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Scottish Health Services wishes the world a peaceful Eid day

Eid-ul-Fitr marks the end of the month of Ramadan; the month of Fasting and the beginning of the month of Shawwal, the 10th month of the Islamic Calendar.  It is a day of celebration and thanksgiving for Muslims all around the world is dependent on the sighting of the moon.  Most of the world is celebrating Eid day today with their family and loved ones and remembering those are no longer with them.

 

Eid-Ul-Fitr 2016

 

Eid-Ul-Fitr wallpapers

Let workers self-certify illness for 14 days, say GPs

On Wednesday BBC News reported on the self-certification debate with doctors saying that workers should be able to self-certify sickness for up to two weeks to help reduce the number of unnecessary GP appointments.

People need a doctor’s note if they are off for more than a week, but GPs said people should be trusted more and it could reduce the growing burden on GPs.

The call at the British Medical Association’s annual conference comes amid rising demand for appointments.

But the government said it had no plans to change the existing policy.

Doctors also want to be paid for carrying out health checks on patients who apply for firearms licences.

GPs are asked by police to report any health conditions – mental or physical – that may present a risk.

These assessments can take up to an hour to do as medical records have to be examined, and doctors said that uses valuable NHS resources.

Dr John Canning, a GP from Middlesbrough and chairman of the BMA’s professional fees committee, said: “That’s half a dozen appointments that it will take up. That’s six people who don’t get seen.

“We’re busy enough doing the day job, curing the sick.”

Both these issues on their own represent a relatively small share of the average GP workload, but Dr Richard Vautrey, a Leeds medic who sits on the BMA’s GPs committee, said combined with other issues, they could start to help reduce the burden.

‘Sensible move’

It is estimated that GPs in England carry out 370 million appointments a year – a rise of 70 million in the past seven years.

Dr Vautrey said doubling the length of time someone is able to self-certify illness would be a sensible move in helping to ease the strain.

“If you’ve got a patient who very clearly has an illness that is going to last 10 days to two weeks, why do they need to make an appointment with a GP, just to get that note to tell their employer what their employer probably knows already, and what the patient should be trusted to be able to pass on?”

He also highlighted other examples of unnecessary appointments – including people asking for certificates to show that their children were well enough to take part in school plays and council tenants needing proof that damp houses made their asthma worse in order to move.

A DWP spokesman said it had no plans to change the existing self-certification policy, adding: “The system was set up following consultation and we believe it supports individuals and employers without overburdening GPs.”

Last year, a report by Citizens Advice found that a fifth of GPs’ time was taken up with non-health issues.

Locum GPs needed for Manchester Medical Practice and ‘walk-in’ centre

Scottish Health Services are seeking locum GPs to work in two medical practices, including a ‘walk-in’ centre in the Manchester area.  Full-day and half-day sessions are available as well as a full day session each Friday from the 15th July until the 30th December.  An excellent rate of pay is on offer along with flexible sessional times.  If you are interested then please contact our Managing Director, Glenn on 01467 620547 or by email at: glenn@scottishhealthservices.co.uk.

Locum GPs needed in West London

Scottish Health Services are working with a number of medical practices in the West London area and are seeking locum GPs!  Top daily rates of pay are on offer.  Full-day sessions are available from July.  If you are interested then please contact our Managing Director, Glenn on 01467 620547 or by email at: glenn@scottishhealthservices.co.uk

Locum GPs needed in the Highlands

Scottish Health Services are seeking locum GPs to work in an established medical practice in the Highlands.  An excellent daily rate of pay is on offer with free self-catering accommodation and travel expenses.  Daily sessions are available from August until December with further sessions available in the New Year.  For further details please contact our Managing Director, Glenn on 01467 620547 or by email at: glenn@scottishhealthservices.co.uk

Sessional GPs – the ball is in our court

The Practice Blog on the BMA website reported on last month’s LMC Conference, and the Sessional GP Subcommittee attended via GPC.

As reported last month, the format of the conference was different, and apart from an afternoon of parallel sessions, the number of actual motions was less and focused on the response of the profession to the government and the crisis in General Practice.

