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Found 387 results
  1. News Article
    The Modality Partnership, one of England's biggest general practice groups told HSJ that its GPs are regularly seeing more patients each day than is safe, after the number of people going to see their GP surged in the wake of Covid-19. Data has shown the provider’s GPs had an average of 20 patient contacts per day during April 2020, which has now risen to to an average of nearly 50 patient contacts per day. Modality, which had drawn up a report on the situation were quoted as saying, "There is just so much to cover – I am worried about missing something.” One partner at Modality who is also quoted in the report said: “An increasing number of patients I see are broken, often in tears, and seeking help to cope with the new stresses of life.” Read full story (paywalled). Source: HSJ, 31 August 2021
  2. Content Article
    In this blog, James Perry a GP for Primary Care Wirral GP Federation, describes his experience of being a member of the UK's first multidisciplinary quarantine unit in 40 years. Starting from when 83 British nationals arrived in the UK from Wuhan, China and were transferred to Arrowe Park on the morning of 31st January, he details several operational and medical approaches, including how the multidisciplinary team had to create a strategic operational plan and how the mental health team aimed to promote a normalising, practical and human approach without medicalising people’s natural responses to a challenging and unusual circumstance.
  3. News Article
    GPs have been given until the 31st July to sign up patients to the new enhanced long Covid enhanced service (ES). The new service was set up to help support patients with the condition as it was considered complex and needed consistent support. The ES is also intended to help GP practices 'plan their workforce set up, training needs and infrastructure in order to support patients with this new condition’. The payment to practices will occur on a monthly basis and will be paid 75% of the fee (£0.371) per registered patient. The remaining 25% (£0.124 )will be paid once patients have been signed up. Read full story. Source: Pulse Today, 21 June 2021
  4. News Article
    Labour has urged the NHS and Matt Hancock to pause their plan to share medical records from GPs to allow time for greater consultation on how the idea would work, saying that maintaining patients’ trust must be paramount. In a letter to the head of NHS Digital and the health secretary, the shadow public health minister, Alex Norris, said Labour backed the principle of improved data collaboration but shared the concerns of some doctors’ groups. The Royal College of General Practitioners warned NHS Digital a week ago that plans to pool medical pseudonymised records on to a database and share them with academic and commercial third parties risked affecting the doctor-patient relationship. NHS Digital needed to explain the plans better to the public, the group said, as well as outlining how people could opt out. The British Medical Association (BMA) has also called for a pause to the General Practice Data for Planning and Research scheme. Another group, the Doctors’ Association, said it was worried it would “erode the doctor/patient relationship, leaving patients reluctant to share their problems due to fears of where their data will be shared”. Read full story Source: The Guardian, 6 June 2021
  5. Content Article
    n the UK, while most primary care contacts are uncomplicated, safety incidents do occur and result in patient harm, for example, failure to recognise a patient’s deterioration in health. This study by Cecil et al. determined the patient and healthcare factors associated with potentially missed acute deterioration in health. Differentiating acute deterioration from self-limiting conditions can be difficult for clinicians, particularly in patients with sepsis, urinary tract infections, or long-term conditions. The findings of this study support the call for longer GP consultations and caution against reliance on telephone consultations in primary care; however, more research is needed to understand the underlying mechanisms.
  6. News Article
    Patients who had longer consultations with their GP were less likely to subsequently self-refer themselves to hospital due to a worsening of their condition, a study has found. The study, which looked at factors associated with potentially missed acute deterioration, said this might be because GPs with more time to assess patients ‘are more likely to recognise deterioration and refer the patient for secondary care’. A longer consultation might also allow GPs more time to provide advice, such as telling the patient to contact the practice again if their condition worsens, the British Journal of General Practice study found. The researchers defined a potentially missed acute deterioration as a patient having a self-referred admission to hospital after being seen by a GP in the three days beforehand. They found that 116,097 patients had contacted a GP three days before an emergency admission, with patients with sepsis or urinary tract infections more likely to self-refer. GP appointment duration was associated with self-referral, with a five-minute increase in appointment time resulting in a 10% decrease on average in the odds of self-referred admissions. Patients having a telephone consultation compared with face-to-face, previous health service use, and the presence of comorbidities were all also associated with self-referred admission, according to the research. Read full story Source: Management in Practice, 2 June 2021
  7. News Article
