Ammendments to POM act

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Hi everyone,

Check out the following link regarding recent ammendments to the POM Act for Podiatrists to come into force on the 1st July 2011.

http://www.legislation.gov.uk/uksi/2011/1327/pdfs/uksi_20111327_en.pdf



Paul.

 

Can't see that there is much difference to the old Order - they haven't given us anything extra.

Nick

 

Really
It looks different to me. I read it as. We are now not limited to a 3 day supply for
Co-Dydramol.
Co-Codamol and Codeine Phosphate are new additions
& I get the impression that we may now administer mixed Depo Medrone (providing we do not do the mixing)

But it is not easy trying to decipher the amendments in conjunction with all the other amendments to the original 1968 act.

If anybody reads it differently please come back to me. I think the best thing is to wait until the journal comes out with a definitive explanation.

europod

 

Hi Europod

Yes I saw those but actually I wouldn't bother to hold and supply those anyway. Is there much difference between using either of those and doubling up ibuprofen (providing you can take it) and paracetamol.... both of which are available from supermarkets at about 40 - 80p a packet.

Much easier to pack them off to GP and get decent anti inflams or painkillers and sell them topical medicaments (Biofreeze/ClearZal cold gel etc).

As for Depo medrone... sorry I wouldn't be using that either. I would suggest that you really need to know what you are doing with that and unless you have done the injection courses and maybe an ultrascan guided course with practice (under supervision) and feel confident in using it.

I don't need to use such a thing in private practice .... I can send them off to a GP to decide whether to or not.

Obviously I also recognise that some others might work in PP directly with Consultants etc who are fine with them using it.

Having read the Ammendment Act, it is such a difficult piece of work to make head or tail of especially as it refers not only to us but also to Midwives etc.

I won't hold my breath on Podiatry Now giving an update on it either !

Best wishes
Nick

 

Kitos seems like you have it sorted, anything you don't like just send it to the GP. Way to keep up that professional image.

1) Why wouldn't you send to another Podiatrist colleague who is willing to utilise their scope of practice?

2) Why do you feel you have to work with a consultant / get a GP to decide whether or not the use of Depo is needed?

3) I'm not even going to comment on the double up on ibruprofen comment

4) I wonder how you voted on the name change? :bang:

George

 

Hi George

I suspect that kitos spends his/her time pulling legs between treating feet!

Cheers

Bill

 

george question 1

i would not refer a patient to a podiatrist for a depo injection. why 1 because if its to nhs podiatric surgeon the wait is at least 3 months a gp could do it immediatly. 2 if the pod was in pp the pt would have 2 pay with the gp its free. so best advicebook an appt with gp tommorow get it done free. name change i wanted to keep name chiropodist im not ashamed to be called a chiropodist i was proud when i graduated nothing has changed that feeling,
regards fishpod

 

fishpod,

firstly rather than just direct your patient to the GP surely you would give them an option of seeing a private pod to do it, after all they are paying you aren't they?

it doesn't have to be a podiatric surgeon to perform a steroid.

quite often if you do refer them to their GP, the GP will then refer on anyway.

I have never said you shouldn't be proud to be a Chiropodist, however my argument all this time is that the profession has a habit of stagnating. It needs to move with the times which includes every PODIATRIST utilising their scope of practice and unifying the name.

No matter how much PR the professional bodies undertake, it is down to each individual practitioner to promote the profession and what it has to offer.

Podiatrist's who do not utilise their scope and just refer anything slightly more complex than nails and callus back to a GP will always damage the image of the profession

George

 

no i would never increase the patients financial burden if it was not necessary and as gps get paid a minor surgery fee it is my experience that they never pass them on.also george they dont wont to refer because if they refer to a specialist that costs £180 POUNDS OFF THIER BUDGET. i agree with you completely that we should always strive to increase our scope of practice and professionalism. i am aware you are at the top of your game george and you have my full respect but most podiatrists dont seem to grasp how gps operate if they can get the money they do and if the patient does not pay everybody is a
winner. regards fishpod

 

100% agree George.

If, in conversation, a patient c/o dental caries then presumably our automatic advice would be to see a dental surgeon. NB. automatic advice 'not' to see the GP. Yet the patient will have to pay to see the dental surgeon, even though the GP is legally qualified to deal with the dental problem. In addition, the GP will, equally automatically, send the patient to see a dental surgeon rather than treat him/herself.

I simply cannot understand why our profession does not expect a similar response. We are to foot problems as a dental surgeon is to oral problems. I suspect that the underlying issue is simply that we cannot accept this ourselves, and individuals are so frightened of referring on to colleagues that they hold a 'rabbit in the headlights' attitude.

To change this position will take a profound re-appraisal of the both the individual practitioner's psychology and that of the profession as a whole.

All the best

Bill

 

because i treat nhs patients on contracts guys and the patients dont want fees they want it for free i would love to refer them privately but the patients mostly wont have it.incidentaly how much do you chaps charge for a depo injection as it would help when the patient askes how much will it cost me.i dont personally know any local pods to me that offer this service .but i am personally aquainted with at least 30 gps who will.your replies are eagerly awaited.

 

I sympathise with the problem. We have become locked into a vicious circle of disregard. I recently paid my dentist £17.00 for a 10 minutes examination and polish; that is, I think, 50% of his fee, the rest is paid by the NHS, but I really did not think of the fee, nor question it; it's something I expect to pay every 6 months. If he is required to treat a complaint then the fee is naturally much, much higher.

The BUPA fee for L.A./depo-medrone injection into a trigger point is £91.00 but colleagues may have a fee more or less of that figure based on costs/facilities etc. I refer to my previous posting; I think that we need to ask why there is no colleague locally offering the treatment, and if there is, why do they not make their colleagues aware of the fact? As far as the patients are concerned it's really a matter of psychology. The fact could be phrased for instance as:
" Unfortunately, there is no specialist available in this area; it may be possible that your General Practitioner carries out injections into painful areas on the bottom of the foot but it is rare that they will use an injection to numb the bottom of the foot first since these are normally carried out only by specialists who have that particular skill."

Generally, I find that patients undergo plantar fasciitis injections, for instance, just once with GPs. Thereafter the patient is only too willing to pay, and the GP only too willing to refer! I am not being destructively critical here, there may indeed be GPs who have developed the necessary skills, but I do feel that it is time that we ensured that feet R us!

All the best

Bill

PS If the patient wants to go elsewhere or use some of the frankly strange and expensive devices/treatments advertised in the press then that is their choice.

 

Thats what I make out of this too, although it is not an easy read. the MHRA website which clearly explains the exemption issue has not as yet been updated - I would use this as a source of confirmation rather than the journal!

Just off to tear up some pgd's