Of particular importance to sessional GPs, we debated a motion for the Subcommittee wholly rejecting the Department of Health’s fixing of maximum indicative locum rates, and reaffirming that locum rates should be a matter of mutual agreement between the practice and the locum. (See How will changes to indicative locum rates impact you?) I am pleased to report that the motion was carried in all its parts.

At conference it was good to see and meet up with some familiar faces and indeed meet some new and energetic colleagues. However, as a proportion of the GP workforce, we remain underrepresented at conference. From the returned conference survey results only 17% of those GPs who attended were locum and salaried GPs, compared to just under 60% of contractors GPs, and is a reflection of our continuing lack of representation at grassroots LMC level. Not just from a representational point of view, but with the roll out of devolution, vanguards, new models of care and the formation of networks/federations, it is increasingly important that Sessional GPs are there at LMC level.

The ball is firmly in our court in this matter, and it is for Sessional GPs to put themselves forward when and where we can.

As part of our support for you, we are currently revising the Sessional GPs and LMCs-working together more effectively guidance, and this will be re-launched next month. The guidance is aimed not just at Sessional GPs, but as the title suggests, LMCs, and should be helpful for all.

Lynx back in UK: 90% of public supports reintroduction of big cat to wild

Scottish Health Services fully supports the reintroduction of the Lynx in Aberdeenshire and other designated release sites across the UK.   Indeed one of the trial release sites is located near Huntly in rural Aberdeenshire and is close to the home of Glenn Millar, Managing Director of Scottish Health Services who, along with his 4 and-a-half year old daughter is wildly excited about the prospect of observing such a beautifully striking feline predator in its natural environment.

Rather encouragingly a report by Hannah Osbourne published on the 27th April 2015 on the International Business Times website indicates that the vast majority of the UK population are also behind the reintroduction of the Lynx.

 

lynx in uk
Public supports reintroduction of lynx to UK.  stefanie kraus/Flickr
The vast majority of the UK public would like to see the lynx reintroduced back to Britain, with over 90% of people saying they would support a trial programme.The survey, by Lynx Trust UK with support from the University of Cumbria, had over 9,500 responses from people across the country, with data coming from both rural and urban communities.

Findings were weighted towards people in the countryside, who would likely live near the extinct cat and the long-term effects of their introduction.

In the survey, rural respondents made up 20% of the UK but 50% of the sample. Young people aged between 18 and 35 also make up a fifth of the UK population, but 50% of the sample. “Our figures are weighted towards those who will live alongside lynx, and those who will live with the long term effects of a reintroduction, two important groups of people,” the charity said.

“Amazingly, the figures weighted towards rural communities and young people came out most positive, but the positivity overall has really stunned us; positive responses are above those recorded for beaver reintroductions in Scotland, and negative responses are a really long way below those recorded for beavers.

“And with all that said, here’s some pro-active data; 91% back a trial reintroduction of lynx in the UK, 84% believe it should happen within the next 12 months.”

The plan would be to put the big cats at sites in Aberdeenshire, Cumbria, Norfolk and Northumberland.Susanne Nilsson/Flickr

The Lynx Trust is hoping to reintroduce the big cat for a five-year trial, releasing up to 24 creatures on estates in Aberdeenshire, Cumbria, Norfolk and Northumberland.

After the lynx went extinct, there was a surge in Britain’s deer population – largely attributed to the lack of natural predators.

 

Chief scientific adviser Dr Paul O’Donoghue said: “Lynx have proven themselves across Europe to be absolutely harmless to humans and of very little threat to livestock, whilst bringing huge benefit to rural economies and the natural ecology, including species like capercaillie, which face some serious problems in the UK. It’s wonderful that the general public want to see lynx given the chance to do the same here.”

A similar survey about the reintroduction of beavers in Scotland got an 86% approval rating, which led the government to go forward with the programme. “We’re expecting to see a consistent response from Scottish Natural Heritage and hope for similar in England and Wales,” he added.Applications for the reintroduction programme are expected to be completed by the summer. The animals would be monitored by satellite for between three and five years.

 

 

 

What Is Ramadan? A Simple Explanation For Non-Muslims

Article 

Only very few people have never heard of Ramadan, but that doesn’t mean that everyone actually understands it, or knows anything about it aside from the fact that Muslims might seem a little less active than usual. Still, since it is a month that greatly affects about a fifth of the world population, it might be a good plan to educate ourselves on what exactly Ramadan is. After all, during my time in Bahrain, finding myself in a house full of Muslims in an Islamic country, I found out that Ramadan doesn’t quite work the way we might think in the West.

