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Therapists in Philadelphia
Verified by Psychology Today
Linda L. Guerra
Psychologist, MA, PhD
"I help people to clarify what they want from psychotherapy, and then work with them to facilitate their achieving their goals as quickly as possible. I have a warm and flexible style and tailor what I do to the individual client. I do not believe that psychotherapy is a "one size fits all" process, and will therefore use different approaches depending on what is most appropriate and useful with a particular client at a particular time.
(215) 798-0921
Verified by Psychology Today
Mary R Ragland
Clinical Social Work/Therapist, MSW, LCSW
"I am a Licensed Clinical Social Worker with experience treating adolescents, adults, couples and families. My goals are to help you experience more joy, freedom of expression, and satisfying relationships. Working with me is a collaborative process: A session with me is a two-way conversation based on identifying and creating solutions that will help you achieve your goals for happiness and success. My commitment to you is to provide support and resources through honest, accepting, non-judgmental communication.
(215) 987-3371
Philadelphia, Pennsylvania 19129
Verified by Psychology Today
Allan L Goldberg
Psychologist, PhD
"I believe that the work of therapy needs to be done in an atmosphere of safety, intelligence, warmth and humor. Therapy is often hard work because it takes so much commitment for us to look at ourselves objectively and work through challenging issues in our lives. Sometimes we come to therapy because there is a specific situation that we need immediate and/or brief assistance with or for an objective voice of reason. Sometimes we come to therapy because there have been challenges over time that have gotten in our way of getting what we want out of our lives.
(215) 592-4060
Verified by Psychology Today
Taniek A Gentles
Marriage & Family Therapist, LMFT
"You were given this life because you were strong enough to live it"-Unknown Inspiration is a person, place, experience that makes someone want to do something or create something. I like to think of therapy as a place to inspire people to do better, to want better, to create better and to live better. My ultimate goal is for my clients to walk out feeling empowered and courageous about obstacles that may come their way. I strive to create a safe, nurturing environment where vulnerabilities are embraced and used to shape people into the human beings they were created to be.
(267) 863-2927
Verified by Psychology Today
Alternative Psychotherapy Services
Marriage & Family Therapist
"Using a brief and cognitive therapy approach, I specialize is working with individuals, couples, marriage counseling, and families for issues of relationship problems, self-esteem issues, depression, anxiety, anger management, trauma informed treatment, decision making, assertiveness skills, adjusting to new situations and the emotions and decisions that come along with it. I am a licensed professional counselor in PA, NJ, and DE and offer evidence-based treatments, clinical supervision for new counselors in obtaining their license, and I am a Board Certified Executive Coach. I also offer consultation within the realm of career, work, and future planning.
(267) 612-4345
Philadelphia, Pennsylvania 19147
Verified by Psychology Today
C P Mirarchi
Counselor, LPC, LCADC, JD, NCGC
"Nothing has more of a negative impact on the family dynamic than addiction problems. If you have a gambling/addiction problem. it can affect every facet of your life. It can change your perception, strain relationships and interfere with your obligations and responsibilities. You may think you can stop any time you want. However, you just can't seem to do it. Compulsive gambling is an addiction, which can be successfully treated. If you have the right help. Let me help you get your life back on track.
(215) 987-5011
Philadelphia, Pennsylvania 19145
Verified by Psychology Today
Craig Cohen
Clinical Social Work/Therapist, PhD, LCSW
"Are you struggling with depression, anxiety, a life transition, or problems in your relationships? Are you feeling sad, angry, or in need of help right now with complicated issues? I work to create a safe, enriching environment as we collaborate together to develop a clearer understanding of these concerns. We explore your goals in life and what gets in the way of experiencing a sense of fulfillment and purpose. I strive to listen and support the needs of my clients and explore with them meaningful changes they can make in their lives and in their personal and professional relationships.
(215) 559-9558
Verified by Psychology Today
Melanie Rychok
Clinical Social Work/Therapist, MSW, LCSW
"We all face difficulties in our lives and in our relationships. If you have painful memories of traumatic events, there is help and there is hope. Whatever may be getting in your way we can find a path through it. Together we can engage in the process of healing from past hurt, trauma, and pain to a sense of peace, wholeness, and wellbeing.
(267) 603-3101
Verified by Psychology Today
Arielle Seidler
Clinical Social Work/Therapist, MSW, LSW
"No matter your reason for beginning your search for a therapist, you have started your journey toward a happier and more fulfilling life. Therapy is meant to free you from the external and internal pressures that keep you locked into painful and sometimes debilitating patterns. Whether you are struggling with the aftermath of a traumatic experience, depression, anxiety, addiction, an eating disorder, or difficulty in relationships, I will work with you as you process your lived experiences, gain a deeper understanding into how these experiences are impacting you today, and implement change.
(215) 253-5784
Verified by Psychology Today
Ruth Naomi Feinblum
Clinical Social Work/Therapist, LCSW
"Would you like to feel closer with your partner? Would you like to improve your ability to communicate? I can help you and your partner improve communication, see your strengths and enjoy your time together.
(610) 745-9571
Verified by Psychology Today
Melanie Stitt Psychotherapy
Clinical Social Work/Therapist
"Are you struggling with your daily interactions with friends, family and coworkers? Do you have difficulty figuring out why you feel certain ways? Would you like to have more "good" days than "bad" days? If the answer is "yes", then I can help you. My mission is to help you explore solutions to everyday challenges by assisting you in finding creative ways of reducing negative feelings of guilt and shame. I will help you identify your own strengths and discover ways to use them so that you may start enjoying your life.
(215) 839-3142
Verified by Psychology Today
Jonathan D. Small
Psychiatrist, MD
"Whether you are seeking psychiatric medications, psychotherapy, or a combination of the two, I will provide you compassionate, pragmatic care that is optimized for your well-being and your busy schedule. I offer weekend, evening, and early morning appointments. For urgent matters or emergencies, I can be reached 24/7, with only brief exceptions.
(215) 254-6715
Verified by Psychology Today
Ai Ikunaga
Psychologist, PsyD
"I have experience working with clients of diverse backgrounds with a variety of mental health concerns. My areas of expertise include multicultural issues as well as eating concerns/eating disorders. Though I use different approaches based on clients' needs, I am trained in a psychodynamic approach which focuses on the importance of relationships we form with others and their impact on our current lives. My previous experience as a licensed music therapist for almost a decade continues to enrich my current work as a psychologist. In working together with clients, I strive to be authentic and focus on their strengths, uniqueness, and creativity.
(267) 728-0082
Verified by Psychology Today
Julia Weinberg
Psychologist, PhD, JD
"As a forensic and clinical psychologist, I provide evaluations and psychotherapy. My therapy clients work with me on a variety of issues, including anxiety, loss, relationships, adoption & infertility, career challenges, adult ADD, and chronic health problems. My treatment approaches include psychodynamic therapy, CBT, and DBT. Your treatment will be tailored to your culture, communication style, and other personal factors. I avoid gimmicks and trendy ideas that have not been demonstrated effective for long-term change. As a forensic psychologist, I perform evaluations and provide expert testimony for civil and criminal procedures, including specialized evaluations for adoption, disability accommodation, and guardianship.
