8 August 2024
WA Primary Health Alliance acknowledges and pays respect to the Traditional Owners and Elders of this country and recognises the significant importance of their cultural heritage, values and beliefs and how these contribute to the positive health and wellbeing of the whole community. Throughout this newsletter, the term 'Aboriginal' is used to refer to Aboriginal and/or Torres Strait Islander people, unless stated otherwise.
-
WA Primary Health Alliance (WAPHA) has launched Clinician Assist WA, a free to access, secure website to help GPs and other health professionals access guidance for assessing, managing and referring patients across Western Australia. The new website replaces the existing HealthPathways WA website, and users are encouraged to register for Clinician Assist WA by 14 August – see below for detailed instructions. To ensure a smooth transition for users, both Clinician Assist WA and HealthPathways WA will operate concurrently from 8 to 14 August 2024, after which time HealthPathways WA will cease. A redirect will be put in place thereafter.
Our most important consideration in designing the new website was to ensure users can still access the same trusted, local clinical and referral guidance and the same features and functionality they are used to, in a more secure and user focused way. Developing and managing this website locally will allow WA Primary Health Alliance to better tailor the service to local user requirements into the future, supported by a unique login for each user to increase security.
We encourage you to register and create your unique profile now, to ensure you are ready to use Clinician Assist WA when the need arises. All current and new users will need to register and create a unique login. This quick, simple process is part of the improved security of the new site. Health professionals registered with AHPRA will be automatically verified by the system and given immediate access. All other users may experience a slightly longer verification period; however, our team will be prioritising these registrations.
Support is available Monday to Friday, 8am to 5pm AWST. Contact Practice Assist Help Desk via email practiceassist@wapha.org.au or by telephone 1800 2 ASSIST (1800 2 277 478), or your usual WAPHA contact.
For a comprehensive guide to Clinician Assist WA, live demonstrations will be available monthly and are CPD accredited for 1 Educational Hour through RACGP. View upcoming dates and register.
The Department of Health and Aged Care has announced major changes to the Medicare Benefits Schedule (MBS) items for chronic disease management from 1 November 2024. The changes recommended by the MBS Review Taskforce, are ‘the first major change to the framework in almost 20 years’ and include:
To inform patients and their carers about MyMedicare the resources below can help explain the benefits and what it means for them. Patient Brochures
Derbarl Yerrigan Health Service, the largest Aboriginal community-controlled health service (ACCHS) in Western Australia on the lands of the Wadjuk Noongar people in metropolitan Perth and the RACGP 2023 WA General Practice of the Year, is helping to prevent congenital syphilis with point-of-care testing (PoCT). Dr Daniel Hunt, Deputy Medical Director and Aboriginal GP at Derbarl Yerrigan, explained that their service responded to the syphilis outbreak in the Perth metropolitan area by creating a dedicated team to implement and monitor a unique model of care, whilst providing clinical and community oversight with support from an Aboriginal health practitioner. “Derbarl Yerrigan’s success with diagnosing and treating infectious syphilis can be attributed to our model of care and continued quality improvement program, which provides holistic and culturally respectful care. We have also been using syphilis PoCT for the last three years and have not seen a presentation of congenital syphilis,” Dr Hunt said. Syphilis PoCT provides a reactive or non-reactive result to syphilis antibodies within 15 minutes. A reactive syphilis PoCT result in a patient with no history of syphilis enables treatment and contact tracing to start on the day of presentation, rather than waiting for the results of syphilis serology and a follow-up appointment. “At Derbarl Yerrigan, we have increased our testing for syphilis by 240 per cent since 2019 and developed our own protocols on PoCT with an emphasis on at-risk populations. We also incorporate discussions about syphilis testing into team huddles and provide education sessions for increased awareness within the service. I would not want to have missed a congenital diagnosis that could have been prevented with a simple blood test,” Dr Hunt said. The WA Department of Health is providing health services with free syphilis PoCT supplies and training. For more information, email syphilispoct@health.wa.gov.au
We are excited to share that the first Primary Sense nurse facing prompt – Child due vaccination will be accessible soon. The prompt was agreed to by The Clinical Advisory Group, which includes a representative from the Australian Primary Health Nurses Association. The Child due vaccination is the first of many upcoming nurse prompts (Bone density testing to follow soon after). We will notify you as soon as the nurse prompts become available in Primary Sense. To get the most out of Primary Sense, ensure that the desktop application is installed on the Nurses computers and configured within your practice. Please see the instructions below:
Nurses are an integral part of continued patient care. This prompt is designed to assist nurses by swiftly identifying when a child is missing vaccinations during a consultation.
