It provides a general introduction to the discipline of medical anthropology and anthropological concepts of culture, embodiment, health and illness. Click here for more information or visit www.otago.ac.nz/dsm/gp.

Southern Balint
A Balint weekend workshop will be held in Christchurch on February 20 and 21, 2010.The workshop offers the opportunity for GPs, GP Registrars and other health professionals to experience a Balint group with a focus on the doctor-patient relationship. This workshop has been endorsed by the RNZCGP, and has been approved for 9 hours CME for General Practice Educational Programme Stage 2 (formerly AVE) and Maintenance of Professional Standards (MOPS) purposes. To register, please contact Cecile Pilkington at c.pilkington@auckland.ac.nz.

Palliative care forum for medical practitioners
The Australian and New Zealand Society of Palliative Medicine (ANZSPM) invite you to attend one of 3 forums being held in New Zealand in March 2010. The invited speaker, Professor Janet Hardy, (BSc, MBChB, MD, FRACP, FAChPM) is palliative medicine specialist from Brisbane, Australia, and will be discussing What's new in pain control in palliative care - the science behind the myths. This workshop has been endorsed by the RNZCGP, and has been approved for 9 hours CME for General Practice Educational Programme Stage 2 (formerly AVE) and Maintenance of Professional Standards (MOPS) purposes. The forums will be held in 3 locations from 6.15-9pm (a light meal will be served): Christchurch on 29 March 2010, convenor Dr Kate Grundy; Palmerston North on 30 March 2010, convenor Dr Joy Percy; Auckland on 31 March 2010, convenor Dr Cathy Miller. For more information or to register: ANZSPM website www.anzspm.org.au or email Karen Cooper: karen@anzspm.org.au.

OBSTGYN 712 & 715
Want to update your knowledge in contraception, pre and early pregnancy or medical gynaecology? Click here for more information.

Postgraduate Diploma in General Practice
The Postgraduate Diploma in General Practice is designed to meet the needs of GPs and the Postgraduate Diploma in Rural & Provincial Hospital Practice is designed to meet the needs of doctors working in rural hospitals. Click here for more information or visit www.otago.ac.nz/dsm/gp.

Advanced Wilderness Life Support Course
Host; Southland Wilderness Medicine Group (WildMed). Venue: Crown Plaza, Queenstown, New Zealand. Dates 12-14 March 2010 or 16-18 July 2010. Approved by the RNZCGP for up to 17 hours endorsed CME. More information; www.wildmed.co.nz or wildmed@xtra.co.nz.

Spine in Action: Low Back Pain - Can Chronicity be Prevented? Auckland March 27-30, 2010
The NZ Association of Musculoskeletal Medicine is holding a Scientific Conference examining the factors that contribute to, or predispose to the development of chronic low back pain and how these factors can be managed. The neurobiological & anatomical substrate, as well as the clinical basis to the identification and management of low back pain will be explored. Internationally renowned speakers include Prof Lars Arentdt-Nielsen, Prof Johan Vlaeyen, Prof Paul Watson, Prof Jacob Patijn as well as local and Australian speakers. Visit www.musculoskeletal.co.nz for program and speaker details and registration. Earlybird rates apply until end January. The NZ Association of Musculoskeletal Medicine is an RNZCGP endorsed CME provider.

Skin Cancer Courses
HealthCert and the University of Queensland, Australia, have released the dates for skin cancer certificate courses. Essential theory and practical aspects are covered in basic or advanced workshops. 2010 courses include Certificates in Primary Care Skin Cancer Medicine; Surgery; Advanced Dermoscopy and Dermal Imaging. The workshops are presented by highly qualified, experienced lecturers and include hands-on practical sessions. Local expert presenter, Dr Sharad Paul (NZ) will be conducting the Surgery course and an Advanced Surgery Workshop. Dr Paul covers highly relevant and concise information for GPs. 2010 courses start in Melbourne, 20-21 Feb with the Certificate in Primary Care Skin Cancer Medicine and Primary Care Skin Cancer Surgery. The Certificate courses are individual short courses or they can be part of the Master of Medicine (Skin Cancer Medicine) programme. Now in its third year, this dynamic programme has seen over 180 students enrol and 75 students graduate. The programme offers doctors the chance to formalise and develop vital skills in Skin Cancer Medicine through an internationally recognised institution. For course information please visit www.skincancercourses.com.au or email christine@healthcert.com.au or call +61 7 3137 1399.