    A group set-up following the Winterbourne View scandal is urging more people with learning disabilities to attend their annual health check-up. Healthwatch South Gloucestershire said regular health checks could prevent people from dying unnecessarily. It formed after BBC Panorama exposed abuse of patients at Winterbourne View hospital 10 years ago. Only about 36% of people with learning difficulties are believed to have an annual GP health check-up. The Local Democracy Reporting Service (LDRS). said the lack of regular, medical observations contributed to them having a life expectancy of 20 years lower than in the wider population. Healthwatch South Gloucestershire, a regional, independent health and social care champion, has created a checklist to encourage more people to attend appointments to help them improve their life expectancy. Vicky Marriott from the group said: "It is our unrelenting mission to listen and share people's lived experience so that the information informs how health and social care services improve. "We recently listened to people with learning disabilities and their families and developed with them an accessible info-sheet packed full of easy-to-read explanations about the lifesaving benefits of annual health checks." Read full story Source: BBC News, 1 June 2021
  8. News Article
    Rising numbers of patients needing care and a shortage of GPs is threatening to overwhelm the system, doctors and patient groups are warning. It comes after the pandemic has caused severe disruption to GP practices for more than a year. Analysis of NHS England data by the Health Foundation found more than 28 million appointments were booked in March, among the highest recorded. Doctor's leaders say what they are being asked to achieve is "undoable". The analysis of NHS data in England carried out by the Health Foundation for the BBC also that that between 2019-20 and 2020-21: The total number of appointments dropped by 10% - meaning 31 million fewer consultations with GPs and practice nurses Major shift from face-to-face to remote consultation, with the proportion seen in practices dropping from 79% to 54% The number of patients referred by GPs for urgent cancer check-ups dropped by 15%, putting lives at risk The escalating situation has prompted patient groups to call for an urgent review of access to services, amid reports that patients are struggling to get through. Read full story Source: BBC News, 27 May 2021
  9. News Article
    Family doctors are being forced out of their jobs after developing long Covid, prompting demands for the government to compensate NHS staff with the debilitating condition who cannot work. GPs struggling with the condition have told the Observer they felt “shocked and betrayed” when their colleagues removed them from their posts because of prolonged sick leave. “I received a lawyer’s letter on behalf of the other partners in the GP surgery telling me that they were ending my partnership. I understood why they did what they did, because I was too sick to work at the time. But it was also callous and mercenary,” said one doctor who lost her job. “It was hard on me, as one of the partners was also my best friend. The partners were worried I’d be a ‘disabled partner’ and wouldn’t be able to pull my weight. Long Covid meant I simply couldn’t function normally and so couldn’t meet the return to work date they gave me, so they exercised their right under our partnership agreement to end my partnership at the surgery,” added the GP, who asked to remain anonymous. The issue has prompted soul-searching within the medical profession about what duty of care family doctors owe each other when they cannot work because they have been laid low with exhaustion, brain fog, breathlessness and other symptoms of long Covid. Locum medics and hospital doctors with the condition are also having problems including loss of income, trouble accessing sick pay, contractual difficulties and getting employers to accept that they cannot work normally, sometimes for months. Read full story Source: The Guardian, 23 May 2021
  10. News Article
    GP practices should not switch off their online consultation systems outside of core hours as it will “reduce patient satisfaction”, according to NHS England. It comes in controversial new guidance issued amid a row over GP access. NHSE issued the new “standard operating procedures” this afternoon. HSJ revealed last month that large numbers of overwhelmed GP practices were turning off their online consultation services at weekends after the recent boom in digital appointments uncovered an ‘unmet demand’, leading to large numbers of queries to deal. But the new SOP says: “Patients should be able to make requests in an online system at any time.” Disabling the system outside of core hours, which some practices have done to help manage demand, is “less convenient” for patients and would “reduce satisfaction”, it says. Read full story Source: HSJ, 20 May 2021
  11. Content Article
    In the Patients Association 2020 survey, patients told us about their experiences of living with health and care needs during the COVID-19 pandemic. Their testimony painted a bleak picture in many ways. This follow-up survey finds that many aspects of their experiences are not much better, and some are worse.
  12. 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
  13. Content Article
    The Doctor Will Zoom You Now was a rapid, qualitative research study designed to understand the patient experience of remote and virtual consultations. The project was led in partnership with Traverse, National Voices and Healthwatch England and supported by PPL. The study engaged 49 people over 10 days (June 22nd – July 1st 2020) using an online platform, with 20 additional one to one telephone interviews. Participants were also invited to attend an online workshop on the final day of the study. Using insight from the key findings from the research, this website provides useful tools and tips for getting the most out of your appointment.
  14. Content Article
    Dr Helen Simpson, Lisa Shepherd and Dr Steve Kell summarise the guidance and implementation of the steroid emergency card in primary care.
