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Found 386 results
  1. News Article
    General practices should delay rolling out the accelerated citizens’ access programme, due to go live on 1 November, if they have concerns over safety, the BMA has said. In guidance published on 25 October the BMA’s General Practitioners Committee said that while many practices would be able to implement the scheme before the deadline some would need more time to prepare, to ensure that they can roll it out in line with the Data Protection Act and safeguarding measures. The access scheme, led by NHS England, will automatically give patients the ability to see any new entries to their GP medical record through the NHS App. As part of safeguarding practices it will require GPs to review each record to identify any safety concerns related to providing patient access, such as in cases of domestic violence or coercive relationships. Where there are safeguarding concerns, practices can prevent patients from having automatic access by adding a specific SNOMED code to the patient’s record before 1 November 2022. David Wrigley, deputy chair of the BMA’s GP Committee for England, said, “We have a duty of care to speak up when patient safety is at risk, which is why we encourage practices even slightly unsure about whether they can deliver this programme before the start of November, to refer to our guidance. Our patients are at the heart of what we do, and we will always act in their best interests.” Read full story Source: BMJ, 26 October 2022
  2. News Article
    Private companies are offering “misleading” home blood-testing kits that fuel health anxieties and pile pressure on the NHS, a report has suggested. There has been a boom in sales of the kits, which promise to reveal everything from cancer risk to how long patients can expect to live. But an investigation by the BMJ found these “unnecessary and potentially invasive tests” can be misleading and generate false alarms. The NHS is then left to “clear up the mess” as worried patients see GPs for reassurance or extra tests, piling more pressure on the overstretched service. One GP described patients coming in “clutching the results of private screening tests”, with doctors asked to review the results. The companies have been criticised for not providing sufficient follow-ups after the “poor quality and overhyped” tests, and for misleading results such as wrongly telling people their test levels are outside the “normal” range. Bernie Croal, president of the Association for Clinical Biochemistry and Laboratory Medicine, said: “Most of the online [tests] will send the results to the patient with at best a sort of asterisk next to the ones that are abnormal, with advice to either pay some more money to get some sort of health professional to speak about it or go and see your own GP.” Doctors are calling for the tests to be more tightly regulated by the health watchdog, the Care Quality Commission. Read full story (paywalled) Source: The Times, 27 October 2022
  3. News Article
    Patients in England are being put at risk because of the unacceptably poor service they receive from GPs, MPs say. The House of Commons' Health Committee blamed the failure to tackle doctor shortages, which had led to a decline in the GP-patient relationship. Seeing a GP should not be like booking an Uber with a driver you are unlikely to see again, the MPs said. The warning comes just weeks after ministers launched a drive to improve access to GP services. But the cross-party group of MPs said more needed to be done. Louise Ansari, from the patient group Healthwatch England, said, "The impacts of poor access can be huge, with people feeling abandoned and suffering in silence and not getting referred to hospitals for more specialised treatment." Read full story Source: BBC News, 20 October 2022
  4. News Article
    More than a quarter of women with ovarian cancer saw their GP three or more times before getting a referral for tests, according to a new study. Researchers also found that almost a third had waited for longer than three months after first going to see their GP before being given the right diagnosis. If doctors are able to diagnose ovarian cancer at the earliest stage, nine out of 10 women will go on to live for five years or longer, but only around one in 10 survive if it is not caught until it has progressed to stage 4, the most advanced stage. The report, by Target Ovarian Cancer, also revealed that 14 per cent of women polled said they were not given their diagnosis in private, meaning others could listen in on the exchange. “I was told of my stage 4 diagnosis behind the curtain on a busy respiratory ward. The rest of the ward heard the conversation,” one woman said. Meanwhile, GPs and ovarian cancer patients told researchers that the support available for the disease is insufficient – with almost half of the women polled not having been asked by a doctor, nurse or other individual providing treatment about how the cancer diagnosis was affecting their mental health. This is despite the fact that 60% of the women diagnosed with ovarian cancer said their mental health had been harmed by the disease. Read full story Source: The Independent. 18 October 2022
  5. News Article