(215) 839-1097
Verified by Psychology Today
Jill Lipschutz Snyder
Clinical Social Work/Therapist, MSS, LCSW
"Loss and life transitions offer opportunities for growth and emotional healing. I specialize in helping people cope with anxiety, depression, grief and loss. Managing health conditions including cancer, infertility and chronic illness are among my areas of specialization. I also address a broader range of issues such as couple and family relationships, and parenting.
(215) 995-4027
Philadelphia, Pennsylvania 19147
Verified by Psychology Today
Alyce S. Jackson
Psychologist, PhD
"...To see ourselves as others see us..." Most people enter therapy after they experience some event which feels like the proverbial "final straw". Their immediate goal is to feel better as soon as possible. My goal is to help them achieve that. I accomplish this via ongoing conversations, which help people see themselves, others and their difficulties more clearly. Human beings often have difficulty solving problems because we do not ask ourselves the right questions. Additionally, we have both ends of the conversation in our heads. We ask ourselves the same questions and answer ourselves with the same
(267) 536-9946
Verified by Psychology Today
Kimberly L. Hoffman
Psychologist, PhD
"I am a licensed psychologist providing therapy to older adolescents and adults. My practice includes treatment for anxiety, depression, eating-related concerns, trauma, loss, family issues, illness, self-esteem concerns, academic and work stress, and relationships conflicts. I tailor my approach to each client's unique personality and needs and draw from my training and experience with insight-oriented, relational models; cognitive-behavioral interventions; and mindfulness-based approaches.
(215) 310-5863
Philadelphia, Pennsylvania 19110
Verified by Psychology Today
Eric B Spiegel
Psychologist, PhD
"I specialize in working with anxiety, relationship concerns, and trauma. With an expertise in clinical hypnosis, I will help you: (1) improve your reflective awareness of how your feelings and thoughts impact your well-being, relationships and behaviors and (2) enhance your coping and stress management skills to deal with your problems more effectively. As we build our therapeutic relationship, I will challenge you to observe yourself and reflect. Together, we will work collaboratively to facilitate positive change in your life and relationships. Enhancing your wellness is central to my work.
(215) 995-5035
Verified by Psychology Today
Therese M. Daniels
Counselor, NCC, LPC
"Therese has earned a BA degree from Villanova University and a Masters in Counseling Psychology from Immaculata University. Therese has over 10 years of experience in the mental health field working with children, adolescents, adults, couples and families. She is also trained as a Sexual Assault Counselor. Therese has provided counseling to individuals and families focusing on issues such as; anger management, social and communication skills, behavioral disorders, ADHD, anxiety, depression, sexual abuse, self-esteem, trauma, life transitions, and parenting skills. She has worked in a variety of settings such as school-based services, residential treatment centers, outpatient offices, and in-home services.
(855) 284-7483
Verified by Psychology Today
Deb Owens Counseling
Counselor, LPC, CAADC, CEAP
"Does this sound like you? I specialize in working with professionals and couples who are stressed, stuck, anxious, or concerned about their spouse's alcohol or drug use, or adult children of alcoholics or addicts (ACOA). Here you'll find support and effective strategies to help you get your life, career, recovery, or relationships back on track.
(215) 802-6521
Philadelphia, Pennsylvania 19118
Not enough Therapists to choose from?
Try expanding your search for Therapists in Philadelphia to a larger area (e.g. Philadelphia County, Pennsylvania)
How can I tell if a therapist is right for me?
Therapists in Philadelphia have broad skills and are able to work with a wide range of issues.
For example, if you're seeking a marriage counselor in Philadelphia you'll find that most therapists are trained in marriage counseling or couples counseling in Philadelphia and couples therapy. And they welcome families for family counseling in Philadelphia or family therapy in Philadelphia.
How to find a specialist?
If you're looking for specialist counseling in Philadelphia, Pennsylvania, such as a child psychologist or sex therapist, try to refine your search with our left nav bar.
What method of therapy is right for me?
When it comes to treatment methods, there's no "right way". A couples counselor or a family counselor may use different treatment methods depending on the one that works best for you.
How to use my insurance?
Many therapists accept health insurance. Check to see if your insurance is covered. Feel free to discuss this when you contact the therapist.


text:
They dip their wings in the sunset,
They dash against the air
As if to break themselves upon its stillness:
In every movement, too swift to count,
Is a revelry of indecision,
A furtive delight in trees they do not desire
And in grasses that shall not know their weight.
They hover and lean toward the meadow
With little edged cries;
And then,
As if frightened at the earth's nearness,
They seek the high austerity of evening sky
And swirl into its depth.
This poem is in the public domain.
This poem is in the public domain.
Women Poets in History
A collection of essays and ephemera about several women poets whose lives and work have influenced American poetry.
Naomi Shihab Nye
Dorothea Lasky
Ada Limón
Still I Rise
You may write me down in history With your bitter, twisted lies, You may trod me in the very dirt But still, like dust, I'll rise. Does my sassiness upset you? Why are you beset with gloom? 'Cause I walk like I've got oil wells Pumping in my living room. Just like moons and like suns, With the certainty of tides, Just like hopes springing high, Still I'll rise. Did you want to see me broken? Bowed head and lowered eyes? Shoulders falling down like teardrops, Weakened by my soulful cries? Does my haughtiness offend you? Don't you take it awful hard 'Cause I laugh like I've got gold mines Diggin' in my own backyard. You may shoot me with your words, You may cut me with your eyes, You may kill me with your hatefulness, But still, like air, I'll rise. Does my sexiness upset you? Does it come as a surprise That I dance like I've got diamonds At the meeting of my thighs? Out of the huts of history's shame I rise Up from a past that's rooted in pain I rise I'm a black ocean, leaping and wide, Welling and swelling I bear in the tide. Leaving behind nights of terror and fear I rise Into a daybreak that's wondrously clear I rise Bringing the gifts that my ancestors gave, I am the dream and the hope of the slave. I rise I rise I rise.

subset: commoncrawl


text:
Robert Klanten interviewed by PAGE.
Henrik Vibskov
As the Henrik Vibskov book launch tour saw its finale in New York last week, we bring you a video recap of the starting leg in Berlin.At the end of April in our crowded Gestalten Space, Vibskov staged an exclusive performance before mingling with guests and signing books. The tour continued to Copenhagen.
Henrik Vibskov is the first comprehensive presentation of his remarkably multifaceted creative vision. The enlightening texts and project descriptions, many written by Vibskov himself, offer deeply personal insight into the twisted yet tantalizing worlds that he creates on a daily basis.
Follow Us On
Hide and Seek in the April issue of the UK edition of Wired.
Der Honigdieb reviewed in the February 27 issue of the Nürnberger Zeitung. "So schön verpackt kommt die Sorge um unsere Umwelt selten daher."
Edwina ermittelt in Berlin recommended in 1000 und 1 Buch's February issue. "Eine spannend zu lesende Geschichte, die mit vielen interessanten Details zur deutschen und Berliner Historie aufwartet und Lust auf einen Berlin-Besuch macht. Liebevoll ausgestattet. Kurz: rundum empfehlenswert."
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We welcome portfolio and proposal submissions for Gestalten's potential publications and collaborations.


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Stock Market & Financial Investment News
News Breaks
December 12, 2012
WidePoint announces federal awards worth up to $7.1M
WidePoint announced it has received awards from five different agencies worth up to approximately $7.1M. The awards periods of performance are through September 2013 and are for services in our telecommunications life-cycle management and professional services areas.
