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Found 132 results
  1. News Article
    GPs in England are being told to see more patients face-to-face as ministers unveil a £250m winter rescue package. The emergency funding is being handed to GPs so they can recruit extra locum staff with an emphasis on providing more same-day appointments. Social distancing rules are also expected to be relaxed so that GPs can bring more people into their buildings. It comes amid mounting criticism about the fall in face-to-face appointments since the start of the pandemic. Only 58% of patients were seen face-to-face in August - the first full month following the ending of restrictions. That compares with 54% in January and more than 80% before the pandemic. Patients have also complained of long waits on phone lines to book an appointment. The £250m funding is part of the extra £5bn Covid fund announced last month to help the NHS through to the end of the year, and comes on top of the £12bn set aside for GP services this year. Read full story Source: BBC News, 14 October 2021
  2. News Article
    Acutely ill patients requiring emergency care are being diverted to their GP via the new NHS 111 First call-before-you-walk A&E triage system, Pulse has learned. GPs have reported receiving inappropriate NHS 111 referrals including: an acutely dizzy elderly patient who was later confirmed to have had a posterior circulation stroke; a patient with acute coronary syndrome; and a patient with acute UTI symptoms. Meanwhile, GPs are also warning that patients are using the triage system as a way of ‘jumping the queue’ because the route is likely to get them an appointment quicker than calling their practice. From this month, patients in England are being asked to call 111 before attending A&Es – with 111 triaging them to the most appropriate service, including GP practices. Scottish patients are also being asked to phone ahead of attending A&E; while pilots are ongoing in Northern Ireland; and Wales is in the process of rolling out a ‘contact first’ model following summer pilots. The BMA has said the influx of inappropriate referrals by NHS 111 is likely being ‘compounded’ by the new 111 First system, which is ‘contributing to the immense pressures currently facing primary care’. GPs have raised concerns about several cases in which patients should not have been sent to them by 111 because they required more urgent care. One GP, who asked not to be named, told Pulse: "I had a patient with UTI symptoms – a temperature of 39°C, a heart rate of 140, nausea and abdomen/loin pain. They were told: speak to your GP." Read full story Source: Pulse, 21 December 2020
  3. News Article
    Coronavirus vaccinations at GP practices will now take ‘twice as long’ after regulators announced new rules just days before the jabs are rolled out across primary care. The Medicines and Healthcare products Regulatory Agency announced patients would have to be observed for 15 minutes after they received the vaccine. This came after two people had severe allergic reactions to the Pfizer/BioNTech vaccine. Primary care directors told HSJ the change means they have had to overhaul plans in their primary care networks and, in some areas, the vaccine programme will be “unfeasibly challenging” to deliver. Sources told HSJ workforce plans are being overhauled, while vaccines risk being wasted because of the additional time constraints. There have been claims some practices may drop the vaccination programme altogether, as they lack capacity to carry out 15-minute observations for each patient. One primary care director, who spoke to HSJ anonymously, said: “For us, we now need additional space for an observation area. It also makes it more difficult to efficiently flow through the vaccines as the actual vaccination process might take a few minutes, but the through flow of patients will be limited by the 15-minute wait.” They added: “The vaccine now taking at least twice as long to do creates logistical problems. Not insurmountable but there nonetheless." Read full story (paywalled) Source: HSJ, 11 December 2020
  4. News Article
    A GP surgery that had been told it required improvement has been shut down after an inspection found patients could be at "risk of harm". Hampshire's Brockhurst Medical Centre had already been due to close on 31 December. However, the Care Quality Commission (CQC) suspended its registration with "immediate effect" following an unannounced inspection on Monday. Patients are expected to be transferred to other practices on Saturday. In September, a CQC assessment of the practice, on Brockhurst Road in Gosport, rated it overall as "requires improvement". The issues highlighted in the report included that the practice "did not have systems for the appropriate and safe use of medicines" and "there was a risk that some patients were not receiving the care and treatment they needed". Following Monday's inspection, Garry Higgins, of the CQC, said it had taken "urgent action" to suspend the registration of the GP surgery. "We took the action because we believe if we didn't people using the service may be exposed to the risk of harm," he added. Read full story Source: BBC News, 5 December 2020
  5. News Article