Identify when a child is missing vaccinations Display missing vaccinations on screen
For questions related to access or use of Primary Sense email practiceassist@wapha.org.au or call 1800 2 ASSIST (1800 2 277 478 or 08 6278 7900).
Due to the very significant implications of accurate and consistent diagnosis of children and adolescents with suspected ARF, the Department of Paediatric Cardiology at Perth Children’s Hospital, would like to advise that the on-call Cardiologist/Fellow is now the designated contact for all new suspected diagnoses of ARF in all paediatric (to age 16 years) patients in Western Australia. This is in addition to any existing referral and consultation processes. It is requested that all medical and nurse practitioners contact the PCH Cardiology on-call consultant at the time of making a diagnosis of acute rheumatic fever and prior to submitting the required notification to the RHD Register. The cardiologist/fellow will advise re:
The on-call PCH Cardiologist can be contacted via PCH switchboard on 6456 2222. Notification of ARF by the practitioner making the diagnosis is still required as per the Health (Rheumatic Heart Disease Register of Western Australia) Regulations 2015.
Watch part two of our video series with Dr Walid Jammal from Hills Family General Practice as he shares his thoughts on the importance of multidisciplinary team care. Every practice is different and there is no single answer that will work for all, however the need for multidisciplinary team care is clear. Working as a team, with a common purpose and vision, can improve the care of patients and the sustainability of the practice. Dr Jammal also highlighted that teamwork can be built across sites, not just under the same roof. Practices should focus on what multidisciplinary team-based care means to them and put enablers in place to build trust and improve workflows. Watch more!
The Department of Veterans’ Affairs (DVA) Veteran White Card and Veteran Gold Card holders can now store their Veteran Card in the myGov app.
Digital Veteran Cards, accessible in the MyGov app is simply another way Veteran Card holders can choose to carry and use their Veteran Card to access services.
Digital Veteran Cards have the same information and functionality as physical versions and has retained familiar features such as the card colour, the poppy, and the DVA logo. The Card holder’s personal details appear on a separate screen, when they tap the card in the myGov app. More information here.
The Awards acknowledge the dedication of health professionals who have enhanced the range and quality of medical care available in rural Western Australia. Whether it's through exceptional patient care or leadership in clinical practice, we want to celebrate those who make a difference. To learn more about each award category and the nomination criteria, please visit the 2025 WA Rural Health Excellence Awards website. Rural Health West looks forward to receiving your nominations and celebrating the outstanding contributions of rural health professionals in WA. Nominations close 4 September 2024.
Healthcare environments can be challenging for Autistic individuals – we can change this together! The Autism Association of Western Australia is hosting a series of co-design workshops for individuals with Autism, family members, carers and health professionals who have experiences of accessing or providing health care in Australia. Each workshop will have a different focus area and look at barriers and opportunities to improve health service access, care, and outcomes for Autistic people. Learn more by visiting the website or to register to attend a workshop. Improving Health Outcomes for Autistic People - Autism Association of Western Australia.
The Royal Australian College of GPs (RACGP) says people who want to stop taking antidepressants should see their GP for support after endorsing the Maudsley Deprescribing Guidelines for use in Australia. RACGP President Dr Nicole Higgins said: "GPs are at the front line of Australia's mental health crisis, and we know how hard it can be for people who want to stop using antidepressants to do so. More than 22 million Australians visit a GP every year. GPs are increasingly reporting mental health in their most common reasons for a patient visit - from 61% in 2022 to 72% in 2023, according to our Health of the Nation report." Read the full media release here.