First of all, the basics: Ramadan is the ninth month of the Islamic lunar calendar, and it is seen as a holy month due to the fact that the Quran was first revealed to Prophet Muhammad during this month. Muslims observe this month by fasting during the day, something the Prophet himself did as well, abstaining not only from food, but also from sex, smoking and even water. Yes, you read that right: no water, even if you live in a desert in the Middle East. More on that later.

The entire thing becomes a bit more complex when you start talking about the start of Ramadan. See, the Islamic calendar is a lunar one, so not only does the date of Ramadan change by approximately 11 days every year, slowly moving through the seasons, but its beginning is based on the standing of the moon, and that isn’t always fully predictable. Specifically, Ramadan starts when the crescent moon is sighted, and it ends with the new moon after 29-30 days (a day that is called Eid). A difference of opinion exists, however, about how to determine this. Some use a Saudi Arabian declaration that is based on prior calculations, others use the sighting of the crescent moon itself. As an example, at 1 AM on the 28th of June (2014) my Islamic friends in Bahrain were still unsure about whether or not they would be fasting the next morning. It later appeared that Ramadan would start on the 29th, but the doubt was there until very late at night.

Either way, once Ramadan starts, Muslims are not allowed to eat, drink, smoke or have sex during the day, although other things are often added such as not getting into arguments or swearing. For instance, in case you thought not eating for 12 hours was impressive, I had the honour of watching a fasting friend in Bahrain play multiple Fifa 14 matches, and losing, without swearing even once. Now THAT is impressive.

One thing that might need some more explanation, though, is the term “during the day”. “The day” ends when the sun has gone down, so when it’s still relatively light outside but when the sun itself is no longer visible on the horizon, at which point Muslims break the fast with a meal called Iftar, often starting by eating dates, just like Prophet Muhammad did. It starts again when the sun comes up, before which Muslims all over the world have “Suhoor”, the last meal before fasting again.

However, the “all over the world” thing is slightly problematic  as well… See, as some of you might know, the earth is round, and that not only means that when the sun is up in Bahrain, it’s down in Tokyo, but it also means that there are places in the world where the sun doesn’t go down at all for a very long time. Being a practising Muslim in Qaanaaq, Greenland is a little problematic when the sun is up 24/7 from the 21st of April until the 22nd of August. It means that if Ramadan falls in the summer, they wouldn’t be eating nor drinking for 30 days, which is going to make it very difficult to pray 5 times a day. Or to do anything else ever again, for that matter…

But the main thing people in the West misunderstand about Ramadan, is that it isn’t just about the not-eating and drinking. Sure, it is incredibly impressive and good for your discipline to spend a day on excursion through Bahrain, visiting a zoo and a desert even though it’s 50 degrees, all without drinking any water, but there is much more to it. Ramadan is a month of reflection, of spiritual strengthening. Muslims are extra involved in their religion, in their role as a spiritual being, and that makes it not a month of difficulty that has to be survived, but a month of celebration. Ramadan is a month which Muslims look forward to rather than one they fear or look up to, and that, to me, is even more impressive and inspiring.

Of course, that doesn’t mean that they wouldn’t appreciate some support. Particularly in non-Islamic countries, fasting isn’t easy, because while in the Middle East the daily schedule can at least be slightly adjusted, in the West, it’s difficult to eat at 3 AM if you have to get up again at 6 to go to work. Living more at night is not an option since sleep is vital as well, not to even mention the fact that in the summer, most places in the West see the sun go down a whole lot later than in the more traditionally Islamic countries. Some kindness and understanding, therefore, can go a long way, just as long as you do remember that Ramadan is a blessing, and not a curse.

 

Boy outside mosque waits for evening Ramadan prayer

Muslims before the evening prayers on the first day of Ramadan

 

 

 

 

 

Career Profile: working as a locum GP

Support 4 Doctors published an interesting article on its website on what it’s like being a locum GP.

Dr Richard Fieldhouse, Chairman of NASGP (National Association of Sessional GPs), explores the practicalities – and the pros and cons – of working as a locum GP
Q: In your experience what are the main advantages of being a locum GP?

