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Found 386 results
  1. News Article
    The performance of one of the NHS’s flagship strategies to reduce demand on over-stretched hospitals has collapsed, HSJ can reveal. Internal NHS figures show the number of processed advice and guidance requests (A&G) from GPs to hospital consultants fell by 28% between June and August, alongside a 32% fall in the number of processed cases where patients were diverted away from secondary care. This comes despite the overall number of A&G requests from GPs only falling by 5% in the same period. A&G services allow GPs to contact hospital consultants before making a referral in order to ensure only clinically appropriate patients are referred to secondary care. The model is described by NHS England as a ”a key part of the National Elective Care Recovery and Transformation Programme’s work.” The data showing the fall in processed requests and diversions from secondary care came from NHSE’s specialist advice activity dashboard, which HSJ has seen. Read full story (paywalled) Source: HSJ, 26 October 2023
  2. Content Article
    The Care Quality Commission (CQC) State of Care is an annual assessment of health care and social care in England. The report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve.
  3. News Article
    Britain’s top family doctor is calling for a “black alert” system to be introduced in general practice so that doctors can warn when surgeries are dangerously over capacity. It comes as a report reveals that almost half of GPs can no longer guarantee safe care for millions of patients, as a shortage of medics means they are unable to cope with soaring demand. Prof Kamila Hawthorne, the chair of the Royal College of General Practitioners (RCGP), which represents 54,000 family doctors across the UK, wants a patient safety alert system introduced that is modelled on the operational pressures escalation levels (Opel) warnings – known as “black alerts” – already used by hospitals. It would enable practices and GPs to flag unsafe levels of workload, triggering support from their local health system. GP surgeries would be able to temporarily suspend non-priority activities – including some regular health checkups, certain routine but mandatory staff training and non-urgent paperwork – during periods of excessive workload. This would allow surgeries to reprioritise routine and non-urgent activity and ensure patient safety is prioritised. Hawthorne said: “General practice is a safety-critical industry yet GPs have none of the mechanisms that other safety-critical professions, such as the air traffic industry, have in place to protect them. “Our number one priority is the safety of our patients, but GPs are doing more and more to try to meet the rising demand for our services. When you’re fatigued, you’re more likely to make mistakes and our survey shows that many GPs are no longer able to guarantee that the care they are providing to their patients is as safe as it could be.” Read full story Source: The Guardian, 17 October 2023
  4. News Article
    ChatGPT , the artificial intelligence tool, may be better than a doctor at following recognised treatment standards for depression, and without the gender or social class biases sometimes seen in the physician-patient relationship, a study suggests. The findings were published in Family Medicine and Community Health. The researchers said further work was needed to examine the risks and ethical issues arising from AI’s use. Globally, an estimated 5% of adults have depression, according to the World Health Organization. Many turn first to their GP for help. Recommended treatment should largely be guided by evidence-based clinical guidelines in line with the severity of the depression. ChatGPT has the potential to offer fast, objective, data-based insights that can supplement traditional diagnostic methods as well as providing confidentiality and anonymity, according to researchers from Israel and the UK. Read full story Source: The Guardian, 16 October 2023
  5. News Article
    The number of doctors seeking help for mental health issues has risen by more than three quarters within two years, according to figures from a specialist treatment service for NHS staff. For one GP, the relentless stress of the job led to him taking three months off work with burnout. David Triska is no stranger to high-pressure situations. As an army medic, he served two tours of Afghanistan. But mounting workloads at his village GP surgery left him feeling "hollowed out and spent". Simple tasks, like unlocking his car or making a meal, became a challenge - an experience he describes as leaving him feeling "like a husk of a human". "At that extreme point, I couldn't see why I needed to be here anymore," Dr Triska said. He is not alone. Since the year ending March 2021, there has been a 77% rise in the number of doctors seeking help for mental health issues, according to figures shared with the BBC by a confidential support service for NHS staff. More than 5,600 doctors used the NHS Practitioner Health programme in England in 2022/23, with about a third having thought about taking their own lives. Read full story Source: BBC News, 5 October 2023
  6. News Article
    Doctors missed a man’s stroke which led him to suffer another one and go temporarily blind. The man said that the experience had changed him from ‘an outgoing social person, to a sheltered man living in fear that he is not being looked after competently’. The 75-year-old visited his GP in Darlington complaining of dizziness, light-headedness, and a numb foot. He had experienced a stroke and should have been immediately sent to hospital. But doctors missed the signs, diagnosed him with a ‘dropped foot’ and requested an urgent MRI scan. However, due to an administrative error the referral wasn’t made and the scan never happened. A month after visiting the GP, the man suffered a blinding headache and diminished vision. He saw an ophthalmologist who referred him to a specialist team. He had suffered another stroke. He also paid for a private scan which confirmed the first stroke happened a month earlier. Distressingly, the man lost vision in his right eye, which he was told could be permanent. Fortunately, his sight returned eight weeks later. His daughter, who described the experience as ‘horrendous’, complained to the Parliamentary and Health Service Ombudsman (PHSO) about her father’s care. The PHSO found that the initial symptoms were signs of a problem with nerve, spinal cord, or brain function. Doctors should have suspected a stroke and immediately sent him to hospital. If that had happened, the second stroke and sight loss would likely have been avoided. Ombudsman Rob Behrens said: “Having a stroke and then being told you could be permanently blind must have been incredibly frightening. The impact on the man, and his family who supported him through the ordeal, will have been deep and long-lasting. “Mistakes like these need to be recognised and acted upon so that they are not repeated.” Read full press release Read case file Source: PHSO, 4 October 2023
