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Found 386 results
  1. News Article
    Patients who feel fortunate to get a doctor's appointment then find they are in and out of the GP surgery in less than five minutes. A fifth of the consultations in England last year were done within that time. Dennis Reed, of the Silver Voices campaign group for over-60s, said: "It is hard enough to get a face-to-face appointment with a GP these days, without being shown the door before you have had a chance to take your coat off. "The public wants the family doctor back, who knows your family history and has the time to chat about your general health and wellbeing. "A revolving door policy, with the patient exiting after a couple of minutes clutching a prescription, is not the way to run a primary care service." Research from the House of Commons Library, commissioned by the Lib Dems, found 22% of GP appointments between January to October 2023 lasted five minutes or less. Lib Dem MP Wera Hobhouse said: "Seeing a GP is the most vital contact for people to address their health concerns, seek help and start treatment. "Not having quick and easy access to a GP and not having sufficient time for patients during an appointment leads to huge problems later on, let alone the anxiety and additional pain people suffer because of delays." Read full story Source: The Express, 31 December 2023
  2. News Article
    An alarming number of Britons are turning into “DIY doctors” because of the struggle to get an NHS GP appointment in 2023, new polling has revealed. Some 23% of those surveyed said they could not get an appointment, while three in 10 (33 per cent) said they had given up on booking one altogether, according to a Savanta poll commissioned by the Liberal Democrats. Many said they had resorted to “DIY” medical care or gone to A&E instead. One in seven (14 per cent) said they had been forced to treat themselves or ask someone else untrained to do so, with the same proportion seeking emergency care. One in five people said they had bought medication online or at a pharmacy without advice from a GP, and one in three had delayed seeing a doctor despite being in pain, as pressure on the NHS mounts. Liberal Democrat leader Sir Ed Davey described the figures as “utterly depressing” and said they should serve as an “urgent wake-up call for ministers asleep on the job”. Read full story Source: The Independent, 1 January 2024
  3. News Article
    Mothers in England will be asked in detail if pregnancy or giving birth has affected their mental health as a result of new NHS guidance to GPs. The move is part of a drive by NHS England to improve support for women suffering postnatal depression or other mental health problems linked to their pregnancy or childbirth. Under the new guidance GPs will ask women more questions than before about how they are feeling when they attend their postnatal health check six to eight weeks after giving birth. Family doctors will look for any sign that the woman may have a condition such as postnatal PTSD as a result of experiencing a traumatic birth or psychosis induced by bearing a child. Anyone who the GP feels needs help with their mental wellbeing will be referred to specialist maternal mental health services, which have been expanded in recent years. Read full story Source: The Guardian, 18 December 2023
  4. News Article
    GP practices with the most outdated technology and processes do not have enough staff or funding to take part in NHS England’s performance recovery programme, integrated care boards are warning. In new recovery plans which they were required to publish by NHSE, multiple ICBs have said that stretched capacity means hardly any practices have signed up to the “general practice improvement programme”, which is meant to help them implement the national primary care access recovery plan. The ICBs pointed out that the programme is time consuming, and practices which take part are not always given funding to pay for staff time. HSJ has reviewed the primary care recovery plans which all ICBs were required to bring to their board meetings in October and November, to explain how they were implementing the national plan published by NHSE in the spring. NHSE’s plan sought to improve ease and speed of access through spreading “modern” methods and processes; as well as measures to save clinicians’ time, improving same-day access, and delivering more appointments. But HSJ’s review of the ICB plans found several warning that their uptake of the improvement plan was off track, especially for “intermediate” and “intensive” support, which require substantial time for the practices, and are likely to be required by those most in need of help. Read full story (paywalled) Source: HSJ, 12 December 2023
  5. Content Article
    In this blog, Dr Nadeem Moghal looks at the recent case of a 30 year-old patient who died after a physician associate (PA) at her GP surgery failed to diagnose her with a pulmonary embolism. He outlines a recent debate about the role of PAs in general practice and why employing them has become an attractive option for GP partnerships, which run as businesses. He highlights the need for PAs to be adequately trained and supervised to ensure patient safety and argues that the role is here to stay as PAs play an important role in tackling gaps in the NHS workforce.
