An annual conference organised by GPs for GPs, thei r Nurses & thei r Managers wi th the Montgomeryshi re Medical Society & Ins t i tu te of Rural Heal th

GreGynoGR u r a l P r i m a r y C a r e C o n f e r e n c e

25th to 27th September

Chairman’sIntroduct ion

Welcome to Gregynog 2013 to all new and repeat delegates from medical students to senior partners. We have indeed been basking in a golden summer; we are told the best for seven years. Ann Whale and team have been working through the heat to produce a programme to rival the quality of our summer, so a big thank you to them.

Seemingly whenever we see the news there is another negative story about the NHS courtesy mainly of our politicians and journalists. A large ray of sunshine was that in an English survey over 99% of families and patients would rate their experience of a particular ward in a positive light, this is I am sure a reflection of the true state of the NHS. Let us hope a similar survey in Wales would show matters to be even better! This is our NHS: the public, politicians and staff need to work together to raise standards for the good of all. As we meet in Gregynog we can celebrate quality health care and learn to do even better in our daily practice. High morale and high standards appropriately portrayed are vital to keeping a vibrant rural work force and attracting new recruits to all disciplines.

So welcome once again. I am sure that the staff at Gregynog will ensure that we are well rested and fed as usual. I look forward to your company over the three days of our course.

Martin Green Chairman Montgomeryshire Medical Society

Certificates of attendance are available, please make sure you sign the attendance register daily/each session that you attend.

Gregynog is a magnificent country house set in 750 acres of landscaped grounds some five miles from Newtown, Powys.

Between 1924 and 1963, its owners Gwendoline and Margaret Davies established one of Europe’s finest private printing presses and formed an outstanding collection of Impressionist and other paintings and sculptures, including Monet and Renoir, which are now on view at the National Museum Wales in Cardiff.

The sisters also founded the Gregynog Festivals of Music and Poetry which attracted leading musicians including Adrian Boult, Gustav Holst and Henry Walford Davies.

GreGynoG Hal l

ProGramme 2013

TUESDAY 24th SEPTEMBER

7.00pm Buffet Supper followed by

Trauma to the Head & Neck – Surgical Management & Repair

Sunil Bahatia Consultant Maxillofacial Surgeon, Shrewsbury & Telford NHS Trust

WEDNESDAY 25th SEPTEMBER

9.15am Coffee and registration

9.30am Introduction and Welcome Dr Martin Green Chairman Montgomeryshire Medical Society

SESSION ONE

Chair: Dr Chris Nevill HOLDEN’S SOAPBOX & HOT TOPICS

9.40am Holden’s Soapbox Dr Peter Holden, GP Matlock, GPC UK Negotiator with lead responsibilities for finance and rural matters and Vice Chairman of BASICS

9.40am Introduction to Rural Practice Dr John Wynn Jones (parallel session for F2s only) GP & Senior Lecturer in Rural Health Keele University School of Medicine

11.00am Coffee

11.20am Hot Topics in Legal Challenges in Richard Griffith Practice - an update Lecturer in Healthlaw, Swansea University

12.30pm “Not a Penny Less, Not a Penny More” Dr Jonathan Jones Ill Health Retirement – a Government Retired GP, North Wales Health Warning

1.00pm Lunch

SESSION TWO

Chair: Dr Martin Green HOT TOPICS IN NEUROLOGY

2.15pm Neurology Made Easier? Dr John Bowen (practice points that seem to work for me) Consultant in Neurology, Shrewsbury & Telford Hospitals

4.45pm Ends (break for afternoon tea at 3.15 pm)

7.00pm Reception followed by Course Dinner with after dinner speaker – Dr Prudence Hamade

THURSDAY 26th SEPTEMBER

SESSION THREE

Chair: Dr Adrian Weston MEN’S HEALTH DAY

9.15am Coffee & registration

9.30am Welcome & introduction

9.40am STDs, HIV, ED – I Colm O’Mahony Consultant Physician in Sexual Health Countess of Chester Hospital, Chester

10.40am Coffee Break

11.00am STDs, HIV, ED – II Colm O’Mahony Consultant Physician in Sexual Health Countess of Chester Hospital, Chester

12.00pm Sex, Relationships & Prof. Kate Bullen, Head of Department, Aberystwyth Masculinity University & Honorary Psychologist, Dept of Urology,

Morriston Hospital NHS Trust, Swansea (with the support of Prostate Cancer UK)

