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Found 387 results
  1. 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
  2. Content Article
    Each year, up to 100 million people in the US experience acute or chronic pain, mainly because of short-term illnesses, injury and medical procedures. It is therefore important that patients are offered effective treatment options to reduce symptoms and improve function. Nonopioid management is the preferred option, but there are circumstances for which short-term opioid therapy is appropriate and beneficial. Finding the balance between these approaches is an ongoing problem in the management of acute noncancer pain. This cluster randomised clinical trial featured in JAMA Health Forum, aimed to assess whether clinician-targeted interventions prevent unsafe opioid prescribing in ambulatory patients with acute noncancer pain. The authors found that the use of comparison emails decreased the proportion of patients with acute pain who had never taken opioids receiving an opioid prescription. The emails also reduced the number of patients who progressed to treatment with long-term opioid therapy or were exposed to concurrent opioid and benzodiazepine therapy. They concluded that healthcare systems could add clinician-targeted nudges to other initiatives as an efficient, scalable approach to further decrease potentially unsafe opioid prescribing.
  3. News Article
    GPs have warned of a ‘tsunami of demand’ this winter as patient contacts surged 200% during the pandemic. One of the largest GP providers in the UK, Modality Partnership, told The Independent it received 4.8 million calls from patients in one year alone with around a quarter going unanswered every day. The provider, which covers 500,000 patients across the country, said its practices were now working above “safe levels” with 50 appointments a day per GP, far higher than the 35 advised by the British Medical Association. Speaking with The Independent, Vincent Sai, chief executive and partner at Modality said the new health secretary Therese Coffey must “not point fingers” and “not find a scapegoat” as “every part of the system is under pressure. Every player in the health system is under the cosh.” Dr Sai said: “We believe patient contacts have increased 200 per cent, over the last few years. The expectation is that GP practices have maybe four to five patient contacts per year, but if you just look at just the number of phone calls alone, it’s showing that it’s much more now. “So something is broken somewhere...there’s more work, there are fewer people. People say I can’t get access to my GP and the hypothesis is they’re just lazy and not working, but it’s not the case.” Read full story Source: The Independent, 7 September 2022
  4. Content Article
    The non-profit Patient Information Forum (PIF) has published a new one-page guide to Body Mass Index (BMI). The poster was developed following user engagement sessions with patients and healthcare professionals which highlighted the amount of misinformation surrounding BMI. It is free to download and share and can be used directly by patients or a resource for healthcare professionals. Welcoming the publication of 'BMI – What you need to know', Dr Juhi Tandon said: “As a GP for more than a decade, I still struggle to have the BMI conversation with patients. Discussing someone’s BMI can easily make them feel uncomfortable as they feel like they are being judged. It will be very helpful to share a clear fact sheet to help patients understand more about BMI in a non-judgemental way.”
  5. Content Article
    GPOnline Editor, Emma, speaks with Dr Carey Lunan, a GP in Edinburgh and chair of the Deep End GP Group in Scotland, and Dr David Blane a GP in Glasgow and clinical research fellow in General Practice, University of Glasgow, who is the academic lead of the Deep End GP Group. The Deep End Group covers the 100 most deprived practices in Scotland and the discussion highlights what the group is doing to tackle health inequalities, the impact of COVID-19 and what other practices can learn from their work.