A: Perhaps the greatest advantage to being a GP locum is about committing as much as possible of one’s time working as a GP to seeing patients. Rather than forming long-term ongoing relationships with patients, often seeing the same patient on many occasions, our caseload is much broader, and less specific. In one year, a full-time partner will see around 1,600 different patients, whereas most patients a locum sees are for the first time, so they could see up to 10,000 different patients a year if they’re working in lots of different practices, as many are.

Because of this, our approach often has to be quite different. As well as not knowing the patients so well, we also might be working in unfamiliar practices that could be struggling or even underperforming.

And it’s the variety of those practices that can make the work very exciting. It’s great to be able to help out and support struggling practices, and offer patients alternative opinions; to be a fresh pair of eyes, and working with patients to support our colleagues’ ongoing management.

Q: What are the financial implications?

A: On the whole, the financial implications for the practice are cost neutral. Yes, some practices can spend what they feel is a fortune on locum GPs, but they would have otherwise have had to spend it on a salaried GP or partner income. At least this way it can be a tax-deductible expense.

In my 19 years as NASGP chairman I’ve never met a GP locum who was just doing it for the money. Granted, if one extrapolates up what a locum agency could potentially charge a practice for a locum, it could come to an eye-watering amount. But generally what a locum actually receives in income, factoring in a reasonable daily rate, periods of unemployment, unpaid holiday, study and sick leave, and medical indemnity, it’s pretty similar to what a partner would be earning. And bear in mind that for agency locums, the agency can take a cut of around 30% of the fee the practice pays.

Q: Is there anything about the way locums work that might be seen as a disadvantage?

A: To me, the biggest problem faced by GP locums is professional isolation. Back in 2010, the RMBF produced an excellent report on this, and found locum GPs to be some of the most isolated professionals working in the UK.

Professional isolation can have a big knock-on effect in a lot of what we do, and how we can support practices.

Every practice does things differently: referrals, policies, guidelines, their preferred specialists, how they organise care etc. Although a GP locum may be a brilliant clinician, what can often let us down is access to those 200 or so different bits of non-clinical information. At the very best, some practices will provide a ‘locum folder’, but these are invariably out-of-date and very hard to actually find the information one needs when one needs it.

And when it comes to learning, sharing experiences, supporting colleagues or being supported, and working through significant events, these are all very difficult to do if you don’t actually have any colleagues.

Q: Are there any ways of reducing the possible disadvantages?

A: Yes! When we established the NASGP 19 years ago, our first job was to develop the Standardised Practice Induction Pack (Spip). We produced over 3,000 copies for practices, and have just released a vastly improved online version. Using Spip, practices can centralise all their core information about services, policies, guidelines, etc that any GP unfamiliar with that practice can access, rather than (as often as not) having to painstakingly find out this essential information from staff on a very time-consuming and disruptive ad-hoc basis.

Another thing we set out to achieve is to increase the number of locum groups from a then total of five, to over 100 sessional GP groups today. However, these groups often didn’t have the infrastructure to provide the high level of logistical support needed to support GPs working in lots of practices. For this reason, in 2002 NASGP developed the locum chambers concept, in which locums pay a small percentage of their income to provide all of that support. These chambers function very much as ‘virtual practices’, with members meeting up on a regular basis, sharing experiences and disseminating best practice amongst their locum colleagues and local practices.

Q: If I want to become a locum GP, what can I do to find work?

A: This depends. If there’s a locum chambers near you then we would very much recommend you check them out first and see if it’s for you; they’ll book all your work for you, and will generally be the first port of call for local practice managers. Failing that, join a local locum group who may have a local practice mailing list. At the end of the day, even if you’re new to a chambers, nothing beats putting a CV together and visiting local practices to introduce yourself and to find out a bit more about the practices.

There are a growing number of websites that can help put you in touch with practices, but make sure you’re with one that allows you to set your own rates.

Q: What about agencies?