1.00pm Lunch

SESSION FOUR

Chair: Dr Donna Griffiths

2.00pm Prostate Disease Update – Dr Jon Rees BPH, Prostate Cancer, Prostatitis, PSA GP Backwell & Nailsea Medical Group (with the support of

Prostate Cancer UK)

3.30pm Tea

3.45pm The Diagnosis & Management Jason Kasraie, Consultant Embryologist & Andrologist of Male Factor Infertility Shropshire & Mid Wales Fertility Centre Shrewsbury & Telford Hospitals NHS Trust

4.45pm Session ends

7.30pm Dinner, followed by social programme

FRIDAY 27th SEPTEMBER

SESSION FIVE

PRACTICE, COMMUNITY & MIU NURSES WELCOME

Chairs: Dr Lisa Hunt CLINICAL SKILLS IN PRIMARY CARE

9.15am Coffee & registration

9.30am Welcome & introduction

9.40am Delegates will have had the choice of attending a workshop of their choice during the morning and afternoon. Allocatation of workshops has been organised on a first come, first served basis and numbers strictly limited to 20 due to the practical content of each of the sessions.

Radiology in Primary Care Dr David Allan Parker, Consultant Radiologist Wrexham Maelor Hospital.

Minor Surgery Dr Paul Metcalf, GP Brecon

Heart Failure – When to Refer Richard Lawrance, Consultant Cardiologist (Case-based learning) & Lead for Heart Failure Services, & Dr Jenny Welstand,

Lead Nurse Heart Failure Services, Betsi Cadwaladr University Health Board, Wrexham Maelor Hospital

Emergencies at the Doorstep Dr Fiona Rae, Consultant in Accident & Emergency Medicine Wrexham Maelor Hospital

12.45pm Lunch

SESSION SIX

Chair: Dr Joe Vibhishanan CLINICAL SKILLS contd

1.45pm Dermatology Update Dr Stephen Murdoch FRCP, Consultant Dermatologist, Shropshire Skin Clinic

Eyes in Primary Care Robert Dapling, Consultant in Opthalmology Shrewsbury & Telford Hospitals

Diabetes – why do things always change? Carwyn Jones, GP Carmarthen

Acute Knee Injury Pete Gallacher, Consultant Orthopaedic Surgeon Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation trust

4.30pm Conference Ends

PRACTICE MANAGER’S PROGRAMME WEDNESDAY, 25TH SEPTEMBER 2013

9.15am Coffee & Registration

9.30am Welcome & introduction

9.40am Holden’s Soapbox – a topical update on political issues and trends Dr Peter Holden, GP Matlock, GPC Negotiator

11.00am Coffee and biscuits

11.20am Hot Topics in Legal Challenges in Practice – an Update with Richard Griffith, Lecturer in Healthlaw, Swansea University

12.30pm “Not a Penny Less, Not a Penny More” Ill Health Retirement Dr Jonathan Jones, Retired GP, North Wales

1.00pm Lunch

2.00pm What’s New in Employment Law Stuart Plage, Conciliator/Adviser, ACAS Wales

3.00pm Tea and cakes

3.15pm Employment Law – Employer Responsibilities – a look at Appraisals (legalities & implementation), Formal & Informal Grievance

4.15pm Ends

PRACTICE NURSE PROGRAMME THURSDAY, 26TH SEPTEMBER 2013

9.15am Coffee and Registration

9.30am Welcome & Introduction

9.40am STDs, HIV, ED - 1 Colm O’Mahony Consultant in Genito-Urinary Medicine Countess of Chester Hospital, Chester

10.40am Coffee and biscuits

11.00am STD, HIV, ED – II Colm O’Mahony Consultant in Genito-Urinary Medicine Countess of Chester Hospital, Chester

12.00pm Sex, Relationships & Masculinity Dr Kate Bullen, Head of Department Aberystwyth University

1.00pm Lunch

2.00pm Tips for use in the Heart Failure Clinic Fiona Wilcocks, Heart Failure Nurse, Wrexham Maelor Hospital

3.00pm Tea & Cakes

3.20pm What’s new in Cardiac Rehabilitation Jacqueline Cliffe, Lead Nurse Cardiac Rehabilitation, Wrexham Maelor Hospital

4.30pm Ends

Date of next year’s conference is

1st – 3rd October 2014

Mr Sunil BhatiaMr Bhatia is trained as both a dentist and a doctor. He has completed training in all parts of the UK in particular in the East Anglia rotation and has undertaken postings in Nigeria, Canada and India. Mr Bhatia has extensive experience in all aspects of Oral and Maxillofacial Surgery including surgical removal of wisdom teeth. He has a special interest in head and neck cancer, skin cancer and salivary gland disease and neck lumps. Mr Bhatia also undertakes facial reconstruction including microvascular techniques.

