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Found 386 results
  1. News Article
    It is ‘not right to normalise’ the current workload in general practice as numbers of GPs and practices goes down, the RCGP chair told delegates at Pulse Live this week. Professor Kamila Hawthorne highlighted the pressure GPs are under with general practice appointments increasing most last year, compared to A&E and outpatients. She also said her priority from a new GP contract would be better resourcing for GPs working in deprived areas. Her speech looked at the challenges facing general practice and imagined what the future could look like, including what the college can do to bring about change. Professor Hawthorne said: ‘The workload that we’re facing – it’s not right to normalise it. The sort of work days that we have in general practice, it is not right to normalise this. ‘The number of GPs is going down because they’re leaving the profession faster than they’re entering it. The number of practices in England is going down, and compared with affluent areas, GPs in deprived areas earn less but see more patients with more chronic illness.’ Read full story Source: Pulse, 21 March 2023
  2. News Article
    Young people with eating disorders are coming to harm and ending up in A&E because they are being denied care and forced to endure long waits for treatment, GPs have revealed. NHS eating disorders services are so overwhelmed by a post-Covid surge in problems such as anorexia that they are telling under-19s to rely on charities, their parents or self-help instead. The “truly shocking” findings about the help available to young people with often very fragile mental health emerged in a survey of 1,004 family doctors across the UK by the youth mental health charity stem4. The shortage of beds for children and young people with eating disorders is so serious that some are being sent hundreds of miles from home or ending up on adult psychiatric wards, GPs say. “The provision is awful and I worry my young patients may die,” one GP in the south-east of England told stem4. Another described the specialist NHS services available in their area as “virtually non-existent and not fit for purpose”. Read full story Source: The Guardian, 22 March 2023
  3. News Article
    GPs in the UK have some of the highest stress levels and lowest job satisfaction among family doctors, a 10-country survey has found. British GPs suffer from high levels of burnout, have a worse work/life balance and spend less time with patients during appointments than their peers in many other places. Heavy workloads, seemingly endless paperwork and feelings of emotional distress are prompting many GPs to stop seeing patients regularly or even retire altogether, the research found. Seven in 10 (71%) NHS family doctors find their job “extremely” or “very stressful”, the joint-highest number alongside GPs in Germany among the countries analysed. The Health Foundation, which undertook the survey, said its “grim” findings showed that the “unsustainable” pressures on GPs and number of them quitting pose a threat to the NHS’s future.
  4. Content Article
    GPs in the UK are under extreme strain and public satisfaction with general practice has plummeted. Pressures on general practice are not unique to the UK and GPs around the world are contending with the impact of the pandemic on their patients and working lives. The 2022 Commonwealth Fund survey compares perspectives from GPs across 10 high‑income countries. The survey asked GPs’ views about their working lives and wellbeing, quality of care and how services are delivered. The Health Foundation analysed the survey data to understand the experiences of GPs in the UK and how they compare to other countries.
  5. Content Article
    This report by the Royal College of General Practitioners (RCGP) sets out recommendations for the Government to tackle the workforce and workload crisis in general practice, and support GPs and their teams to meet the healthcare challenges of the 21st century. Based on a survey of more than 2,600 GPs and other practice team members from across the UK, the report provides a snapshot of what frontline staff have faced during one of the most difficult winters experienced in the NHS, and what they think needs to happen to make general practice more sustainable. Respondents describe a profession in crisis, with unmanageable workload and workforce pressures fuelling an exodus of fully qualified GPs.
