I read with interest Dr Gerard Pantingês article on surgery premises (•Practice premises: How does your surgery measure up?ê Guidelines in Practice, August 2002, pp. 31-3).
I am currently undertaking infection control audits in over 50 surgeries. There are many recurring problems; some of the more significant ones include decontamination of instruments, disposal and storage of waste, re-use of single-use devices, use of named patient medicines for other patients and lack of hand hygiene and the generally poor standard of cleanliness of many premises.
Perhaps Dr Panting would like to cover infection control in a future article?
Infection Control Nurse
Dr Gerard Panting replies:
The issues you raise, which have not given rise to claims against MPS members, are clearly very important and do need to be addressed.
Would it be possible for you to send me more details of your audit so that I can write something about these issues in a future edition of Guidelines in Practice?
The malignancy of CHF
I was struck by the news item in Guidelines in Practice which stated that the majority of patients with heart failure receive inadequate treatment and may even go undiagnosed (•Heart failure patients are undertreatedê, June 2002, p. 12).
The National Service Framework for Coronary Heart Disease already charges GPs with the task of identifying their patients with chronic heart failure and providing structured care for them.
Identifying patients who are entering the terminal stage of heart failure is often a complex task.
There is a need for a collaborative network which engages, as a minimum, cardiologists, GPs and palliative care specialists. They all need to acknowledge the •malignancyê of chronic heart failure.
I believe that patients with chronic heart failure have needs comparable to those with cancer. The palliative care of chronic heart failure has been overlooked in primary and secondary care. Perhaps the NSF will finally turn the tide.
Dr Kausar Jafri, GP, Stoke on Trent