A new webpage on RGoC is now available for health professionals on the Department of Health website. The Goals of Care webpage for consumers has also been updated to include information about RGoC. The RGoC is a clinician-led form completed as part of discussions between a resident and their health care team in residential aged care facilities. It outlines the resident’s goals and preferences for care, and the type of care and treatments that would be appropriate in the event the resident’s condition deteriorates in the context of end of life. Organisations can create links to the new pages from their websites to share the information. Thank you to the WA Country Health Service for developing the content. For more information, or if you are interested in implementing the Residential Goals of Care form at your facility, contact Department of Health WA Advance Care Planning Information Line on 9222 2300 or ACP@health.wa.gov.au
Presented by WA Primary Health Alliance 29 August 2024 (5pm to 6pm AWST)
Vaccination during pregnancy does not only protect the mother but also generates antibodies that can cross the placenta, providing protection to the unborn baby. Immunisations are even more important as we age. Our immune system begins to decline in its ability to fight off infections, which makes people ages over 65 (Aboriginal people over 55) and older more vulnerable to diseases like influenza, COVID-19, pneumonia, and shingles. Join us to learn about more about the immunisations that are recommended before and during pregnancy and also as we age. Register now here.
To support the changes to the National Immunisation Program (NIP) from 1 July 2024, the following enhancements will be made to the Australian Immunisation Register (AIR) in late-August 2024:
With the recent addition of the MenQuadfi vaccine on the NIP, MenQuadfi will become a standard vaccine in the AIR. This means that individuals who receive the MenQuadfi vaccine as part of the adolescent NIP schedule will be considered up-to-date for Meningococcal ACWY.
The National Centre for Immunisation Research and Surveillance (NCIRS) advises GPs and other immunisation providers that when recording hepatitis A and hepatitis B combination vaccines (Twinrix and Twinrix Junior) on the Australian Immunisation Register (AIR), the vaccines only display as ‘Hepatitis A’. The hepatitis B antigen is not displayed. If providers require the immunisation record to display both hepatitis A and hepatitis B antigens, they can update the record by recording a generic hepatis B vaccine (via the practice software or AIR website) OR by sending an amendment request to the AIR. Amendment requests can be made via HPOS messages or by calling the AIR on 1800 653 809. More information is available on the NCIRS website.
Updated vaccine safety data published by AusVaxSafety have shown more than half of Shingrix vaccine recipients (52.9%) experienced no adverse events in the three days following vaccination. In those who did experience an adverse event, local reaction – mainly pain, swelling and redness at the injection site – was the most common. While some people opt to receive Shingrix by itself, Shingrix can be administered concomitantly with other inactivated vaccines. AusVaxSafety has received more than 11,000 vaccine safety survey responses from people who received Shingrix concomitantly. Reassuringly, these individuals reported similar rates of adverse events, impact on routine activities and medical attendance as those who received only the Shingrix vaccine. AusVaxSafety has now been collecting Shingrix safety data for more than 6 months. During this period, Shingrix safety data has remained stable, with minimal changes to the safety profile observed. Continued monitoring of Shingrix and updated safety data monthly will occur for the remainder of 2024.
Following the increase in cases of Mpox (formerly Monkeypox) in Australia this year, ATAGI has released an interim statement on the use of vaccines – including booster doses – for the prevention of Mpox in 2024. Studies suggest the Mpox vaccine JYNNEOS® has moderate to high vaccine effectiveness against Mpox and that 2 doses provide higher protection than a single dose. In the interim statement, ATAGI does not recommend booster doses for people who are already fully vaccinated with a 2-dose course of Mpox vaccine, including those with severe immunocompromise. ATAGI advises that those who are recommended to receive the Mpox vaccine and who had their first dose more than 28 days ago should get their second dose as soon as possible, to maximise protection. ATAGI will continue to monitor the evolving Mpox epidemiology in Australia and to review and revise recommendations as needed. The full statement can be found here.
A refreshed version of the National Centre for Immunisation Research and Surveillance’s (NCIRS) FAQs resource on pneumococcal disease and the use of pneumococcal vaccines has been published. The resource, which is designed for both health professionals and the public, includes general information about pneumococcal disease as well as a clear overview of current pneumococcal vaccination recommendations in Australia. The new FAQs feature a summary of the newly available higher-valency pneumococcal vaccines 15vPCV and 20vPCV. Australia’s pneumococcal vaccination program is currently under review, and these FAQs will be updated as new developments occur. Access the FAQs here.
This event aims to highlight advancements in diagnosis, treatment and prevention of pneumococcal disease.
To register for this activity, simply:
Click on the arrow next to the event and click on register.
We know cancer screening saves lives, but only around 50% of Australians eligible for the national cancer screening programs – BreastScreen Australia, National Bowel Cancer Screening Program and National Cervical Screening Program – complete the tests. Australians diagnosed through the national cancer screening programs are: Research shows primary healthcare workers are key to motivating patients to participate in cancer screening.