News For WYY From The Last 14 Days
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March 19, 2015
WidePoint receives task orders under Department of Homeland Security agreement
WidePoint subsidiary iSYS LLC has received a Task Order renewal from the Department of Homeland Security Headquarters and a new Task Order from OBIM. Both Task Orders were issued under the Department of Homeland Security Cellular Wireless Managed Services Blanket Purchase Agreement. The renewal is worth a total of $17M if all options are exercised and is for one base year worth $5.9M and two option years. The new order from OBIM is for one base and two option years and a total value of nearly $700K if all options are exercised.
March 16, 2015
WidePoint reports Q4 net loss approximately ($0.9M), consensus (1c)
Reports Q4 revenue $16.8M, consensus $15.96M. Gross margin was 21% of revenue as compared to 21% in the fourth quarter of 2013.
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Why is fall one of the most popular times of year in North Dakota? Because there's so much to see and do. The air is crisp, national and state parks are ablaze with brightly colored fall foliage, and there is a plethora of pumpkin patches, corn mazes, hay rides and more. Click here for more great things to do in the outdoors in North Dakota.
Discover More On Fall
Trip Ideas & Travel Information
6 Spooktacularly Haunted Hideaways (Best Places Lists)
Don't let a few ghosts and goblins stand in your way of fun.
Gear up for new season (Articles)
No foolin' around, now is the time to prepare for hunting, fishing trips
The birthday parties are over, the celebration doesn't have to end
Start making plans FORE golf season (Articles)
It won't be long before golfers hit the links in North Dakota
Pheasants abound in North Dakota (Articles)
Pheasant hunting experience in North Dakota: Legendary
Spring goose hunting in North Dakota (Articles)
Location in Central Flyway makes state prime for duck and goose hunting
5 Pumpkin Patches and Corn Mazes to Explore in ND (Best Places Lists)
From pumpkin patches to corn mazes, fall is a magical time in North Dakota.
Americana Tour: North Dakota Roadside Art (Articles)
North Dakota's roadside art is Classic Americana
Wildlife Abounds on Des Lacs National Wildlife Refuge Scenic Backway (Best Places Lists)
Looking for wildlife? Waterfowl, raptors, deer, moose and other species of wildlife can be seen.
5 Sites on the Chan SanSan Scenic Backway (Best Places Lists)
Follow the Chan SanSan Scenic Backway through a glacial valley carved 12,000 years ago.
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Most will admit that business travel never comes cheap. U.S. domestic trips cost $990 (2014), yet these prices pale in comparison to this city.» Read More
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text:
Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a PCT Original actions identified in "Learning Review Action Plans" in 2004, MIAA The position for NHS Halton and St Helens as at March 2009 Ref 2005 and 2006 rating of St.Helen s PCT in 2006 1 Copy MIAA report – Information Survey Template circulated 2 Action Plan – re information Survey – March 2006 RECORD KEEPING, RECORDS MANAGMEMENT (STORAGE & RETRIEVAL 3 Evidence of action plan re information survey being monitored: Group – Information Governance Steering Group (reporting to Integrated Rationale: Ensure the PCT has in place robust record keeping and record Governance Board). management processes. This will mean that health records are improved and 4 Minutes of Joint Information Governance Steering Group to provide easily understood and that all PCT documents are stored in such a way that they evidence of action plan being monitored are secure and can be recalled when necessary. 5 Integrated Governance Board receiving Minutes of Information Governance Steering Group – evidencing it having monitored the action plan following These actions were identified by the learning review team as being required to address a information survey full range of issues associated with both record keeping in terms of entries within a health 6 Confirmation of appointment of Senior Records Manager – interview – Feb record and the storage and retrieval of health records, complaints records and other 06 documents that were held by the PCT and its predecessors. 7 Job Description of Senior Records Manager 8 Records Data protection and Governance Manager – Commence June 06 Halton and St Helens PCT has a Records Management Strategy that sets out the 9 Records Management Evidence of review of policies and procedures – overarching framework for integrating current records management initiatives as well as March 06 recommending new ones. It defines a strategy for improving quality, availability and Which Committee and Minutes? effective use of records in the Trust and provides a strategic framework for all records management activities. The strategy relates to all clinical and non-clinical operational 10 Communication and training of Records Keeping Policy / Change to clinical records and is compliant with the DoH publication Records Management: NHS Code staff 2006. The Code details the length of time all documents should be stored and this is 11 Communication and training of Records Keeping Policy / Change to detailed in the PCTs policy. independent contractors 12 Evidence of secondment of Senior Librarian – Feb 2006 – 12 months The PCT has a policy on the Storage and Retrieval of Records that is compliant with 13 Evidence of "buddying" and mentoring arrangements with neighbouring the national standards on Information Governance. The policy is designed to provide Trusts comprehensive guidance and advice to all PCT staff to assist with the securing and 14 Policy for record keeping developed safekeeping of health and non health records created by the PCT. The policy is updated 15 Policy for record keeping approved – due by July 2005 on a regular basis and is supported by an implementation programme. Feb 2005 Board 16 Record Keeping Policy details length of time for storage? The PCT has purchased an electronic document management system,Deployer and the 17 Record Keeping Policy included within appointment letter (directly Assistant Director of Performance is now working to implement this within the PCT so employed staff)? that staff can have ready access to all policies and procedures. th The PCTs Editorial Board has developed an Intranet site that went live on 5 November 2007. All policies and procedures will be available on both the intranet and the Internet. The PCT has a policy on the use of Safe Haven Fax Machines. The policy ensures 1 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a compliance with the PCT's Confidentiality Code of Conduct that was produced in February 2007. In December 2006 an Information Governance training programme commenced and to date over 750 staff have attended the training. Information Governance covers the full range of issues associated with record keeping, storage, retrieval, disclosing of confidential data and information sharing with key partners. In August 2007 a "Master Class" on Record Keeping and Record Management commenced and these will be run every 2 months. At the end of October 2007 46 staff had attended the Master Class. Both predecessor organisations had in place Record Keeping policies, these have been reviewed and consolidated and a new Record Keeping Policy has been produced. All staff have access to training and the PCT retains records of all of those staff who attend. Staff receive regular updates on record keeping issues via email cascades from the Communications Team and in "The Brief" which is the PCT staff news bulletin. The PCT has in place an Information Governance work stream that is led by the Assistant Chief of Operations (IG) and supported by a team comprising an Information Governance Officer and Records Management Assistant. The IG workstream meets bi-monthly to review the full range of information governance issues including record keeping, records management, records storage, Subject Access Rights Notifications (SARNS), Freedom of Information requests (FOI) as well as information sharing between staff in the PCT and external agencies. The IG workstream has a line of reporting and accountability to the Governance Assurance Committee which reports to the Board. Record Keeping forms part of the training that is provided at Protected Learning Time events for independent contractors. The most recent Record Keeping policy will be shared with independent contractors in both Halton and St Helens with a request that they adopt the policy within their own practice areas. PCT employment contracts stipulate a requirement for all members of staff to comply with all policies and procedures implemented within the PCT. In 2005 the Government began to roll the NHS Connecting for Health programme (CfH) that will eventually allow healthcare professionals access to a patients full medical history. PCT staff and independent contractors receive regular updates and information leaflets on progress in respect of this initiative. This work is led and developed by the Information Governance work stream 2 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a November 2008 update Record Keeping, Records