Sutherland Division of General Practice
Inside this issue...
GP Census Results………......2
The GP Direct Connect Project Team advises that the GP Hotline has
been reviewed and improved and in now being relaunched. This
St George Hospital
Outpatients……………….…...3 hotline is to provide GPs with a direct line to the Admitting Team in the
Sutherland Hospital Emergency Department.
The hotline number is:
Feedback on this service can be provided to Dieuwke Chavez on (02) 9540 7123
(M-F 8am - 5pm) or via email Dieuwke.firstname.lastname@example.org
2010 ANNUAL GENERAL MEETING
THURSDAY 21 OCTOBER
Anxiety - not just for
1/8 Water Street, Sans Souci
7 pm Registration; 7.30 pm AGM and Dinner
Antenatal Care - Changes to Members of the Division are invited to join colleagues and friends at the beautiful
Shared Care Protocol………11
Blackwater Restaurant for the 2010 AGM. This year Dr Robyn Napier from AMA
NSW will speak on Health Reform and the impact on general practice.
SUTHERLAND We will also recognise the contributions of GPs who are standing down from the
Division of General Practice Management Committee: Dr Philip Lye, a founding member of the board, Dr Jack
Phone: 9545 3533 Ng and Dr Hannah Wright.
Fax: 9545 3522
RSVP to Lynne on 9545 3533.
Address correspondence to:
Suite 502, Level 5, 3-5 Stapleton
Ave, Sutherland NSW 2232
DEADLINE FOR NOVEMBER -
GPS AND WORK CONTINUING PROFESSIONAL DEVELOPMENT
Increasingly GPs are electing to work part time, with 62% of The five most popular topics for further education are:
GPs who completed the survey indicating that they work less
than 10 sessions a week. Almost 85% of GPs indicated that
they did not expect to change the total number of sessions Mental Health
worked in general practice over the next 12 months. Orthopaedics
GPs were asked if their visits to residential aged care
facilities have changed. 31% of GPs indicated that they do
not visit RACFs and a further 12% indicated that visits had
Some suggestions for the CPD program include “more
decreased. The majority of GPs had maintained similar
active and interesting learning modules with CPD points”
numbers of patients in RACFs however 22% said that their
and “lunch time CPD meetings”. The Education Sub
visits had increased.
Committee will take your preferences and these comments
into consideration when planning the 2011 program.
100 GPs (42%) are registered with ARGUS and now receive SHIREGPS
electronic discharge summaries from area hospitals.
The Division’s website (www.shiregps.org.au) has been
Satisfaction levels were assessed with 48.5% of GPs
accessed by almost 70% of GPs in the last 12 months. Of
indicating that they are satisfied to very satisfied. However,
those GPs, 86% found the information on the website
there is still room for improvement with almost 19% of GPs
useful. The newsletter is still the major medium for
dissatisfied and we are currently working with the Hospital to
communication between the Division and GPs, with 98% of
improve the process.
GPs indicating that they found the newsletter useful.
GPs commented that they were still not receiving discharge
Division programs and activities are supported by GPs with
summaries for every patient and that it varied across the
94% indicating that the current programs support GPs:
hospital with “good” summaries from Accident and
“I will be very concerned due to government legislation if we
Emergency. Some GPs thought that there had been an
lose what divisions provide for the average GP.
improvement, particularly in legibility now that the
summaries are mainly typed.
WHO Statement on Rotavirus Vaccines and Intussusception
On 22 September 2010, the WHO released a statement relating to intussusception following rotavirus vaccination as,
in Mexico, surveillance data had indicated a clustering of hospitalisations (no deaths) for intussusception in the
period 1-7days following the first dose of Rotarix vaccination.
At present, the WHO considers the benefits of rotavirus vaccination far outweigh the slightly increased risk of
intussusception. The full statement can be found at: http://www.who.int/vaccine_safety/topics/rotavirus/
Questions and answers on this issue have also been posted on the US Food and Drug Administration web site at:
At the time of writing, there has been no specific advice from Australian medical authorities.