Managing Sexual Problems for Medical Practitioners
An evidence-based up-to-date online training programme specifically designed for GPs and approved by RNZCGP for 12 hours CME credits: download in writing to produce a surgery reference; download in audio form to listen to as you travel to work and back. Access all three forms for the same cost plus make the most of email access to ask tutor, Clinical Psychologist Robyn Salisbury, director of Sex Therapy NZ about your patients’ sexual dysfunctions. Enquiries: admin@sextherapy.co.nz or ph 0800 739843 (0800 sextherapy) or register on www.sextherapy.co.nz.

Smoking Cessation in Practice – E-learning tool
An e-learning tool for registered health workers is available online at: www.smokingcessationabc.org.nz. The tool introduces ABC, the new approach for managing people who smoke (as outlined in the New Zealand Smoking Cessation Guidelines), and contains practical information about giving brief advice and Nicotine Replacement Therapy. The tool takes between 20 and 40 minutes to complete.

Otago Study Options 2010
Otago 2010 study options. Semester one: primary health care, longterm conditions management, Maori health, tropical medicine and travel medicine. Semester two: longterm conditions management and wilderness medicine. Enquiries: Johanna.meaclem@otago.ac.nz. Then there’s Health Research Ethics BITX 406, introducing the basic ethical aspects of health research on humans. Enquiries: Vicki.lang@otago.ac.nz.

Conferences

Doing the Right Thing – The New Zealand General Practice Conference
This year’s RNZCGP conference will be held at the Christchurch Convention Centre, 2-5 September 2010. Book the date in your diary now.

Infant Toddler Preschool Mental Health Conference
The University of Auckland, 18-20 February 2010. International Experts in the Field of Infant and Early Childhood Mental Health will talk about: Relationship Disorders, Premature Birth, Early Behaviour Leading to Conduct Disorder, Autistic Spectrum Disorder. Further information is available here.

RPGN 2010
NZ’s premiere rural general practice conference looms. With just under six weeks before the start of the annual New Zealand Rural General Practice Network conference, rural general practitioners and other interested medical professionals are urged to register now for this not-to-be-missed event on the calendar. This year’s programme is one the best put together by the conference committee and features workshops and sessions as diverse as Wilderness Medicine and Acupuncture in pain control to Fracture management and Dealing with legal issues in twenty-ten. With an emphasis on the inventiveness and resilience of rural general practice, this year’s theme is, aptly, “Rural Health – No. 8 Wired”. Come and listen to sessions on:

•    fertility in rural versus urban
•    wilderness medicine
•    homecare nursing
•    rural practice management
•    emergency transport
•    asthma control and management
•    pain management
•    and much more

Conference 2010 has been endorsed by The Royal New Zealand College of General Practitioners (RNZCGP) and has been provisionally approved for up to 16 hours (= 16 credits) CME for General Practice Education Programme Stage 2 (formerly AVE) and Maintenance of Professional Standards (MOPS) purposes .The conference runs from March 11-14 at the Christchurch Convention Centre. If you have any questions or queries please call Network communications manager Rob Olsen on 04 495 5887, 021 82 2468 or email rob@rgpn.org.nz. Visit www.rgpn.org.nz to register.

Evolving Communities Beyond Services, Building Bridges National Conference for Community Mental Health and Addictions 2010
Conference summary: Transcending barriers, cultures and differences in our approach to community mental health and addictions services. 14 – 16 April 2010, Wellington Convention Centre, Wellington. For more information, go to www.buildingbridges.co.nz.

International

19th Wonca World Conference of Family Doctors, Cancun, May 2010
For the first time in the history of the World Organization of Family Doctors (Wonca), a Latin American country will be the venue for the World Conference of Family Doctors: the Mexican College of Family Medicine is designated organizer of the 19th Wonca World Conference of Family Doctors, to be held in the city of Cancun, Mexico, from 19 to 23 May 2010. The Conference will spread the latest scientific and technological breakthroughs and will lead to the reflection on the technical and social role that Family Medicine must have to achieve the international goals that were proposed in the 2000 Millennium Summit: the Millennium Development Goals (MDGs). For more information visit http://www.wonca2010cancun.com.