Dr Peter HoldenThis is Peter Holden’s 21st attendance at the conference and his 20th Soapbox. He is the longest currently serving member of the GPC (32 years) and his 15th year as a negotiator and has specific responsibility for rural affairs. Very much the corporate memory of the GPC he is the sole surviving negotiator of the 2004 contract. He is the senior partner in a 4 doctor training practice in Matlock Derbyshire where they still have a GP community hospital. He is still active in Out of Hours work and because he has a low boredom threshold also is a HEMS physician on TWO air ambulance services where he flies 3 days per month.

Dr John Wynn JonesDr John Wynn-Jones is a practising rural GP and a Senior Lecturer in Rural and International Health in the School of Medicine at Keele University. He is a Member of the Institute of Learning and Teaching (ILTM) and a Fellow of the Royal College of General Practitioners. After completing his medical training at Guy’s Hospital Medical School in 1975, John became a partner in Montgomery Medical Practice. He is a founding member of the European Rural and Isolated Practitioners Association (EURIPA) and he was President of the Association for over a decade. John is currently Chair-Elect of the World Organisation of Family Doctors (WONCA) Working Party on Rural Practice and is the founder of the Institute of Rural Health.

Richard GriffithLecturer in Healthlaw, Swansea University. Richard specialises in healthcare and the law and is a well established author in the field with four journal columns and a range of book and journal contributions. He is the team co-ordinator for health law within the department of philosophy, history and law in the school of health science. Richard works closely with most of the NHS trusts in South Wales in implementing new policy and legislation affecting healthcare delivery. Most recently this had included the Mental Capacity Act 2005 and the Mental Health Act 2007.

John BowenConsultant Neurologist at Shrewsbury & Telford NHS Trust since 2011. Previously worked in East Midlands and South Coast. Trained in Oxford and London. Likes: when people who don’t know say they don’t know, Des Spence & the null hypothesis. Dislikes: pathways, MDTs and the word urgent!

Mr Jason KasraieJason is Consultant Embryologist and andrologist at the Shropshire & Mid Wales Fertility Centre, based at the Shrewsbury & Telford Hospitals NHS Trust.

Prof. Kate BullenChartered psychologist, Institute Director, Institute of Human Sciences Aberystwyth University. Originally trained as a therapeutic radiographer. Completed undergraduate degree and PhD as a mature student. Works with the South Wales Cancer Network, Prostate Cancer UK and Orchid (voluntary organisation providing support and information for men with prostate, penile or testicular cancer). Interests in research ethics, 13 years experience as committee member of several research ethics committees across Wales.

sPeaKer BIOGRAPHIES

Colm O’MahonyDr O’Mohony is a Consultant at the Countess of Chester Hospital since 1990. He was also the Postgraduate Tutor for 7 years. He first qualified in Science (Microbiology) in 1975, and then went on to do Medicine, in the hope of putting off the day when he would finally have to work for a living! He did an MD in immunology but he was never clever enough to become a “real proper GP doctor” and he liked talking to patients far too much to ever consider being a surgeon. Fortuitously, he ended up in a VD Clinic in Sir Patrick Dunn’s Hospital in Dublin, doing a session, and there - like St Paul on the road to Damascus, enlightenment. Here was just the job for your average repressed Irish Catholic. There was sex, shame, guilt, anxiety, confession, forgiveness and penance. He had found his niche! He came to England in 1986 to explore the sexual diversity of Liverpool and finally to a Consultant post in Chester in 1990. He was elected as Chairman of the National Association of GU Doctors in 2001 and to the British HIV Association executive committee in 2OO5. He was elected president of Chester and North Wales Medical Society 2013/2014

Fiona RaeConsultant in Accident & Emergency Medicine with the Betsi Cadwaladr University Health Board. Fiona qualified in Southampton in 1991. Before joining Wrexham Maelor Hospital, Fiona spent some time working in Australia. Fiona also has a special interest in Simulation and Medical Education.

Dr David ParkerConsultant Radiologist in Wrexham Maelor Hospital since 1988, having trained in Birmingham and Leeds. David’s interests over this time have included GI and interventional radiology, breast disease, nuclear medicine and paediatrics. More recently, in addition to his managerial roles in radiology and R & D, he has developed an interest in the challenges of meeting the radiological needs of rural populations in Wales.