SHIRE GPs NEWSLETTER
The newsletter provides information and is distributed free to all GPs in the Shire, local specialists, some other Divisions, local hospitals, AHS, and selected
national medical newspapers. Opinions expressed are not necessarily those of the Sutherland Division of General Practice.
Chair: Dr Sharyn Wilkins; Deputy Chair: Dr Sheena Wilmot; Secretary: Dr Jack Ng; Treasurer: Dr Philip Dwyer
Members: Drs Philip Lye; Craig Nelson; Rowan Vickers, Owen Brookes; William McConnell, Hannah Wright
CEO: Yvonne Rowling; Program Manager: Belinda Michie
Accounts Supervisor: Barbara Boxall
Program Officers: Jan Sadler; Gillian Minto; Shona Dutton; Liesl McCoy; Amanda Rattray; Laura Denegris; Thien Vo; Amy Young
Programs’ Assistant: Lynne Durie; Newsletter Editor: Dr Fiona Long
Thursday, 28th October 2010
Speaker: Dr’s Mark Brown, Steve Thornley & Andrew Zuschmann
• Hypertension in Pregnancy
• Diabetes Mellitus in Pregnancy
• Post Date Management
Date: THURSDAY,28th October 2010
Time: 7.00pm Registration & buffet dinner, 7.45pm Lecture
Venue: HAZELHURST GALLERY & ARTS CENTRE, 782 KINGSWAY, GYMEA
Contact: Jan at the Division on 9545-3533 or tick the fax back sheet
RACGP QA & CPD
Thank you to our sponsors: Pts:Total 4 points
(2 pts per hr Cat 2)
BAYER SCHERING PHARMA & BAYER CONSUMER CARE
OUTPATIENTS DEPARTMENT – ASHM COURSES IN HIV AND
ST GEORGE HOSPITAL PRIMARY CARE
Please note that there has been some In conjunction with the Australasian HIV/AIDS Conference
changes made to the Outpatients 2010 (22nd Annual ASHM Conference), the Australasian
Department form for the St George Society for HIV Medicine (ASHM) will be running two
Hospital. courses in HIV medicine.
You will find the new form on our website The Introduction to HIV Care for General Practitioners
www.shiregps.org.au under hospital forms for (Saturday 23rd October 2010) is designed to cover HIV
downloading. management in primary care, and aims to encourage more
GPs to engage in shared care management for HIV.
In an effort to improve service provision for patients
attending the clinics of the Outpatients Department there Topics covered include risk assessment, testing,
will be an implementation of SMS Text messaging of management of newly diagnosed and basics of antiretroviral
appointment confirmations to those clients with mobile therapy. This course is also suitable for nurses and other
phone numbers included on referral forms. It is important health professionals.
to include mobile contact details within the form to enable
confirmation by SMS and also to facilitate contact around The ASHM HIV s100 Prescriber Course (Sunday 24th and
notification of changes to clinics after the initial booking. Monday 25th October 2010) is designed to provide
clinicians with the necessary knowledge and skills to
Some key things to remember: prescribe HIV s100 drugs for the management of HIV
infection. This two day course builds on the content from the
When completing the form it is essential that a Introduction to HIV for General Practitioner and covers
full birth date is included on the form not just the common first line therapies and their associated toxicities,
age of the patient. monitoring patients on therapy, long term issues and
If you do not have a preference for a particular complex needs of people living with HIV.
specialist in the clinic that you are referring to
For more information and to register for this course please
please tick all the specialists within that clinic to
visit the ASHM website: www.ashm.org.au/courses. Please
get the next available appointment.
note that the Introduction to HIV Care for General
If you are requiring a priority appointment in any of the Practitioners is a prerequisite for attending the ASHM HIV
clinics please make contact with the registrar attached to S100 Prescriber Course.
the clinic via the hospital switchboard on 9113 1111 and
discuss your needs.