Management and information governance continues to have a high profile in the organisation. There are a range of policies covering the respective components of information governance that are reviewed on a regular basis and shared widely with staff. The Information Governance Work Stream and its Record Management Sub group ensure that there is a whole systems approach to information governance and that any operational issues are addressed swiftly. Record keeping and information governance feature as part of the organisations induction programme and this is supported by a programme of training, including a Record Keeping Master Class available for all staff. This work is now led and developed by the Information Governance work stream (which reports to the Governance Assurance Committee) and the Records Management Group (which reports to the Information Governance Work stream 18 Existing Staff, Declaration of concurrent employment to HR – End Dec 2004 CONCURRENT EMPLOYMENT 19 Independent contractors to seek advice from COM Rationale: PCT to obtain details of concurrent employment so that all agencies employing that individual can be notified when a healthcare professional presents a risk to patient safety and also the other agency may be able to provide details on any issues of concern This was identified as a an action by the learning review so that the PCT has a full understanding of the activities of its employees and can alert other agencies if necessary when a member of staff or an independent contractor is identified as being a risk to patients. The PCTs contract of employment for staff stipulates that all staff must declare details of any concurrent employment. The PCT Standing Orders also require staff to declare in the Register of Interests details of employment were a conflict of interest may arise. The Register is updated regularly and presented to the Board on a 6 monthly basis. Staff have access to advice on when a declaration in the Register of Interests is necessary. The PCT writes out to GPs on annual basis requesting details of concurrent employment and the Human Resources team retains a list with these details and also has a system in 3 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a place for following up those who do not respond. This work is led and developed by the Workforce Development team November 2008 update Declaration of concurrent employment is a contractual obligation for all staff and independent contractors. NHS Halton and St Helens writes to all staff and independent contractors on an annual basis requesting any such declaration. This work is led and developed by the Workforce Development Team 20 Records Management Policy document 21 Staff survey of records – All staff have been asked to review their records SEE RECORD KEEPING, RECORD MANAGMENTS (STORAGE & RETRIEVAL) management 22 Establishment of Safe Haven – All appropriate records will be archived and moved to Safe Haven storage facility 23 Booklet "NHS Connecting for Health" – Healthcare Records has been distributed to all NHS Clinics and GP surgeries 24 Establishment of website and intranet page to contain all newly revised policies – Feb/April 06 25 Issue guidance re record keeping relating to intimate examinations. Letters to GPs etc about recording Chaperone and READ codes. CHAPERONING 26 Chaperone surveying results to Clinical Governance Department Rationale: To ensure that patients can request a chaperone be in attendance Presentation given to clinical staff – content re patient consent and record during a visit to any healthcare appointment and are aware of their right to be able 27 keeping. Independent contractors to be contacted and advised of to do so. availability of training. The PCT has in place a Chaperone Policy. The policy requires healthcare professionals 28 Rerun of chaperoning survey baseline – due 2006 Outcomes? to offer chaperones if patients or clinical staff require them to be present. The policy is 29 Chaperone Survey Reported to? compliant with the DoH Model Chaperone Policy. The policy is updated on a regular basis and is supported by an implementation programme and training for staff and for 30 Chaperone Survey Actions? independent contractors. The implementation of the policy includes notification by email cascade and notices in "The Brief". 31 Evidence of additional support to single handed practices 32 Evidence complied as part of QoF visit to highlight problems St Helens GPs had attended a range of sessions that provided information on 4 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a 33 Systematic review of record keeping relating to intimate examinations chaperoning and this training has now featured in Protected Learning Time events for GPs in Halton. The PCT"s Chaperone Policy will be sent out to GP and dental practices in Halton and St Helens and practitioners will be asked to adopt this policy in their locality and to put notices up in their waiting areas informing patients of their right to request a chaperone and who to ask. St Helens GPs use the READ codes for Chaperoning, this will be rolled out to Halton GPs during November and December 2007. The Audit Plan for 2008/09 includes an audit of the Chaperone Policy which will measure how well it is being implemented and followed in the PCTs own provided services and by independent contractors. In 2005 the Department of Health produced a leaflet that provided both male and female members of the public with information on what could be expected during an intimate examination. This was widely circulated and made available in all premises were patients could access a copy. This work is led by the Integrated Governance Team with support from the Clinical Executive Committee Chair. November 2008 update The Chaperone Policy remains in place and will be reviewed on a 3 yearly basis. In 2008 Protected Learning Time sessions were established for Dental Practitioners and training was provided on Chaperoning. The Policy was sent to all GPs. An audit of the Chaperoning policy in GP practices was completed in 2008. 34 Ensure no more complaints records just lying around COMPLAINTS RECORDING 35 All complaints checked to ensure action has been taken – completed July 05 – CAMS database. Rationale: The PCT should ensure that all complaints are recorded appropriately and that historical records can be accessed. 36 Clinical Governance to produce improvement action plan This action was addressed fully by St Helens PCT and Halton and St Helens PCT continues to have in place robust procedures for recording, reviewing and archiving complaints. To ensure that the PCT has all historical complaints data held in one electronic database the historical complaints from Halton PCT have been retrieved from the archive and the Customer Care Unit is in the process of entering the detail into 5 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a DATIX, the PCT"s Integrated Risk Management System. This work is led by the Complaints Manager, the Customer Care Unit and the Integrated Governance Team November 2008 update All historical complaints from the predecessor organisations have been inputted into the Datix Integrated Risk Management System. This work was completed in March 2008. All informal and informal complaints, concerns or comments are recorded in Datix. The Executive Nurse/Director of Clinical Quality and Standards now has executive lead for overseeing the management and investigation of complaints. Details of complaints and the associated trends are reported to Risk Management Committee and via a bespoke report to the Governance Assurance Committee. The Comments, Concerns and Complaints Policy was revised and approved by the Board in September 2008. 37 Remedial action plans by Clinical Governance following QoF visits RECORD KEEPING IN GP PRACTICES - Feb 2005, 05/06 38 General Record keeping issues identified by QoF Rationale: Concerns about record keeping being identified in primary care and remedied with support from the PCT 39 QoF reviewer outcomes / concerns – referred to Integrated Governance Department. Defined programme to evidence monitoring of record This needs to be considered in conjunction with the information provided in the section on keeping? Record Keeping, Records management (Storage and Retrieval) 40 Evidence of Audit by practice of record keeping against modernisation St Helens PCT had in place a process whereby issues in respect of record keeping that Agencies Essence of Care Standard were identified through the Quality Outcomes Framework (QOF) GP assessments could 6 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a 41 Progress on issues to be included in Board 1/4ly report on Hard be fed back into the PCT and resolved appropriately. Governance 42 Monitoring measures, Evidence of intervention by PCT The PCT continues to monitor record keeping in primary care through the QOF process. Defined links to risk management/Board Update to Board Problems are highlighted in the "QOF visit reports" which also details the remedial action plans in place. Primary Care Development Managers have responsibility for ensuring that practices adhere to their action plans. Any significant issues are reported to the Clinical Governance Team on a reporting proforma that has been produced by the PCT. The Clinical Governance Team has the responsibility for following these issues up. The Clinical Governance Team has a direct line of reporting and accountability to the Integrated Governance Committee which reports to the Board. This work is led and developed by the Primary Care Contracting team with support from the Chair of the Clinical Executive Committee. November 2008 update The Clinical and Quality Standards Workstream has a direct line of reporting to the Governance Assurance Committee. The work of the QCS will be subject to an internal validation inspection in 2009. 