  7. News Article
    Prescribers should not start any new patients on some ADHD medicines because of a national shortage, the Department for Health and Social Care has warned. GPs are also being asked to identify and contact all patients currently prescribed the medicines to ensure they have supplies to last. A national patient safety alert said there were ‘supply disruptions’ of various strengths of methylphenidate, lisdexamfetamine and guanfacine. It follows a previous alert about shortages of atomoxetine capsules in August which is set to resolve next month, DHSC said. The shortages are due to a combination of manufacturing issues and an increased global demand, the alert explained. With the latest issues expected to continue to December for some medicines, new patients should not be started on the products affected by shortages until the supply issue resolves, the guidance sent to healthcare professionals said. Where patients do not have enough to last until the re-supply date – which differs depending on the medicine in question – GPs are being asked to contact pharmacies to find out about stocks and reach out to the patient’s specialist team for advice if a product cannot be sourced. Read full story Source: Pulse, 28 September 2023
  8. Content Article
    There are supply disruptions affecting various strengths of the following medications which are licensed for the treatment of attention deficit hyperactivity disorder (ADHD): methylphenidate (Equasym® XL) capsules, methylphenidate (Xaggitin XL® , Concerta XL® , Xenidate XL® ) prolonged-release tablets, lisdexamfetamine (Elvanse® ) capsules, and guanfacine (Intuniv® ) prolonged-release tablets. This is a safety critical and complex National Patient Safety Alert. Implementation should be co-ordinated by an executive lead (or equivalent role in organisations without executive boards) and supported by clinical leaders in pharmacy, community pharmacy, GP practices, mental health services and those working in the health and justice sector.
  9. News Article
    The NHS has to train two GPs to produce one full-time family doctor because so many have started to work part-time, new research reveals. The finding helps explain why GP surgeries are still struggling to give patients appointments as quickly as they would like, despite growing numbers of doctors training to become a GP. The disclosure is contained in a report by the Nuffield Trust health thinktank that lays bare the large number of nurses, midwives and doctors who quit during their training or early in their careers. “These high dropout rates are in nobody’s interest,” said Dr Billy Palmer, a senior fellow at the thinktank and co-author of the report. “They’re wasteful for the taxpayer, often distressing for the students and staff who leave, stressful for the staff left behind, and ultimately erode the NHS’s ability to deliver safe and high-quality care.” Read full story Source: The Guardian, 28 September 2023
  10. News Article
    The BMA’s GP Committee (GPC) has demanded an investigation into the Government and NHS England’s ‘mismanagement’ of this year’s vaccination programmes. A motion was passed at the GPC England meeting today which called for a review of the ‘circumstances which led to muddled and mismanaged communications’ and for reflection on how to ‘prevent a repeat occurrence’. Last month, there was confusion over the start date for the adult flu and Covid vaccination programmes, which usually start in September. NHS England said the programmes would start in October this year – a move which the BMA said would cause ‘serious disruption’. But the Government then announced that vaccination will begin on 11 September, in what the BMA has called a ‘u-turn’, following the identification of a new Covid variant. GPs were asked to vaccinate ‘as many people as possible’ by the end of October. The GPC has said today that these ‘conflicting instructions’ led to confusion among GPs while also impacting on patient safety. Read full story Source: Pulse, 21 September 2023
  11. News Article
    National leaders are looking to greatly reduce the number of direct hospital referrals made by GPs, by insisting that they first discuss cases with hospital consultants. The approach – known as “advice and guidance” or “A&G” – involves GPs sending a patient’s details to a consultant who specialises in their condition before making a referral. The consultant then advises on the best course of action. “A&G’ has been voluntarily adopted by many health systems, but HSJ has now learnt that a move to significantly increase its use of it is being discussed as part of a new national strategy for outpatient services, due to be published by December. Theresa Barnes, outpatients lead at the Royal College of Physicians, is part of a group of clinicians helping to develop the strategy in partnership with NHS England, and said there is a case for A&G to be used “in preference” to direct referrals in a vast number of cases where it is clinically appropriate. She told HSJ: “I think there should be a push to use advice and guidance in preference to direct referrals, so we can maximise that pre-referral interaction and deliver as much care as close to patients’ homes as they can get it and without the delay of potentially waiting for a secondary care appointment.” Read full story (paywalled) Source: HSJ, 20 September 2023
  12. Content Article
    Even those at the top admit the NHS can’t do what is being asked of it today. But it is far from unsalvageable – we just need serious politicians who will commit to funding it, writes Gavin Francis, who shares his experience as a GP in this Guardian long read.
