Dr Peter GravesChief Executive Bedfordshire & Hertfordshire LMC Ltd

Pastoral Care for sustainable General Practice

Case 1

• 48-year old female GP• Progressively taken on more and

more responsibility and therefore stress

• Self-prescribing Beta-blockers under a patient’s name

• Referred to psychiatrist by LMC• Suspended, referred to GMC dealt

with as ‘Illness’

Roles of the LMC

• Statutory obligations*:– To consider a complaint from one GP

about another and report the outcome

–To make arrangements for a medical examination of a GP

(*Paragraph 27 (1) Part 6 of the NHS (GMS Contracts) Regulations 2004)

Beds & Herts LMC Ltd

• 1400 GPs• 235 practices• Range of services

• Pastoral Care

Case 2

• 37-year old female GP, single mother with young dependent family

• Self-prescribing increasing doses of anti-depressants and up to 30 Zopiclone daily under a patient’s name

• Referred for detox and specialist drug addiction advice at ‘CRI’

• Suspended, referred to GMC dealt with as ‘Illness’

Pastoral Care

• Team of 14 GPs• Regular training and support sessions• Specifically trained to identify mental

health and addiction problems

• Patient Safety

Pastoral Care policies & procedures

• Contacting the office• Maintaining confidentiality• Full information about the policies

and when confidentiality between carer and GP will be broken

Case 3

• 29-year old male GP with wife and newly born baby to support

• Working as locum, with minimal support• Self-injecting opiates acquired from terminal

patients• Discovered almost comatose by practice nurse

when he failed to start afternoon surgery• Suspended by HA and GMC dealt with under

‘Fitness to practice’ • Back at work now and practising with

‘conditions’

Interactions

GP

GP’s own GP

Occupational Health

GP’s practice

NHS England

Patient Safety

Pastoral Care

Specialist Care?

The Future – Our aspirations

LEVEL 1GPs – some with special

training

LEVEL 2Specialist Service

LEVEL 3Secondary Care

Occupational health

LMC Pastoral care

Specialist Services?

• Confidential• Accepts self-referral• Multi-disciplinary assessment• Appropriate treatment• Full support back to work