In 2022 the Australian Government distributed GP cancer screening engagement packs to more than 7000 general practices across Australia including demo bowel screening kits, cervical screening swabs and waiting room posters. In evaluation of that mailout, GPs shared that packs were valuable and future packs should include additional translated resources for consumers from Culturally and Linguistically Diverse communities. This year new and updated kits will be mailed out, including translated materials, to distribute across practices to help encourage patients to screen for bowel, breast and cervical cancer. The packs will include:
More information on cancer screening and resources for healthcare providers can be found on the Department of Health and Aged Care website.
The National Cervical Screening program recommends that Self-collection screening should be offered in a clinic-setting wherever possible. However, self-collection may occur in other settings at the discretion of the requesting healthcare provider. It is the responsibility of the requesting healthcare provider to facilitate patient access to, and return of, self-collection swabs, requesting tests from laboratories (including identifying the sample as self-collected on the pathology request form) and communicating results and any follow-up requirements to patient and with the recommended self-collection swab. Healthcare providers will need to give clear information to their patients on the pros and cons of both screening options (including possible follow-up requirements if HPV is detected using self-collection) to support informed decision-making by the patient. Healthcare providers will still need to offer a consultation for cervical screening whether it be a self-collected vaginal sample or healthcare provider-collected cervical sample. Where self-collection is chosen, healthcare providers can use the time saved to discuss sexual health, post self-collection follow up and other health matters.
NCSP Clinical Management Pathway A4 size (health.gov.au) is a free resource available to order that provides information on collecting a sample for a Cervical Screening Test for:
Links to WA education and training: King Edward Memorial Hospital - Cervical screening education, training and resources (health.wa.gov.au)
The cancer screening programs can make excellent QI activities for your practice. Quality Improvement activities highlight the eligible people who are due for screening and give you framework for recalling and acting on the eligible data. PDSA (Plan, Do, Study, Act) cycles are used to plan and carry out the QI activity. Click here for a cervical screening PDSA. For further information about undertaking QI activities, contact Practice Assist by email practiceassist@wapha.org.au or call 1800 2 ASSIST (1800 2 277 478 or 08 6278 7900) to connect with one of our Practice QI Coaches.
The BreastScreen WA Aboriginal Torres Strait Islander Sarong project was inspired by the success of the Beautiful Shawl Project, an initiative run by BreastScreen Victoria and the Victorian Aboriginal Community Controlled Health Organisation (VACCHO). The Shawl Project gives Aboriginal and Torres Strait Islander women a locally designed cultural screening sarong to wear during their breast screen or take home and wear at their leisure. These sarongs are a culturally based initiative providing safe and empowering breast screening experiences for Aboriginal and Torres Strait Islander women, as well as a gesture of thanks from BSWA for screening with us. These sarongs will be distributed to Aboriginal women who screen with BSWA after engaging with the Health Promotion team at community events. The artwork was designed by Pinjarup Whadjuk Noongar artist Chloe Calyon of Kyooya Designs as owner and founder. The artwork is described as follows: The women are surrounded by meeting place symbols, representing communities offering support, strength, and guidance. In the centre is a big meeting place symbol which represents the people who have an important role in women’s lives and those she holds close. The women are portrayed topless in a reflection of their stories and journey in life.
Bowel cancer is one of the most common cancers in Australia. The National Bowel Cancer Screening Program reduces illness and death from bowel cancer by detecting the early signs of the disease using a free, simple test that can be done at home. If found early, more than 90% of cases can be successfully treated. Recent changes to the eligibility criteria means that Australians aged 45 to 74 can do a free test at home every 2 years.
The Australian Government Department of Health has provided funding to WA Primary Health Alliance (WAPHA) to compensate general practices for the administration of COVID-19 vaccinations for non-Medicare patients within primary care. WAPHA can reimburse general practices to the value of the relevant MBS item number to support non-Medicare patients being vaccinated against COVID-19, and this reimbursement can be backdated to July 2023. Note: To claim, practices will be required to declare reimbursement (ie. private fee charge) has not already been received for the services claimed. WAPHA understands that some practices have withdrawn or are not administering COVID-19 vaccinations. Practices with a large cohort of Non-Medicare patients can be supported to submit an expression of interest to join the program. For further information please contact Practice Assist or email the COVID-19 team GPvaccination@wapha.org.au
Although SARS-CoV-2 infection or COVID-19 remains a notifiable infectious disease in WA, positive rapid antigen test (RAT) results are no longer monitored and do not need to be reported to the WA Department of Health (WA Health).
