Scottish Doctors 2

Mapping view

Scottish Doctors 3

Level 3

This could include: Level 4

General principles of patient management

Use of patient-centred, holistic approach with careful consideration of all information available from history, physical and mental state examination and investigations and in full consultation with patient, relatives etc.

Immediate assessment and illness acuity/severity rating with appropriate intervention, investigation and monitoring.

The principles of patient support (physiological, psychological, social, spiritual) and symptom management until a definitive diagnosis is reached and specific treatment is started.

The ability to recognise the need for specialist help, appropriate environment and the speed with which these two are required.

Patient referral: as above and lines of communication, keeping the patient/family/carers informed.

General principles of teamwork

The roles and relationships of the multidisciplinary team

Accepting corporate decisions and priorities.

Drugs

Knowledge of prescribing and practical demonstration of prescribing ability.

Knowledge of common adverse effects and their treatment.

Selecting method of delivery.

Calculating dosages.

Consideration of dependence, interactions and adverse effects.

Post-op pain relief

Surgery

Recognition of indications for intervention and the available surgical interventions.

Knowledge of principles and practice of informed consent.

Knowledge of common surgical problems and complications and remedies.

Understanding of principles of pre-, peri and post-operative care.

Psychosocial

Recognition of specialist availability and of interventions and their use.

Role of psychosocial factors in precipitating and perpetuating illness.

Consideration of patient’s social circumstances, work, family etc, when determining treatment options.

Available interventions

The role of other organisations.

Identification of child physical and sexual abuse

Radiotherapy

Knowledge of options available and their appropriate use.

Understanding the effect on the patient.

Therapy services

What these are.

Appropriately access, refer and interact.

An understanding of what can be achieved and what is involved for patient and physiotherapist / occupational therapist / speech therapist etc.

Nutrition

Nutrition, nutritional support and specialist dieticians.

Appropriately access, refer and interact.

Understanding the role of nutrition as a major non-drug therapy in some medical conditions.

Selecting appropriate method of ensuring adequate nutrition to meet individual patient’s needs.

Promoting healthy eating as a means to improve and maintain health as well as preventing disease.

Emergency medicine

Adequate assessment, risk stratification and provision of immediate management to life threatening adult emergencies.

Management of adult cardiac arrest utilising UK Resuscitation Council algorithms.

Performance of paediatric basic life support.

Demonstrating systematic approach with appreciation of local protocols/guidelines and working effectively as part of emergency care team.

Acute care

Management of a variety of medical and surgical and psychiatric conditions that are not immediately life-threatening but which require early treatment, or management of more serious, life-threatening conditions in the period following emergency management e.g. uncomplicated cerebrovascular accident, exacerbation of chronic obstructive airways disease, deliberate self-harm or acute confusional states etc.

Chronic care

Consideration for:

patient’s age; nature of chronic disease; effect on patient e.g. loss of mobility, psychological impact

Appropriate use of drugs, appliances/aids, etc.

Intensive care – to include high dependency care, coronary care and other specialist intermediate care e.g. renal, neurological.

To recognise the circumstances under which an individual patient might require referral / admission to these areas.

Knowledge of the criteria for referral and local guidelines, protocols and mechanisms.

Appreciation of the range of facilities and services available.

The implications for patient and family, including psychological, of this form of care.

Palliative care

Recognition of what palliative care can offer, where it can be delivered and by whom. Knowledge of how to involve patient, family, friends as well as healthcare professionals and other relevant bodies.

Pain control

Ability to select and initiate appropriate analgesia using local protocols.

Specific knowledge of pharmacological, physical and psychological interventions.

Understanding the role of the pain management specialist and demonstrating ability to access/interact with pain management specialists/teams.

Rehabilitation

Understanding of the integral role of rehabilitation in recovery especially after major illness, significant trauma or surgery e.g. myocardial infarction, spinal injury, transplantation, chronic mental illness such as schizophrenia.

Appreciation of the need for a specific programme of rehabilitation and the role of other healthcare professionals in providing this.

Complementary therapies

Appreciation of what is available.

Outline of what is involved in most commonly practised therapies; how alternative and conventional therapies might be combined.

Keeping an open mind and remaining non-judgemental regarding the use of complementary therapies.

Patient referral

Making appropriate referrals to the right professionals.

Assessing at what stage of management referral may be indicated.

Giving and receiving the appropriate information.

Keeping the patient informed.

Blood Transfusion Services

Nature and extent of service.

How blood products are obtained through donors and by manufacture including issues of safety.

Diversity of blood products available and how they are used in different circumstances.

Making the most efficient and appropriate use of the Blood Transfusion Service in the care of patients

Importance of sample / patient / blood product identification.

Management of transfusion reactions.

Management of Death

Death certification

Cremation

Post-mortem examination – both practicalities of consent and specific sensitivities of different religious groups