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GP & primary care practitioners

This page contains information to help support colleagues working in primary care with their safeguarding adult responsibilities.

Primary care learning from a safeguarding adult enquiry: a forgotten vaginal pessary

The safeguarding adult team recently reviewed the case of an elderly lady with dementia living in a residential care home.  This lady had presented with recurrent vaginal discharge and on examination by the GP was found to have a vaginal pessary in situ.  It transpired that this pessary had been in place for four years.

Further enquiry identified that insertion of the pessary was not coded appropriately in the medical records and as such the need for a recall and change of pessary was overlooked. 

The patient had registered at a new surgery on moving into residential care.  A further learning point was that under System One it appears that when a practice deregisters a patient, recall codes are automatically inactivated.  As such the new practice was not aware that the patient had a pessary in situ. 

 This case highlighted the positive role of the GP surgery in ensuring both the appropriate care and follow up of patients requiring vaginal pessaries for urinary incontinence and pelvic organ prolapse.

  • NICE (NG123) recommends that before starting pessary treatment it should be explained that the pessary should be removed at least once every six months to prevent serious pessary complications and women using pessaries should be offered an appointment in a pessary clinic every six months if they are at risk of complications, for example because of a physical or cognitive impairment that might make it difficult for them to manage their ongoing pessary care. (NG123 last updated 24/06/2019).
  • Does your surgery have a robust system for coding that a patient has a pessary in situ and is an active and appropriate recall code is in place?
  • If an active recall code is removed does the surgery ensure the reason why is recorded?
  • If you are a System One practice it is worth considering reviewing all old recalls when a patient registers and reactivating these if appropriate or aligning these with your own practice search codes to ensure important recalls are not missed.
  • How does the practice support newly registered care home residents?  Would it be possible for an appointed clinician to review the case notes for  newly registered  care home resident to ensure important conditions/issues  are not missed?

Supporting homeless people to register with a GP practice

The charity Groundswell works with people who experience homelessness, offering opportunities to contribute to society and create solutions to homelessness.  People who experience homelessness are entitled to register at a GP surgery.  They do not need a fixed address or identification.  Groundswell have produced “My right to healthcare cards” to empower individuals to register at a GP surgery.

Please view a helpful video demonstrating use of the card.  Please consider raising awareness of this campaign in particular amongst your reception staff who are often the first point of contact for patients.

Domestic Abuse Champions

Does your GP surgery have a domestic abuse champion?  Free training available!

Domestic violence is an abuse of human rights and a major public health problem because of the long term consequences for people who have experienced it.  The RCGP advises that many people experiencing abuse believe that their GP can be trusted with disclosure and GPs can offer practical support to protect people who disclose abuse.

Domestic abuse champions are trained to develop knowledge on asking, responding, and supporting people affected by domestic abuse, and to use their knowledge to help their colleagues to respond effectively and appropriately.  The champion may be a GP but equally would suit a practice nurse or receptionist who has direct contact with patients.

Training is delivered over two full days. The next two dates are 22/29 April 2021. Training is free although a charge is made if delegates fail to attend without notice.

If you or one of your staff are interested in registering on the free training please complete the form and return it to da.change@norfolk.gov.uk 

Multi-Agency Risk Assessment Conference (MARAC)

Date: 2018-07-13 / DOCX (169 KB)

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MARAC GP notification letter template

Date: 2020-12-04 / DOCX (410 KB)

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Adult Safeguarding Bulletins

GP bulletin March 2019

Date: 2019-03-29 / PDF (689 KB)

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GP bulletin Dec 2018

Date: 2019-03-27 / PDF (574 KB)

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GP bulletin summer 2018

Date: 2018-07-13 / PDF (349 KB)

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Adult Safeguarding: Roles and Competencies for Health Care Staff | Intercollegiate Document

The Royal College of General Practitioners: National Standards and Policies

Date: 2018-12-27 / PDF (366 KB)

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Safeguarding Adults at Risk | Generic Policy

This policy has been designed for use by general practice and can be adapt as needed. NSAB would like to thank OneNorwich for their support in developing this document. 

GP Generic Adults at Risk Policy 2019

Date: 2019-03-27 / DOCX (192 KB)

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Mental Capacity 

Health Education England Level 3 Adult Safeguarding Training module on Mental Capacity for the e-learningforhealth platform. 

Carrying Out and Recording Capacity Assessments | 39 Essex Chambers (Jan 2021)

This purpose of this document is to provide for social workers and those working in front-line clinical settings an overview of the law and principles relating to the assessment of capacity. Its focus is on:

  • how to apply the MCA 2005 principles when assessing capacity; and
  • how to record assessments, primarily in the context of health and welfare decisions

Safeguarding Adult Reviews | Summaries for GPs

Learning summary for SAR AA

Date: 2018-07-13 / PDF (409 KB)

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Learning summary for SAR BB

Date: 2018-07-13 / PDF (633 KB)

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Self-neglect and Hoarding

NSAB publicity material for PIP screens (MP4 and JPEG)

Please contact james.butler@norfolk.gov.uk

NHS England

Date: 2019-08-21 / PDF (454 KB)

HEALTH