  15. News Article
    Many GPs find telephone appointments with patients frustrating and want to see them in person because they fear they will otherwise miss signs of illness , the leader of Britain’s family doctors has said. Prof Martin Marshall told the Guardian that remote consultations felt like working “in a call centre” and risked damaging the relationship between GPs and their patients. Telephone and video appointments had proved useful during the Covid pandemic, when GP surgeries limited patients’ ability to come in for face-to-face appointments, he said. However, while that helped limit the spread of coronavirus, “this way of working has been frustrating for some GPs, particularly when most consultations were being delivered remotely, who have felt like they’ve been delivering care via a call centre, which isn’t the job they signed up for." “Remote consultations have advantages, particularly in terms of access and convenience for patients. But we know that patients prefer to see their GP face to face." “Remote working has been challenging for many GPs, particularly when delivering care to patients with complex health needs,” said Marshall, who is a GP in London. “It can also make it harder to pick up on soft cues, which can be helpful for making diagnoses.” His remarks come as NHS leaders and doctors groups are discussing how far appointments should return to being in person now the pandemic is receding. Read full story Source: The Guardian, 28 March 2021
  16. News Article
    A survey of an area’s GPs and other primary care staff found those from a minority ethnic background feel they are less involved in decision making and less respected by their colleagues, according to results shared with HSJ. The survey, instigated by GPs in Doncaster, South Yorkshire, also found more staff from a minority ethnic background said they had experienced some form of bullying or harassment, including “instances of physical violence”. The work is thought to be unusual in primary care — annual “workforce race equality standard” surveys are required by NHS England for NHS trusts and, in the past year, clinical commissioning groups, but not in primary care. The survey in October was instigated by Doncaster Primary Care BAME Network and facilitated by Doncaster clinical commissioning group. It was sent to GPs and practice staff, community pharmacy staff, and other “healthcare professionals” in primary care. There were 136 respondents. The report of the results said minority ethnic staff felt they were less able to make decisions to improve the work of primary care, less involved in decisions regarding their area of work and less respected by their colleagues compared with their white colleagues. Read full story (paywalled) Source: HSJ, 9 March 2021
  17. Content Article
    It takes around seven to eight years on average for a woman to get diagnosed with endometriosis from the time she starts experiencing symptoms. Whilst this has reduced from the eleven years measured previously, it is still far too long. The symptoms of endometriosis are very similar to other common conditions. It's important to share as much information with your doctor as possible To help you prepare for a GP appointment, Endometriosis UK has produced a factsheet giving tips on what to say to your GP, what will happen at your appointment, what to do if you are not satisfied that your symptoms are being properly looked into by your GP, how to get a referral and questions to ask your GP.
  18. News Article
    The Royal College of GPs has called for an independent review of the link between poor Care Quality Commission (CQC) inspection ratings and the ethnicity of GP partners. The college called for the regulator to commission the work in particular for those rated “requires improvement” and “inadequate” over the past five years, including practices which have since closed down. This will assess “if there is an association between the outcomes of inspections and ethnicity or country of qualification of the GP partners”, according to the RCGP. In addition, the RCGP wants to work with the regulator to discuss how the availability and transparency of this information can be improved to ensure minority ethnic GPs’ experiences are heard. Minority ethnic GPs shared their experiences of CQC inspections at an RCGP council meeting last week, where council members voted to support the above actions. Dr Howsam said: “The college’s BAME action plan commits us to delivering positive change for all our Black, Asian and minority ethnic members and we will continue to work constructively with the CQC towards an improved system of inspection that is supportive of GPs and keeps patients safe as we move away from the immediate crisis of the pandemic and into recovery.” Read full story (paywalled) Source: HSJ, 1 March 2021
  19. News Article
    Almost half of people with potential cancer symptoms did not contact their GP during the first wave of the pandemic, a survey suggests. Symptoms left unchecked included coughing up blood, lumps and changes to the appearance of moles. NHS figures showed a fall in referrals to cancer services last spring. However, this study, of almost 8,000 people, captures the fall in people contacting their GP in the first place. The team that carried out the study, from Cardiff University and Cancer Research UK, said this raised concerns that people could be diagnosed later - and so be less likely to be treated successfully and recover. They surveyed a representative sample of people across the UK and found that of 3,025 people who said they had experienced at least one symptom which could be a warning sign of cancer, 45% did not seek help. They also found that: 31% did not seek help after coughing up blood 41% did not seek help for an unexplained lump or swelling 59% did not seek help after noticing changes to the appearance of a mole. Some of the reasons given by people who did not contact their GP were not wanting to waste doctors' time or put extra strain on the NHS; not wanting to be seen as someone who made a fuss; and fear of catching Covid at appointments. But people who did contact their GP reported feeling "safe" and "secure" when attending face-to-face appointments. Read full story Source: BBC News, 25 February 2021
