Audit and Prescribing proformas

Scottish Medical Appraisal & Revalidation Toolkit Role specific additional considerations Sessional GPs Supporting Information

Audit

Audit as a sessional doctor is often harder because you may need to undertake all the design, data collection and analysis yourself. Topics are more limited because you may not have access to the same group of patients to do a second audit cycle.

However, you are in a longer term locum - or if you chose a topic that involves immediately necessary care - then the templates in the main toolkit will be suitable.

Also remember that you need to be one of the doctors involved in the activity being audited, but not necessarily to perform the data collection or analysis - as long as you can learn and have the potential to change what you do.

Also consider:

Emergency equipment/drugs check list
Audit your use of investigations
Management plan proforma: as for prescribing, perhaps including other aspects of management

Prescribing

As a sessional doctor you probably won't have a cipher number. It may still be possible to be involved in practice-based prescribing work, however. For example:

Auditing the practice computer to compare your prescribing with others in the practice
Taking part in implementing a new prescribing guideline and providing an account of what you did and how you changed your practice
A review of 50 acute prescriptions: antibiotics or analgesics are suggested as suitable topics
Management plan proforma: this focuses your use of a prescribing protocol or guideline with a single patient
Case report proforma: this allows you to reflect on a patient who presents a difficult prescribing problem
Implementation at a personal level of a guideline or formulary

Although audit and prescribing reviews are separate topics, many doctors have undertaken a review of their prescribing which has taken the form of an audit. Prescribing review needs to be undertaken against acknowledged standards, and these are widely available. Examples are practice or local formularies, Health Board prescribing guidelines and SIGN guidelines. You might decide to use an audit of your practice against a published standard in one of these areas. (Examples 1 and 3 below)

Audit has become an established part of general practice training and is now a recognised tool for examining the effectiveness of clinical care. It is suggested that you should be involved in two audits, at least one of which you should have contributed to, and both of which you have learned from and can show changes that you have made as a result.

It is recognised that sessional GPs may have difficulty in undertaking audit when they have no fixed practice base and are therefore unable to measure the effects of their care - for example in chronic disease management.

Possible solutions

Using a log of some of your consultations can provide you with audit material. You can later repeat measuring similar consultation data to see whether any changes introduced after the first part of the audit have been effective. It can also provide you with data for examining aspects of your prescribing, if you need appraisal supporting information in that area.

NES has a Peer Review service to assist the review of your audits or significant event analysis (SEA). More information and relevant templates available on the CPD Connect website.

Audit

Prescribing

Possible solutions

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