Tips for Practice Staff to distribute AUSDRISK Tool
Practice staff can play an important role in identifying patients who may be eligible for the Lifestyle Modification
Program. Because of this, the Division has developed a ‘Tip Sheet’ to help practice staff identify patients who may
be eligible. Below is an outline of the tip sheet. If you or your practice would like any further assistance with
identifying patients for the Lifestyle Modification Program, please contact the Division on Ph: 9545 3533 or email
Suggested activities for reception staff
When patients report their arrival to the receptionist, check their date-of-birth/age
If the patient is aged between 40 and 49 years, hand the patients an AUSDRISK Tool
Ask these patients to complete the tool while waiting and give to the GP in their consultation
Alternatively, ask the patient to complete the tool while waiting for the GP and give back to the reception
staff. The reception staff can then provide the GP with a copy when the patient is called for their
consultation. This step can aid with patient’s forgetting to give the tool to the GP.
If the GP decides to refer the patient to a Lifestyle Modification Program, the referral form is available from
the Division website www.shiregps.org.au in the Lifestyle
Modification Program section
Shona Dutton, Program Officer
VARICELLA – Post-Vaccination rash
ALL IN THE FAMILY? A varicella-like rash within 14 days of vaccination
is usually due to coincidental wild virus infection
A local practice rang for advice regarding a household Rashes due to the vaccine occur a median 21
where the baby was due for varicella vaccination but days post vaccination
someone in the household did not have antibodies to A rash >42 days post vaccination is considered
varicella post-vaccination: is it safe to vaccinate the child? to be breakthrough varicella caused by wild virus
This raises a few issues regarding the safe use of varicella infection.
vaccine and the place of serology.
The following points have been developed from the Breakthrough varicella
Australian Immunisation Handbook, 9th edition and the Infection with wild varicella virus occurs in a
National Centre for Immunisation Research and percentage of vaccinees; however, in 70% of
Surveillance’s Varicella fact sheet*. these the disease is mild with <50 lesions.
Breakthrough infection can still be contagious
and exclusion from child care or school is
The vaccine: recommended. There is evidence that two doses
Varicella vaccine is available as a monovalent, of varicella vaccine for children under 14 years
live attenuated vaccine. provides improved protection and less
The dose is 0.5mL administered subcutaneously. breakthrough infection.
As a live vaccine, it can be safely given at the
same time as other vaccines (though not mixed
in the same syringe) but if not given
A reliable history of chickenpox correlates well
simultaneously with other live viral parenteral
with serological evidence of immunity. If there is
vaccines, they should be given at least 4 weeks
a clear history of clinical chickenpox, serological
testing is not required.
At present, only one dose is required for children
Adolescents or adults without a clear history of
up to 13 years of age and this is thought to
chickenpox or vaccination (2 doses in people
prevent any varicella infection in 80-85% of
aged 14+years) should be considered vulnerable
recipients and prevents 95-98% of severe
and offered serological testing and/or
vaccination. A majority of those with a negative
clinical history will turn out to be immune, so
Who should be vaccinated? serological testing can be offered initially to
Varicella vaccine is available on the National determine whether or not vaccination is required.
Immunisation Program as a single dose at 18 Alternatively, vaccination can proceed as the
months of age (unless child has already had vaccine is well tolerated in seropositive people.
chickenpox) (It may be more cost-effective to test first if
Children in Year 7 are also offered a single dose vaccination is not subsequently required.)
of varicella vaccine at school if they do not have Serological testing following vaccination is not
a history of chickenpox or previous vaccination. recommended as the commercially available
(If they have already turned 14 years, 2 doses tests are not reliable.
are required, at least one month apart.)
Vaccination is particularly recommended for
people in certain groups if they do not have a Discussion
previous history of chickenpox. This includes: Going back to the original situation, the baby should be
health care workers, child care workers and vaccinated as a) serological testing after vaccination is not
household contacts of immunosuppressed reliable so if the household contact has received the
people. appropriate number of valid doses they are highly likely to
be protected, and b) if a member of the household is
Who should NOT be vaccinated? immunosuppressed, it is important to vaccinate all non-
Patients with history of anaphylaxis following immune household contacts to minimise the risk of the
vaccination. immunosuppressed person developing severe wild-type
Pregnant women. varicella virus infection. The risk of transmission of vaccine
People with impaired immunity caused either by strain varicella is extremely rare but if vaccinees develop a
disease or immunosuppressive treatment rash, they should cover the rash and avoid contact with
(including general radiation, X-ray therapy or people with impaired immunity for the duration of the rash.