  6. News Article
    GPs have warned that the extent of verbal abuse directed at them and their practice staff ‘is increasing’, with the majority reporting that things are worse now than during the height of the Covid pandemic. A UK-wide survey of more than 2,000 doctors – of which 617 were GPs – found that 85% of GPs have reported receiving verbal abuse from patients within the last 12 months. The research conducted by Medical and Dental Defence Union of Scotland (MDDUS) also found that 15% of GPs reporting verbal abuse said they ‘had to resort to involving the police’ to deal with abusive patient situations over the past year. In the survey, GPs identified key triggers such as ‘lack of access to a face-to-face consultation’ and ‘complaints about their quality of care’ as the factors that could escalate to verbal abuse. One GP who responded to the survey said: "During a consultation with a young adult, they got very irate and demanded I just give them what they came for. "I explained they had to calm down and we would only proceed then at which they called me an ugly, fat, c**t and threatened to smash my face in. That consultation stayed with me for quite a while after that." Another said: ‘A patient smashed the surgery front door (it needed replacing) because he didn’t get what he wanted when he wanted it. "This was very scary for staff and other patients and the police didn’t even come until the next day. I felt alone, defensive and wondered why we bother to try to provide a service when some patients have already decided it isn’t good enough for them." Read full story Source: Pulse, 7 December 2023
  7. Content Article
    In this episode of the Medicine and the Machine podcast, Scottish GP Gavin Francis talks about the need to reconsider the importance of convalescence. He discusses the role of GPs in supporting patients through recovery after a hospital admission or period of illness and talks about a lack of awareness of the principles of convalescence amongst patients.
  8. Content Article
    Physician associates (PAs) support doctors in the diagnosis and management of patient. They are often employed in general practice as members of the multidisciplinary team, trained in the medical model. This update outlines the Royal College of General Practitioners' (RCGP's) policy position on PAs. The RCGP sees PAs as having an enabling role to play for general practice, but highlights that they must always work under the supervision of GPs and must be considered additional members of the team, rather than a substitute for GPs.
  9. News Article
    There will be no national mandate for GPs to use advice and guidance in a certain number of cases, NHS England has told Pulse. National medical directors for primary and secondary care said that formalised pathways should be developed ‘locally’, and decisions should be based on an area’s population. In September, it was reported that NHS England’s upcoming outpatients strategy would further increase the use of advice and guidance (A&G) before GP referrals are accepted, with the RCGP then "voicing concerns" about this proposal. However, when asked about the reports that this would be mandated, Dr Stella Vig, national medical director for secondary care and clinical director for elective care, said she ‘doesn’t know’ where that came from, and ‘doesn’t recognise’ those comments. NHS England also released guidance clarifying the medico-legal risks and clinical responsibility for clinicians using A&G or referral assessment services (RAS), which is now available on the NHS Futures website. The guidance said that these forms of specialist advice are "expanding rapidly" as a result of improvements to digital services. On legal issues, it said liability ‘will be determined on a case by case basis’ but that GPs could be liable if "all relevant clinical information is not provided" when sending an A&G request. But specialists at hospitals would be accountable if they send back advice to the GP which is ‘not clinically appropriate’ or if they ‘refuse to accept a patient’. On turnaround times, NHS England has said that ‘local variables will ultimately dictate the agreed response times’ for hospital teams dealing with A&G – but the guidance recommends that the response time "should not exceed 10 working days for routine requests". Read full story Source: Pulse, 30 November 2023
  10. News Article
    Patients are at risk of having serious health conditions missed because of the lack of continuity of care provided by GPs, the NHS safety watchdog says. Investigators highlighted the case of Brian who was seen by eight different GPs before his cancer was spotted as an example of what can go wrong. Brian had a history of breast cancer and had been discharged from the breast cancer service. Two years later he began to have back pain. Over the following eight months, he saw two out-of-hours GPs and six GPs based at his local practices as well as a physio and GP nurse, before he was sent for a hospital check-up in late 2020. A secondary cancer had developed on Brian's spine, but it was too late to offer him curative treatment and he was given end-of-life care. He has since died. The watchdog said the lack of continuity of care resulted in the diagnosis of Brian's cancer being missed. One of the key problems was that the different GPs he saw missed the fact he was attending repeatedly for the same issue. Senior investigator Neil Alexander said Brian's case was a "stark example" of what can happen when there is a breakdown in continuity of care. "He told our team 'when I am gone, no-one else should have to go through what I did'." Read full story Source: BBC News, 30 November 2023