    NHS officials ruled a man who died after his ear infection was not picked up in GP telephone consultations should have been seen face to face, a BBC Newsnight investigation has found. David Nash, 26, had four remote consultations over three weeks during Covid restrictions but was never offered an in-person appointment. His infection led to a fatal abscess on his brainstem. David first spoke to the practice on 14 October 2020, after finding lumps on his neck. He sent a photograph but was never examined. With David worried the lumps might be cancerous, the GP asked a series of questions about his health and reassured him that while she could not rule it out completely, she was not worried about cancer. She suggested he booked a blood test for two to three weeks' time. In those three weeks, David would go on to speak to another GP and two advanced nurse practitioners but never face to face or via video call. He was actually due to be seen in person at the GP surgery that day, for the blood tests booked some 19 days earlier, when he had presented with neck lumps. But - fearing he could have coronavirus, despite a negative PCR test - the nurse cancelled the bloods and asked David to retest for Covid. In its investigation, NHS England found "the overarching benefit [of this decision] was less than the risk with going ahead with blood tests". After five calls to NHS 111, David was taken to hospital in an ambulance that day but died two days later. NHS England, in a finding seen by Newsnight, said: "A face-to-face assessment should have been offered or organised to confirm the diagnosis and initiate definitive management." Read full story Source: BBC News, 29 September 2022
  6. News Article
    Too many women feel fobbed off or not listened to when they raise concerns about their health, according to a women's health campaign group. The Women's Health Wales coalition says women are often misdiagnosed or have to push for a diagnosis. The theme has emerged repeatedly during BBC Wales interviews with women. The Welsh government said it had set out what's expected of the NHS on women's health, and a full plan is due to be published this autumn. "From the moment I went to my GP about my symptoms in my late teens, I have always felt dismissed," said Jessica Ricketts, 35, who was diagnosed with endometriosis. But the feeling of being fobbed off has cropped up in countless conversations with women whether it be in relation to a heart attack, UTI, stroke, autism or even brain tumour. Patients have told us that clinicians thought they were having a panic attack rather than a heart attack," said Gemma Roberts, policy and public affairs manager at British Heart Foundation Cymru, and co-chair of the Women's Health Wales coalition. "We hear from patients and from clinicians that women have to see their GPs multiple times before they get a diagnosis. Women often aren't listened to. "They are told that pain is a normal part of the female experience but actually that isn't the case. I think we need to be listening to women more about what's going on with their own bodies." The coalition wants: Greater focus on women's health from the very beginning of medical training. Health data to be broken down by protected characteristics because "the stories of women with those backgrounds goes untold". Equitable access to healthcare, including specialist care, regardless of where women live in Wales. Read full story Source: BBC News, 28 September 2022 Related blogs on the hub ‘Women are being dismissed, disbelieved and shut out’ The normalisation of women’s pain Gender bias: A threat to women’s health
  7. News Article
    One in four people could be left without a GP within a decade, medics say. The forecasts from Doctors’ Association UK suggest 16 million people in England could be left without access to a family doctor, amid growing staffing shortages. Today the new Health Secretary is expected to set out plans to boost access to GPs, following warnings that public satisfaction is the lowest on record. Research by the Health Foundation suggests that the NHS will lose up to 8,800 full-time equivalent GPs by 2030 if current trends continue. On Wednesday, Doctors’ Association UK said this could leave one in four people without access to a GP. Dr Lizzie Toberty, GP lead for the Doctors’ Association UK, said the workload of a family doctor now placed “unrealistic demands” on them. She said: “GPs will cut their hours, quit the NHS, or quit the country. We fear patients will suffer the same ‘postcode lottery’ for seeing their GP as many do now with getting an NHS dentist.” Read full story (paywalled) Source: The Telegraph, 21 September 2022
  8. News Article
    The government is promising to improve access to GPs, including same-day appointments for those that need them, as part of a new plan in England. Health Secretary Thérèse Coffey will make the pledge as she unveils her NHS plan for this winter and next. GPs will be able to take on extra staff, including senior nurses, while pharmacists will be asked to take on more work to free up appointments. Ms Coffey is due to announce the plan, which will also cover hospital services, in the House of Commons today. She is expected to say: "I will put a laser-like focus on the needs of patients, making their priorities my priorities and being a champion for them on issues that affect them most." Alongside same-day appointments when needed, Ms Coffey will promise no-one will have to wait more than two weeks for a routine appointment - currently one in five appointments take longer. The promises on waiting times are not official targets, but Ms Coffey said they should be seen as clear expectations of what patients should be entitled to. But GP leaders said the announcement would have a "minimal impact". Read full story Source: BBC News, 22 September 2022
  9. Content Article
    In this blog, Carl Heneghan, Urgent Care GP and Professor of Evidence-based Medicine at the University of Oxford, looks at how the shortage of doctors working in urgent care is affecting patient safety. He tells the story of a patient with a blocked catheter, highlighting that with early intervention, this should cause few complications, but if not treated promptly, it can cause bladder damage and chronic kidney failure. This example highlights the need to ensure patients are seen quickly if they have an urgent need in the community. The blog points out that current Government plans to scale up urgent community response teams are inadequate as they only cover 12 hours a day and there is a shortage of GPs willing to work in urgent care.