    Wearable devices will monitor the mood of all 70 staff at a large GP practice, in a trial aimed at improving employee health and wellbeing. Staff at Amicus Health, a GP practice in Devon, will be provided with a wearable device which allows the user to log how their day is going by pressing one of two buttons. The information gathered can be viewed by employers on a dashboard, identifying whether there are particular times in the day when moods drop. Users will also be able to see their data on a personal app, allowing them to track mood triggers and patterns. On the dashboard, employees’ data is divided into teams and is not anonymised, so employers can track the mood of individuals. Asked by HSJ whether this could deter some from using it, company co-founder Jonathan Elvidge said previous trials suggested it does not. He told HSJ that during trials on construction sites, employers found it easier to take action if they were able to identify workers who were regularly reporting that they were feeling low. He said employees preferred being identified as it gave them a voice and made it easier to express how they were feeling. The device — called a Moodbeam One — will be trialled on all 70 clinical and non-clinical staff members at the practice, including 25 GPs. It will largely be down to the practice to decide how the data is used, according to Mr Elvidge. Read full story (paywalled) Source: HSJ, 5 November 2020
  6. News Article
    General practices will struggle to cope with a second wave of COVID-19 unless urgent measures are put in place to support them, the BMA has warned. It said that practices in England were reporting that they did not have the capacity to carry out all of the work required of them while managing ongoing patient care, dealing with the backlog of care put on hold during the first wave of the pandemic, and reconfiguring services. Richard Vautrey, chair of the BMA’s General Practitioners Committee England, said, “GPs, like all doctors, are extremely concerned that without decisive action now services will be overwhelmed if we see another spike in the coming weeks and months.” In the report, the committee called for a package of measures to support the GP workforce, including making occupational health services available to all staff to ensure that they are properly risk assessed and to provide free supplies of personal protective equipment. It also called for the suspension of routine inspections by the Care Quality Commission and of the Quality and Outcomes Framework, as part of efforts to reduce bureaucracy. NHS England’s covid support fund for practices should be rolled over until March 2021 and expanded to ensure that all additional costs such as additional telephony and cleaning are included, it added. Vautrey said, “The measures we’ve outlined are aimed at supporting practices and their staff to deliver high quality care while managing the increased pressures of doing so during a pandemic, and it is vital that the government and NHS England listen and implement these urgently, to ensure that primary care can continue to operate safely through what looks to be an incredibly difficult winter.” Read full story Source: BMJ, 1 October 2020
  7. News Article
    GP practices are being told they must make sure patients can be seen face to face when they need such appointments. NHS England is writing to all practices to make sure they are communicating the fact doctors can be seen in person if necessary, as well as virtually. It's estimated half of the 102 million appointments from March to July were by video or phone call, NHS Digital said. However, the Royal College of GPs said any implication GPs had not been doing their job properly was "an insult". NHS England said research suggested nearly two thirds of the public were happy to have a phone or video call with their doctor - but that, ahead of winter, they wanted to make sure people knew they could see their GP if needed. Nikki Kanani, medical director of primary care for NHS England, said GPs had adapted quickly in recent months to offer remote consultations and "safe face-to-face care when needed". Prof Martin Marshall, chair of the Royal College of GPs, said general practice was "open and has been throughout the pandemic", with a predominantly remote service to help stop the spread of coronavirus. He said: "The college does not want to see general practice become a totally, or even mostly, remote service post-pandemic. However, we are still in the middle of a pandemic. We need to consider infection control and limit footfall in GP surgeries - all in line with NHS England's current guidance." He said most patients had understood the changes and that clinical commissioning groups had been asked to work with GP practices where face-to-face appointments were not possible - for example, if all GPs were at a high risk from coronavirus. "Any implication that they have not been doing their job properly is an insult to GPs and their teams who have worked throughout the pandemic, continued delivering the vast majority of patient care in the NHS and face an incredibly difficult winter ahead," he said. Read full story Source: BBC News, 14 September 2020 Research from the college indicated that routine GP appointments were back to near-normal levels for this time of year, after decreasing at the height of the pandemic. "Each and every day last week an estimated third of a million appointments were delivered face to face by general practices across the country," added Prof Marshall.