  13. Content Article
    When the Covid-19 pandemic started, video consulting became standard practice for many GPs, who became rapidly acquainted with the technology for video calls. Doctors worked on improving their video consulting technique, not knowing for how long they might have to limit in-person consultations. Now that vaccination has reduced the risks of face-to-face appointments, the vast majority of GP practices rarely use video consultation, and fewer than 1% of consultations were conducted this way in England in May 2023. In this BMJ article, GP Helen Salisbury looks at the reasons for this decline in the use of video calls, arguing that face-to-face consults allow for a more accurate and safe diagnostic process and facilitate building rapport between healthcare professionals and patients.
  14. Content Article
    Many patients struggle to book a GP appointment in England. Once people have been successful in getting a booking to see their doctor, however, how long are they having to wait for their appointment? Charlotte Paddison looks at the latest data to reveal the answer – and argues that quick access to GP appointments is not the only factor to consider.
  15. News Article
    The Government has decided to cut the fee GPs are paid per Covid vaccination by a quarter, prompting BMA to issue a patient safety warning. NHS England has published the new enhanced service specification for Covid vaccines to be delivered between 1 September and 31 March next year, setting out that GPs will be paid £7.54 for each vaccine administered – down from £10.06 – and continue to be paid £10 for each housebound patient. The fee had already been reduced from £12.58 last year, when the BMA advised GPs to review whether they were still able to fulfil the ES commitments. The new specification said that practices with ‘sufficient workforce capacity so as not to impact the delivery of essential services and appropriately trained and experienced staff’ must indicate their willingness to participate in the programme before 5pm on 29 August. The Item of Service fee for flu remains £10.06 of each vaccine delivered, according to the new specification published last week. But the BMA said that that NHS England’s decision to reduce the Covid fee ‘undervalues general practice and threatens the safety of vulnerable patients’. Read the full article here: https://www.pulsetoday.co.uk/news/clinical-areas/respiratory/25-cut-to-covid-vaccine-ios-threat-to-patient-safety-bma-warns/
  16. News Article
    GP practices in England will be able to order a host of checks directly to help speed up the diagnosis of a range of heart and respiratory conditions. Traditionally GPs refer to specialists when conditions like heart failure and lung problems are suspected. But the ability to direct refer, which was rolled out for cancer last year, is now being extended. GPs welcomed the move, but questioned whether there was sufficient testing capacity to cope. Royal College of GPs chair Prof Kamila Hawthorne said: "Any initiative to accelerate the process by which patients can be diagnosed and begin to receive any necessary treatment should be seen as positive." She said GPs had "long been calling" for better access to diagnostic tests. But she added: "For this initiative to be successful, it is vital that diagnostic capacity - both in terms of testing and people to conduct and interpret tests - is sufficient." Read full story Source: BBC News, 3 August 2023
  17. News Article
    Patients in all but one integrated care system found it more difficult to contact their GP practice by phone this year compared to last year. GP patient survey data, published this month, showed the proportion of patients who found it “very” or “fairly easy” to get through by phone had fallen across almost every ICS by as much as seven percentage points. The measure fell nationally from 53 to 50%. The drop in performance comes as NHS England and the government ramp up focus on ease and speed of access to GPs as part of the primary care recovery plan, published in May. An NHSE spokesperson said: ”Despite GP teams experiencing record demand for their services, with half a million more appointments delivered every week compared to before the pandemic, the GP survey found that the majority of patients have a good overall experience at their GP practice. “However, the NHS recognises more action is needed to improve access for patients, which is why it published a recovery plan in May.” Read full story (paywalled) Source: HSJ, 31 July 2023
  18. News Article
    The Government has rejected several policy proposals to promote “continuity of care” in general practice which were put forward by Jeremy Hunt. The now chancellor championed significant policy changes to strengthen the link between patients and an individual, named GP, when he was Commons health and social care committee chair. However, the government’s response to the report rejects several of the key proposals. The committee under Jeremy Hunt said “NHS England should champion the personal list model” – under which each patient is linked to a particular GP – “rather than dismiss it as unachievable”. The Department of Health and Social Care response said: “The department does not accept this recommendation. We agree that continuity of care is important within general practice but do not agree that requiring a return to the personal list model is the correct approach. Government also rejected recommendations from Mr Hunt’s committee to introduce a new national measure to track continuity of care by practice; and to fund primary care networks to appoint a GP “continuity lead” for a session a week. Read full story (paywalled) Source: HSJ, 24 July 2023
  19. Content Article
    The Health and Social Care Select Committee report on the future of general practice examined the pressure currently facing general practice, highlighting the challenges being faced by general practice and provided clear recommendations to respond to them. This document sets out the Government’s reply to each of these recommendations.
