your gp and dhc

At DHC we aim to provide quality healthcare in local setting for the benefit of patients.

Your GP and DHC?

Will my GP refer me to DHC Services?

Your GP will always refer you to the best service for your individual needs. Who you are referred to is always a joint decision between you and your GP.

We expect many referrals will be made to DHC consultants because in these cases the best option for the patient will be to see a well-respected consultant, with a short waiting time, in a local facility.

However, there are many different options in the local area and as choice is paramount your GP should discuss these with you at the point of referral.

The relationship between your GP and DHC Consultants

One of the main reasons for developing DHC was to create a closer working relationship between GPs and consultants. We have developed an understanding over how patient care should happen in each speciality. This has many benefits, including:

  • GPs organising more investigations (eg. x-rays or laboratory tests) so these are available when a patient sees a consultant. This should mean that decisions on treatment can be taken at the first appointment and not need the delay and cost of a second appointment.
  • An increased understanding amongst GPs about when to refer patients to a specialist for certain conditions.
  • GPs increasingly following up patients under care plans drawn up by consultants or after operations.
DHC organises an educational programme where the consultants come to Dorking or Holmhurst Medical Centre to give a talk to the local GPs.

Prescribing Policy

Under the terms of our NHS contract with Surrey Downs Clinical Commissioning Group (CCG), and Care Quality Commission (CQC) standards of care, Dorking Healthcare has a responsibility to ensure that patients receive the best and most appropriate drug treatments and that NHS resources are not wasted by inappropriate prescribing.

Compliance with NICE guidance

NICE (the National Institute for Health and Clinical Excellence, www.nice.org.uk) is the independent organisation responsible for providing national guidance on the prevention and treatment of health disorders. NICE guidance is based on the best available evidence of the most clinically and cost effective treatments, and aims to ensure treatment is available equally across different regions (avoiding ‘postcode prescribing’). Dorking Healthcare will prescribe medication in line with the latest recommendations of NICE. Under the NHS Constitution, patients have the right to drugs and treatments recommended by NICE if their doctor thinks it is clinically appropriate.

Surrey Prescribing Advisory Database (PAD)

Dorking Healthcare is also obliged to prescribe drugs in line with the Surrey-wide Prescribing Clinical Network (PCN) which has membership from all the CCGS and acute NHS Trusts in Surrey.

The PCN holds a Prescribing Advisory Database (PAD : at http://pad.res360.net/) which sets out the local approved drug formulary for different clinical indications. The PAD also has links to shared care guidelines, updated NICE Technology Appraisals, policy decisions and medicines safety alerts.

The purpose of the PAD formulary is to ensure Surrey-wide evidence-based and cost-effective prescribing and to provide other information relating to drug use. All prescribing from within DHC must comply with the formulary.

Advice given to GPs with regard to drug treatment options must also be in line with the formulary.

Each drug entry on the PAD has been assigned a Traffic Light Status which is a locally agreed colour-coded guidance system (green/amber/red/black) on the use of medicines across the interface between primary and secondary care. It provides a framework for defining where clinical and therefore prescribing responsibility should lie. The system is only advisory but is intended to clarify expectations of prescribing responsibility. Full details can be found in the Surrey Interface Prescribing Policy.

Surrey Interface Prescribing Policy

If a clinician wishes to use a new NICE-approved medicine a request should be made to the DHC Medicines Management Committee. Where NICE has not recommended a certain drug, it may still be used on an individual basis via an individual funding request if exceptional clinical circumstances exist. The decision then rests with Surrey Downs CCG.

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