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Found 387 results
  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. 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
  7. News Article
    Pharmacists will be allowed to write prescriptions under plans reportedly being considered by England's Health Secretary Sajid Javid. Mr Javid last month vowed the Government will "do a lot more" to ensure GPs see more patients face-to-face following complaints from the public. The proposals would see more prescriptions provided through pharmacies and hospitals for routine illnesses to allow doctors more time to see patients in person, according to The Sunday Times. GPs will also reportedly be able to pass off bureaucratic processes such as providing supporting medical evidence to the Driver and Vehicle Licensing Agency (DVLA) over a patient's fitness to drive. The plans are expected to include sanctions for doctors who do not increase the number of face-to-face appointments with patients, the paper added. Read full story Source: 11 October 2021, Medscape
  8. News Article
    Continuity of care in general practice reduces use of out-of-hours care, acute hospitalisations and mortality, researchers have shown - as GP leaders warned staff shortages and heavy workload means it is becoming harder to deliver in the UK. Long-lasting personal continuity with a GP is 'strongly associated with reduced need for out-of-hours services, acute hospitalisations, and mortality', according to a study by researchers in Norway. An association lasting more than 15 years between a patient and a specific GP reduces the probability of any of these factors by 25-30%, the study published in the British Journal of General Practice found. The researchers said 'promoting stability among GPs' should be a priority for health authorities, and warned that continuity of care was under pressure. The findings come as general practice in the UK faces intense pressure amid a shortage of GPs and intense workload after more than 18 months of the COVID-19 pandemic. Responding to the findings, RCGP chair Professor Martin Marshall said: "Continuity of care is highly valued by patients and GPs and our teams alike. It is what allows us to build relationships with our patients, often over time, and this study builds the strong evidence base of its benefits for patients and the NHS." Read full story Source: GP Online, 4 October 2021
  9. News Article
    GPs are failing to urgently refer patients with “red flag” signs of suspected cancer to a specialist, research suggests. Six out of 10 patients in England with key symptoms indicating possible cancer did not receive an urgent referral for specialist assessment within two weeks, as recommended in clinical guidelines, according to a new study. Nearly 4% of these patients were subsequently diagnosed with cancer within the next 12 months. The findings were published in the journal BMJ Quality & Safety. In the study, researchers analysed records from almost 49,000 patients who consulted their GP with one of the warning signs for cancer that should warrant referral under clinical guidelines. Of the 29,045 patients not referred, 1,047 developed cancer within a year (3.6%). Early diagnosis and prompt treatment is crucial to survival chances. Every four-week delay in cancer treatment increases the risk of death by 10%. Read full story Source: The Guardian, 5 October 2021
  10. 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
  11. News Article
    Many patients are being prescribed unnecessary and even harmful treatments, a new report warns. The review, in England, suggests one-tenth of items dispensed by primary care are inappropriate or could be changed. Around 15% of people take five or more medicines a day - some are to deal with the side-effects of the others. The government is appointing a prescribing tsar to help with the issue and stop waste. Overprescribing can happen when: a better alternative is available but not given the medicine is appropriate for a condition but not the individual patient a condition changes and the medicine is no longer appropriate the patient no longer needs the medicine but continues to be prescribed it. Chief pharmaceutical officer for England, Dr Keith Ridge, said: "Medicines do people a lot of good and this report is absolutely not about taking treatment or services away from people where they are effective. But medicines can also cause harm and can be wasted." Read full story Source: BBC News, 22 September 2021
  12. News Article
    GPs in England are finding it "increasingly hard to guarantee safe care" as the number of doctors falls and demand surges, a senior medic said. Prof Martin Marshall, chair of the Royal College of GPs, told the Guardian GP numbers had fallen by 4.5% despite an ageing population with an increased need for care. GPs feared making serious mistakes due to excessive workloads, he said. Prof Marshall also defended the continued use of remote consultations. Prof Marshall said the demand for services from GPs, including more complex consultations and the vaccination programme, on top of this decline in numbers was putting family doctors under strain. "The fact that general practice is under such enormous pressure means it can't deliver the patient-centred services that it wants to. Many GPs are even finding it challenging to maintain a safe service," he said. He said family doctors were more likely to make a mistake if they were working 11- or 12-hour days, seeing 50 or 60 patients. "GPs are finding it increasingly hard to guarantee safe care to their patients," he said. "The chances of making a mistake in a diagnosis or a mistake in a referral decision or a mistake in prescribing are all greater when you're under stress." Read full story Source: BBC News, 11 September 2021
  13. News Article
    Patients being assessed remotely in general practice, rather than face-to-face, has been raised as a risk in reports on five deaths by a single coroner since the pandemic hit. Senior coroner for Greater Manchester Alison Mutch has written five prevention of future deaths reports highlighting concerns that doctors were missing details in telephone appointments which may have been spotted, had the patient been seen in person. The reports cover a variety of conditions, including covid, a broken femur, and anxiety and depression. In March 2020, NHS England guidance instructed GPs to adopt a “total triage” approach, where face-to-face appointments should generally only follow a phone, video or digital consultation. But, in May, NHSE wrote to GPs to ask them to “ensure they are offering face to face appointments”, adding remote appointments “should be done alongside a clear offer of appointments in person”. There have been growing calls in the media for increased face-to-face appointments, while, in March 2021, a report by Healthwatch concluded: “While telephone appointments are convenient for some, others are worried that their health issues will not be accurately diagnosed.” Maureen Baker, former chair of the Royal College of GPs and Patient Safety Learning trustee told HSJ she was “not aware pre-pandemic of any major concerns with remote consulting”, adding: “It’s not that things don’t go wrong. They do, but things can and do go wrong in face-to-face consultations as well.” “Many practices have been using remote consulting very successfully for many years [but for GPs introducing remote consultations during the pandemic] the concern is that practices will have had to change and implement it very quickly.” Read full story (paywalled) Source: HSJ, 9 September 2021 You may also be interested in a recent blog from Trish Greenhalgh: 'Why remote consultation with a doctor is difficult – and how it can be improved'
  14. 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
  15. News Article
    GP surgery staff are facing abuse from patients who are “angry and upset” that their blood test has been cancelled because of the NHS-wide chronic shortage of sample bottles. “Patients are angry when we ring them up and say, ‘Sorry we can’t do your blood test after all’. A lot of people are quite angry and concerned about their own health,” Dr David Wrigley, the deputy chair of council at the British Medical Association, said. “Patients are quite rightly upset and some get quite aggressive as well. They are worried because they don’t know what the implications of their cancelled test are for their health.” GP practices in England had begun cancelling appointments because the NHS’s main supplier could not deliver stocks as planned for one to two weeks because of “unforeseen road freight challenges”. NHS England has responded to the shortage of blood sample bottles by telling GPs to cancel all but clinically urgent blood tests and hospitals to cut back the tests they do by at least 25%. Read full story Source: The Guardian, 6 September 2021
  16. 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
  17. 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
  18. 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
  19. 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
  20. 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
  21. 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
  22. 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
  23. 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
  24. 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
  25. 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.
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