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Points for TFTs and carers

nOur 1,200-patient practice has 265 patients on thyroxine We can earn six points for doing TFTs on them every 12-15 months. As they do not need to be seen by a GP, a clerk will supervise a rolling programme of blood tests with forms and a standard letter sent out around month of birth.

nPatients will be advised to attend the treatment room for the blood test, that they do not need to see the doctor and that they will be told the result within two-three weeks. Results will automatically go on to the computer via our lab links; normal results will be followed by an 'all okay' letter, while any abnormal ones will result in a request to see the doctor.

nNon-responders will be telephoned and if they decline the test will be exception reported (refusal to attend review after at least two invitations).

nIdentifying carers and referring them for social service assessment gives three points under practice management indicator 9. Our protocol reflects what we, and I suspect a lot of GPs, do in real life.

nPatients in whom it is important to identify a 'carer' are generally well-known and frequently seen. An opportunistic policy is therefore appropriate. Names and contact numbers for key carers are to be written clearly on the front of the relevant patient's records.

nOnce identified, and in cases of need, most carers can be advised to self-refer to social services and should be given the appropriate contact number. In situations in which the carer might have difficulties with this approach, the GP or nurse should initiate the relevant contact with social services.

Alistair Moulds is a GP in Basildon, Essex

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