high doses of oral corticosteroids – see Handbook
for definition.) *For further information see:
See Handbook for precautions relating to Australian Immunisation Handbook, 9th edition. Pp 309-321
varicella vaccination before and after NCIRS Fact sheets on Varicella and Herpes Zoster: http://
administration of immunoglobulin or blood www.ncirs.edu.au/immunisation/fact-sheets/index.php
products and patients on long-term salicylate
therapy. Gillian Minto, Program Officer
PERINATAL MENTAL HEALTH
Last year, the National Perinatal Depression Initiative was launched and as part
of that initiative, the Division was able to offer specialised ATAPS services for
women and their families in the perinatal period through the local Child Youth and
Family Counselling Service. Since then, 44 GPs have referred 51 clients who
have attended 194 treatment sessions, either individually or in a group setting.
At a national level, Draft Clinical Practice Guidelines for Depression and Related
Disorders – anxiety, bipolar disorder and puerperal psychosis – in the Perinatal
Period have been developed and will be submitted to the NHMRC for approval
later this year. Beyondblue research indicates that 9% of women experience
depression antenatally and 16% experience it postnatally.
A nationwide community survey has also been conducted which revealed high levels of misunderstanding about perinatal
mental health – including the fact that 52% thought it was “normal” for a woman to feel depressed during pregnancy and
35% believed postnatal depression is due to being unable to cope with motherhood. Such perceptions mean that
depression may not be perceived as a diagnosable or treatable illness and patients may therefore not seek help. Screening
therefore becomes important and 74% of respondents agreed with screening during pregnancy and 81% agreed with
screening after the birth.
Locally, all women attending Sutherland or St George Public Hospitals’ antenatal clinics will be screened using the
Edinburgh Postnatal Depression Scale (which has been validated for antenatal use) and other questionnaires; however
those attending private obstetric services may not. GPs should therefore consider screening patients during their
pregnancy using the EPDS. Women with scores consistently 13 or more have a high probability of meeting diagnostic
criteria for major depression.
Postnatally, all women living in Sutherland Shire will be visited by Child and Family Health Nurses after the birth (no matter
whether the birth was in the public or private systems) under the Universal Home Visiting program and screening with the
EPDS should be performed by the nurse. However, in some circumstances this does not happen and, again, GPs should
consider routinely using the EPDS postnatally, for example when the mother brings the child for the first vaccinations.
beyondblue has developed some excellent resources for GPs on this issue which can be found at http://
www.beyondblue.org.au/index.aspx?link_id=7.102 and there is an extensive range of consumer materials including “Hey
Dad: Fatherhood – First 12 Months” (http://www.beyondblue.org.au/index.aspx?link_id=7.980)
If you consider a woman (or her partner) needs professional assistance, there are a number of options which are listed on
the Division’s website (http://www.shiregps.org.au/mental-health-1542091103.php#Perinatal Mental Health Service). If you
want to refer to the Perinatal ATAPS Program, first complete a GP Mental Health Treatment Plan then fax a copy of the
Plan to the ATAPS clinician using the ATAPS referral fax coversheet. The website includes the documentation necessary
to make a referral and also a range of information for GPs.
The Division’s mainstream ATAPS program continues to operate for “low income” clients, based at Community Mental
Health in Sutherland Hospital. Referrals should be made using the same referral fax coversheet and GP Mental Health
Treatment Plan mentioned above (- select the appropriate fax number for perinatal or mainstream services).
Gillian Minto, Program Officer
ANXIETY – not just a problem for adults
Anxiety and depression are the most common forms of psychological disorders but these conditions are
not only present in the adult population, children suffer too. While depression in children can be hard to
identify, anxiety is much more readily recognised. Parents are all too familiar with the symptoms, and it
must be remembered that anxiety is a normal part of life serving a protective function. So, when is
anxiety a problem that we need to do more about than reassure a child and their parents? When a
child’s anxiety produces symptoms that are severe enough to prevent them participating in activities
appropriate for their age, it is wise to seek professional help. We don’t expect a 2 year old to sleep in an
unfamiliar environment without anxiety but we do expect an 11 year old to be able to sleep at a friend’s
house or go to school camp. School refusal is a symptom that should be addressed as soon as possible at any age.