  6. News Article
    Health Education England (HEE) has outlined a new vision for general practice training which it says will better prepare GPs for future models of care. The programme will have greater focus on areas such as addressing health inequalities and managing the growing proportion of patients with mental health care needs seen in general practice, HEE said. Innovative placements, perhaps with charities, third sector organisations and services such as CAHMS will be explored, the Training the Future GP report said. And it should include educational opportunities around improving cancer detection and referral, the report said, as well as training in the harms of overdiagnosis. Overall the goal is to move to a flexible model of training that meets the needs, skills and experiences of the trainee as well as the area they are working in. HEE said it would also continue to work to address issues of discrimination, prejudice, bias and specifically racism at individual, institutional and systemic levels, and to reduce differential attainment. It will include plans to ensure patients in deprived areas are able to access care, with the development of specific training offers on these issues and prioritising expansion of training capacity to areas in need. Read full story Source: Pulse, 17 March 2023
  7. News Article
    GPs are facing “insurmountable pressures”, experts have said as they warned that the NHS “will not survive” without general practice. A new report into GP pressures suggests one in four staff fear their practice is in danger of closing because of unmanageable workloads and rising demand. The document, from the Royal College of GPs (RCGP), says general practice is “in crisis”, and makes a series of calls to help ease pressures and stop the growing number of GPs from quitting. The report says GPs are bracing for “winter-style pressures” well into spring and summer. “The workload pressures in general practice over this winter have been immense, and high levels of patient demand are set to continue for some time,” the report authors wrote. “General practice is in crisis. We cannot rely on short-term emergency funding pots over winter to try and paper over the cracks." Read full story Source: The Independent, 10 March 2023
  8. Content Article
    Continuous glucose monitors (CGM) are devices that offer an alternative to finger stick blood glucose testing in adults and children with any type of diabetes. This practice guide in the BMJ offers guidance on CGM for primary care providers and aims to reduce uncertainty and improve prescribing rates of CGM.
  9. Event
    until
    Primary care services are the front door to the NHS – they are the first port of call when we feel unwell and the main coordinator of care when we are living with ill health. The primary care team have an important role in making people feel welcomed, listened to and taken seriously. At National Voices we often hear stories from groups of people who struggle to have their communication needs met within primary care. As just one example, five years after the launch of the Accessible Information Standard, 67 per cent of Deaf people reported that still no accessible method of contacting their GP has been made available to them (Signhealth, 2022). This issue also affects other groups with specific communication needs - people who don't speak English fluently, people with learning disabilities, autistic people, people with dementia, people with low or no literacy, people who are digitally excluded, people living nomadically, people experiencing homelessness and more. We know that these experiences happen within the context of a primary care team under exceptional pressures. This workshop will bring together people with lived experience from all the groups mentioned above, as well as voluntary sector organisations, members of the primary care workforce, primary care policy leads, as well as commissioners and providers to discuss the challenges and co-produce solutions. At the workshop, we hope to build and improve understanding of: The experiences of people with diverse communication needs within primary care. The barriers primary care teams experience in meeting diverse communication needs, especially under existing pressures. Practical ways that we can embed and improve inclusive communications within the primary care setting. Register for the webinar. If you have any questions, please contact aleyah.babb-benjamin@nationalvoices.org.uk
  10. News Article
    Demand for private GPs has soared as patients seek out face-to-face appointments with doctors at short notice. Spire Healthcare, one of the UK’s largest private healthcare providers, saw 32,000 GP appointments booked with it last year – up from 23,000 in 2021. The hospital company, which runs 125 GPs, said revenues from its private doctor appointments rose by 46% in 2022. It said demand was soaring as patients look for “fast access to longer face-to-face appointments with a GP”. On the surge in demand, Spire Healthcare boss Justin Ash told The Telegraph: “Clearly there is a well known problem of GPs being under pressure, the 8am scramble [for appointments] is a thing. People want to be able to book online and they want to be able to book at short notice.” Read full story Source: The Independent, 4 March 2023
  11. News Article
    Pharmacies do not have the capacity to absorb pressure from GPs unless it comes with additional funding, pharmacy leaders have warned. A new NHS England ad campaign, announced earlier this week, aims to redirect patients from GP practices to local pharmacies for minor conditions such as coughs, aches, cystitis and colds. But community pharmacy negotiating body PSNC has spoken out against the campaign calling it ‘deeply concerning’, ‘irresponsible, ‘extremely unhelpful’ and ‘irritating’. Malcom Harrison, chief executive of the Company Chemists’ Association (CCA) said: ‘Community pharmacies are often the best place for patient to go for help with minor health concerns. ‘However the current situation that many pharmacies find themselves, with a 30% cut in real term funding, the NHS recruiting their pharmacists and technicians to work in general practice and with the continuing increase in the number of medicines prescribed, will mean that there is now a very real risk that when patients visit a pharmacy, they will be faced by exhausted teams and longer than expected waiting times. ‘The NHS policy of moving asking patients to visit their local pharmacy does not address the problem of delays to access in primary care, it simply moves it from one pressurized location to another. The NHS must address the chronic underfunding of primary care, and of pharmacy in particular, if patients are to be able to access the care they need and should rightly expect.’ Read full story Source: Pulse, 28 February 2023
  12. Content Article
    Patients with Long Covid—defined by the National Institute for Health and Care Excellence (NICE) as signs and symptoms that persist for more than four weeks following acute Covid-19—may present in primary care with symptoms of palpitations (tachycardia) triggered by standing or minimal exertion. These may be accompanied by dizziness, breathlessness, chest pain, sweating, bloating, fatigue and other symptoms which may be caused by a dysfunction of the autonomic nervous system (dysautonomia). This practice pointer in the BMJ outlines: how tachycardia present in patients with Long Covid. what clinical assessment should involve. how to test for postural orthostatic tachycardia syndrome in primary care. drug and non-drug treatments that are available. what patients can do for themselves. when patients should be referred to a specialist.