A: Since agencies employ their locums, you won’t be entitled to contribute to the NHS pension scheme (unlike chambers, where you remain self-employed). But they can take a lot of the legwork out of finding work, and are often very efficient at making sure you get paid on time. You can register with multiple agencies, and some have better reputations than others so do ask other local locums what their experiences are. And make sure you read the small print as they can often have restrictive clauses that mean you can’t work independently at a practice once you’ve worked there through the agency. The real strength of agencies is their tenacity, with staff who are trained to do all they can to fulfil practices’ requests.

Q: Who do I need to be registered with or inform?

A: To be a locum GP, you need to first and foremost be a fully qualified GP. Depending where in the UK you live, you’ll need to be on a specific performers list, pay self-employed National Insurance contributions, be GMC registered, do annual NHS appraisals, have had a recent DBS check, and have a smart card  I also strongly advise getting an accountant!

We’ve put together a lot of this information on the NASGP website, and you can always have a word with your chambers, agency or locum group if you get stuck.

Q: How good a financial manager do you need to be as a locum?

A: Very! If you’re a self-employed locum, you’re running your own private business. So as well as a financial manager, you’re also your own sales, marketing, accounts, bookkeeping, human resources and complaints department too. It’s one of the reasons why chambers are so popular.

Q: How can I keep up to date professionally?

A: Getting access to CPD can be tricky as a locum because you’re often left off local mailing lists from your CCG or postgraduate centre. Locum chambers usually have their own CPD programme provided for members as well as all other local GPs, or again you can ask at your local locum group to see what they provide or know about.

Q: What equipment would you suggest a locum takes with them?

A: I use a professional rugged camera bag, in which I have my stethoscope, diagnostic set, sphygmomanometer, BNF, Oxford Handbook of Clinical Medicine and Oxford Handbook of Specialities, thermometer, adult pulse oximeter, tendon hammer, tuning fork, pens, and always a bottle of water and some roasted nuts or a banana as a mid-morning snack. Never rely on being offered a cup of tea or coffee.

Q: What would your top three tips be for someone starting out as a locum GP?

A: Enjoy the challenge of working in lots of different practices. Adopt the mindset that you are providing an invaluable service to local practices and offering patients an opportunity to see a different GP. Never say to anyone that you’re ‘just a locum’.

Q: Where can I find out more?

A: www.nasgp.org.uk

Dr Richard Fieldhouse is the Chairman of the National Association of Sessional GPs (NASGP)

On Call: The Trials of Being a Muslim Doctor during Ramadan

From the Virtual Mosque Website; by Ahmed Zaafran

Originally published in August 2010

77745389_5dc2b84dd6_oWith Ramadan rapidly approaching, the time has come to prepare mentally, spiritually, and physically for one of the most important times of the year in Islam. The month of Ramadan comes at the height of summer this year, bringing unique challenges.

The focus of this particular article is geared towards those who are medical professionals: physicians, students, nurses, technicians. However,  as people from all lines of work deal with time management issues, in sha’ Allah (God willing) those who do not work in the healthcare industry  may still benefit from this advice and can work collectively to implement it.

Making a Plan

Making a plan is a useful way to get things moving in the right direction.  List out the objectives you aspire to meet for the day. For example, as a resident physician in Anaesthesiology at the busiest trauma centre in the country, I anticipate being in the operating room for many hours at a time, often without a break.  Knowing that, sometimes I have to use lunchtime or break time to fulfil my obligatory prayers and may even be forced to combine my prayers in unusual situations.

Many hospitals provide prayer areas within chapels for Muslims to pray or even have a masjid (mosque) within the hospital. However, this may not always be the case. Whatever the situation, try to find a spot where you can reflect on your prayer, reconnect with Allah and your intentions for fasting, and reenergize yourself.  In time, you’ll find many unexpected gifts from Allah peppered throughout your day, giving you a firsthand view of the fruits of hard work and good intentions. Remember that Allah knows your circumstances even more than yourself. You may become discouraged that because of your time constraints, you cannot fulfil your desire to be fully engaged with Allah during your Ramadan. Don’t allow yourself to fall into that rut; your two rak`at (units of prayer) are worth more than you think.

Establishing the Right Mindset

Establishing the right mindset is half the battle. I can’t tell you how many times throughout medical school my Muslim peers would make excuses as to why they don’t need to fast during Ramadan. The most common excuse I heard was, “How could I possibly concentrate on my studies if I’m fasting?”  Another common cop-out was, “Bro, I’ll just make it up later once finals are done with.”