One of the most effective treatments for childhood anxiety is participation by both the child and parent in a group
programme that uses psycho education, behavioural and cognitive strategies. The Child Youth & Family Counselling
Service at Sutherland Hospital has been using such a programme with great success for the past 15 years. Cool Kids is run
by clinical psychologists for children in Years 3 -6 after school for 8 weeks. The group runs twice a year but referrals can be
taken at any time and families are assessed individually with standardised anxiety measures before being placed in a group.
As avoidance is the most common anxiety symptom in children this age, they are often reluctant to attend initially and need
firm encouragement and support from their parents and therapist. When they make it to the end of the programme, having
achieved most if not all their goals, it is satisfying for children, parents and psychologists alike!
Parenting skills are an integral part of managing childhood anxiety and if appropriate, parents may attend other group
programmes such as Triple P and TIPS offered by the service.
Wendy Conroy, Clinical Psychologist
Mental Health Training
As the end of the triennium nears, GPs should check their RACGP statements to ensure they have attended the
required mental health training in the past 3 years to allow them to retain their registration for either MBS item 2710 or
Focussed Psychological Strategies items. If not, there are a number of options including online courses and
attendance at a Black Dog Institute or NSW Institute of Psychiatry course.
GPs who are not currently registered to claim item 2710 for Mental Health Treatment Plans, but would like to do so,
may be interested in a new perinatal mood disorders course to be held by the Black Dog Institute at Randwick on
Saturday 6 November 2010.
For further information, see http://www.blackdoginstitute.org.au/healthprofessionals/educationtraining/gps/
coursedatesregistration.cfm or http://www.nswiop.nsw.edu.au/index.php?
LTRAS & CHILDHOOD ASTHMA
UPDATED INFORMATION PAPER NOW AVAILABLE
The National Asthma Council has updated its information paper: Leukotriene receptor antagonists in the management of
childhood asthma to reflect the most recent clinical evidence.
It details the role of Leukotriene receptor antagonists (LTRAs), such as the PBS-listed montelukast (SINGULAIR), in the
treatment of children aged two to 14 years with mild persistent asthma, intermittent asthma, exercise-induced asthma or
allergic rhinitis. It examines the latest evidence-based findings and how they translate to everyday practice and includes
information about asthma diagnosis, assessing asthma severity, patterns of asthma in children and a suggested approach
to preventive therapy in children.
New evidence, contained in the paper, supports the use of LTRAs to protect against exercise-induced bronchoconstriction
in children, recommending that montelukast therapy be considered, in addition to inhaled corticosteroids, in children with
exercise-induced asthma that is not controlled by ICS at an optimal dose. The paper recommends that montelukast therapy
also be considered in children with seasonal allergic rhinitis, based on good evidence from recent trials.
The paper can be downloaded from the National Asthma Council Australia website: www.nationalasthma.org.au
THIS MAY BE SOMETHING YOU DIDN’T KNOW YOU NEEDED...
Imagine being able to access your surgery workstation from anywhere in the world –
whether it be from a café in France or from your laptop at home.
By using the internet we establish a Private ‘Highway’ between your remote computer and
your surgery’s internet modem. Technically, this is called a VPN connection, or, Virtual
Private Network Connection. This highway is created on demand and requires a password
to ‘travel’ on it and all communication data is encrypted. At this stage your remote computer becomes a part of your
From here, we use the built in tools within Windows to access your chosen surgery workstation. This communication
also requires a password and is encrypted once more.
The End Result:
The items and resources that are available on the surgery workstation travel down this private highway and down to
your remote screen. You’ll have access to your surgery’s documents, shortcuts and of course your Medical software
Although a number of software solutions that can do this, the most secure method is to communicate exclusively
over a VPN Connection.
Requirements and Considerations:
• A VPN Capable Internet Modem
• High-speed broadband internet connection on the remote computer and at the surgery
• The Surgery Server and Workstation must remain powered on during the time you wish to have remote
access to them
• The Scheduling of any automated nightly backup may need to be revised
• Internet security measures may need to be modified or enhanced
• The surgery workstation you wish to connect do must be one of the following;
Windows XP Professional
Windows Vista Business
Windows Vista Ultimate
Windows 7 Professional
Windows 7 Ultimate
Thien Vo, IT Officer
Why use our IT Support Service ?