In line with the current Australian Government Department of Health and Aged Care Coronavirus Disease 2019 (COVID-19) – Surveillance case definition (July 2024), WA Health continues to monitor a number of other metrics to estimate the burden of COVID-19 on the WA community, including positive polymerase chain reaction (PCR) test results, hospitalisations and the concentration of SARS-CoV-2 virus fragments in wastewater.
Positive COVID-19 PCR results will continue to be reported to WA Health by the pathology laboratory performing the test.
A new provider bulletin was released on Friday 2 August 2024. Topics covered:
For the full bulletin please click here.
It is essential that general practices conduct an annual check of their My Health Record registration details to ensure compliance with relevant legislative obligations. To support providers, the ADHA provides guidance on the critical items to check annually. General practices are required to review their My Health Record security and access policy, which must address the requirements outlined in the My Health Records Rule 2016. The office of the Australian information commissioner provides a template and guidance for developing a My Health Record security and access policy In addition to reviewing the security and access policy; it is also important to:
More information about ongoing participation obligations, a policy requirements checklist, and training resources can be found on the Australian Digital Health Agency website. Practices should conduct an annual My Health Record health check to ensure compliance and continued participation in the My Health Record system.
Daffodil Day is Cancer Council's most iconic and much loved fundraising campaign.
On this day, Australians all over the country come together to support people impacted by cancer and give or donate to support cancer research that will save lives.
In 2023, Australians gave a bunch for Daffodil Day, raising $2.5 million towards lifesaving cancer research. This year, Cancer Council would love to have your vital support once more.
Almost 1 in 2 people will be diagnosed with cancer by the age of 85, so it takes all of us to give hope for better treatments and better outcomes. The more hope we give, the more lives we can save.
Daffodil Day 2024 is Thursday, 22 August but you can get involved and help support this special day any time throughout the month.
View the Daffodil Day website for more information or Start a fundraiser for Daffodil Day.
Presented by RACGP 13 August 2024 (7pm to 8.30pm AEST)
As of 1 July 2024, eligible GPs, including sole providers can start participating in the General Practice in Aged Care Incentive. This incentive provides GPs and practices with financial incentives for delivering a quality bundle of care including regular visits and care plans to patients that live in a residential aged care home as part of MyMedicare. Incentive payments of $300 per patient, per year, to the responsible providers and $130 per patient, per year, to practices are available to participating GPs and general practices, who provide services to each of their MyMedicare registered patients in a residential aged care home rather than at their practice. These payments will be made quarterly and are in addition to the MBS or DVA rebates and the MyMedicare benefits. To help GPs understand this new incentive and what it means for them, the RACGP is hosting a webinar presented by the Department of Health and Aged Care. The webinar will provide an overview of the General Practice in Aged Care Incentive, how GPs can make the most of the new incentive and how GPs can keep on top of their obligations under the scheme. The webinar will also feature a Q&A allowing participants to ask questions about the scheme directly to the Department.
Find out more and register today.
Vaccination during pregnancy does not only protect the mother but also generates antibodies that can cross the placenta, providing protection to the unborn baby. Immunisations are even more important as we age. Our immune system begins to decline in its ability to fight off infections, which makes people ages over 65 (Aboriginal people over 55) and older more vulnerable to diseases like influenza, COVID-19, pneumonia, and shingles. Topics included in this webinar:
Presented by WA Primary Health Alliance Multiple Dates & Times
WA Primary Health Alliance (WAPHA) is providing GPs in WA with paid online Initial Assessment and Referral Decision Support Tool (IAR-DST) training, designed to help practitioners and clinicians recommend the most appropriate level of care for a person seeking mental health support. GPs and GP registrars who attend the two workshops in the one online session will be remunerated $300 and CPD hours are available.
For the August IAR-DST training dates and registration links, visit the WAPHA IAR-DST webpage. For the August IAR-DST training dates and registration links, visit the WAPHA IAR-DST webpage.
