For confidential advice call 020 3049 4505

FAQs

Practitioner-Patients FAQ

Not a doctor or dentist?

The services below offer support for nurses and pharmacists.

Pharmacists,

http://pharmacistsupport.org.uk/

Pharmacists Support is an independant charity working for pharmacists and their families and pharmacy students to provide help and support in times of need.

Nurses,

The following offer support services to its members,

http://www.rcn.org.uk/support/services/counselling

http://www.unison.org.uk/welfare/index.asp

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Who can use the service?

The service is available for any registered doctor or dentist who has:

  • A mental health or addiction concern (at any level of severity)
  • A physical health concern (where that concern has raised a performance issue).

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What support is available for my relatives or friends?

Support for Family and Friends – PHP Family Group

A safe place to meet for relatives of health professionals in recovery / with dependency problems

When a member of any group has a dependency problem, be it alcohol or other drugs, it causes problems within that group. This is especially true when that group is the family unit with its close emotional ties and intricate dynamics. Both the family member and the alcohol/drug dependent must learn to recognize their role in the dynamics of the relationship and seek to change their behavior which is often a painful process.

The way in which support is offered to family members is of paramount importance, sensitively keeping the focus upon them and exploring the impact of the dependency on their lives.

The family group at PHP offers a safe place for family members and friends of health professionals. The group is facilitated and aims to assist in finding hope and strength through realizing that there is a solution and that you are not alone.

For any information about the family group, please contact Naomi 0781 8475 825

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Does the PHP replace existing health services?

No: The PHP is designed to enhance rather than replace existing health services for practitioners by providing advice on access to local health services and prompt access to confidential treatment where local services are unable to meet their needs.

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Can I use a pseudonym?

Yes you can use a pseudonym for telephone advice or enquiries if this is what you prefer to do. We will also arrange for pseudonyms to be used if a PHP clinician knows you or alternatively arrange treatment via one of our preferred providers. The important issue is that you feel confident in being able to approach PHP for help.

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What are the aspects of PHP?

PHP has two key components:

  • An expert advice, consultation and case management function, provided from one centre within London – PHP 1
  • Rapid access to specialists for further assessment and treatment, where required – PHP 2.

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Can PHP provide ongoing support and case management?

Yes: The PHP will provide case management support for practitioners who have complex issues. PHP can also arrange for the monitoring of practitioners who have been referred on for treatment of addictions.

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What if I need a referral to a Specialist Practitioner?

The Practitioner Health Programme  (PHP) has a number of specially commissioned external specialist providers within and outside the London area. These providers have been chosen because they have expertise in managing sick health professionals and have robust systems for ensuring confidentiality. The PHP team will try to find the right service for you depending on your needs, preferred location and other factors. The external providers include:

  • In-patient detoxification services for drug and/or alcohol dependence
  • In-patient mental health services
  • In and out-patient rehabilitation services
  • Psychotherapy

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Where is the service provided?

The NHS Practitioner Health Programme is discretely based within an existing general practice surgery. Practitioner-patients should be reassured that they will be unidentifiable from other patients attending the practice for “normal” primary care services.

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How do I know if I should contact the service?

If you are a registered doctor or dentist and are in doubt about whether we can help, please get in touch and we can talk through the issues with you.
Telephone 0203 049 4505

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Why has this service been set up?

Doctors and dentists are like everyone else and encounter all types of health problems. The focus of this programme is on early intervention, to support the health of doctors and dentists so that wherever possible they can continue providing safe and valued care to their patients. There is a tendency for doctors and dentists to manage their own health problems, to self medicate, to chat informally to colleagues etc. rather than seek a proper consultation and treatment. For this reason many problems go unreported or unrecognised. This service seeks to provide a way that doctors and dentists can access support and advice that they need in a confidential and understanding environment.

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Do I need to tell my GP that I am coming?

No: This is a confidential service. You do not need to tell anyone you are contacting us. The very fact that you are using our service is because you do not feel able to use existing NHS services. If you want to let your general practitioner know you have attended then that is fine and we can write to him/her with your consent. Ideally we hope that you have a general practitioner that you can trust with your problem, but sometimes this is not possible and we will always respect that.

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Is the service confidential?

Individual practitioners approaching the PHP for advice or treatment will be assured that their case will be handled on a confidential basis. Only in exceptional circumstances will confidentiality be breached. This will be where there are serious and unresolved concerns that the practitioner-patient maybe putting their patients at risk.

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Will you tell my employers I am unwell?

Within the confines of the law the service we offer is confidential. Only in exceptional circumstances may we have to breach your confidentiality and this will only ever be as a last resort. For example, there may be instances where we have a duty to inform the DVLA or if we think that your behaviour is putting children or vulnerable adults at risk. There maybe exceptional cases where we think that you are putting patients at serious risk because of your behaviour. We then have a duty to let the GMC/GDC or your employer know about this. Just to reassure you this is seldom necessary. Further information on confidentiality can be found on the tab above.

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What if I come through GMC/GDC procedures?

It may-be the case that the GMC/GDC have recommended that you approach PHP as they think you may benefit from the services we can offer you rather than being part of any restrictions or undertakings on your practice. Your contact with PHP is therefore purely voluntary on your part and the GMC/GDC will have NO further involvement and your care will be entirely confidential.

www.gmc-uk.org/concerns/doctors_under_investigation/health_assessments.asp

For some health professionals a condition of continuing practice might be that restrictions are placed on registration, known as undertakings or conditions.

www.gmc-uk.org/concerns/doctors_under_investigation/undertakings.asp

These doctors/dentists often have a substance misuse or dependency diagnosis, and in these circumstances the GMC/GDC will appoint their own medical supervisors. Medical supervisors report back to the GMC/GDC on the doctor/dentists progress under treatment and also engage with the workplace and clinicians or others involved in the health professionals care. GMC/GDC medical supervisors do not provide ongoing treatment to the sick doctor. Some doctors/dentists in this category who contact PHP may want reports on their progress from PHP to form part of the GMC/GDC medical supervision process. However if the doctor/dentist does not give consent for PHP to share details of their health with the GMC/GDC then PHP will not do so (unless it appears that patient safety is compromised).