  10. 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.
  11. 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.
  12. 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.
  13. 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.
  14. 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.
  15. News Article
    The number of people waiting more than two months to start cancer treatment remained over 30,000 — double the pre-covid level — for three months to the end of October, according to new data published. NHS England previously committed to bringing the number of people waiting longer than 62 days to be diagnosed and begin treatment, after referral for suspected cancer, to pre-pandemic levels – roughly 14,000 – by March 2023. But the number has been generally growing since the spring, and remained above 30,000 from August through to the end of October, the latest figures available. September and October’s monthly totals were higher than the previous monthly peak in May 2020, after services were disrupted in the first covid wave. The increase in waiters this year has been caused by diagnostic and treatment capacity falling short of an increased number of referrals. Matt Sample, policy development manager at Cancer Research UK, said: “While it’s good to see significant numbers of people coming forward with potential cancer symptoms, performance against key targets are among the worst on record, continuing a trend that existed long before the pandemic hit, with one target having been missed for almost seven years.” Read full story (paywalled) Source: HSJ, 8 December 2022
  16. News Article
    GP leaders have urged the government to put out clearer advice for parents about when to seek help over potential strep A infections. Prof Kamila Hawthorne, of the Royal College of GPs, said many surgeries were struggling with the extra demand on top of existing pressures. The government should consider "overspill" services for surgeries unable to cope, she said. Since September, 15 UK children have died after invasive strep A infections. This includes the death of one child in Wales, and one in Northern Ireland. There have been no deaths confirmed in Scotland. The UK Health Security Agency figures (UKHSA) show there have also been 47 deaths from strep A in adults in England. Most strep A infections are mild, but more severe invasive cases - while still rare - are rising. Prof Hawthorne, said: "We do not want to discourage patients who are worried about their children to seek medical attention, particularly given the current circumstances. "But we do want to see good public health messaging across the UK, making it clear to parents when they should seek help and the different care options available to them - as well as when they don't need to seek medical attention." Read full story Source: BBC News, 8 December 2022
  17. News Article
    Five million people were unable to book a GP appointment in October, analysis of NHS data suggests. The Labour party, which studied figures from the GP Patient Survey, warned the struggle to see a doctor will mean many patients will not have serious medical conditions diagnosed until it is “too late”. According to the survey, some 13.8% of patients, or around one in seven, did not get an appointment the last time they tried to book one. With almost 32 million GP appointments reported in England in October, the party said it means that more than 5 million people could have been unable to book a GP appointment when they tried to make one that month. October saw GP surgeries carry out the highest number of appointments since records began in 2017, despite a depleted work force. Labour’s shadow health secretary Wes Streeting told Labour List: “Patients are finding it impossible to get a GP appointment when they need one. I’m really worried that among those millions of patients unable to get an appointment, there could be serious conditions going undiagnosed until it’s too late". Professor Kamila Hawthorne, chair of the Royal College of General Practitioners, said in a statement: “GPs and their teams are working flat out to deliver the care and services our patients need. GPs want our patients to receive timely and appropriate care, and we share their frustrations when this isn’t happening. But difficulties accessing our services isn’t the fault of GP teams, it’s a consequence of an under-resourced, underfunded, and understaffed service working under unsustainable pressures.” Read full story Source: The Independent, 6 December 2022
  18. News Article