  8. News Article
    NHS England has said GP practices must start opening their receptions and allow people to book initial face-to-face appointments — scrapping the controversial ‘total triage’ rule — for the first time since the early days of the coronavirus pandemic. Since last spring, NHSE guidance, supported by the profession, has said that face-to-face appointments must generally only take place after a phone, video or digital consultation. Many GP practice receptions have been closed to people wanting to make routine appointments. This rule was kept in place throughout last summer, despite covid circulation being low, and some health systems made the approach one of the pillars of planned post pandemic transformation. “Embedding total triage” was encouraged in 2021-22 operational rules for the NHS. The shift was seen by some as part of a move to a potentially more effective and efficient way of working. But there have been concerns about access and complaints in the media. Read full story (paywalled) Source: HSJ, 14 May 2021
  9. News Article
    General practices are “reaching breaking point” because of the “intense” workload pressure facing doctors and staff, the country’s most senior GP leaders have warned. The warning came as new figures from NHS Digital showed that practices in England delivered almost five million more appointments in March 2021 than the month before and nearly three million more than in March 2019. Richard Vautrey, chair of the BMA General Practitioners Committee, said that the figures underlined the huge efforts practices were going to and the workload pressure on staff. He said, “GPs and their teams are consistently telling us they’re busier now than they have ever been, and this data—which does not include a large proportion of the vaccine programme undertaken by practices, nor a vast amount of other daily tasks—backs this up.” Last week the Ivy Grove Surgery in Derbyshire provided an example of the strain facing some practices in a 16 page open letter to its patients about the huge demand it was facing and the resulting risk of staff burnout. The surgery said it would be reducing its use of the video consultation tool eConsult, as it had seen a doubling of demand over recent months, with some patients submitting several requests a day. In a statement the practice told The BMJ, “We are aware of the stir our letter has caused but have also been overwhelmed by the kind feedback from our own patients, and the many encouraging messages of support we have received from GP surgeries all around the country. We therefore know that many of our GP colleagues are experiencing the same issues, but they may be fearful of articulating what is happening." “We feel that open and honest debate about demand and workload in general practice is vital. If this letter goes even a little way towards sparking some much needed discussion then it will have been a good thing.” Read full story Source: BMJ, 4 May 2021
  10. News Article
    Patients are finding it increasingly hard to see their GPs, with warnings that pandemic restrictions have too often “closed the door” on NHS treatment, a report warns. The Patients’ Association survey comes as an investigation reveals that almost 100 GP surgeries closed down or merged with other practices last year. In total, almost 2.5 million patients were forced to switch to a new surgery because of 788 such closures since 2013, the freedom of information disclosures reveal . Rachel Power, chief executive of the Patients’ Association, said the findings from its survey were “worrying” and show “clear dissatisfaction” from the public. The report said: “It is increasingly clear that many patients have found that new methods for arranging appointments do not work for them, or simply that they do not understand how to go about it. GPs are the front door to the NHS, and patients are increasingly perceiving that that door is closed to them.” Roughly half of those who had telephone consultations said the experience was worse than a traditional appointment, with three times as many saying they were unhappy about their experience, compared with those offering praise. The report warns: “The data does not show a ringing endorsement of new or remote methods for accessing NHS care; indeed, in most cases patients rated these methods worse than traditional contact.” Read full story Source: The Telegraph, 30 April 2021
  11. News Article
    More Care Quality Commission (CQC) inspections will take place from next month as pressures from COVID-19 continue to ease. Board papers published ahead of a meeting on Wednesday have revealed the CQC will return to inspecting and rating NHS trusts and independent healthcare services which are rated “inadequate” or “requires improvement”, alongside those where new risks have come to light. From April, the CQC also plans to carry out well-led inspections of NHS and private mental healthcare providers, and programmes of focused inspections on the safety of maternity departments and providers’ infection prevention processes. Focused inspections into emergency departments, which the CQC began in February, will continue. Inspections into GP services rated “requires improvement” and “inadequate” will also resume in April, focusing on safety, effectiveness and leadership. Finally, the papers said the watchdog would prioritise inspections of “high-risk” independent healthcare services, such as ambulances, cosmetic surgery or where closed cultures may exist. Read full story (paywalled) Source: HSJ, 24 March 2021
  12. News Article