43 Concurrent employment Copy declaration of concurrent employment – June 2005 – 06 SEE CONCURRENT EMPLOYMENT New staff/Existing staff 44 Definition of contractor staff? The PCT has in place a policy on recruitment and selection that is compliant with national guidance. The PCT continues to follow its recruitment and selection policy and adheres 45 Copy of proforma declarations re Concurrent Employment returned to national guidance in respect of pre-employment checks. 46 Revise recruitment and selection protocol – May 06 47 Using media, publications events… educate the public of services provided by PCT and robustness of systems COMMUNICATION 48 Quarterly reports to the Board on progress re Education Public of Rationale: The PCT should have robust internal and external communications so robustness of systems – March 2005 that staff are regularly informed of the activities of the PCT and the public are 49 Updated communication plan to the Board – Jan 2005 consulted with and engaged in the work of the PCT. 7 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a The PCT has a Communications Strategy that has been agreed by the Board and circulated throughout the PCT. The PCT"s Assistant Director – Communications has managerial responsibility for the dedicated Customer Care Unit comprising Complaints Manager, Complaints Assistant, Patient and Public Involvement Manager as well as Patient Advice and Liaison Services (PALS) staff that offer the public a range of information and sign posting advice about NHS services. The services provided within the Customer Care Unit are widely publicised and the unit receives a significant amount of calls on a daily basis. The CCU are able to share the experience of patients, users and carers both positive and negative, with the governance team through regular reporting to a number of sub committees. The PCT has an internet and intranet so that the public, local stakeholders and staff can easily access information about the PCT. The PCT has a Patient and Public Involvement Strategy and action plan. The strategic sets out the PCT"s commitment to real and meaningful engagement with its community, staff and partners. This work is led by the Assistant Director Corporate Services - Communications with support from the Customer Care Unit. November 2008 update In 2007, the Communications and Involvement Strategy was developed. The strategy includes views from staff, partners, service users and carers. All PCT communication and involvement work now uses the principles outlined in this strategy. To support the strategy, the PCT developed a robust Patient and Public Involvement Action Plan that is led by the PCT Patient and Public Involvement Team to ensure that the PCT continuously engages patients and the public in PCT business 50 Update of Chaperone policy – Dec 04 Launched? (issued to staff April 04 by Risk Manager) SEE CHAPERONING 51 Chaperone Policy – April 2005 52 Chaperone Policy – Subject to review – Dec 2005 53 Revised Chaperone policy reviewed and ratified – January 2006 54 Chaperone Policy – Cascade to staff – April 2005? 55 Evidence Chaperone Policy rolled out to clinical staff 56 Evidence rolled out to independent contractors. Protected learning event – July 2006 – workshop session 8 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a 57 Requirement to offer chaperone in essential contract monitoring – posters/clinical audit report 2005. 58 Requirement to offer Chaperone in essential contract monitoring – posters/clinical audit report Autumn 2006. 59 Evidence of monitoring of clinicians…challenge in terms of performance….by Poor Performance Assessment Group 60 Training programme for chaperoning policy 61 & Training programme re Chaperone Policy delivered to Clinical staff 62 63 Training programme delivered to Professionals re Chaperone Policy 64 Training programme re Chaperone Policy delivered to practice staff 65 Database of those attending chaperone training sessions 66 Summary report from learning and development department re Chaperone policy to Head of Governance 67 Evidence/output of audit of chaperone policy in use 68 Audit programme re implementation of Chaperone Policy applied by Integrated Governance Department –Autumn 06 69 Copy of clinical Audit Report re implementation of Policy 70 Minutes of Poor Performance Assessment Group having monitored implementation of Chaperone policy / audit outcomes ADDRESSING CONCERNS ABOUT PERFORMANCE 71 Comprehensive monitoring of contracts with independent contractors – Rationale: The PCT should have in place a mechanism for reviewing the Chief Performance Analyst/Integrated Governance Committee/PEC. performance of clinical staff and independent contractors when a risk to patient Minutes of the Serious Incident Team having monitored implementation of safety has been identified. 72 Chaperone policy / audit outcomes. Referral to PPAG? 73 Referral / minutes to Performers List Committee The Performance Assessment Group (PAG) was established as formal sub committee of the Board and regularly deals with a range of issues associated with performance issues relating to staff and independent contractors. The Board receives regular updates on the work of this group during Part 2 of Board meetings. There are clearly defined links between the Governance Team and the Complaints Team so that issues that may come to light as part of these processes are reported promptly to the PAG. The work is led by the Director of Workforce Development and Provider Services and the Chair of the Clinical Executive Committee November 2008 update 9 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a The Performance Assessment Group continues to operate and reports, when necessary to the Board. There are a number of ways in which performance issues can now be picked up and reported including complaints, concerns, whistle blowing and details of incidents. 74 Revised whistleblowing policy – March 2005 WHISTLEBLOWING 75 Whistleblowing policy to be included in Team Brief, cards – handbook 76 Whistleblowing policy part of induction training Rationale: The PCT should have in place systems and process so that staff can 77 Whistleblowing policy part of mandatory training report any issues of concern in a confidential way. These processes need to be 78 Attendance log of training regarding Whistleblowing policy – Sept 2005 understood and easily accessible. 79 Copy programme of awareness raising sessions re Whistleblowing policy. 80 Awareness raising re Whistleblowing etc. Evidence of attendance by staff The PCT has in place a Whistleblowing Policy that has been developed in accordance group – to include staff and contractors with the Public Interest Disclosure Act 1998. This is currently being circulated and will be 81 Evidence of improved response fro contractor re Whistleblowing policy sent out to GPs and Dentists in Halton and Helens for them to adopt in their practices. awareness – PEC March 2006 The policy includes specific guidance on the reporting of incidents involving sexualised behaviour. Since 2004 the registration requirements for healthcare professionals has altered and they now have a positive rather than a discretionary duty to make disclosures in the interest of patient safety. The PCT"s Whistle blowing Policy will be sent out to GP and dental practices in Halton and St Helens and practitioners will be asked to adopt this policy in their locality. This work is now led by the Workforce Development team with support from Integrated Governance November 2008 update The Whistle blowing policy was published in December 2007 and was made widely available to all staff with a copy being sent to all independent contractors. The policy has been used on a number of occasions to report concerns that have subsequently been investigated. A copy of the policy is given out at induction and staff are asked to sign a receipt. Credit card sized information cards on how to report concerns are soon to be made available to staff and independent contractors. 82 Letter reinforcing recruitment and selection policy – CE to Directors and SMs 10 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a 83 Procedures for appointment of locum The procedures for the appointment of locums are managed by COM (Central Operations 84 Formal Service specification re COM Mersey) and practitioners are required to undergo rigorous pre employment checks 85 Instances of PCT active link with COM for update re contractors / locums before joining a Performers List. 86 Evidence of verification and check re contractors / locums Work is ongoing to strengthen the service specification with COM so that the PCT can continue to be assured that all GPs, including locums continue to be subject to rigorous checks. November 2008 update (November 07 rating was amber) The Workforce Development team have now developed a protocol that requires providers to provide evidence that the appropriate checks are taking place. 