  13. Event
    until
    More than 1,400 English GP practices, around one in five, offer patients access to their prospective medical records: that means patients can see new entries to their medical records such as tests results, appointment notes and hospital letters online and through the NHS App and certain other apps. This webinar aimed at patients explains more about NHS England's programme to enable patients to access their medical records via the NHS App. Hear from: Patients Association members Claude and Greta about what the benefits are to them of being able to access their health information digitally GP Dr Brian McMillan, a Senior Clinical Lecturer at the Centre for Primary Care and Health Services Research, University of Manchester, and a Registered Health Psychologist, whose research interests include how digital technology can improve patients' experiences of primary care Registered nurse Tristan Stanton who is Assistant Director of Programmes – Primary Care, at NHS England and leads the programme to give people access to their online health records. The Patients Association's Chief Executive, Rachel Power, will chair the webinar. Sign up for the webinar
  14. News Article
    A new report has condemned ‘serious issues’ with NHS referral processes, amid findings that one in five patient referrals made by GPs went into a ‘black hole’. Healthwatch England said that 21% of people they spoke to with a GP referral to another NHS service were rejected, not followed up on or sent back to general practice. The watchdog said that more support should be given to help GP and hospital teams to reduce the numbers of people returning to general practice due to ‘communication failures’ following a referral. According to the findings, the failures were due to GP teams not sending referrals, referrals going missing between services, or being either booked or rejected by hospitals without any communication. Louise Ansari, Healthwatch England’s national director, said that thousands of people told the watchdog that the process is ‘far from straightforward.’ She said: "Falling into this “referrals black hole” is not just frustrating for patients but ultimately means people end up going back to their GP or visiting crowded A&E departments to get the help they need. "This adds more burden to already stretched services, making things even harder for the doctors and nurses trying to provide care." Read full story Source: Pulse, 20 February 2023
  15. Content Article
    GP services are the first point of call for many health issues and the gateway to NHS specialist support.  GP teams are highly skilled and may decide that treatment without specialist care is the best action. But when you need specialist support, such as hospital tests or treatment, you may need a referral from your GP team first. New research from Healthwatch highlights that it can be very hard for some people to get a GP referral to another NHS service. And for 21% of people we spoke to, even when they get referrals, they can be lost, rejected or not followed up on. When services don't process referrals properly, it can cause significant frustration, unnecessary anxiety, and even cause harm to patients.  It can also lead to increased demand for either more GP appointments or help from healthcare teams in other parts of the NHS, putting more pressure on already overstretched services.
  16. Content Article
    Dr Freya Smith, a Specialty Trainee in General Practice, reflects on the sinister and toxic side of medicine, using the recent Paterson and vaginal mesh scandals to demonstrate how patients have been let down by the system. In an honest and personal account, she shares with us the horror and sadness she felt at learning of these scandals and how she aspires to keep her future patients safe.