Dr Jon ReesJon Rees is a 6 session GP Partner at Backwell and Nailsea Medical Group, a 13,500 patient practice outside Bristol. He specialises in Men’s Health and Urology and helps to run a community urology service for Bristol, North Somerset and South Gloucestershire, carrying out cystoscopies, prostate biopsies, flow tests etc in a variety of community settings. He is deputy editor of Trends in Urology and Men’s Health, Chair of the Educational Advisory Group for Prostate Cancer UK, a member of the Global Advisory Committee on Prostate Cancer Survivorship for the Movember foundation and was on the Guideline Development Group for the 2010 NICE LUTS guideline.

Dr Paul MetcalfGP Brecon Medical Practice and Surgical Specialist with Powys Teaching Health Board since 2004 specialising in Minor General and Orthopaedic Surgery including a Carpal Tunnel Service. Previously Paul was CME Tutor in Scarborough for Yorkshire Deanery.

Richard LawranceConsultant Cardiologist at Wrexham Maelor Hosptial and BCUHB lead for Heart Failure services. Trained in Leeds, with PhD in genetics of Coronary Artery Disease and advanced training in echocardiography in Canada following a fellowship at the University of Alberta Hospital. Outside of the hospital, I’m also team doctor for NW Crusaders & Wales Rugby League Team.

Dr Carwyn JonesA GP in Carmarthen since 1986 who worked as CPD co-ordinator for the Deanery for 13 years. Delivered 4 Warwick GP Diabetes Diploma courses and a number of other educational Diabetes presentations.

Dr Stephen MurdochA Consultant Dermatologist on the General Medical Council specialist register. Stephen has been a Consultant Dermatologist in Shropshire since since 2000. In November 2011 Stephen was appointed Honorary Consultant Dermatologist to Shrewsbury & Telford Hospitals NHS Trust (SaTH). Stephen also works in the private sector running the Shropshire Skin Clinic.

Mr Robert DaplingRobert has been Consultant Opthalmic & Ocuplastic surgeon with Shropshire Eye Care Ltd since 1996. He is a Fellow of the Royal College of Physicians and Surgeons of Glasgow and Royal College of Surgeons of Edinburgh as well as a Founder Member of the British Oculoplastic Surgery Society.

Mr Pete GallacherMr Gallacher joined The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust as a Consultant Orthopaedic Knee Surgeon in 2012.

Originally from Glasgow, Mr Gallacher went to the University of Dundee, then trained in Merseyside and undertook his specialist orthopaedic training at Telford, Stafford, Oswestry and Stoke. Whilst training under Mr Dai Rees and the sports injuries team in addition to the knee specialists in both Stoke on Trent and Oswestry, he developed a sub-specialist interest in surgery around the knee. Throughout his training he published on general orthopaedics and on specialist knee topics.

Following completion of his specialist training rotation, he underwent fellowship knee training in Sheffield and undertook a travelling fellowship in Europe supported by the British Association for Surgery of the Knee (BASK) visiting various European centres of excellence in knee surgery.

Fiona WillcocksOver ten years as a DN Sister; 5 years as a Nurse Case Manager for chronic conditions and last three years as a Heart Failure Nurse Specialist at Wrexham Maelor Hospital. Just completed MSc in Advanced Clinical Practice.

Jacqui CliffeLead nurse for the Wrexham Cardiac Rehab team. Has worked in cardiac care for 20yrs and, during this time, completed practice nurse training, and worked as a lecturer practitioner.

Dr Jenny WelstandJenny trained in London in the 1980’s and has a broad experience in both surgical and medical cardiac care; in 1990 she joined the cardiac unit in Oxford and developed roles in surgical pre-assessment, as a cardiology nurse practitioner and a community cardiac rehabilitation service. She joined North East Wales NHS Trust in 2002 to establish a heart failure service. Her interests are in service development and working across the interface between primary and secondary care. Jenny was awarded her Doctorate earlier this year; her thesis investigated patients’ experiences of living with heart failure.

Mr Stuart PlageStuart has worked for Acas for 5 years after a previous career in the Department for Work and Pensions and a Liverpool out of office NHS provider. His main roles are conciliating Employment Tribunal claims before they reach a hearing, mediating individual workplace disputes and employment practice training for North Wales.

The Montgomeryshire Medical Society is grateful to the Institute of Rural Health and Prostate Cancer UK for their support in the organisation of this year’s Conference and to PSUK, Astellas, Chiesi, Grunenthal, Takeda, Menarini, Almiral, Quintiles and Leo Pharmaceuticals, and the many other pharmaceutical companies who continue to sponsor the event each year.

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