Discounted hourly rate for GP Members
Expertise in general practice software and IT systems
Access to discounted computer hardware equipment
Free initial onsite audit assessment of your practice IT systems
Access to maintenance packages to assist general practices in maintaining IT systems to current
accreditation standards, as well as increasing eligibility for PIP payments
Remote and telephone support services
FURTHER INFORMATION CONTACT THIEN AT SHIRE GPS ON 9545 3533
MELATONIN PROLONGED-RELEASE TABLETS (CIRCADIN)
Prolonged-release melatonin can now be prescribed for patients short-term for primary insomnia
who are aged ≥ 55 years. It improves quality of sleep and morning alertness in about one-third of
patients. The following excerpt from the latest issue of RADAR is a good summary of how this drug
fits into clinical practice.
Melatonin prolonged-release tablets are approved for short-term treatment (up to
3 weeks) of primary insomnia characterised by poor quality of sleep in people aged ≥ 55
years. They are not PBS listed.
Non-drug therapies are first line for treating primary insomnia.
Melatonin is an alternative to a benzodiazepine or related hypnotic (zolpidem or zopiclone) if drug therapy
is necessary for persistent primary insomnia.
In clinical trials, people aged ≥ 55 years who received prolonged-release melatonin gained modest
improvements in quality of sleep and morning alertness over those seen with placebo. Clinically meaningful
improvements in both outcomes occurred in one-third of patients.
Prolonged-release melatonin in short-term use has not been associated with impaired daytime alertness,
dependence, withdrawal effects or rebound insomnia. Long-term safety is yet to be established.
There is insufficient evidence at present to support treatment beyond 3 weeks or repeated use after an
Melatonin (Circadin) is not listed on the PBS
Liesl is currently offering GPs and practice nurses an education visit on Management Options to Maximise sleep. If
you would like more information on this topic please fill in the fax back form.
Liesl McCoy, Program Officer
NPS - CLINICAL AUDITS FOR GPS
NPS clinical audits* are available for the QPI year: 1 May 2010 – 30 April 2011
A demonstration tool of this Clinical e-Audit is accessible on the facilitators’ website and online enrolment continues to be
available at www.nps.org.au/health_professionals.
Clinical e-Audit: Review of proton pump inhibitor (PPI) prescribing*. To date 1443 GPs enrolled, 535 GPs submitted
initial phase data and 482 GPs completed the review phase.
Clinical e-Audit: Optimising management of type 2 diabetes. To date 2557 GPs enrolled, 1032 GPs submitted initial
phase data and 961 completed the review phase.
Coming soon! Clinical e-Audit: Management of hypertension. Enrolment will be available in October 2010.
*These activities have been approved in the 2008–2010 triennium by: RACGP QA&CPD Program, total points 40 (Category
1) ACRRM PD Program for 30 points (extended skills).
New NPS flyer for consumers
NPS has developed a flyer for consumers which summarises key QUM messages.
The flyer reminds consumers of the things they can do to learn about, discuss and manage their health and medicines.
Order or download the flyer from the consumer orders page at: www.nps.org.au/consumers/order_free_information/
order_now. For more information, please contact Liane Johnson at email@example.com
- from GP NSW
New DVD Taking Control: Brief online STI Training
Diabetes, Depression & Anxiety The management of STIs in general practice
Beyondblue: the national depression initiative, in association with requires GPs to have an effective but safe
Diabetes Australia (Vic) has produced a FREE DVD aimed at helping approach to achieve the best patient outcome.
people with diabetes, their carers and health professionals to This training is designed to quickly update GPs
recognise the symptoms of depression and anxiety. The FREE DVD knowledge of STI testing using the STI Testing
can be ordered online at www.beyondblue.org.au or by calling the Tool. To access the training tool, go to: http://
Beyondblue info line 1300 22 4636 thinkgp.com.au/education/99966. The STI
testing tool supports GPs with up to date
Advanced prostate cancer:
A guide for men and their families' Other STI resources are available at:
The Australian Cancer Network and the Australian Prostate Cancer order-form.php
Collaboration have released 'Advanced prostate cancer: A guide for
men and their families' (1.23Mb, 133 pages).
