Scottish National Users' Group (SNUG) Podcast

The challenges we face

This month, we are talking to ourselves! Dr Neil Kelly @NeilGKelly reflects on his impressively long stint as chairman of SNUG, and the influence SNUG can have, and has had on strategy and providing support for GP IT users. He considers, as we head into an uncertain winter, how technology can best help us deliver health care and the need for us all to look after ourselves and each other. We have an update on the latest developments in the slow running GP IT Re-Provisioning project (at 14:58), a taster of what's in store at the forthcoming SNUG virtual conference (24:34), and we get a little insight into Neil's secret interests in fermented grape juice and sea-resistant light fittings as well as his favourite SNUG anecdote.

https://www.snughealth.org.uk/events/snug-membersday-2020/

Standards for General Practice Information Technology

A main aim of the 2018 GMS Contract was to make GP workload more sustainable and this has resulted in the addition of many Health Board employed staff to work in general practice teams - pharmacists, ANPs, physiotherapists, phlebotomists and mental health nurses. National standards have been set for the IT hardware and systems available within general practices in Scotland.

Dr Andrew Cowie @DrAndrewCowie is deputy chair of the BMA's Scottish GP Committee and a GP partner in Dundee. He helped negotiate the current GMS contract for General Practice in Scotland and this episode features a conversation between Dr Cowie and Dr Andrew McElhinney of the Scottish National Users' Group (SNUG) about the standards which have been set for GP IT currently, whether these are being met, and what the main needs are going forward.

SNUG Survey: we are keen to gather thoughts from our members on how funding for the  new GMS contract has been used in each area, and this will aid discussions at the SNUG Virtual Conference in November.

Programme and registration page for the SNUG virtual conference on November 10

2018 GP contract

Scottish GP Committee

Is SCI Gateway really essential?

NHS Scotland developed SCI Gateway in the early 2000s to allow secure communication of clinical data and enable GPs to make protocol-based referrals from Primary to Secondary Care. Over the years it has been used for many thousands of GP referrals, and also a much wider range of purposes including the requesting of advice from specialists, death certifications, infection notifications, and tertiary referrals. It has been adopted by the NHS in Wales and Northern Ireland. However the NHS now has to make a decision about the future of SCI Gateway in Scotland and consider whether to invest in its future, or whether it may be time to consider a new alternative product. We have discussions with Lesly Donovan, the General eHealth manager in NHS Fife, and John Wells, eHealth Project manager in NHS Forth Valley who consider some of our questions about how vital Gateway currently it is for the daily working of the NHS and is it really essential to keep it for the future?

We would be interested in what other GP IT users think...

Starting to eConsult

As we continue to develop new ways of working in Scottish general practice, face to face consultations are no longer the norm. Many practices are making much greater use of telephone and video consultations and good triage systems are essential to help patients use services most effectively. eConsult (@econsult_thinks) from WebGP is a platform which provides new and easier ways for patients to get help with a problem - whether through self help, online advice or via telephone, video or face to face contact where appropriate. It is all requested online through the practice website - which removes the need to phone the practice. This episode features a discussion with Dr Kris McLaughlin of Stonehaven Medical Group who spoke to Dr Andrew McElhinney of SNUG, along with other members of his practice team, to discuss the details of how best to get eConsult up and running, and what practical issues need to be addressed.

What is eConsult, and how does it work?    eConsult demo site

Let us know if you have any comments on Twitter at https://twitter.com/snusersgroup or Facebook at  https://www.facebook.com/scottishnationalusersgroup

Good Outcomes from Evidence Based Medicine

This month, we have a special edition of our podcast, starting to look at online resources for Clinical Decision Support, this time featuring a wide-ranging conversation with @medmyths James McCormack, Professor of Pharmaceutical Sciences at the University of British Columbia. We discuss why shared decision making about starting treatments is a vital part of Evidence Based Medicine, where many guidelines and the Quality and Outcomes Framework (QOF) may have got it wrong, and why Scotland's move to Realistic Medicine is to be applauded. We also discuss why lower doses of medicines are often better, how Homer Simpson can help you learn and what some of the beneficial outcomes from the Covid pandemic might look like.

Visit James McCormack's YouTube site to see these educational videos and more: Evidence-based look at Clinical Practice Guidelines, Dose response curve, The surrogate battle - is lower always better?

The Best Science Medicine Podcast looks at evidence for managing common  conditions seen in Primary care.

The BSM CHD risk calculator not only calculates the 10 year cardiovascular risk but lets you easily see the benefits or harms of a range of interventions for that patient.

As usual comments are welcome  via our Twitter or Facebook pages.

Using Teams in Practice

Graham Gault is the eHealth Lead for Dumfries and Galloway and he was involved in the Scottish Government deal with Microsoft to purchase Office 365 for the NHS. He speaks to Dr Neil Kelly of the Scottish National (GPIT) Users Group (SNUG) about how he expects #office365 and @MicrosoftTeams to start to transform the way the NHS works, providing new opportunities for flexible and collaborative working online. We will be able to share documents and other files much more easily, also speak and meet online, with an impressive reduction in the need to travel and improvements in cybersecurity.

