Sedatives for Scans

We do NOT prescribe sedatives for patients undergoing radiological procedures eg CT scans or MRI scans

Patients often ask if we can prescribe sedatives prior to radiological procedure eg CT scans or MRI scan.

It is NOT safe for GP practices to prescribe sedatives for patients.

Safe and effective analgesia and sedation should be delivered by an appropriately trained and credentialed team with good access to anaesthetics, pre-procedure assessment, sedation plan and checklist, with appropriate monitoring and availability of resuscitation equipment and reversal agents.

Sedated patients should be regularly monitored, and we are aware of a case where a GP-provided sedative was given, the patient not monitored, and subsequently had a respiratory arrest in an MRI machine.

Practices are not required to prescribe this, and we would highlight the following:

  1. Benzodiazepines such at 2mg diazepam are probably sub-therapeutic for most adults for any effective sedation.  Conversely anxiolytics can have an idiosyncratic response in patients, and even very small doses can cause increased agitation in some groups of patients.
  2. A patient may take a sedative ‘an hour’ before their assumed procedure, to then attend the hospital to find their procedure has been delayed, therefore the timing of the anxiolytic being sub optimal.
  3. GPs are not regularly involved, skilled, trained or appraised in sedation skills.
  4. Hospital consultants, both those requesting imaging and those providing it, have access to the same prescribing abilities as GPs. If a patient needs a certain medication to enable an investigation to go ahead, they are best positioned to provide a prescription, either through the hospital pharmacy or a hospital prescription.
  5. The Royal College of Radiologists‘ own guidelines on sedation for imaging makes no mention of GP involvement or provision of low dose anxiolytics and stresses the importance of experienced well trained staff involved and the monitoring of sedated patients:  “Safe and effective analgesia and sedation should be delivered by an appropriately trained and credentialed team with good access to anaesthetics, pre-procedure assessment, sedation plan and checklist, with appropriate monitoring and availability of resuscitation equipment and reversal agents.” (see this link for more information).

To help patients avoid situations where they are not adequately sedated for a procedure or are unmonitored due to the procedure team being unaware of consumed sedation provided by general practice, we would decline requests even if the hospital asks to do so for prescribing in those circumstances.

 

Where the referral for imaging is made, it may be useful to highlight that an assessment for support during the procedure by the radiology team may be beneficial on the referral form as well.

Fear of Flying

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Privacy Notice

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Children’s Privacy Notice

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Violence Policy

The Practice staff shall always show due respect and courtesy when dealing with patients and their representatives. We respectfully request that patients and their representatives do the same when dealing with members of the practice team.

The NHS operate a zero-tolerance policy with regard to violence and abuse and the practice has the right to remove violent patients from the list with immediate effect in order to safeguard practice staff, patients and other persons.

No form of aggression (whether verbal or physical in nature) will be tolerated – any instances of such behaviour on the practice premises may result in the perpetrator being reported to the Police and removed from the practice’s List of Registered Patients.

Violence in this context includes actual or threatened physical violence or verbal abuse which leads to fear for a person’s safety. In this situation we will notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and the circumstances leading to it.

Training

GPs in Training

Our practice is approved to train fully qualified doctors who wish to specialise in general practice. Our GP registrar will have had 2-4 years of experience as a qualified hospital doctor working in various specialities. They consult patients on their own, under the mentorship of our trainer. Occasionally we ask permission to video a consultation. You will always be asked in advance and are given the option not to take part, and this will not affect your care in any way. No recording will be taken without your consent and the camera will be switched off on request. These videos are used only for educational purposes with the doctor doing the consultation and are destroyed after use.

Medical Students

Medical students are sometimes attached to the practice for 2 – 3 weeks as part of their training. If you do not wish a student to be present during your consultation, please inform the receptionist.

Summary Care Record

Your patient record is held securely and confidentially on the electronic system at your GP practice. If you require treatment in another NHS healthcare setting such as an Emergency Department or Minor Injury Unit, those treating you would be better able to give you appropriate care if some of the information from the GP practice were available to them.

This information can now be shared electronically via: The Summary Care Record, used nationally across England

The information will be used only by authorised health care professionals directly involved in your care. Your permission will be asked before the information is accessed, unless the clinician is unable to ask you and there is a clinical reason for access.

If you would like to opt out, please ask reception for our opt out form.

A parent or guardian can request to opt out children under 16 but ultimately it is the GP’s decision whether to create the records or not, because of their duty of care to the child. If you are the parent or guardian of a child under 16 and feel that they are able to understand, then you should make this information available to them.

Who Has Access?

Across all health care settings, including urgent care, community care and outpatient departments in England.

Information Source

GP record

Content

  • Your current medications
  • Any allergies you have
  • Any bad reactions you have had to medicines
  • Additional information (upon request to your GP)

For more information visit:

www.digital.nhs.uk

 

Personal Data

The following IT systems are in use at the practice:

  • Referral Management (using NHS numbers in referrals)
  • Electronic Appointment Booking (the facility to book routine appointments online and, similarly, to cancel appointments
  • Online booking of repeat prescriptions
  • Summary Care Record (uploading details of your current medication and allergies to the national “spine” so that these are available for doctors involved in your care elsewhere)
  • GP to GP transfers (the electronic transfer of records from practice to practice when you re-register
  • Patient Access to records (the facility to view your medical records online).

If you are not already registered for online access and would like to be please complete our online form.

If you would like access to your medical records enabled or would like to opt out of the local or national summary care record, please contact reception.

IT Policy

This practice is committed to preserving, as far as is practical, the security of data used by our information systems. This means that we will take all reasonable actions to;

Maintain the Confidentiality of all data within the practice by:

  • Ensuring that only authorised persons can gain access to our systems
  • Not disclosing information to anyone who has no right to see it

Maintain the integrity of all data within the practice by:

  • Taking care over input
  • Ensuring that all changes are reported and monitored
  • Checking that the correct record is on the screen before updating
  • Reporting all apparent errors and ensuring that they are resolved

Maintain the availability of all data by:

  • Ensuring that all equipment is protected from intruders
  • Ensuring that backups are taken at regular, predetermined intervals
  • Ensuring that contingency is provided for possible failure or equipment theft and that any such contingency plans are tested and kept up to date

Additionally we will take all reasonable measures to comply with our legal responsibilities under: