Persistent tennis elbow /rotator cuff/plantar fasciitis presents which would benefit from injection. You don’t feel confident to do it and have to temporise/refer/use less effective NSAID. Skill PUN may be met by delegation to partner who does injections for the practice or by fulfilling your own DEN by arranging appropriate training. Many patients will attend the same GP repeatedly during the course of their lives: this longitudinal relationship can influence attitudes, feelings, biases and processes within consultations for both patients and doctors Approaches for optimising continuity of care and long-term relationships with your patient and their families We’ve put together this template to make it really easy to identify plenty of PUNs, leading you on to then create the DENs, all together in a very presentable AppraisalAid template to upload to your favourite appraisal toolkit like Clarity or Fourteen Fish. CPD – Puns and dens Techniques to manage consultation time efficiently, including approaches for ending a consultation when appropriate

in different locations for example, patients' homes, residential or nursing care homes, urgent care centres and out of hours venues; and Maintain and develop your knowledge and skills in pharmacology, therapeutics and medicines management relevant to your role and prescribing practiceFreedom of Information and information governance including Caldicott guardians, management of data, confidentiality When prescribing, consider whether requests for repeat prescriptions received earlier or later than expected may imply poor adherence which could lead to inadequate treatment or adverse effects In the 'Tomorrow's Doctors' (2009) the GMC stated that "It is not enough for a clinician to act as a practitioner in their own discipline. They must act as partners to their colleagues, accepting shared accountability for the service provided to their patients. They are also expected to offer leadership and to work with others to change systems when it is necessary for the benefit of patients."

Understanding of statistics and application of tools (for example, run charts, process mapping, tally charts, Pareto charts, statistical process control charts, driver diagrams)As a GP, you share responsibility for the health of your local population and should understand fundamental concepts in epidemiology. These include: This exercise should be carried out over a week in the surgery. The first stage is to recognise the PUNs that arise during your consultations. The question the GP must ask himself after each consultation is “WAS I EQUIPPED TO MEET THE PATIENTS NEEDS?” or “COULD I HAVE DONE BETTER?”. In this way an area will be identified that would benefit from further learning or development. These areas for learning should be grouped into Equality and diversity encourages the promotion of inclusion as well as protects employment rights. It is important to be able to raise issues and challenge colleagues should any behaviour lead to discrimination. Patients need care that is in keeping with their own beliefs and values, irrespective of the religion or beliefs of the healthcare professional. 8Patients must also receive care that meets their communication needs – both mental and physical; all organisations in England that provide NHS care are legally required to follow the Accessible Information Standard which aims to ensure people who have a disability are provided with information that they can easily read, understand and receive appropriate support to help them communicate.

If, like me, the thought of appraisal slightly fills you with dread (alongside the annual failure to update your portfolio as you go along) fear not: there have been some significant changes to this year’s appraisal which should make it a less stressful process for all! Health and Safety at work regulations relevant to general practice including infection control, vaccine storage, decontamination/spillage (COSSH regulations), safe practice and methods in the working environment relating to biological, chemical, physical or psychological hazards, which conform to health and safety legislation Knowledge of the self-management of acute and chronic disease as well as appropriate information sources to which patients can be directed In response to the impact of a global pandemic, climate change, COP26 and the need to deliver a ‘Net Zero’ NHS, the RCGP felt it was vital that the GP curriculum should be updated to reflect the impact of theseLearning about the differences between primary and secondary care will help the specialty trainee gain a broader understanding of the principles and practice of clinical governance and how to maximise benefit for patients. There should be opportunities to undertake clinical audits and critical event analysis with hospital colleagues.

Assessment and evaluation are words that present difficulty both in meaning as well as content. They carry with them highly charged feelings which need to be defused. In the context of portfolio, or planned learning, they represent the learners own evaluation of both the method chosen, as well as the effectiveness. An important part of the process of understanding assessment is the expression of the persons understanding of the word(s) and the feelings attached to it. Chapter Introduction -- chapter 1 Why bother with learning? -- chapter 2 Finding time for learning -- chapter 3 Discovering learning needs with PUNs and DENs -- chapter 4 Examples of reflective learning -- chapter 5 Research to reality -- chapter 6 Sharing PUNs and DENs -- chapter 7 From PUNs and DENs to PDPs Prescribing and monitoring of medications and other products needs to be understood, developed and explored to ensure high-quality, safe care. Unsafe prescribing practices and prescribing errors are a leading cause of patient safety incidents across the world 8. This includes adverse reactions to medications which can be defined as any response that is noxious, unintended and occurs at doses used for prophylaxis, diagnosis or therapy 9. Recognition that personal emotions, lifestyle and ill-health can affect both your consultation performance and the doctor-patient relationshipDeath and cremation certificates including regulations on completing certificates, when to refer to the Coroner/Procurator Fiscal The primary/secondary care interface is especially vulnerable to patient safety incidents. Observing and understanding how different systems and processes manage this and other key transitions of care (for example, between health and social care) can often reveal areas for quality improvement. Learning with other healthcare professionals