87 Accident and Incident reporting & Management Policy amended – May 2005 ACCIDENT AND INCIDENT REPORTING 88 Revised serious clinical incidents policy – Jan 2006 Rationale: The PCT should have in place a systems for reporting incidents and 8990 Replies evidencing receipt of revised policy – March 2006 accidents to ensure that any incidents that pose a risk to patient safety can be recorded, actioned and services improved as a result. 91 Documenting range of staff groups responding The PCT has in place an Accident and Incident Reporting and Management Policy. 92 Programme of training to be delivered to staff re accident and incident The policy provides comprehensive guidance to PCT staff and providers for the reporting reporting and management policy and management of all incidents whether clinical or non clinical including near misses. The policy also details the reporting of incidents of sexualised behaviour. 93 Serious clinical incidents – training for helpline staff 2004 – Delivered by Healthwise The policy incorporates the report of Serious Untoward Incidents and also incorporates 94 Refresher course delivered in house by complaints manager – 2005 StEIS (Strategic Executive Information System) reporting procedures. 95 Accident and Incident reporting and management policy – Jan 2005 Update for helpline staff The Policy is supported by guidance for staff on how to undertake a Root Cause 96 Extract minutes of poor performers group demonstrating links re Accident & Analysis of an event so that all the root causes are identified and remedial action take to Incident Reporting & Management policy – Dec 04 – Sept 06 address them. Evidence active monitoring. Extract minutes of Poor Performance 97 Assessment Group/Performance list committee – TOR – May 2006 The policy is updated on a regular basis and is supported by an implementation 98 - Extract minutes – to evidence defined reporting links between PPAG / programme including training. The policy has been assessed by the NHS Litigation Clinical Gov/ Serious Incidents Team into Integrated Governance Board? - Authority as part of its assessment cycle and is fully compliant with their standards as well Extract minutes – as the Healthcare Commissions Standards for Better Health. 99 Copy of revised Accident & Incident Reporting & Management policy – To The most recent Accident and Incident Reporting and Management Policy will be shared Health and Safety with independent contractors in both Halton and St Helens with a request that they adopt the policy within their own practice areas. 11 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a 100 Evidence of significant events analysis and audit sessions (SEA sessions) 101 Awareness sessions re Accident & Incident Reporting & management Significant Event Analysis is a key indicator for the QOF and practices are required to policy – lunch and learn – Dr J Holding 2005 – Haydock Park Racecourse undertake a minimum of 3 SEAs a year. Significant Events processes follow the same methodology as those applied in Root Cause Analysis. All incidents are recorded in DATIX, the PCT"s Integrated Risk Management System alongside, complaints and PALS enquiries. The Claims Module will soon be included. This work is led and developed by the Integrated Governance Team and associated work streams. November 2008 update The Accident and Incident Reporting Management Policy is currently being reviewed to ensure that it remains dynamic and compliant with the NHS Litigation Authority requirements. In the first quarter of 09/10 a simplified reporting form is being introduced which is quicker and easier to complete and will encourage greater reporting of all incidents. To support the roll out of this form a training and communication strategy will be developed to ensure all staff are aware of the reasons for reporting and their role and responsibility for reporting Incident reporting has a high profile in the organisation and a number of workstreams review incidents by incident type. The Risk Management Committee continues to have overall oversight of all incidents; but health and safety incidents are overseen by the Health and Safety Advisory Group; the Records Management group oversees Records management related Incidents; confidentiality breaches and data protection incidents are monitored by the Information Goverance Workstream and the Quality and Clinical Standards Workstream reviews clinical incidents. There is now also a "Lessons Learned" bulletin that is sent out bi-monthly that provides details of incidents or complaints and describes the way in which improvements have been made as a result. The Claims module has now been included to Datix 102 Single handed GP support group having met – led by Dr J Goldstone SUPPORTING AND INCLUDING GPs Rationale: The PCT should have in place a system for ensuring that single handed practitioners are not working in isolation from their colleagues. GPs should be 12 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a able to access peer support and be able to discuss issues of concern in a group setting. The PCT should have in place a process for ensuring that single handed practitioners are included in all PCT related activities. St Helens PCT did establish a mentoring and support group for single handed GPs and this was well attended. The group has met less frequently over the past 12 months due to the development of Practice Based Commissioning that has resulted in GPs within the Consortia working more closely together. The Clinical Executive Committee (CEC) Chair leads on clinical engagement for the PCT. The CEC agreed a process for engagement and a Clinical Leads Group has now been established. November 2008 update This was a bespoke action that arose from the Learning Review. Over the past 12 months the development of Practice Based Commissioning and the Clinical Leads Group has ensured that GPs work collaboratively and that single handed practitioners are included in activities and work programmes. 103 Communication policy to be reviewed – Jan 2005 104 Evidence – Communications strategy revised and ratified reviewed by SEE COMMUNICATION Management Team – minutes Sept 2005? 105 Evidence of Communications strategy in team brief / to staff – June 2006 106 Copy of revised Jan 2005 Communication strategy 107 Evidence of communication strategy approval. April 2005 Board minutes 108 Copy of Communications Plan in respect of serious incidents 109 Copy of Consent Policy – April 2005 – Approved by Board CONSENT 110 Copy revised Consent policy – Sept 2006 111 Evidence of monitoring application of consent policy Rationale: The PCT should have in place robust procedures for obtaining valid 112 Copy of Information Governance Programme consent from patients before commencing treatment. 113 Copy of Information Governance Programme The PCT has a policy on Consent to Treatment. The policy is designed to provide comprehensive guidance to PCT staff and providers to ensure that the correct level of consent is obtained by examination or treatment is undertaken. The Consent policy is supported by a training programme that has been attended by many staff. It is a dynamic document that is revised regularly to take into account changes to legislation such as the Mental Capacity Act and Mental Health Act but also to 13 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a reflect changes arising as a result of evolving case law. The Consent to Treatment Policy has been developed in accordance with the Department of Health Model Consent Policy and has been assessed as compliant with the NHS Litigation Authority Risk Management Standards and the Healthcare Commission"s Standards for Better Health. The most recent Consent policy will be shared with independent contractors in both Halton and St Helens with a request that they adopt the policy within their own practice areas. The Audit Plan for 2008/09 includes an audit on the use, application and implementation of the consent policy. This work is now led by the Integrated Governance Team and associated work streams. November 2008 update The Consent Policy remains in place and will be reviewed in December 2008. Consent training is available to all staff. An audit of the Consent Policy was detailed in the Audit Plan for 08/09 and the audit is currently being designed. 114 Draft Information sharing policy to RMG 3/3/06 (David Hamm Consultant) 115 Governance development session with Board, PEC and Management INTEGRATED GOVERNANCE Team members – Feb 2005 116 Paper recommending an Integrated governance System for PCT - Rationale: The PCT should have in place a system of Integrated Governance so Approved by Board – Oct 2005 that all risk areas can be brought together in a cohesive framework. This will 117 Progress on implementation of Integrated Governance system. ensure that emerging themes are quickly identified an addressed. 