  11. Content Article
    Patients who visit their GP practice with an ongoing health problem may see several different GPs about the same symptoms. To make sure they receive safe and efficient care, there needs to be a system in place to ensure continuity of care. In the context of this report, continuity of care is where a patient has an ongoing relationship with a specific doctor, or when information is managed in a way that allows any doctor to care for a patient. While some GP practices in England operate a formalised system of continuity of care, many do not. This investigation explored the safety risk associated with the lack of a system of continuity of care within GP practices. The investigation focused on: How GP practices manage continuity of care. This includes how electronic record systems alert GPs to repeat attendances for symptoms that are not resolving and how information is shared across the healthcare system. Workload pressures that affect the ability of GP practices to deliver continuity of care. This investigation’s findings, safety recommendations and safety observations aim to prevent the delayed diagnosis of serious health conditions caused by a lack of continuity of care and to improve care for patients across the NHS.
  12. News Article
    GP appointments over the phone or online risk harming patients, a new study published in the BMJ has found. An analysis of remote NHS doctor consultations between 2020 and 2023 found that “deaths and serious harms” had occurred because of wrong or missed diagnoses and delayed referrals. Distracted receptionists were also found to be responsible for deaths after they failed to call patients back. The report, led by the University of Oxford, suggested doctors should stop giving phone appointments to the elderly, people who are deaf, or technophobes. As many as a third of GP appointments are now virtual after face-to-face appointments slumped to less than half during the pandemic. Restoring access to face-to-face appointments has been a priority of multiple health secretaries, with Steve Barclay last year promising to name and shame GPs who did not see patients in person. Patient groups said the study was likely to be “just the tip of the iceberg” given the “potential for tragic misdiagnoses because of the limitations of online or telephone consultations”. Read full story (paywalled) Source: The Telegraph, 29 November 2023
  13. Content Article
    Triage and clinical consultations increasingly occur remotely. In this study, published in BMJ Quality & Safety, Payne et al. aimed to learn why safety incidents occur in remote encounters and how to prevent them. They found that rare safety incidents (involving death or serious harm) in remote encounters can be traced back to various clinical, communicative, technical and logistical causes. Telephone and video encounters in general practice are occurring in a high-risk (extremely busy and sometimes understaffed) context in which remote workflows may not be optimised. Front-line staff use creativity and judgement to help make care safer. As remote modalities become mainstreamed in primary care, staff should be trained in the upstream causes of safety incidents and how they can be mitigated. The subtle and creative ways in which front-line staff already contribute to safety culture should be recognised and supported.
  14. News Article
    NHS England has taken the unusual move of warning multiple GP practices they are breaching their contract by refusing to give people automatic access to future entries in their record. Under the current national GP contract, practices were ordered to give people on their list automatic access to prospective (future) medical records, via the NHS App, by 31 October. However, the British Medical Association GP committee has urged GPs to instead adopt an “opt in” model, saying it is concerned that giving automatic access could endanger some people. The BMA gave practices a template letter to use to tell their integrated care boards they cannot move ahead with automatic access “due to several risks that cannot be sufficiently mitigated”. NHS England’s own template letter for ICBs to use in response, seen by HSJ, states: “Based on your letter we interpret that the required changes were not implemented by 31 October 2023, thereby putting you in breach of your contractual obligations. We would therefore like to discuss with you your plan, including the timeline to become compliant.” It is an unusual warning from NHSE which could potentially apply to hundreds or thousands of practices. Read full story (paywalled) Source: HSJ, 16 November 2023
  15. Content Article
    On Nov 7 2023, NHS Resolution’s Safety and Learning team, hosted a virtual forum on learning from venous thromboembolism (VTE) claims in primary care. The purpose was to raise awareness of the cost and scale of harm, discuss the challenges and recommendations around recognition and treatment of VTE in general practice. We heard from a range of experts in the field with experience in developing and spreading best practice.