    GPs are being paid £1,000 to cancel second dose appointments for Covid jabs and given a script to follow to deal with angry patients amid growing chaos in the roll-out of the vaccine programme. Practices have been offered the payments to cover the workload of postponing hundreds of patients who were set to have their second dose and booking new ones in their place. NHS sources said the shift has contributed to delays in rolling out the programme. Some GPs have refused to postpone the appointments, with practice managers saying it was "too cruel" to dash the hopes of those who were booked for a second jab. In December, everyone given a first vaccine by Pfizer was told to come back for their second dose three weeks later. But the strategy was changed 10 days ago in a bid to get a first dose to more of the population more quickly. Patients are now being told they will have to wait 12 weeks for the second dose, with a reassurance from health officials that the longer gap could strengthen its effectiveness. By the time the plan was changed, around one million people had already been booked in for their second dose. GPs are now under orders to postpone such appointments and instead give the slots to those awaiting a first dose. Read full story Source: The Telegraph, 8 January 2021
  13. News Article
    The abuse of staff at GP surgeries has "no place in the NHS", a healthcare boss has said, following complaints it has risen during the pandemic. Dr Joanne Watt, GP chairwoman of the Northamptonshire Clinical Commissioning Group (CCG), said she understood patients' frustrations as surgeries battle with increased demand. But she said the reports of abuse were "extremely upsetting and demoralising". A receptionist told the BBC she had "never seen this level of abuse". Claire, who works at Harborough Field surgery in Rushden and has been employed by the NHS for 34 years, said staff were being verbally abused on a daily basis and it was "becoming the norm and it shouldn't be". "We work within the rules we're given. It's very upsetting, we've been reduced to tears," she said. The latest NHS staff survey found one in three staff claimed to have experienced at least one incident of bullying, harassment or abuse from service users, their relatives or other members of the public, in the year to March 2021. Read full story Source: BBC News, 7 October 2021
  14. News Article
    GP practices will be included in the remit of a new patient safety watchdog, due to come in from 2023 under the new Health and Care Bill, the Department of Health and Social Care (DHSC) has said. DHSC said that it expects the new Health Services Safety Investigations Body (HSSIB) to be ‘fully operational’ in England from April 2023 – ‘subject to parliamentary clearances’. It confirmed that the statutory independent body will investigate NHS care in GP practices, although it said that the HSSIB’s ‘focus is likely to be predominantly on investigating patient safety incidents in NHS trusts’. The body will also investigate care provided by the independent healthcare sector. RCGP vice-chair Dr Gary Howsam said: ‘It is important that we have further details about how this regulator will interact with general practice, and the expectations it will have of GPs and our teams, including ensuring GPs are not implicated for systemic issues out of their control.’ Read the full article here
  15. News Article
    Community doctors in Scotland have told the BBC they cannot imagine returning to normal face-to-face service with current levels of demand. Allowing more patients to see their GP in person is a top priority for the government's NHS Recovery Plan. But as the country tries to emerge from the pandemic, surgeries are seeing unprecedented pressure to catch up with patients. The health secretary has confirmed that new guidance should allow practices to see more people in person. But greater use of telephone and video appointments, brought in when the pandemic hit, is going to continue. Dr Begg has been a GP for 25 years. He says they won't go back to business as usual, the way they worked before. "In person consultations are really important, to examine people, to give injections, to remove lesions, all of these. I think a flexible approach is what we need. It's what we were planning to do before the pandemic anyway; a flexible mix of phone call, video and in-person consulting where it is appropriate." Dr Begg says the new ways of working are essential to deal with the huge number of requests they get. "There is a demand, capacity gap and indeed there was before the pandemic. We are seeing at last more students come through medical school and more people finally coming to join general practice training, but this is going to take at least ten years to turn things around." Read full story Source: BBC News, 7 September 2021
  16. News Article
    A study by React have estimated around 2 million people may be suffering from long Covid but scientists say the cases are going under reported. Currently, there is no universal definition of long Covid and the symptoms are varying and broad. To better understand the condition, the government has set up around 80 clinics and have invested £50m for research. Read full story. Source: BBC News, 30 June 2021
  17. News Article