118 Devising pathway – clinical to integrated governance/development of Assurance Framework The Board received a paper in November 2006 that described the system of integrated Board approval – Oct 2005 (Paper) governance. The PCT established an Integrated Governance Committee as a formal sub Exec Team event – 15/11/05 committee of the Board. This committee oversees the work of a range of work streams MIAA session – the Mansion House – 21/10/05 119 Evidence of revised arrangements communicated to all staff Work on the development of integrated governance has continued and the Governance Integrated governance structure via a team brief? Team have recently produced a strategy for integrated governance that will strengthen 120 Governance structure in induction programme this further. 121 Board adoption of revised Governance structure Oct 2005 – Evidence of application. This work is now lead by the Integrated Governance Team 14 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a November 2008 In March 2008 the Board established a Governance Assurance Committee (GAC) that is responsible for overseeing the work of the various sub groups and work streams within the PCT. The GAC now has a 12 month work programme in place to receive reports from the respective sub groups and work streams. Built into this is a validation plan that will test out the processes used to provide assurance. Were gaps are identified awareness raising and training will be made available so that the GAC can be assured that the work streams are functioning optimally. The work of the GAC has recently been reviewed by Mersey Internal Audit Agency. 122 Copy of Steis escalation policy/risk management group minutes – June 2006. SEE SECTION ON ACCIDENT AND INCIDENT REPORTING 123 "Soft Knowledge" to be recorded on CAMHs database 124 Written procedure for PCT managers – Oct 2006. COMMENTS, CONCERNS AND COMPLAINTS 125 Copy of Comments, Concerns and Complaints policy – Feb 2005 126 Copy Integrated Governance Framework – Nov 2005 Rationale: The PCT should have in place robust systems and process for 127 Copy Proposal to Board re improved documentation real concerns of receiving, handling and recording complaints. The PCT should also have in place a complaints system and process for recording anecdotal information and informal concerns 128 Hard Governance – Systematic review learning from complaints etc. from the public. Minutes, Action Plan, Reporting / referral into wider Governance forum/ pathway to Board? The PCT has in place a Comments, Concerns and Complaints Policy. This is updated 129 Correspondence – Hill Dickinson re definition of knowledge and appropriate on a regular basis and is supported by an implementation programme and training. management and recording – Sept 06 Training is offered to all staff including independent contractors in St Helens and Halton. 130 Learning from complaints – Copy qualitative Board report with effect from June 2006 The Comments, Concerns and Complaints Policy provides information to staff how to 131 Copy of PCT guidance management of knowledge/complaints to Board – record information obtained through informal mechanisms and the process that needs to cross reference to complaints and whistle blowing policies be followed for receiving and recording "soft knowledge". Information relating to complaints is reported to the Risk Management Committee, the Integrated Governance Committee and to the Board as part of the Performance Report. The PCT"s Comments, Concerns and Complaints Policy will be sent out to GP and dental practices in Halton and St Helens and practitioners will be asked to adopt this policy in their locality This work is led by the Customer Care Unit and the Integrated Governance Team. 15 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a November 2008 update All historical complaints from the predecessor organisations have been inputted into the Datix Integrated Risk Management System. This work was completed in March 2008. All informal and informal complaints, concerns or comments are recorded in Datix. The Executive Nurse/Director of Clinical Quality and Standards now has executive lead for overseeing the management and investigation of complaints. Details of complaints and the associated trends are reported to Risk Management Committee and via a bespoke report to the Governance Assurance Committee. The Comments, Concerns and Complaints Policy was revised and approved by the Board in September 2008 and has been sent to all GPs for use in their practices. 132 Copy written reminder sent August 06 to professional responsibility to notify PCT of performance concerns SEE SECTION ON WHISTLEBLOWING 133 Copy of contract of employment for health professionals – relevant clauses in relation to professional responsibility and code of conduct. 134 Evidence of distribution of national leaflet "What to do if you have concerns over a colleagues performance" - refer protection learning event – July 06 Copy of leaflet, Distribution, Agenda for event 135 Training and briefing sessions to be held to reinforce message re professional responsibility and code of conduct 136 Confirmation of protected training and education in support of GPs to 2005/06 SEE SECTION ON SUPPORTING AND INCLUDING GPS 137 GP support and mentoring group for salaried GP"s and single-handed practices. 138 Widen current mentoring scheme for GPs to include isolated clinicians 139 Copy of the support programme issued early 2006 140 Practices provide information on Significant events within the QoF reports Practices are required to undertake a minimum of 3 Significant Event Analysis a year. This is part of the QOF assessment process. 141 Revised procedure for inclusion on professional list – Draft March 2006 – Performers List Committee? MANGEMENT OF THE PERFORMERS LIST FOR GPS 142 Performers list procedures formally adopted Which forum? Rationale: The PCT should have in place a process for assessing applications 16 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a 143 TOR/Minutes of performers list committee (Nov 2005?) from GPs wishing to join the Performers List 144 HR written to everyone on list to check their details re management of professional list The PCT has a Performers List Committee that meets regularly to review applications from GPs to join the performers list. The Committee is responsible for interpreting and 145 Evidence of validation of detail for GPs on professional list? enforcing the NHS (Performers Lists) Regulations 2004 in relation to: admitting doctors to 146 Evidence of validation of detail for all GPs, dentists, opticians – SLA/formal the PCT medical performers list, refusing to admit doctors, granting conditional inclusion, links contractor services/COM consider removals from the performers list, consider suspensions and to review decisions if requested to do so. The work is led by the Workforce Development team and the Primary Care Team November 2008 update The Performers Lists for GPs and Dentists are managed by the Workforce Development Team. Any concerns are automatically refereed to PPAG. 147 Due Oct 2006 – Copy of the updated call and recall letter This action was completed by St Helens PCT and related to patients being recalled for cervical screening due to some concerns about the test results not to the way in which the tests had been undertaken. 148 Due Nov 2006 – Intimate examination leaflet The Department of Health produced a leaflet that was circulated nationally. A copy of this leaflet was made available in all PCT premises. 149 Evidence of education programme for anyone that may consent to an intimate examination This work is being developed by the Governance Team with support from public health 150 Copy of PALs leaflet posters re how to complain in general circulation. 151 Evidence/copy "Health Matters" column SEE COMMENTS CONCERNS AND COMPLAINTS 152 PALs communication plan developed This action related to an article that was published in the St Helens local paper "The Star". This article was published SEE COMMUNICATION 153 Confirmation that training has been delivered – due March 2005 Director of This action was not as a direct result of the incident but was training that was taking place PH(Cervical smear training) at the time when the learning review action plan was being updated. This training was "Liquid Based Cytology" training which when implemented significantly reduced the risk of patients being recalled for duplicate tests. 154 Programme of reducing complaints, promoting compliments workshops for 17 Update on Murray Learning Review Action Plan – March 2009 Agenda Item 09 05 02 i Appendix 3 Part 1a staff. Copy of agenda Copy of attendees listing SEE COMMENTS CONCERNS AND COMPLAINTS 155 Continue with complaints training and awareness raising sessions to clinical teams regarding the PCT complaints process 156 Copy performance reports re complaints, PALs, H & S to Board before and after enhancement 157 Robust process for analysis of significant events/complaints Evidence of adoption and dissemination There were 10 further action points that MIAA considered as part of their review. Those actions related specifically to potential action required by the PCT following the publication of the External Review Team. 18
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shelly19911's Mom Answers Activity
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Anyone else tired of being reprimanded for wanting a baby while you're "young"?!
