S6W-20711

Asked by: Lennon, Monica (Scottish Labour - Central Scotland)

Question

To ask the Scottish Government what training is currently being provided to GPs on the diagnosis and treatment of chronic urinary tract infections (UTIs).

Answered by Minto, Jenni - Minister for Public Health and Women's Health

NHS Education for Scotland (NES) are responsible for managing all training provided to doctors in Scotland. NES ensure that all doctors receive high quality training in line with curricula that is set by the relevant Medical Royal College so that they are able to demonstrate that they have met all GMC curricular requirements, in order to practise independently as a GP in the UK.

The General Practice Specialty Training (GPST) programme lasts for 3 years with trainees typically spending 18 months in General Practice and 18 months in secondary care i.e. hospital settings.

All GP practices receive funding for protected time consisting of one session a month (usually within practice time) to allow GPs to maintain and develop their training and skills, and those of their practice teams.

Training currently provided to GPs on the diagnosis and treatment of UTIs include:

1. Educational activities during the first year of training under most GP Speciality Trainees (GPSTs), such as: tutorials, case based discussions, post consultation prescribing checks and referral reviews that are undertaken by their GP educational supervisors.

2. Management of UTI’s (uncomplicated lower UTI’s in females) in primary care also occurs through the Scottish Pharmacy First initiative. https://www.nss.nhs.scot/publications/pharmacy-first-scotland-urinary-tract-infection-uti/ .

3. The RCGP ‘Being a General Practitioner’ Curriculum Guide ( https://www.rcgp.org.uk/mrcgp-exams/gp-curriculum/clinical-topic-guides#kidney ) section on Kidney and Urology includes: Urinary tract infections in children and in adults including lower urinary tract infection, pyelonephritis and persistent/recurrent infection There are questions based on this clinical topic guide within the Applied Knowledge Test (AKT) and Simulated Consultation Assessment (SCA- OSCE style exam) which form essential components of the MRCGP exam.

4. SIGN 160: “Management of suspected bacterial lower urinary tract infection in adult women. A national clinical guideline. September 2020” is a readily available resource for all GPs in Scotland.

5. All GP practices receive an annual prescribing report which focusses on antibiotic prescribing and review of current guidelines on management of UTI’s in primary care. Each Health board has its own guidance - see below:

https://www.clinicalguidelines.scot.nhs.uk/nhsggc-guidelines/nhsggc-guidelines/emergency-medicine/diagnosis-treatment-and-management-of-uti-in-children-rhc-glasgow/

https://handbook.ggcmedicines.org.uk/guidelines/infections/urinary-tract-infections-utis/

6. Evaluation of the impact of Scottish Reduction in Antimicrobial Prescribing (ScRAP) programme on GP Practice management of patients with suspected UTI – is an example of initiatives regularly offered to GP practices to review their antibiotic prescribing. GPs through annual appraisal have to demonstrate annual QI initiatives and many include antibiotic prescribing in UTI’s and compliance with local and national guidelines.

7. Common reference sources used by GPs (GP notebook, NICE CKS guidelines, BNF, BMJ best practice) all have comprehensive sections on management of UTI in adults and children.