Presented by WA Primary Health Alliance 23 August 2024 (7.30am to 9.30am AWST) or (5.30pm to 7.30pm AWST) Face to Face Event - Kalgoorlie
The online Initial Assessment and Referral Decision Support Tool (IAR-DST) is designed to be used alongside a comprehensive, holistic mental health assessment to gather information and guide referrals. WA Primary Health Alliance is providing IAR-DST training in the Goldfields covering two workshops in one session. GPs and GP registrars who attend the two workshops in one session will be remunerated $300* and CPD hours are available upon successful completion of both workshops. View the flyer here for more information and to register.
Presented by WA Primary Health Alliance 24 August 2024 (6pm to 8.30pm AWST) Face to Face Event - Kalgoorlie
Join this important mental health education event in the Goldfields region. Psychiatric Associate Professor Mat Coleman will facilitate a discussion on mental health treatment plans including medication, titration and a variety of referral options using GP-led case studies. You will also get the opportunity to meet and hear from many of our local mental health treatment services. Find our more and register here. If you would like further information, contact Sarah Brown, WAPHA Regional Integration Manager – Goldfields: sarah.brown@wapha.org.au
Presented by Black Dog Institute Multiple Dates & Times
Please make your GPs and GP registrars aware that they can attend free online training sessions throughout the 2024 calendar year with a choice of target topics including:
CPD hours are available for the online training sessions. For more information, dates and registration links, visit WAPHA’s suicide prevention webpage.
Presented by Alzheimer’s WA 18 September 2024 (9am to 5pm, Perth Convention Centre)
Alzheimer’s WA Dementia Symposium provides a platform to exchange latest dementia care strategies, challenge existing perceptions, and explore innovative approaches to supporting people living with dementia. Featuring a keynote by The Hon. Emma McBride MP Assistant Minister, Department of Health and Aged Care and Dr. Shirley Bowen Director General, Department of Health WA, register to hear about the latest policies, research breakthroughs, technology and AI opportunities, practical tips and more. Register online: The Dementia Symposium 2024 | Humanitix (Early bird tickets end 15 Aug 2024).
Creating a Health Vision for Autistic Individuals Presented by Autism Association of WA and funded by the State Government through the Department of Communities Multiple Dates
Better Health Program - Term 3 Program Now Available! Presented by Better Health Program Multiple Dates
The Active8 - Term 3 Program Now Available! Presented by The Active8 Multiple Dates
Intimate Partner Violence and Reproductive Coercion and Abuse eLearning Presented by SHQ Online training
Aboriginal Health Conference 2024 Presented by Rural Health West 10 August & 11 August
WA Sexual and Reproductive Health in Primary Care Presented by ASHM 10 August to 17 August
Free Chronic Conditions of the Foot Workshop Presented by Benchmarque Group 13 September
Certificate in Sexual and Reproductive Health (Nursing) Presented by SHQ 20 August to 23 August
Contraceptive Implant Theory Workshop Presented by SHQ 21 August
AAPM Educare | Perth Series Presented by AAPM 22 August
Cervical Screening Training Presented by SHQ 22 August to 23 August
WA Culturally Responsive Care and Hepatitis B Presented by ASHM 22 August
Goldfields Suicide Prevention Collaborative Workshop (Kalgoorlie) Presented by WAPHA 23 August
RACGP Early Career GP Conference Presented by RACGP 24 August & 25 August
Practical Ideas for Workplace Culture Improvement Presented by AAPM 26 August
Essentials of Medical Abortion in Western Australia – Live Webinar Presented by SHQ 27 August
BreastScreen WA visit to Cottesloe Presented by BreastScreen WA 27 August to 3 September
BreastScreen WA visit to West Lamington (Kalgoorlie) Presented by BreastScreen WA 28 August to 25 September
WA Could it be Syphilis? Presented by ASHM 29 August
BreastScreen WA visit to Kojonup Presented by BreastScreen WA 30 August to 11 September
BreastScreen WA visit to Booragoon Presented by BreastScreen WA 4 September to 20 September
BreastScreen WA visit to Tambellup Presented by BreastScreen WA 17 September to 19 September
De-escalation Skills NEW half day (face-to-face) Presented by WAAMH 30 September
Chronic Disease Care Planning Presented by Benchmarque Group 11 October
Course in Wound Closure Presented by Benchmarque Group 25 October