    NHS staff at GP surgeries are facing unprecedented abuse and aggression from patients, while stressed doctors are increasingly suffering from mental illness, because of an appointments system “in meltdown”, family doctors’ leaders have revealed. The scale of the deep crisis in GP surgeries was revealed in an emergency summit of more than 60 NHS doctors, dentists and administrative staff in Salford, which the Guardian attended, triggered by a recent rise in verbal abuse. "Patients are short-tempered and not happy waiting for anything … They want letters. The latest one was a request to speak to a GP because he needs a letter to confirm anxieties that cause him a problem in long queues – because he wants to take his son to [Southport amusement park] Pleasureland and does not want to queue," says Jan Crowshaw, a GP manager It comes after a recent poll by the body representing GP surgery staff across the UK found that 75% of them face abuse every day, including assaults, threats, racism and sexism. Read full story Source: The Guardian, 28 May 2021
  18. Event
    until
    With general practice in crisis due to workforce shortages, an increasingly complex workload, rising public expectations, and further pressures caused by the Covid-19 pandemic, The King's Fund are providing the time and space for you to reflect, think differently, share and learn. Join peers and experts from The King’s Fund to explore: what the future of general practice looks like how the experience for patients and staff can be improved how to ensure those actions are building blocks towards the future. This event is for GPs, commissioners, nurses, practice managers, allied health professionals, Additional Roles Reimbursement Scheme (ARRS)-funded roles, and other professionals working in multidisciplinary general practice teams and those responsible for general practice at place or neighbourhood level. Register
  19. Content Article
    The GP Patient Survey (GPPS) is an England-wide survey of patients aged 16+. It provides GP practice-level data about patients’ experiences of general practice.
  20. Content Article
    The aim of this study from Avery et al. was to determine the prevalence and nature of prescribing errors in general practice; to explore the causes, and to identify defences against error. The study involved examination of 6,048 unique prescription items for 1,777 patients. Prescribing or monitoring errors were detected for 1 in 8 patients, involving around 1 in 20 of all prescription items. The vast majority of the errors were of mild to moderate severity, with 1 in 550 items being associated with a severe error. The following factors were associated with increased risk of prescribing or monitoring errors: male gender, age less than 15 years or greater than 64 years, number of unique medication items prescribed, and being prescribed preparations in the following therapeutic areas: cardiovascular, infections, malignant disease and immunosuppression, musculoskeletal, eye, ENT and skin. Prescribing or monitoring errors were not associated with the grade of GP or whether prescriptions were issued as acute or repeat items. A wide range of underlying causes of error were identified relating to the prescriber, patient, the team, the working environment, the task, the computer system and the primary/secondary care interface. Many defences against error were also identified, including strategies employed by individual prescribers and primary care teams, and making best use of health information technology.
  21. Content Article
    This is the final report of the stocktake undertaken by Dr Claire Fuller, Chief Executive-designate Surrey Heartlands Integrated Care System and GP on integrated primary care, looking at what is working well, why it’s working well and how we can accelerate the implementation of integrated primary care (incorporating the current 4 pillars of general practice, community pharmacy, dentistry and optometry) across systems.
  22. Content Article
    Mike Fell, executive director of national cybersecurity operations at NHS Digital,, discusses the WannaCry cyberattack, teaching GP surgeries to up their game and how data can save lives.
  23. Content Article
    Acute prescribing forms a large part of the daily workload for GP practices. Quality improvement (QI) methodology can be used to help improve prescribing processes and ensure that prescribing work is managed by the right member of your team, safely and effectively. This toolkit is designed to help primary care multidisciplinary teams, including pharmacotherapy services, safely improve their acute prescribing processes in line with the Essentials of Safe Care. An acute prescription is defined as any prescription without a serial or repeat mandate.
  24. Content Article
    In this study, Avery et al. estimated the incidence of avoidable significant harm in primary care in England, and describe and classify the associated patient safety incidents and generate suggestions to mitigate risks of ameliorable factors contributing to the incidents. The study found there is likely to be a substantial burden of avoidable significant harm attributable to primary care in England with diagnostic error accounting for most harms. Based on the contributory factors we found, improvements could be made through more effective implementation of existing information technology, enhanced team coordination and communication, and greater personal and informational continuity of care.
  25. Content Article
    In this short analysis from the Health Foundation, data from the GP patient survey, an annual independent survey run by Ipsos MORI on behalf of NHS England, was used to explore who gets good access to general practice, unpicking how patient satisfaction with the service they receive varies by deprivation, age and ethnicity. Note: The 2020 GP patient survey data were mostly collected before the COVID-19 pandemic, therefore this analysis doesn’t reflect patient experiences or service changes during the pandemic.
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