The pandemic has increased the need for remote working and been a catalyst for rapid change within the NHS. General Practices can start to benefit now from this new ability to work, meet with colleagues remotely, and share documents in the Cloud. This will greatly ease the difficulties caused by the current need to save files within local systems. NHS Scotland will also get a new email system later on this year as NHS Mail is replaced.

"Massive opportunities...the industry is changing, and our single message is that people have got to change and embrace this", says Graham.

Learn more about how to use MS Teams at:

NHSScotland - An introduction to Microsoft Teams

NHSScotland MS Teams knowledge base

MS Teams - short training videos

Using technology to fight Coronavirus

The Covid-19 pandemic has changed the world - and Scottish general practice. Many practices are using technology in new ways, and existing innovations have been accelerated - Dr Andrew McElhinney talks to Dr David Cooper @davidcooper1975  from Old Machar Practice in Aberdeen about using eConsult (http://www.oldmachar.co.uk/econsult.html)  and to Karen Hotopp @KarenHotopp of  @NHSForthValley about using Attend Anywhere/Near Me for video consultations. A number of new technologies are growing fast in general practice as we try to keep patients and staff safe and use other methods of consultations where possible.

Find out more at: https://nhsforthvalley.com/health-services/near-me-video-consultations/

Patient guide: https://nhsforthvalley.com/wp-content/uploads/2019/08/How-To-Attend-A-Near-Me-Appointment.pdf 

This is a short video showing the set up in NHS Forth valley: www.carronbank.co.uk/eHealth_training_videos/Near_Me_set_up_GPs_and_patients.mp4

Practice managers are usually set up as service administrators and have the capability to set up users in the practice by using their email address. Log in to Attend Anywhere (in Chrome) and follow this link: https://nhs.attendanywhere.com/rc/Content/C_Tasks/VCM/VCM_WA_AddUser.htm

And a little light relief at.... https://www.youtube.com/watch?v=ojrtwXqqc6g

40 years in GP Information Technology

Dr Jim Campbell  is the Clinical Advisor to the @NHSNSS National GP IT Re- Provisioning Team @GPITScotland. He has been a key influencer in GP IT for nearly 40 years and describes his journey through the world of IT as a GP in Irvine, and GP IT advisor in Ayrshire, and also his roles with the GPASS Users Group, SNUG, and now NSS and GP IT Re-provisioning, with Dr Neil Kelly @NeilGKelly) of SNUG. Jim describes moving from a world in which all prescriptions and appointments were handwritten, and how he designed a Lunar Landing game, analysed orthopaedic discharges, asked if GPs were able to record disease incidence and prevalences, and then with the GPASS Users' Group, helped support other practices and share ideas, up to the present time, when he helps  clarify the requirements for the new GP systems by developing "User Stories" to illustrate these to suppliers.

How will GP IT need to up its game during the current Covid 19 pandemic? He thinks the telephone and remote access to systems will be vital. How will the current crisis change peoples' perceptions of what general practice is going to be? That will be an on-going question.

https://www.campbellsoftware.co.uk/    https://www.gpit.scot.nhs.uk/news-events/

Medication, medication, medication

A recent series of workshops called "Transforming the Primary Care Prescribing / Dispensing Pathway" was jointly sponsored by the Pharmacy and Medicines Division and Primary Care Division of the Scottish Government. We discussed some of the matters arising from these workshops and some potential  solutions for Primary Care prescribing with Dr Scott Jamieson (@DocScott82) of the RCGP and Tony McDavitt (@skepticine) a Primary Care pharmacist in Shetland.

Topics included polypharmacy, barcode problems, increases in non-medical prescribing, who should do those medication reviews, why do GPs sign thousands of paper prescriptions which could be sent electronically, how to increase serial prescribing from general practice, can smarter IT systems give us better warnings when prescribing, and how can better communication between GPs and pharmacists help everyone do things better in the future?

Thanks to Prof James McCormack (@medmyths) for use of his excellent Bohemian polypharmacy video! See also his Youtube channel  and listen to the BS medicine podcast  to be better informed about using medicines well.

When Neil met Lucy

When you or your relatives are ill or in need of care don't you want the people looking after you to have the right information to look after you properly? Sharing the right information securely and at the right time with all providers of health and social care is both extremely important and also suprisingly difficult to achieve. Dr Lucy Munro (@DrLucyMM) is a GP and  the Associate Medical Director for Primary Care at NHS National Services for Scotland (@NHSNSS). In a conversation with SNUG co-chairman Dr Neil Kelly (@NeilGKelly), she talks about her career and also how she has helped to develop the important new joint data controller arrangement recently negotiated between the Scottish General Practitioners Committee and the Primary Care Directorate of the Scottish government as part of the new GMS contract for Scottish General Practice. There is advice on what practices need to do now about completing the Joint Controller and Information Sharing Agreement document issued in November 2019. Just imagine you're in an Edinburgh coffee shop listening to them..

SNUG members check out https://www.snughealth.org.uk/events/into-the-future-of-digital-healthcare-in-scotland/ and the latest newsletter https://www.snughealth.org.uk/news/snug-winter-2019-newsletter-now-available/

Do give us some comments at https://twitter.com/snusersgroup or https://www.facebook.com/scottishnationalusersgroup