  16. News Article
    Community clinics credited with easing pressure on A&E and GP practices nationally last winter have not yet been funded for this year, and many may not be able to open, HSJ has learned. Several local and regional sources said they were concerned no funding had been announced for acute respiratory hubs, despite respiratory illness already starting to rise. Last year national funding was announced in December and – despite the late notice – NHS England collected evidence showing that, once they were opened, ARI hubs reduced acute respiratory infection attendances by up to two-thirds, and released GP appointments. The hubs, normally held at community clinics, offer urgent same-day appointments for those with suspected ARI problems to patients referred in by other services. David Bramley, deputy director in NHSE’s NHS@Home team, said on a webinar on Tuesday: “This year, perhaps unsurprisingly, we are seeing ARI rates beginning to climb… but we’re also not expecting any additional funding for ARI hubs this year.” Read full story (paywalled) Source: HSJ, 10 November 2023
  17. News Article
    One in 10 people attempting to contact their GP practice do not manage to get in contact, while a further 6% are only told to try again another day, according to new official survey findings commissioned by the government. The Office for National Statistics has been quietly carrying out the new regular GP access survey since the spring after ministers said they wanted to monitor the impact of their primary care recovery plan. After a sign of slight improvement in the summer, the latest survey results – for October – show no significant change since May. It also found, as did previous rounds, that of those who had tried to contact a GP practice in the past month, 10 per cent said they could not do so (see chart below, ‘Contact with GP practice’). Of those who did make contact, a further 6 per cent reported they were told to try again another day (see chart below, ‘Next step after contact’). The government and NHS England have made it a high priority in recovery plans that patients should no longer be asked to call back another day to book an appointment and should know “on the day” how their request will be managed, which may mean being advised to use a different service. Read full story (paywalled) Source: HSJ, 9 November 2023
  18. News Article
    The BMA’s GP committee for England (GPC England) has called for an immediate pause in the recruitment of physician associates (PAs) in general practice. In an emergency motion passed on 2 November the committee expressed “concerns over the increasing trend of PAs being used to substitute GPs” and called on practices and primary care networks to stop PA recruitment “until appropriately safe regulatory processes and structures are in place.” GPs and GP registrars were also reminded that they can refuse to sign prescriptions and turn down requests for investigations made by PAs. Read full story (paywalled) Source: BMJ, 3 November 2023
  19. Content Article
    Recently, in the wake of growing unrest, plummeting morale, and industrial action, doctors have created an increasingly hostile narrative towards physician associates (PAs) on social media and raised repeated concerns about their impact on patient safety and training opportunities. In this BMJ opinion piece, David Oliver looks at the recent history to understand how we got here and discusses why we need a mature debate about these matters otherwise interprofessional solidarity and multidisciplinary team working could be harmed by the degree of vitriol and resentment.
  20. Content Article
    UKCVFamily was set up in November 2021 to support patients in the UK who have had an adverse reaction to a Covid-19 vaccination. The group provides help and advocacy as well as raising awareness amongst healthcare professionals, the media and the Government. In this video, founder of UKCVFamily Charlet Crichton talks to us about why she established the group and describes the support it offers to patients. She outlines some of the issues people face when trying to access diagnosis and treatment, and discusses the limitations of the MHRA's Yellow Card scheme in collecting data about adverse reactions. She also describes how healthcare professionals can support people with adverse reactions by taking their concerns seriously and investigating symptoms thoroughly.
