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Content ArticleTalking General Practice speaks to Dr Helen Garr, medical director of NHS Practitioner Health, the NHS service that looks after doctors and dentists - and also other NHS staff - who are experiencing mental ill health. In this conversation, Helen talk about the impact that pressures on the NHS are having on doctors’ wellbeing and how this is affecting GPs in particular. Helen also explains what doctors and other NHS staff can do if they are suffering from burnout, how to prevent burnout, what people can do if they are worried about a colleague and how NHS Practitioner Health supports doctors who seek help from the service. She also outlines how she thinks the NHS could change to help ensure better mental health for doctors and other staff.
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Content ArticleAcute 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.
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Content ArticleIn this blog, Jeremy Hunt MP, Founder of Patient Safety Watch, argues against introducing more targets for GPs. The new Health Secretary, Therese Coffey MP, plans to introduce a target to ensure that all patients see their GP within two weeks. The blog highlights two issues with this approach: Setting a new target won’t make it a reality Having too many targets result is a system that depersonalises patients, deprofessionalises frontline staff and means it is difficult for health services to prioritise It then proposes that the health system should learn from the UK education system's approach to regulatory oversight, which is aimed at driving up standards, rather than achieving grades.
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Content ArticleThis practice pointer in The BMJ provides an update on treating Long Covid in primary care and outlines how healthcare professionals might respond to questions that patients ask about the condition. The article provides information on: Definition of Long Covid Epidemiology Symptoms and case definition Questions patients ask Further resources for patients and healthcare professionals
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EventuntilWhen things go wrong - doctors in the dock series provides a unique opportunity to hear real patients discuss their experience of medical errors. Well-known witnesses of clinical errors will talk about their first-hand experiences, what happened, how they and their family had to deal with them, and how they have dealt with the aftermath in the most constructive way possible. Gain more experience and insight about the best way to deal with clinical errors as professionals, and from a patient perspective, and convert them into an opportunity for improvement for all involved, even leading to very successful careers. Register
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Content ArticleThe Royal College of General Practitioners has put together useful resources for GPs during the coronavirus pandemic.
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Content ArticleLast week a letter signed by 435 GP practice staff on access to GP practices was published in The Times. The letter was drafted by a group of grass root GPs, in response to the recent misleading allegations that GPs have been “closed” during the pandemic. These headlines damage the reputation and morale of the workforce. Responsible media reporting is a patient safety issue, as those patients who believe this false rhetoric may not seek help for worrying symptoms. We have already seen reduced rates of cancer diagnosis during the pandemic by around 40%, along with reduced presentations of other major non-covid illnesses. Irresponsible media may also cause inappropriate use of emergency departments and the NHS 111 helpline, which adds further pressure on our secondary care colleagues at a critical time for the NHS. GPs Simon Hodes and Neena Jha discuss this further in this BMJ Opinion article.
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Content ArticleIn 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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Content ArticleDr Kathryn Leask outlines steps GPs can take to try and avoid patients coming to harm as a result of delayed referrals and provides advice on dealing with patient complaints on this issue. There are some steps GPs can take to try to avoid patients coming to harm while putting themselves in the best position to address the potential medico-legal ramifications. In their guidance on Delegation and referral the GMC says that you are not accountable for the actions or omissions of colleagues to whom you make referrals. However, you are accountable for your decisions to transfer care and the steps you have taken to make sure that patient safety is not compromised. If you are aware that there are delays for a particular service and your patient is likely to be affected by this, you should make this clear to them and manage their expectations from the outset. In this GP Online article, Kathryn gives practical tips for GPs and shares a case example.
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Content Article
UCL Partners: Proactive care frameworks
Patient Safety Learning posted an article in Care pathways
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. -
Content ArticleThis NHS Resolution video looks at three diseases where GPs often miss the diagnostic signs resulting in late referrals: cauda equina, colorectal cancer and subarachnoid haemorrhage. Clinical symptoms to be aware of in these diseases are highlighted.
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Content ArticleThis NHS Resolution video outlines the key components of good medical record keeping and highlights common mistakes to avoid.
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Content ArticleThis video from NHS Resolution looks at the criteria that need to be met in order for patient consent to be legally valid. Advice is provided on how to ensure practitioners obtain legally valid consent.
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Content ArticleDr Gordon Caldwell shares his hospital ward round sheet attached which follows a standard process, including quality and safety checking. Feel free to adapt.
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Content ArticleA new toolkit to support GPs to deliver care for patients with hearing loss and aims to encourage deaf patients to access primary care, has been launched. The educational kit, developed by Royal College of GPs (RCGP) in collaboration with the UK’s largest hearing loss charity, RNID and NHS England and Improvement aims to support GPs to consult effectively with deaf patients by offering tips on how to communicate during face to face and remote appointments. It also offers guidelines on how to recognise early symptoms of hearing loss and how to refer patients for a hearing assessment. The project aims to support GPs implement the latest NICE Guidelines, NHS Accessibility Quality Standard and Guidance across the UK. Resources include an Essential Knowledge Update (EKU) Screencast, GPVTS Teaching Powerpoint, Podcasts, Hearing Friendly Practice Charter for your GP Surgery to sign up to, EKU Online E-learning Module, RCGP Accredited Deaf Awareness Online Course, Hearing Friendly Practice Animation Video and much more.