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Good for you! I am not a young mom, however I have a little regret that we did not start sooner. We were busy with education and careers ...posted by gibsonkj
how long should you wait to try for a baby after miscarriage
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I was told to wait 6 weeks. Different OBGYNs may have different opinions. I ended up getting pregnant almost exactly 6 weeks later- so wh...posted by Mistressego
no 2nd period after miscarriage, advice please
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thank you everyone for your comments :) I am happy to say i have just finished my 2nd period, and we are now ttc again. fingers crossed i...posted by shelly19911
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its now over 1 week late, I just wont my periods to come back normal so we can try for a baby again... im not pregnantposted by shelly19911
HELP ! coming of contraception :-)
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yes you can, after your periods if you know when you get them, say you get them every 5weeeks, your most likely to get preg around 10 to ...posted by shelly19911
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Not really. Remember it takes a couple of days to conceive after the sperm has reached the egg...posted by a BabyCenter Member
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I would try everyday :-) some say every other day to make the sperm stronger but that's a proven MYTH and even the experts say everyd...posted by a BabyCenter Member
I am 6 weeks pregnant, and light pink discharge?
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some times its normal some times its not, I sadly had a mc 3months ago I was 9weeks, if the bleeding keep up go see your doc, try not to ...posted by shelly19911
im almost 8weeks, is everything ok?
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I'm not sure why you are worrying. No spotting and no cramping is considered a good thing. And while not having any symptoms CAN indi...posted by ekburke89
when is my due date? please help me out
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thank you, thats wat I was thinking but wasn't sure. thank you. iv been reading how my baby is growing each week. and my doc apt is 2...posted by shelly19911


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Indoor Passiflora caerulea Pruning HELP!
Hi there! I am ecstatic that my Passion Vine just opened a flower today (people, I mean jumping up and down as if I won the lottery-I'm a geek, I know).
I'm creating a "living wall"...really just shaping the vine the way I want up a tall wall in my morning room. My idea is to make it in the shape of a tree, about 2 feet across and as high as it will go. I am using 3 plants potted in one large pot.
Anyway, onto the help-I have noticed several tendrils that seem "crisp" and weak, like they almost could break or I could pull them off as opposed to the bright green strong
tendrils. Should I clip these hard crisper ones off, so the plant can give more nutrients to the healthy tendrils, buds, etc? Or would it harm the plant if I do that?
PS-I have no idea if this cool live wall thing will work, just thought it would be a fun change of pace to try.
Thanks in advance for any help!
I tried the living wall thing with my first passiflora that has since passed away, may it rest in peace. It did wonderfully, but It was hard to keep off my blinds, lol! I am not sure what you mean by crisp, are they still green?


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Established as a partnership in global health, the Global Fund works closely with a wide diversity of partners –implementing governments, donors, civil society, international development organizations, the private sector and communities living with and affected by the diseases. This partnership model actively supports country-owned approaches that develop and implement effective, evidence-based programs to respond to AIDS, tuberculosis and malaria.
News Release - 25 March 2015
Reuters Corrects Inaccurate Article on Global Fund Grants to Malawi
Announcement - 25 March 2015
Doing the Right Thing: Human Rights for Those Affected by TB
News Release - 24 March 2015
Find, Treat and Cure All People with TB
Announcement - 23 March 2015
Global Steering Committee Advances Efforts for Quality Assurance
News Release - 20 March 2015
Honduras Aims for Malaria Elimination
Turning the Tide Against HIV and Tuberculosis: Global Fund Investment Guidance for Eastern Europe and Central Asia
26 March 2015
One Stop Shops for HIV and TB Testing and Care a Winning Strategy in Zimbabwe
24 March 2015
In a Country Highly Burdened by TB, Public Private Partnership is Key
Global Fund News Flash Special – World TB Day
02 October 2012
Global Fund investments secure treatment for an additional 10,000 people
Geneva – The Global Fund to Fight AIDS, Tuberculosis and Malaria today announced a disbursement of US$84 million to help Zimbabwe to achieve its plans for universal access to AIDS treatment by the end of 2012.
The new disbursement will cover the cost of life-saving antiretroviral drugs (ARVs) for an additional 10,000 new patients, bringing the total number of people on treatment with Global Fund support to 203,440 by the end of the year.
Part of the new funding will also pay for the creation of a buffer stock of 6 months of ARVs for all 480,000 adults on treatment in Zimbabwe. The buffer stock will provide additional security of supplies of medicines to patients.
The Global Fund has agreed to raise treatment coverage together with the U.S. President's Emergency Plan for Aids Relief (PEPFAR), which is also funding an increase in the number of adults and children on treatment it supports in Zimbabwe, from 80,000 to 140,000 this year and to 160,000 next year.
These efforts are being closely coordinated with the Government of Zimbabwe, which is supporting 124,000 patients on ARV through its innovative AIDS levy initiative, and with the United Kingdom's Department for International Development (DFID), which is funding treatment for 35,900 patients.
These combined efforts will make possible the attainment of universal coverage, which is generally defined as at least 80% of people in need of treatment. Zimbabwe is expected to surpass that target for the adult population, reaching 85% of people in need by the end of the year.
The disbursement, made today, was part of a grant that began in 2010, and was renewed in June 2012. It is targeted at prevention and treatment for young people, people living with HIV, women and children.
The Global Fund will continue to work very closely with the government of Zimbabwe and with other partners, including PEPFAR, to ensure that the anticipated gains are sustained.
For more information please contact:
MARCELA ROJOMedia Relations Mobile: +41 79 540 2667E-mail:
The Global Fund is committed to the highest standards of accountability and responsibility. If you have heard of any instance of inappropriate use of money related to the Global Fund, please report it immediately, here: Report Fraud and Abuse
© 2015 The Global Fund to Fight AIDS, Tuberculosis and Malaria


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36447 - Le Ginestre
from £19 / night help
Estimated nightly price based on a weekly stay. Excludes fees (if applicable). Enter your dates to see the total cost.
Availability Your dates are available
Apartment / 1 bedrooms / sleeps 4
|Key Info
Please note these Check-in Day Requirements for this property: Apr 03 - Apr 05 : Friday, Saturday and Sunday check-out required.; Aug 03 - Aug 08 : Saturday check-out required.; Aug 10 - Aug 15 : Saturday check-out required.; Aug 17 - Aug 22 : Saturday check-out required.; Oct 29 - Oct 31 : Thursday, Friday and Saturday check-out required.;
2-room apartment 45 m2: living/dining room with 2 sleeping possibilities. 1 double bedroom. Kitchenette. Shower/bidet/WC. Air-conditioning (extra). Barbecue. View of the sea. Please note: In some houses, the beds in the living room can be stored on the top floor.Holiday development "Le Ginestre". In a quiet, sunny position on a slope, 650 m from the sea. Grocers, restaurant, bar, sandy beach 650 m. Please note: The photograph is a typical example. There are more similar properties for rent in this same residence. All houses/apartments are individually designed/furnished. The apartments have garden or balcony.
|Sleeps up to 4, 1 bedrooms
|Family friendly
|Suitable for people with restricted mobility
|Pets welcome, Yes, smoking allowed
Features and Facilities
|Sea view
|1 bedroom, 1 bathrooms of which 1 Family bathrooms
About this location
The Sardinia region
Costa Rei
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You're booking with
Red Awning (Property Manager RedAwning)
- 1 Years listed
65% Response rate
Calendar last updated:01 Apr 2015
Based in United States
- English
Payment accepted
Credit cards accepted