    In an eleventh-hour decision NHS England has halted the automatic, blanket roll-out of a scheme that would have given all NHS patients in England prospective online access to their GP-held records the day before it was due to come in. The high-profile scheme to enable patents to automatically view their GP records via the NHS app by 30 November, has been a key digital promise by successive Conservative health secretaries. The last-minute u-turn came following a series of talks between the British Medical Association (BMA) and NHS England, in which the BMA made clear many practices would not be ready to roll out the programme in a safe way for patients, and that it didn’t comply with their data protection obligations. The BMA says the decision is the ‘right thing to do’ for patient safety. The BMA said in a statement that while some practices were ready to implement this, many expressed concerns over safety aspects and that it wasn’t fit for purpose at the present time. Dr David Wrigley, deputy chair of GPC England at the BMA, said: “We’re pleased to hear that NHS England has decided to review the pace and timing of the automatic, mass roll-out of the Citizens’ Access programme. This is, without doubt, the right thing to do for patient safety. “We want patients to be able to access their GP medical records, but this must be done carefully, with the appropriate safeguards in place to protect them from any potential harm. “The deadline of 30 November was, for many practices, just too soon to do this, and removing it will come as a huge relief to GPs and their teams across the country.” Read full story Source: Digital Health, 30 November 2022
  19. News Article
    Some of the country’s GP are advising patients requiring urgent hospital care to “get an Uber” or use a relative’s car because of the worst ever delays in the ambulance service in England. Patients with breathing difficulties and other potentially serious conditions are being told in some cases that they are likely to be transferred more quickly from a general practice to accident and emergency if they travel by cab or private vehicle. NHS England data shows that October’s average ambulance response times for category 1 to 3 emergencies, which cover all urgent conditions, appear to be the highest since the categories were introduced nationally in 2017. Some patients who require emergency treatment may have to wait several hours for an ambulance to arrive. Dr Selvaseelan Selvarajah, a GP partner in east London, said: “If somebody is not having a heart attack or a stroke, my default advice is ‘have you got someone who can drive you or do you want to get an Uber?’ “These are patients who may have breathing difficulty or are suffering severe abdominal pain, but their life is not in immediate danger.” He said such patients would have previously been transferred by ambulance. Read full story Source: The Guardian, 27 November 2022
  20. News Article
    Ill patients are refusing sicknotes from their GP because they cannot afford time off work, while doctors suffer “moral distress” at their powerlessness to do more to help the most vulnerable, the new leader of Britain’s family doctors has revealed. More patients are experiencing asthma attacks or other serious breathing problems because they cannot afford to heat their homes, said Dr Kamila Hawthorne, the chair of the Royal College of GPs, while many have reported deteriorating mental health due to financial stress. Soaring food costs are also leading to a rise in fatigue, mouth ulcers and weak muscles, with people deficient in key vitamins because they cannot afford to eat anything other than a poor diet. So many patients are presenting with complex physical and psychological problems related to poverty, domestic violence, childhood abuse or poor housing that GPs are suffering psychologically from their inability to take the requisite action, she said. Hawthorne said: “Recently I’ve had patients refusing sicknotes because they can’t afford not to work. Quite often, when it’s clear that somebody needs some time off, they won’t take it. “These are people who ideally, medically, should not be at work [because] they have a chronic condition such as asthma or diabetes, but quite often mental health problems, quite severe mental health problems, I [see] some cases that really do require a bit of sicknote peace and quiet to try and help them get better. “I’ve been really surprised in the last year that when I’ve offered a sicknote they’ve said: ‘Oh no, no, I can’t take time off. I need the money from work.’ They’ve refused. They say: ‘I need to keep working to earn and to feed myself and my family.’ I don’t take it personally, of course, but I feel sad for people because for a few minutes you enter their lives and see that it’s really tough.” Read full story Source: The Guardian, 23 November 2022
  21. News Article
    An NHS England director says trusts should use ‘as robust triage as you can possibly do’ when deciding whether to accept referrals from GPs. Ian Eardley, NHSE’s joint national clinical director for elective recovery, was asked during an internal NHSE webinar how trusts can encourage GPs to work more closely with secondary care to make sure they only send appropriate referrals. He said: “There’s got to be as robust triage as you can possibly do, so if you’ve got referrals coming in which haven’t got the relevant or wrong information, then I think you need senior clinicians in a position to go back to the GP and say we need this bit of information or the other… Ultimately, it’s about robust front-end management.” However, he admitted it was a “difficult [issue and] really difficult to do anything centrally”. Read full story (paywalled) Source: HSJ, 23 November 2022
  22. News Article