Men’s Liver Health Campaign
To view the guide online, go to:
http://www.prostatehealth.org.au/resources/ Hepatitis NSW has initiated a liver health
Advanced_Prostate_Cancer_Guide_2009.pdf campaign, targeting men in the 35-60 year age
Hardcopies of the Guide can be ordered from Andrology Australia by group. Full page advertisements running in four
phoning 1300 303 878. magazines highlight the common risks for liver
disease and suggest men consult their GP for
annual health checks that potentially include
New Needs Assessment Tool for people with liver function tests. The adverts are expected to
have a readership of 250,000 nationally.
progressive disease Professor Jacob George of the Storr Liver Unit
The team from the Centre for Health Research and Psycho-oncology at University of Sydney/Westmead Hospital
(CHeRP) at the University of Newcastle in NSW has now released a assisted with the campaign.
new tool to support the ongoing assessment and management of the
unmet needs of people with any progressive chronic disease (including For more information, go to:
cancer, heart failure and chronic obstructive pulmonary disease) and http://www.hep.org.au/index.php?
their carers: Needs Assessment Tool: Progressive Disease. article=content/media-room/2010-men-s-liver-
'Resources Guide at Australian Centre for Grief and Bereavement
The Australian Centre for Grief and Bereavement (www.grief.org.au) is located in Melbourne. In addition to a
comprehensive nationwide education program, the Centre publishes a comprehensive 'Resource Guide' which details the
materials they have available for children and adolescents; adults; professionals and students; general information.
Referral form for Antenatal Care – Medical Director Template
The Medical Director Template/Form has been updated and placed on the Shire GPs website www.shiregps.org.au.
If you have MD3 or Best Practice – this template now works and can be downloaded off the website.
Additions to the referral form include:
Pre-pregnancy weight and height (on patient information side)
Investigation Results – Pregnancy Pathology Results
Changes to Shared Care Protocol
Recently the Area Antenatal Shared Care Committee met and there have been a few changes to the Shared Care
1. Provider visits:
GP: 37 – 39 weeks
This used to be 37 - 40 wks
ANC: 40 weeks gestation onwards
2. Early pregnancy information:
Discuss Chlamydia testing with <25yr olds
3. Earlier presentations to the Antenatal Clinic should occur if:
There is a history of recurrent miscarriage; or
If vaginal bleeding occurs. Any vaginal bleeding should be referred to the Early Pregnancy Assessment
St George Hospital
Early Pregnancy Assessment Service (EPAS) is a drop in service, patients are asked to arrive at the Women’s
and Children’s Health Clinic at 8am.
The Sutherland Hospital
Contact the O & G registrar 9540-7111 page 125
Royal Hospital for Women
Early Pregnancy Assessment Service (EPAS) phone for appointments Monday – Friday Ph: 9382-6701
NHMRC recommends supplementation of 150 micrograms ( g) / day to ensure that all women who are
pregnant, breastfeeding or considering pregnancy have adequate iodine status.
5. GPs and Leave:
If the GP is to take leave eg: sick leave, holiday leave etc, the GP should inform the patient that they are welcome to
See one of their colleagues in their practice or contact the Antenatal Clinic to make an appointment for their next
scheduled GP visit.
Antenatal Education Update - Thursday, 28th October 2010
Hazelhurst Gallery, Gymea
4 SANC points available
A rotation workshop including:
Hypertension in Pregnancy – Dr Mark Brown
Diabetes Mellitus in Pregnancy – Dr Steve Thornley
Post Date Management – Dr Andrew Zuschmann
RSVP to the Division via Faxback sheet or phone the Division on 9545 3533
Jan Sadler, Program Officer
DO YOU VALUE YOUR PRACTICE NURSE?