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Medicines safety: NHS online learning index
Claire Cox posted an article in Medication including labelling
This alphabetical index helps NHS staff with an interest in the safe use of medicines to quickly find e-learning or videos that have already been produced by the NHS, government agencies, or professional bodies. -
Content ArticleIt is hypothesized that 90% of antibiotic allergies documented in patients’ health records are not actual, potentially life threatening, type I allergies. This distinction is important because such documentation increases antibiotic resistance, as more second-choice and broad-spectrum antibiotics are then used. Evidence is lacking regarding causes of this inappropriate documentation. To develop interventions aimed at improving documentation, the authors of this study, published in the Annals of Family Medicine, explored experiences of family physicians and pharmacists in this area. They found that the professionals involved perceived that antibiotic allergy documentation is seldom accurate, which may contribute to development of antibiotic resistance, increased costs, and decreased patient safety.
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Content ArticleThis Royal College of General Practitioners (RCGP) report calls on the four governments of the UK to each produce a comprehensive plan to support GPs in managing the longer-term effects of COVID-19 in the community.
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Mental Health inpatient discharge V2.1
Claire Cox posted an article in Transfers of care
People with mental health problems need good, joined up physical and mental health care, both in hospital and the community. Successful joined up care depends on GPs, community and acute mental health care teams and social care professionals all having access to timely information about a persons care and treatment. The Professional Records Standards Body (PRSB) has developed the mental health discharge summary standard to ensure that relevant information is shared, so professionals can provide continuity of care when an adult is discharged from mental health services. It includes information on patient history and social context, medications, the details of their hospital admission, as well as current and previous diagnoses. The mental health discharge summary will improve professional communication between the patient's secondary care providers to their GP. It is very important to recognise the different nature of mental illness to physical illness and disease including the different methods of treatments and imperative follow-up care after discharge. The language used in the headings and in the clinical descriptions has been modified, where necessary, to be more inclusive and sympathetic to the nature of mental illness and processes of care. This project supports the NHS Digital and NHS England interoperability work -
Content ArticleTeamworking is fundamental to the future of general practice. Practices are coming together at scale in primary care networks and new roles are being introduced, creating multidisciplinary and multi-agency teams. Making these teams function effectively is a complex task. This guide from The King's Fund brings together insights from their research, policy analysis and leadership practice. The need for collaboration and communication underpins much of the guide and it providex further reading and case studies to support each section. Some of the sections will be more relevant to you than others, but if you are a GP, practice manager or other professional working in primary care, or you are supporting practices, this guide will help you think how you will go about creating and sustaining effective teams within general practice.
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CQC case study: outstanding, safe care for all (May 2017)
Claire Cox posted an article in GP and primary care
Inclusion Healthcare, a social enterprise, provides primary medical services for homeless people in Leicester. It was rated outstanding following its CQC inspection in November 2014. CQC inspectors found strong leadership at its heart and a positive culture that ensures patient safety is paramount. In this short film, we hear from service users and staff and find out how they are promoting patient safety. -
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Seeking treatment for an eating disorder: GP leaflet
Patient Safety Learning posted an article in Eating disorders
This leaflet has guidance for the person who has or may have an eating disorder, anyone supporting them, and their GP. It’s based on the guideline on eating disorders from the National Institute for Health and Care Excellence (NICE), which the GP should use when making decisions about patients’ healthcare. -
Content ArticlePrimary care services provide an entry point into the health system which directly impact's people well-being and their use of other health care resources. Patient safety has been recognised as an issue of global importance for the past 10 years. Unsafe primary and ambulatory care results in greater morbidity, higher healthcare usage and economic costs. According to data from World Health Organisation (WHO), the risk of a patient dying from preventable medical accident while receiving health care is 1 in 300, which is much higher than risk of dying while travelling in an airplane. Unsafe medication practices and inaccurate and delayed diagnosis are the most common causes of patient harm which affects millions of patients globally. However, majority of the work has been focussed on hospital care and there is very less understanding of what can be done to improve patient safety in primary care. Provision of safe primary care is priority as every day millions of people use primary care services across the world. This paper, published in The Journal of Family Medicine and Primary Care, focuses on various aspects of patient safety, especially in the primary care settings and also provides some potential solutions in order to reduce patient harm as much as possible. Some important challenges regarding patient safety in India are also highlighted.
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Content ArticleReferrals to hospital are increasing as more people continue to live longer with a range of complex conditions. The Professional Records Standards Body (PRSB) recognise that good information sharing is integral to ensuring that patients can receive the ongoing care that they need. Currently there are differences between GP systems and GP practices in the clinical content of referrals, with multiple templates in use. The clinical referral information standard is designed to improve the exchange of referral information from GPs to hospital consultants and other health care professionals providing outpatient services.
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Royal College of General Practitioners: COVID-19 advice
Patient Safety Learning posted an article in Guidance
The Royal College of General Practitioners is closely monitoring the situation and developing practical resources and support for GPs and their teams. They have launched specific guidance for general practice, including out-of-hours. This will be updated as the situation develops but things are extremely fast moving so please make sure you are using the latest version.