  17. News Article
    GPs are attempting to deal with up to 3,000 patients each, amid worsening staff shortages, according to new analysis commissioned by the Liberal Democrats. The research shows that the number of patients per GP has risen sharply, as rising numbers of doctors reduce their hours, or opt for early retirement. The figures, which track the number of “full-time equivalent” fully qualified GPs, show the number has fallen from 29,320 in 2016 to 27,372 last year. The trend follows a rise in part-time work, with the average GP now working a three-day week. On average, there are now 2,273 patients per fully qualified doctor, up from 1,981 in 2016, the research commissioned by the Liberal Democrats shows. While the total number of GPs fell by almost 2,000, the number of registered patients grew from 58 million to 62.2 million, according to the House of Commons Library. Professor Kamila Hawthorne, chairwoman of the Royal College of GPs, said the research “shows yet again how GPs and our teams are working above and beyond to deliver care to an ever-growing patient population, with falling numbers of fully qualified, full-time equivalent GPs.” Read full story (paywalled) Source: The Telegraph, 14 February 2023
  18. News Article
    GPs have raised concern about a new colorectal cancer pathway aimed at reducing referrals into one of England’s largest acute hospital trusts. The pathway was implemented in December 2022 to tackle long waiting lists at United Lincolnshire Hospitals Trust (ULHT) by reducing the number of referrals from primary care. But the Lincolnshire LMC and Primary Care Network Association both raised concerns about the pathway and its impact on general practice in a letter to their ICB earlier this month. Read full story Source: Pulse, 13 February
  19. News Article
    Charging for GP appointments will worsen patient safety and drive more people to A&E, the head of a national safety watchdog has warned. Dr Rosie Benneyworth, the chief investigator for the Healthcare Safety Investigation Branch (HSIB), was responding to a suggestion by former health secretary Sajid Javid who said the present model of the NHS was “unsustainable”. He said “extending the contributory principle” should be part of radical reforms to tackle growing waiting times. But Dr Benneyworth said it would only drive more people to seek help from already overstretched services. She said: “I don’t want to be drawn into the politics around this but I believe in free at the point of delivery NHS and my concern would be [if] we charge people that people would not come forward early for their care and that would leave people needing more urgent and emergency care, because of delayed presentations.” Dr Benneyworth said there needed to be a bigger focus on patient safety in services outside of A&E, such as NHS 111 and out-of-hours services. Read full story Source: The Independent, 26 January 2023
  20. News Article
    Two-thirds of GPs feel ‘advice and guidance’ is preventing patients who really need a referral to secondary care from getting one, according to the findings of a snapshot survey of Pulse readers. Advice and guidance (A&G) services, which involve GPs accessing specialist advice before making a referral, have become a major part of NHS England’s plans for clearing the pandemic backlog. But of the 366 GP survey respondents in England who said they had used advice and guidance, 68% said they felt the pathway is blocking necessary referrals. The survey also found that of those 366 GPs who had used A&G services: Around half (49%) said A&G was reducing referrals; More than three-quarters (78%) said it was increasing their workload; Just over half (60%) said it was requiring them to work beyond their competence; Two-thirds (68%) said A&G was resulting in patients complaining because their wish to see a consultant had been diverted. One GP who wished to remain anonymous commented: "An increasing number of referrals are being rejected for secondary care service pressure reasons rather than clinical need. [This] often duplicates GP admin work as we need to re-refer, rewriting the referral and/or enclosing further information or tests results in order to get a referral accepted." Read full story Source: Pulse, 25 January 2023 Further reading on the hub: Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs Patient referrals and waiting lists: A ticking time bomb A child left waiting for ‘urgent’ surgery, a blog by Clare Rayner
  21. News Article
    A law student who died after four remote GP consultations might have lived had he been given a face-to-face appointment, a coroner ruled. David Nash, 26, died in November 2020 from a bone infection behind his ear that caused an abscess on the brain. Over a 19-day period leading up to his death, he had four phone consultations with his GP. The coroner, Abigail Combes, said the failure to see him meant he underwent surgery ten hours later than it could have been. Andrew and Anne Nash fought for more than two years to find out whether their son would have lived if he had been seen in person by clinical staff at Burley Park Medical Centre in Leeds. Yesterday they said they were “both saddened and vindicated by the findings that the simple and obvious, necessary step of seeing him in person would have saved his life” and wanted to make sure “others don’t die as David did”. Read full story (paywalled) Source: The Times, 21 January 2023
  22. News Article