The 2010 Australian Practice Nurse Association (APNA) Best Practice Nurse Awards ARE NOW OPEN! With five award
categories, the APNA Best Practice Nurse Awards aim to recognise and reward outstanding nurses working in general
practice. The prize in each category is $5,000 to use in enhancing their continuing professional development and advance
their role in general practice.
Why don’t you nominate your practice nurse for their outstanding work in your practice?
Award Categories: Immunisation - Continence Care - Chronic Disease Management - Muscoskeletal - Innovation
For more information, application criteria and terms and conditions visit www.apna.asn.au
HEIGHT ADJUSTABLE BEDS
The 4th edition RACGP Accreditation standards will officially be launched at the RACGP annual conference GP10 later this
month. It is anticipated that 4th edition will replace the current 3rd edition in late 2011 and be mandatory from 2012.
One of the key changes is the inclusion of the mandatory indicator 5.1.3 “Our practice has a height adjustable bed”. Note
that the indicator requires that the practice needs to have a height-adjustable bed, it does not specify per GP. Therefore at
minimum, a practice will need to have at minimum one height adjustable bed.
The RACGP is aware of the cost to practices and continues to advocate for infrastructure support for general practices to
the Department of Health and Ageing.
The following are the minimum requirements for a height adjustable bed
Range of height adjustment: 45-95cm
Weight capacity: 175kgs
Width of table: 71cm
Number of Sections: Two sections, where the head section can be raised
Specific Purpose Features: A side rail that can be moved up and down
Stirrups for gynaecological examinations
Suggested supplier à Majac medical supplies $1750 http://www.majacmedical.com.au/Couches.html
Source: Royal College of General Practitioners www.racgp.org.au
QUESTIONS ABOUT BEST PRACTICE
Laura can organise a time to come to your practice for either a mock accreditation visit or a practice visit on best practice
standards. For practices that have registered for accreditation or going through reaccreditation, a mock accreditation visit
will help your practice to identify areas that may need improvement before the actual accreditation surveyor’s visit. For
practices who are not accredited, a practice visit on the best practice standards may help your practice to identify areas that
could need improvement or implementation of systems for optimal patient / staff care.
Laura is available Monday-Friday to help you out with any Accreditation or Practice nursing questions/resources. Call the
office on 9545 3533 or email firstname.lastname@example.org
Laura Denegris, Program Officer
W hat’s On - UPCOMING CPD EVENTS
Hazelhurst Gallery & Arts Centre, 782
Thur Monthly CPD - Shire GPs “Antenatal Update - The Kingsway, Gymea
Hypertension, Diabetes and Post Date
Thursday 28 October 2010 Management in Pregnancy” 7.00pm Registration 7.45pm
(4 Antenatal Shared Care Points) Presentation
Dr’s Mark Brown, Steve Thornley &
Tick faxback sheet or contact Division
Thursday 21st October Shire GPs - Blackwater Restaurant
Annual General Meeting 1/8 Water Street, Sans Souci
Dr Robyn Napier from AMA NSW will 7pm Registration; 7.30pm AGM and Dinner
speak on Health Reform and the impact on RSVP: Division on 9545-3533
Hazelhurst Gallery & Arts Centre, 782 The
Monthly CPD Best Practice - Cardiology Kingsway, Gymea
Thursday 25 November
Dr Rob Smith
7.00pm Registration 7.45pm Presentation
Tick faxback sheet or contact Division on
Tuesday, 30 November “Managing Acute Low Back Pain in Rydges Hotel, Cronulla
6.30pm Registration 7.15pm Presentation
An NPS education workshop for GPs
Invitations out soon
Dr George Pitsis
Practice Staff & Nurse Education Enquiries: Shire GPs 9545-3533
16 November Woundcare for Practice Nurses Stapleton Ave, Sutherland
2 December Safety in General Practice - Hazelhurst Gallery, Gymea
for Practice Staff
Invites out soon
A D V E R T I S E M E N TS
New Resource available for
older people at risk of
This resource outlines:
Simple strength and balance home based
exercises essen al to staying ac ve
A Health and Lifestyle checklist
Pictures and descrip on of how to get up
from a fall
A home safety checklist
Health Professionals are able to order this
The Resource Distribu on Unit at Gladesville
Ph: 9879 0443 Fax: 9879 0994