To many of you, this may sound outlandish or even blasphemous, but it is commonly seen in people who deal with the physical and emotional demands of being a medical student or physician, which brings me to the point of this section. Establishing the right mindset means more than just telling yourself that you will fast during Ramadan. It means training yourself that your “starvation” is in fact the easiest part of Ramadan. The real challenge lies in your remembrance of Allah, making all of your actions a form of worship, and fulfilling your role as a representative of Islam in the midst of a watchful environment.

To be honest, Ramadan is the best time to showcase the beauty of our religion and its focus on self-control. For example, how many times, in any occupational platform, have people come up to you, after finding out that you are fasting from food AND water (for some reason they are always impressed with the water part),  to inquire more about your fast and your faith? This is the perfect time to explain to them what fasting during Ramadan really means, that abstaining from our material desires, including food, sexual relations, backbiting, and slander, are only the physical vehicles that allow the spiritual self a viable platform to elevate itself. People in the healthcare industry understand what it means to make sacrifices. It might sound like clockwork to you, but for many of your colleagues, it is the most profound thing they will ever hear.

Time

Amongst medical students and physicians, a quite broad category in and of itself, a high demand on time handcuffs their abilities to have an effective Ramadan. The amount of information required of medical students to learn, memorize, digest, and apply is quite daunting, and they often find themselves missing out on prayers entirely, whether during Ramadan or other times of the year. The key is to prioritize your time around your prayer by redistributing it. The epicenter of your day is your prayer, and you should make everything else the ornamentation to that foundation. As hard as it many seem at the time, you’ll eventually find yourself both excelling in your prayers and concentrating on patient care as well. Keep in mind that the workday has its gaps and moments when you can take quick breaks. For the student, study breaks are a part of the daily routine. Rather than rushing to the TV for a break, take a moment to reconnect with the Qur’an, even if it is just for a few minutes. Ramadan comes only once a year. Don’t let the month leave without cashing in on those precious moments that usually go wasted.

Spiritual Connection

Finally, put your work into perspective. The type of work you do in medicine exposes you to various situations that challenge your mind and your soul. You are given the task to heal people’s ailments, whether physical or mental, and are able to provide them with a service that nurtures and improves the thing most precious to them: their health. Personally, I can relate to the spiritual challenges faced by physicians on a daily basis at the hospital. Just a few weeks ago, I took care of a young man in his early 30s who seemed to have the world ahead of him. A minor ailment initially brought him to the hospital, but his health deteriorated quite rapidly.

2:156

“Who, when disaster strikes them, say, “Indeed we belong to Allah, and indeed to Him we will return.” [Qur’an, 2:156]

The team working to save his life moved quickly and diligently, doing everything humanly possible to resuscitate him. The exact moment Allah subhanahu wa ta`ala (exalted is He) took his soul was quite evident, and the organized chaos in the room instantly transformed into a deafening silence. Despite exhaustive measures on my part and on that of the medical professionals around me, we were not able to save his life. Muslims and non-Muslims alike had to deal with that situation, and the fear can choke the air out of your throat. Moments like these can shake one’s faith if he is not prepared, but it can also strengthen one’s resolve and solidify his love for Allah.

Use Ramadan to strengthen yourself. Seek refuge from Allah from all your insecurities. Use the training that Allah has blessed you with to fulfil His commandments. Take every opportunity to show Allah that more than anything else, you are trying to purify yourself and humble yourself under His Presence. Medicine is a field that carries much responsibility and much prestige. Use your status amongst your peers as a pedestal to serve your Lord and as a mechanism to eradicate arrogance.  The Qur’an gives us pearls every time we read it, and perhaps the verse that can be used by medical practitioners the most to correct their intentions and set the tone for their daily work lies in Surat al-Ma`idah,  entitled  “The Table Spread.”

5:32

“Whoever kills a soul unless for a soul or for corruption [done] in the land – it is as if he had slain mankind entirely. And whoever saves one – it is as if he had saved mankind entirely.” [Qur’an, 5:32]

With this verse in mind, we can truly use the month of Ramadan as a springboard not only to serve our fellow human beings in need of medical treatment but also as an opportunity to use our skills  as a means to please our Creator, Allah, exalted is He.