It may be the case that a complaint has been sent to the GMC/GDC and as yet the GMC/GDC has not completed their investigation or, or having investigated the complaint has decided to refer it to a Fitness to Practise panel. This might be the case where for example you have been referred to the GMC/GDC following a drink-drive offence. We can help you deal with your problem ahead of the GMC/GDC process and put you in a much better position when the case is eventually heard. This will especially be the case where you are able to demonstrate insight into your problem and benefit from the support and help that PHP is able to provide

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If I am dependent on alcohol and approach PHP1 do you have to tell the GMC/GDC?

No. If there is no risk to patients (for example turning up for work intoxicated) then there is no reason for the GMC/GDC to be involved at all.

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If I am dependent on illicit drugs (e.g. heroin, cocaine) do you have to tell the GMC/GDC?

We have set up an agreement with the GMC and the GDC that allows us to see and treat practitioner patients without informing them of individual cases. The exceptions to this are where patient safety is at risk, where a practitioner is not complying with assessment or treatment, not heeding advice to take leave from work, or where there is a significant on-going misconduct issue, or where, even though abstinent, there is a serious risk of relapse. On going criminal activity would constitute such an issue. If such a situation were to occur, we would contact the GMC/GDC with your knowledge – we would try every thing possible not to go behind your back to discuss or refer a named individual. Therefore, whilst in the majority of cases we would have no need to involve the Regulator but we will always advise you that any use of illicit drugs is a breach of your Regulatory requirements and on-going illegal activity needs to be reported to the Regulator.

If you are in any doubt please contact us for a confidential and anonymous discussion

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What happens when I come to the appointment?

When you first come you will talk to one of our experienced health professionals for about an hour (but it might take longer) who will assess what your problem is. We will ask you to fill in some health and/or screening questionnaires and we may carry out a physical examination and/or blood tests. What happens next depends on the findings of the initial assessment and what sort of help you want. It maybe the case that we can provide you with some information and that we don’t need to see you again. It maybe that we refer you immediately to a specialist practitioner or it maybe that we invite you to come to another appointment so that we can continue with a more detailed assessment.

Please expect your first appointment to last around 1 1/2 to 2 hours

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How are records kept?

All details will be kept on a separate confidential computer record. This record will only be accessible by PHP staff and will not be “uploaded” to any shared medical record system. This means that the record will not form part of the NHS shared electronic record.

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What if I need psychological therapy?

We can offer you up to six therapy sessions. We have experts within the team who can provide cognitive behaviour therapy or other psychotherapies (family, group, individuals). If you require more than six sessions then we will refer you for this. We have arrangements with a network of cognitive behaviour and other psychotherapists.

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Will I have to pay for the service?

No, this is a free, NHS service. You will not need to pay anything.

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How do I obtain help out-of-hours?

The Practitioner Health Programme is not an out of hour’s service, we are open Monday to Friday, 9am – 5pm.

Please visit our home page for information on ‘Other Sources of Help’.

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What other organisations can I contact?

Our web site gives a list and contact details for a large number of organisations that can help you. Some of these are telephone advice services only and others can offer you counselling. Please click here for more details.

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What if I need admission for my problem?

If you need admission for a mental health or addiction problem we can arrange this for you. We have agreement with a small number of inpatient mental health and addiction services across and outside London. We will talk with you about where is best for you. This service is free to you.

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How long will you see me for?

We can continue to see you at the service until you feel able to be discharged. This maybe when you feel better or where you are able to talk about your problem with your general practitioner.

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What if I need rehabilitation services?

If you need rehabilitation we have a preferred provider agreement with a residential service based outside of London. A number of doctors and dentists have received residential treatment there, through PHP, since 2008. In exceptional circumstances where the service would not be appropriate we would discuss with you and see if arrangements with an alternative provider could be made.

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Employers and Referrers FAQ

Can PHP provide a report?

Yes: PHP can provide reports, however this will be with the agreement of the practitioner-patient. PHP can provide reports to employers, Trusts, or to the GMC or GDC.

PHP does charge for reports, however, charges are only applicable where payment is being made by a third party e.g. GMC, GDC, or a Defense Organisation. We will not charge for reports where the cost would be incurred by the practitioner patient.

All report fees are reinvested in PHP for service development or the improvement of existing services for practitioner-patients

NHS Practitioner Health Programme Report Fee Schedule

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What can PHP offer with respect to helping a practitioner return to work?

When a practitioner is ready to return to work, PHP help support this process by liaising, as appropriate, with the relevant Trust, occupational health, Deanery.

PHP does not provide occupational health reports on a practitioner’s fitness to practise, we do however with patient consent, provide reports summarising the health issues, treatment and prognosis.

PHP can also help signpost practitioners to coaching, mentoring or career counselling

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Is the PHP service an occupational health service?

No, PHP is not an occupational health service.

The NHS Practitioner Health Programme is a health service for doctors and dentists who have mental health, addiction or physical health problems that affect their ability to work.

However, the PHP team may work with employers, Occupational Health departments and others to develop and implement return to work programmes.

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What can PHP offer with respect to helping a practitioner return to work?

When a practitioner is ready to return to work, PHP can help support this process by liaising, as appropriate, with the relevant Trust, occupational health, Deanery.

PHP can help signpost practitioners to coaching, mentoring or career counselling.

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