    "I got my cervical screening letter in November and I've been putting it off because I don't want to do it - I don't think any girl really wants it done to them." Elena Coley Perez is 26 and due to have her first cervical screening - or smear test - that examines the opening to your womb from your vagina. NHS records show 4.6 million women - or 30% of those who are eligible - have never been screened for cervical cancer or are not up to date with their tests. Women are sometimes too embarrassed to come forward or put it off because they are anxious, surveys have found. Struggling to book their tests due to GP backlogs will not help the situation, say charities. Elena has told the BBC she was already worried about having a smear test, and the difficulty she experienced in booking one put her off even more. "I got another letter in December so I went to book online because with my local GP you have to go through this long-winded form," she said. "I typed in cervical screening and nothing was coming up, so I ended up waiting 35 minutes on the phone to be told they had no appointments for the rest of the year and to phone back in the new year." Elena then tried again in January and was told there was no availability. "At this point I was like, 'what's the point?' - you're trying to do something that can hopefully prevent you from getting cancer and you get to the doctor's surgery and you just get a 'no' - it's really off-putting," she says. Read full story Source: BBC News, 25 January 2023 Further resources on the hub: For patients: Having a smear test. What is it about? (Jo's Cervical Cancer Trust) Cervical cancer symptoms (Jo's Cervical Cancer Trust) For staff: RCN guidance: Human papillomavirus (HPV), cervical screening and cervical cancer
  23. Content Article
    Many people see their GP with symptoms that could either get better without treatment, or be a sign of serious illness; their diagnosis is uncertain. Research has explored how GPs and patients can work together to develop follow-up plans (a process known as safety-netting). New recommendations could help GPs manage uncertain diagnoses. To avoid unnecessary referrals, GPs may adopt a ‘watch and wait’ strategy when someone has an uncertain diagnosis. This strategy should come with a clear follow-up plan so that people understand the possible causes of their symptoms, how to look after themselves and what to do if symptoms persist. This is good safety-netting. Without good safety-netting, watch and wait carries risks. For example, late cancer diagnoses have been linked to poor safety-netting. However, professional guidance on safety-netting is lacking. This is a knowledge and practice gap. A study from Friedemann Smith explored the best ways to deliver safety-netting advice. It suggests that people are more likely to follow advice if they are involved in developing the follow-up plan. They need to understand: why they are receiving this advice what actions are required, and by whom. The lack of time within primary care consultations is well known. This may need to be addressed for clinicians to have long enough to develop a safety-netting plan. Professionals may also need training to develop the appropriate communication skills.
  24. News Article
    Two in five GPs are facing verbal abuse every single day, a new poll suggests. Some 74% of family doctors have claimed they or their staff have experienced verbal abuse on a weekly basis, including almost 40% who say it occurs daily, according to the survey conducted by GP publication Pulse. And 45% said practice staff experience physical abuse every year, according to the poll of 1000 GPs. As well as facing abuse in GP surgeries, a third reported practice staff have faced abuse on social media on a weekly basis. The Royal College of GPs described the survey findings as deeply disturbing. One GP told the journal: "Last week a patient, without any mitigating circumstances, was desperately abusive to one of my receptionists bemoaning the fact it wasn’t the US where she could buy a gun and 'sort us all out'. "Primary care seems to be bearing the brunt and blamed by all and sundry for the current issues and the public are picking up on this." Read full story Source: Medscape, 19 January 2023
  25. News Article
    GPs whose patients want to stop taking antidepressants should reduce the dose of their medication in stages to lower the risk and severity of withdrawal symptoms, the medicines watchdog has said. About one in six (16%) adult Britons experience moderate to severe depression, according to the Office for National Statistics. In England alone, 21.4m antidepressant drugs were prescribed between July and September 2022, according to the NHS Business Services Authority. A new draft quality standard for the care of adults with depression from the National Institute for Health and Care Excellence (NICE) – the first update in 11 years – includes specific guidance to help adults come off antidepressant medication permanently. NICE’s independent advisory committee, which includes experts in treating adults with depression, recommends the staged withdrawal of antidepressants in patients who want to stop taking the drugs. A staggered reduction of medicine, known as tapering, helps to reduce withdrawal effects and long-term dependence on the medication, according to Nice. The committee said primary care and mental health professionals should follow the NICE guideline recommendations on stopping antidepressant medication, including agreeing with their patient whether it is right for them to stop taking the medication and, if so, the speed and duration of withdrawal from it. Read full story Source: The Guardian, 17 January 2023
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