  20. Content Article
    This toolkit summarises good practice for Integrated Care Boards (ICBs) and primary care commissioners and providers regarding the provision of primary care services for people seeking asylum who are living in initial and contingency accommodation. It aims to ensure equality in access to services and improved long-term health outcomes for residents in Home Office accommodation, minimising health inequalities and encouraging collaborative working with accommodation providers and other local stakeholders.
  21. News Article
    GP trainers are more at risk of burnout than the average for all specialties, according to the GMC’s annual training survey results. The survey of over 70,000 doctors who are trainees or trainers found that 15% of GP trainers are at high risk of burnout, which is higher than the average of 12% and ranked second only to emergency medicine at 24%. The results also showed that 24% of GP trainers said that every working hour is tiring for them, compared to 11% of public health trainers. Last month, GP leaders raised concerns about how trainers and experienced GPs will handle the long-term workforce plan’s expansion of training places, especially given the existing pressures and lack of retention measures. Read full story Source: Pulse, 11 July 2023
  22. Content Article
    In this guide you’ll read real complaints made against GPs when a patient’s expectations differ from their experience.  The Medical Defence Union has created this collection of case studies detailing in each case the complaint, the advice given and the outcomes, in order to demonstrate the support available to GPs in these extremely challenging situations. You will need to submit your details below to download the guide containing the case studies. 
  23. News Article
    GPs should offer all patients presenting with signs of colorectal cancer a faecal immunochemical test (FIT) to reduce the waiting times for a colonoscopy, the National Institute for Health and Care Excellence (NICE) has recommended in draft guidance. The current NICE recommendation is to offer FIT to people presenting to primary care with low risk symptoms suggestive of colorectal cancer, while people with high risk symptoms should be immediately referred to the suspected cancer pathway. However, patients often have lengthy waiting times for colonoscopy because of limited capacity. NICE estimates that the recommendation should lead to 50% fewer referrals for urgent colonoscopies being made by GPs each year. Read full story (paywalled) Source: BMJ, 5 July 2023
  24. News Article
    The Government is consulting on a draft code of practice which will ensure health and care staff, including GPs, receive training on learning disabilities and autism ‘appropriate to their role’. Since July last year, all CQC-registered health and social care providers including GP practices in England have been required to provide training for their staff in learning disability and autism, including how to interact with autistic people and people who have a learning disability. The legal requirement was introduced by the Health and Care Act 2022, but the Government has now launched a consultation on the Oliver McGowan Code of Practice, which outlines how providers can meet the new requirement. The BMA’s GP Committee last month said that the Act does not specify a training package or course for staff and that the CQC ‘cannot tell practices specifically how to meet their legal requirements in relation to training’. The Government’s draft code says that CQC-registered providers must ensure that all staff, regardless of role or level of seniority, have ‘the right attitude and skills to support people with a learning disability and autistic people’ and will need to demonstrate to the CQC how their training meets or exceeds the standards set out in the code. Read full story Source: Pulse, 29 June 2023
  25. News Article
    GP services "will collapse in Wales and the NHS will follow" soon after unless urgent support is provided, the British Medical Association (BMA) has warned. As patient levels rise, numbers of GP surgeries and doctors are falling amid inadequate resources and unsustainable workloads, BMA Cymru Wales has claimed. It has written to the Welsh government, urging more funding and staff help. The Welsh government said it was acting to cut pressure on GPs and increasing services by community pharmacists. Launching its Save Our Surgeries campaign, the BMA said the number of GP practices in Wales had decreased by 18% in the past decade from 470 to 386. Read full story Source: BBC News, 28 June 2023
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