  21. News Article
    Doctors are warning that patient safety is being put at risk as podiatrists and pharmacists replace GPs “on the cheap”. Dozens of family doctors have contacted The Telegraph claiming that talk of a GP shortage is “a big lie” and that they are being replaced by less qualified, cheaper staff, in a “crisis”. Documents seen by The Telegraph show staff including podiatrists, pharmacists and physician associates being used in lieu of GPs to diagnose and treat patients with conditions they are not trained in. In the most extreme cases, poorly children with viral infections, asthma-related issues and concerns about menstruation have been seen and diagnosed by a podiatrist – a healthcare professional trained exclusively to care for feet. It is not clear what happened to any of the patients afterwards, or if their parents were aware they had seen a podiatrist rather than a doctor. One GP said it was “a matter of patient safety” and the notion of “everything being supervised” did not work at a GP practice like it does in hospitals. Read full story (paywalled) Source: The Telegraph, 4 November 2023
  22. News Article
    Millions of patients will be handed the power to view their own medical records and test results online after the NHS overruled opposition from the doctors’ union. From 1 November every GP surgery in England will be contractually obliged to give all patients over the age of 16 access to their health information on their phones. It means patients will no longer have to ring up their surgery or book a GP appointment to get details of blood test results, medications and repeat prescriptions, but instead they can access them by logging in to the NHS app. The British Medical Association (BMA) had threatened to go to court over the plans, arguing that granting people access to their records would add to GP workloads and could put patients at risk. However, Jacob Lant, the chief executive of the charity umbrella group National Voices, said: “Ensuring everyone has access to their own medical records through the NHS app is an important step in building a more equal partnership between patients and clinicians. “It gives people much easier access to the information they need to prepare for appointments, and having quick access to test results can help patients manage their conditions better. Using technology in this way has the potential to help millions, and free up capacity of staff to help those who are less able to make use of digital services.” Read full story (paywalled) Source: The Times, 31 October 2023
  23. Content Article
    Medicines talk is a website hosting a collection of stories to inspire new avenues for discussion between healthcare professionals and their patients about their medicines and care. Story 1: Life is meant for laughing Story 2: What is it all for? Story 3: 'Keeping going': Are my medicines a help or a hindrance? Story 4: I look after myself Story 5: Is there anything we can stop today? Story 6: A glimpse of the future? Story 7: Polluting the planet The stories were co-authored by Professor Deborah Swinglehurst and Dr Nina Fudge, based on research conducted between 2016 and 2021 at Queen Mary University of London (QMUL). The researchers studied 24 people aged 65 or older who had been prescribed ten or more different items of regular medication, through home visits, interviews and attending appointments for up to two years. They also observed and spoke with health professionals in three general practices and four community pharmacies.
  24. Content Article
    This guide is a self assessment tool to enable Primary Care to become dementia friendly. It includes a checklist for GP practices to help people with dementia and their carers access high quality care and support. People with dementia, carers and staff in GP practices have worked together to co-design and develop this guide. It outlines the benefits for general practice in becoming dementia friendly and includes checklists covering: General practice systems General practice culture Patient diagnosis, care and support Physical environment This guide is adapted from the Alzheimer’s Society’s Guide to Making General Practice Dementia Friendly.
  25. News Article
    Soaring use of private healthcare for tests and treatments is piling pressure on overstretched GP surgeries, with family doctors warning that standard NHS care is being squeezed as a result. Record numbers of people are paying for private healthcare, with some having procedures such as cataract surgery and hip replacements, amid mounting frustration at NHS hospital waiting lists. Others are opting for private health checks, genetic testing or cosmetic surgery such as liposuction. But the surge in private healthcare use is increasing the workload of GPs, many of whom say they are increasingly having to interpret questionable health checks done privately, organise blood tests or scans and manage additional administration related to private care. Some say more of their hours are being taking up providing follow-up appointments after patients paid for treatment or surgery abroad. Read full story Source: Guardian, 29 October 2023
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