Rapid Responses to:

EDITORIALS: Glyn Jones Elwyn Professional and practice development plans for primary care teams BMJ 1998; 316: 1619-1620 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Professional and Practice Development Plans

David Snadden   (1 June 1998)

Paperless practice's synonomous with good practice

Martin Jones   (1 June 1998)

Tame phlebotomists -an essential for good practice?

Robert Newmark   (2 June 1998)

The CMO's report: Moving towards two-tier GP Education

Richard Fieldhouse   (3 July 1998)

Professional and Practice Development Plans 1 June 1998
David Snadden, Director of Postgraduate General Practice Education Tayside Centre for General Practice, University of Dundee, Dundee, DD2 4AD Send response to journal: Re: Professional and Practice Development Plans	Glyn Elwyn'S editorial raises some interesting issues in terms of moving on current educational activities surrounding PGEA. The idea of practice based, multidisciplinary education is attractive. Recent experiences in the East of Scotland in terms of developing learning portfolios for general practice vocational training (1-3)and informal attempts to loosen the shackles of PGEA activities by encouraging the development of personal learning plans or portfolios by practitioners, does suggest that the widespread adoption of personal learning plans will need to be accompanied by intensive and skilled facilitation support. Such support is not inexpensive and any proposed developments will need to take this into account. General Practitioners are still hurting from the removal of PGEA from net income, and I agree that the re-instatement of this would ease the transition to a new system. All of which means that the financial resourcing of such a change would need to be carefully thought out and negotiated. In addition to this another group that fall outside of the current continuing education programmes are the growing group of non-principals who are becoming important providers of primary care. How will a move to practice based development plans include this group? A question that has to be addressed as a practice based system would make it even more difficult for this group to access educational activities. 1. Snadden D, Thomas ML, Griffin EM, and Hudson H. Portfolio Based Learning in General Practice Vocational Training. Medical Education 1996;30148-52. 2. Snadden D and Thomas ML. Portfolio learning - does it work? In Press. Medical Education 1998. 3. Snadden D and Thomas ML. The use of portfolio learning in medical education. Medical Teacher 1998;20(3):192-9.
Paperless practice's synonomous with good practice 1 June 1998
Martin Jones, Gp Whitchurch H/Centre Bistol Send response to journal: Re: Paperless practice's synonomous with good practice	Though I agree with many of the points raised in the article I would argue that the assumption drawn that paperless practice's are synonous with good practice is a false. Almost all clinical GP systems are excedingly poor at displaying and organising the patient record when compared to good quality written records especially A4 where past entries current medication letters and results are readily available. In my own experience I worked in a paperless enviroment for 2 years and now use only written notes in A4 the overall standard of note keeping does not compare. The paperless system left much to be desired
Tame phlebotomists -an essential for good practice? 2 June 1998
Robert Newmark, Retired GP South Tyneside Send response to journal: Re: Tame phlebotomists -an essential for good practice?	Paperless practice with integrated teams, nurse practitioners on tap, physiotherapy en suite and phlebotomy in the next room - are those really the essentials of good practice? But no word that, in such a practice, patients are seen within a short interval of requesting a consultation, that patients (usually) see the same doctor, that the doctors actually read medical journals.
The CMO's report: Moving towards two-tier GP Education 3 July 1998
Richard Fieldhouse, Chairman, NANP PO Box 188, Chichester, West Sussex Send response to journal: Re: The CMO's report: Moving towards two-tier GP Education	In his editorial, Glyn Elwyn rightly reflects the need for flexibility in developing professional practice development plans (ppdp's) REFERENCE 1. However, the reports' active exclusion of self-employed GP non-principals from professional and practice development plans REFERENCE 2, its ignorance of the 13 recommendations made by SCOPME into the education of non-principals (published two weeks later in paper but on the internet 3 months before REFERENCE 3) and its failure to recognise the existence of nearly 60 non-principal groups as "virtual practices" for ppdp's, will no doubt render this otherwise laudable report a white elephant. It is not so much a move away from a didactic uni-professional educational system, rather a move toward a system of educational apartheid that reaffirms a two-tier system of GP education. Before dismantling the fence between "education" and "quality", we have to demolish the walls of professional "inequality" by fully incorporating the the educational rights and needs of 20 per cent of all GPs that are non-principals. References: 1. Elwyn GJ Professional and practice development plans for primary care teams. BMJ 1998;316:1619-10 2. Department of Health. A review of continuing professional development in practice: a report by the Chief Medical Officer. London: Department of Health , 1998 (http://open.gov.uk/doh/cme/cmoh.htm) 3. SCOPME The educational needs of GP non-principals 1998 http://www.scopme.org.uk/gpnonp.htm Dr Richard Fieldhouse Chairman NANP r.fieldhouse@virgin.net www.nanp.org.uk Dr Tina Ambury NANP North of Scotland Representative nossg@blizad.globalnet.co.uk Dr Tony Downes North Wales Non-Principal Educational Facilitator, UWCM tony.downes@virgin.net Dr Rebecca Viney NP GP Tutor, North Thames RMViney@aol.com Dr Peter Harvey, Chairman of the NANP's PCG subcommittee harvey.nanp@paston.co.uk