1. A GP’s Perspective Andy Hansen GP Partner Ridge Medical Practice Bradford

2. My Working Week 4 sessions General Practice 2 sessions General Neurology 1 session Epilepsy 1 session at YDU

3. Core GP Role Consult people who are ill or perceive themselves to be ill Chronic disease management Palliative care

4. Advanced MS In Primary Care ‘Generic’ care Specific interventions

5. General Practice First point of contact Identify carers Lead GP Community matrons District nurses

6. GP Role Assess new symptoms Treat acute illness Chronic disease management including mental health problems (shared with practice nurses) Coordinate care, refer as appropriate Prescribe medication

7. Community Matron Patients with complex health and/or social needs, especially if DN not involved Single point of contact Co-ordinate care including respite beds in intermediate care Links with district nurses, social services, therapists, fast response team, palliative care

8. District Nurse Catheter care Bowel care Pressure Ulcer Risk Assessment (Maelor Score)- organise special mattresses Wheelchair referrals/assessments Links with therapists and social services and palliative care

9. Specific Interventions Little experience in GP Low confidence Need to access specialist help

10. Links- A GP Perspective Neurology Rehabilitation Therapy Palliative care Psychology Social Services

11. YDU Multiple Sclerosis 8 Cerebral haemorrhage 9 Huntingdon’s Disease 2 CVA 4 Spina bifida 2 Cerebral palsy 2 HIV dementia 1 CMT 1

12. Observations NICE guidance- no mention of NH patients What should they expect? Specialist review Therapy input PEG insertion MS Nurse