  20. News Article
    Local groups of GPs have decided to prioritise all patients with learning disabilities for COVID-19 vaccination, after fresh evidence showed that disabled patients were at much higher risk from the disease. Latest figures from the Office for National Statistics1 showed that 60% of people in England who died from covid-19 from January to November 2020 (30 296 of 50 888) had a disability. This week an extra 1.7 million people in England—including some with severe learning disabilities—are being added to the list of people identified as clinically extremely vulnerable to COVID-19, although this does not include people with mild or moderate learning disabilities. But some clinical commissioning groups (CCGs) have deviated from national guidance and said that they will prioritise all patients with learning disabilities for vaccination given the disproportionate impact on them. In a statement published on its website, Kent and Medway CCG said that it had decided to include all adults with learning disabilities in the current priority phase for vaccination delivery. “Given the evidence of covid-19 inequalities increasing deaths amongst people with learning disabilities, the NHS in Kent and Medway has agreed to prioritise vaccinating the 9500 people on GP learning disability registers,” it said. Oxfordshire CCG was also praised by local campaigners for adjusting its priority list so that everybody with a learning disability is included in priority group 6, regardless of its severity. Read full story Source: BMJ, 19 February 2021
  21. News Article
    People living with HIV in England and Wales can now choose to have their Covid vaccine through specialist clinics, without notifying their GP. NHS England has updated its guidance for people not comfortable with sharing their status. Everyone with HIV should be in vaccine priority groups four or six, and offered a jab by mid-April at the latest. But campaigners worried stigma would cause some to miss out. The updated guidance, obtained by the i newspaper, follows the lead of NHS Wales which put the same measures in place last week. Head of leading HIV charity the Terrence Higgins Trust, Ian Green, said: "Some may be surprised to hear that a significant number of people living with HIV feel unable to talk to their GP about their HIV status, but this underlines how much stigma still surrounds the virus even in 2021." "This is great news and the right decision from the NHS as it means people living with HIV will be able to take up the potentially life-saving Covid-19 vaccine at their earliest opportunity. We are working towards a society where everyone living with HIV feels comfortable sharing their status with their doctor and other health professionals, but we're not there yet and we welcome this fast, pragmatic action." Read full story Source: BBC News, 22 February 2021
  22. Content Article
    UCL Partners have developed a series of proactive care frameworks to restore routine care by prioritising patients at highest risk of deterioration, with pathways that mobilise the wider workforce and digital/tech, to optimise remote care and self-care, while reducing GP workload. The frameworks include atrial fibrillation, high blood pressure, high cholesterol, type 2 diabetes, asthma and COPD.
  23. Content Article
    Keeping a record of your pain and symptoms can help you and your doctor to manage your symptoms, could help with a diagnosis and also could be used when submitting information for evidence e.g. when claiming for benefits, for work or for school/university.  Endometriosis UK has produced a handy pain and symptoms diary you can use.
  24. News Article
    London’s largest acute trust has been accused of ‘emotional blackmail’ by suggesting junior doctors could do voluntary shifts in its ‘really short staffed’ critical care unit. In an email cascaded to all junior doctors at Whipps Cross Hospital, run by Barts Health Trust, hospital medical director Heather Noble said day and night shifts at another trust site, the Royal London Hospital, “really need cover”. She said doctors could work overtime through a “voluntary or paid shift”, and that if they made contact, should “state whether or not they want to be paid”. Doctors working at the trust who received the email, who wished to remain anonymous, described the email as “tone deaf” and “not the right way to incentivise anyone to do what they want”. One medic said: “There has been a lot of anger generated by this correspondence amongst junior doctors. People already working antisocial and demanding rotas are very unhappy about being asked to work more hours for free.” Read full story (paywalled) Source: HSJ, 26 January 2021
  25. News Article
    Doctors on the front line of the UK’s vaccine programme have said they are “ready to go” and will be able to administer doses “very quickly” in the months ahead, amid questions over whether or not the NHS can inoculate 2 million people a week. After suggestions that staffing constraints could hinder the roll-out of the Oxford/AstraZeneca vaccine, which was approved for use last week, NHS officials and GPs have insisted that the health service is primed to deliver doses as soon “as supply becomes available”. On Monday, Professor Stephen Powis, national medical director of NHS England, said 100 hospital hubs and 700 vaccination centres – based in GP practices and other community settings – would have access to the vaccine by the end of the week, with plans in place to expand the programme. “We aim to get it into people’s arms as quickly as it is supplied to us,” Prof Powis said. “If we get 2 million doses a week, our aim is to get 2 million doses into the arms of those priority groups." Read full story Source: The Guardian, 4 January 2021
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