We all know the importance of keeping good records, and now GP Consult makes it easier than ever for doctors to make clear, timely patient notes. Dr Paul Ryan, GP and clinical pharmacist, talks to us about his experience with record keeping and how this new resource can help 

Good medical records are essential for the continuity of care of patients and play a vital role in responding to a complaint or defending a clinical negligence claim. If a complete and accurate medical record is documented, it can make all the difference. Most medicolegal cases focus at some level on the availability of medical records and their contents, so they can make the difference between whether a case is defendable or not.

I’ve always been very aware of how important it is for me to take the time to sit down and make a note of every discussion I’ve had with a patient, every examination I’ve carried out and any action plan that’s been put in place. It takes time and can create a lot of work but ultimately it’s the key to recording everything that happens when I see a patient.

Prescribing guidelines used in Ireland tend to be mainly based on international, as opposed to Irish, guidelines. This is a challenge because not all the medications used in Ireland are on these guidelines and some medications mentioned in the guidelines aren’t available for patients in Ireland.

There are also different reimbursement schemes in Ireland, such as the General Medical Services (GMS) scheme, the Drugs Payment Scheme (DPS) and the hardship scheme. So, for example, if you prescribe antihypertensives as recommended in the UK guidelines, these may not be available under one of these schemes, so may not be affordable for the patient. There are also medications on these prescribing guidelines that are unlicensed in Ireland, and hence difficult to source.

This makes it time consuming and complicated for GPs. Pharmacists will need to go back and forth with GPs, discussing which drugs are available, which are not and what alternatives could be used. This can be especially hard for new GPs and trainees who are relying on the guidelines.

When I started working as a pharmacist 15 years ago, I was asked by GPs and GP registrars to give them some tips and tricks to make prescribing easier and safer in Irish general practice.

A lot of the notes I had developed were short summaries of the UK guidelines that I had made relevant to Ireland. This collection of notes and documents has slowly grown to incorporate history and examination templates, as suggested by GP peers – including relevant red flags to look out for. 

This led me to create GP Consult – a platform dedicated to providing GPs with the relevant resources they could use to make their working lives easier and their time more efficient. It works on the idea that GPs across the country can share information on history and examination templates, as well as management plans for everyday conditions seen in general practice.

“The templates and treatment plans can save them up to three minutes per consultation.”

Once logged in, users can search for advice through a range of categories, such as respiratory, ENT and cardiology, and find tips and templates to use for a variety of symptoms and conditions. Once they’ve run through the relevant questions to ask their patient and looked at the appropriate templates, they can record all answers and discussions in their notes to ensure they have accurate and concise records.

It’s easy for users to add their own tips and advice – they simply find a category they want to add to and enter a comment in the box at the bottom. The GP Consult team of moderators then just need to check that it’s evidence-based and relevant, and they then approve it to go live.

Feedback from GPs who use the site has been overwhelmingly positive, as the templates and treatment plans can save them up to three minutes per consultation.

“GP Consult is high yield medicine. With over 200 templates it is perfect for the GP trainee on the steep learning curve or for the experienced GP who wants to enhance specific areas of interest. GP Consult gives me comfort and reassurance that I won't miss any red flag symptoms.” - Domhnall Heron, GP registrar, Sligo training scheme

What I really like about GP Consult is the goodwill and willingness from GPs to share information between one another. GPs or GP trainees who register will be joining a community of GPs who want to make the working lives of their peers easier and safer, by sharing knowledge that they have accumulated from their own experience in practice.

This risk management tool is there to guide GPs, save them time and help them learn from their peers. I hope to see it grow and become a resource that can not only help GPs but also improve patient care throughout Ireland.

GP Consult is a free resource available to all members of Medical Protection. Simply visit gpconsult.ie and sign up.