    GP practices can block abusive patients from gaining automatic access to their records online if they pose a ‘risk of harm’ to staff, the Royal College of General Practice has said. Automatic access to patients’ prospective patient records is due to be switched on by the end of this month, following delays related to concerns about patient safety. But the RCGP’s toolkit on access to records said practices can refuse access to online records for patients that pose a risk of harm to others too. The guidance said access should "be refused where there is a clear risk of serious harm to the safety of the patient or members of the practice team, or to the privacy of a third party". It added: "If potentially harmful information cannot be successfully redacted and the practice remains concerned about the safety of record access for an individual patient – or in extreme cases, remains concerned that the patient may react violently to information in the record – then the practice may refuse to give the patient record access or restrict the level of access. "It may be possible to give them access to a reduced part of the record such as the Summary Care Record or restrict access to appointments and repeat prescriptions." The guidance said that records access should only be refused or restricted "after discussion with the practice leads for GP Online Services and Safeguarding or after seeking further professional advice from a local relevant agency or national medical indemnity organisation". Read full story Source: Pulse, 18 November 2022
  23. News Article
    GPs are struggling to cope with as many as 90 appointments and consultations a day – more than three times a recommended safety limit. General practices in England are carrying out more appointments than before the pandemic but face severe workforce shortages. More than 1.45 million patients waited at least 28 days to see a GP in September, according to the most recent NHS figures. GPs who spoke to the Observer last week say that almost every day they breach the BM) guideline of “not more than 25 contacts per day” to deliver safe care. One doctor said he had more than 90 consultations on one day. A conference of local medical committee representatives in England this week will highlight the growing pressures faced in general practice. Surgeries are being urged to impose stricter caps on the number of patient appointments for each GP. One of the proposed motions submitted to the conference by Kensington and Chelsea local medical committee says “focusing on patient safety” is more appropriate than meeting high patient demand. It says the NHS should focus on “safe capacity”. Such a move would mean longer waits for GP appointments, but doctors say it would help safeguard patient care and the welfare of staff in general practice. Read full story Source: The Guardian, 20 November 2022
  24. News Article
    GPs are leaving UK practice over workplace incidents rather than due to falling ‘out of love’ with the profession, the General Medical Council (GMC) has warned. Speaking to the NHS Providers conference (16 November), chief executive Charlie Massey said that many specialty and associate specialist (SAS) and locally employed (LE) doctors feel their careers are being ‘curtailed’ and that they ‘can’t tolerate the environments’ in which they work. He cited new GMC research into doctors’ migration which identified poor workplace conditions and ‘negative experiences with colleagues’ as a ‘far more impactful’ as a trigger compared to poor experiences with patients. According to the research, bullying at work, lack of respect from line managers and experiences of favouritism ‘provided the nudge for them to consider making a change and migrating abroad’. Mr Massey said: "This is a senseless waste of talent, not least because these issues are preventable. With a focus on compassionate, supportive cultures, they can be put right. This will not only improve doctors’ wellbeing, but also their productivity. Happier workers are better workers, and they deliver better results." Read full story Source: Healthcare Leader, 16 November 2022
  25. News Article
    All GP practices in England will be able to book cancer tests directly for their patients from later this month, NHS bosses say. The option of GPs booking CT scans, ultrasounds and MRIs has been gradually rolled out in recent years, as community testing centres have opened. NHS England chief executive Amanda Pritchard will announce later all GPs will now be able to do this. GPs have previously relied on referring on to specialist hospital doctors. Before referring, they have to identify clear symptoms the patient may have a specific type of cancer. But only one out of every five cancer cases is diagnosed through these urgent GP referrals. Patients with less clear symptoms face long waits for check-ups or are diagnosed only after presenting at an accident-and-emergency (A&E) unit or being referred to hospital for something else. And Ms Pritchard will tell delegates at the NHS Providers annual conference of health managers, in Liverpool, today, she hopes the new initiative will lead to tens of thousands of cancer cases every year being detected sooner. Read full story Source: BBC News, 16 November 2022
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