  6. News Article
    Nearly 1.5 million patients have lost their GP in the last eight years after the closure of almost 500 practices, research has suggested. Issues around recruitment were a factor in the closure of about two-fifths of the surgeries, while workloads and inadequate premises were also cited as triggers. The investigation, by Pulse magazine, revealed for the first time the number of premises that have closed for good since 2013. Previously, research has identified the number of practices where GP partners have returned their contracts, or certain branches have closed or merged with others. Prof Martin Marshall, the chairman of the Royal College of GPs, said: “The impact of a practice closing on its patients and neighbouring practices can be considerable. As such, a decision to close a practice will be one of the most difficult a GP partner can make. When the reason for closing a practice is workload pressures, and not being able to fill vacancies, then this needs to be addressed as a matter of urgency.” Read full story (paywalled) Source: The Telegraph (29 August 2022)
  7. News Article
    A coroner has expressed concern at the difficulty of getting face-to-face appointments with GPs and other health professionals after a 17-year-old boy suffering from mental health problems was found dead. Sean Mark, who described himself as an “anxious paranoid mess”, was desperate for help but felt “palmed off” when he asked for assistance, an inquest heard. He was found dead in his bedroom four months after a phone consultation with a GP and before he had spoken to anyone in person about his concerns. The area coroner, Rosamund Rhodes-Kemp, recorded a verdict of death by misadventure, saying she could not be sure Sean had intended to kill himself. Dr Robin Harlow, clinical director of the Willow Group, where Sean Mark was a patient, said it had increased the number of face-to-face meetings. When told that Sean felt palmed off, he said: “I would want him to be seen face to face at the second time, if not the first time. We have seen a lot more face-to-face appointments since then.” Read full story Source: The Guardian (23 August 2022)
  8. News Article
    An LMC has created template letters to help practices reject secondary care workload dumping, including rejected referrals and requests to complete work on behalf of hospital trusts. Cambridge LMC said it developed the tools amid a growing ‘tsunami’ of secondary care workload transfer into general practices. One template letter tackles the rejection of a referral ‘on the basis that a proforma was not enclosed or completed in full’. It points out that the GMC requires GPs to refer when they ‘believe it is necessary to do so’ and that their ‘contractual obligations make no mention of a requirement to complete a proforma’. Cambridgeshire LMC chief executive Dr Katie Bramall-Stainer told Pulse that ‘we need the temperature to rise on the understanding around pressures across general practice’. Read full story For more information on the issues raised, read a blog by Patient Safety Learning about the patient safety risks of rejected outpatient referrals. Source: Pulse (19 August 2022)
  9. Content Article
    Louise Greenwood is joined by:  Sarah Kay, GP Clinical Lead for Patient Safety at NHS Dorset Jaydee Swarbrick, Patient Safety Specialist at NHS Dorset to discuss the importance of patient safety at this time of significant pressure across the NHS. Patient safety is about maximising the things that go right and minimising the things that go wrong. It is integral to the NHS’ definition of quality in healthcare, alongside effectiveness and patient experience.
  10. News Article
    GPs around England are to prescribe patients activities such as walking or cycling in a bid to ease the burden on the NHS by improving mental and physical health. The £12.7m trial, which was announced by the Department for Transport and will begin this year, is part of a wider movement of “social prescribing”, an approach already used in the NHS, in which patients are referred for non-medical activities. Minister for health, Maria Caulfield, said the UK is leading the way in embedding social prescribing in the NHS and communities across the country. “Getting active is hugely beneficial for both our mental and physical health, helping reduce stress and ward off other illness such as heart disease and obesity,” she said. Paul Farmer, chief executive of the mental health charity Mind, said he welcomed news of the extra investment, enabling the NHS to try new ways of supporting mental health, such as through social prescribing schemes. But, he added, prescribing exercise is not a miracle cure for treating mental health problems. “What we urgently need to see is proper investment into our country’s mental health services,” he said. “Only that will enable us to deliver support to the 1.6 million people currently sat on waiting lists, and the 8 million people who would benefit from mental health support right now but are deemed by the system not to be unwell enough to access it.” Read full story Source: The Guardian, 22 August 2022
  11. Content Article
    As dentists hand back their NHS contracts in record numbers, GPs are seeing the impact on their workload and patients’ health, especially in “dental deserts,” reports Sally Howard in this BMJ article. Over one week this spring, 20 patients presented at GP Abbie Brooks’ York surgery with abscesses, dental pain, and broken teeth—demanding antibiotics and painkillers. Brooks could not prescribe because she was not indemnified to perform dental work. Many of these patients, Brooks says, were not registered with a dentist or able to find an NHS dentist, and had already been told to call 111. The NHS medical helpline had advised patients to visit emergency NHS dentists 50 miles away from Brooks’ surgery. “Vulnerable patients often can’t get to emergency dentist appointments in Bradford or Leeds for logistical or financial reasons,” she says, adding that a small proportion of patients became difficult when Brooks was unable to help. “One woman was really quite angry that I wouldn’t incise and drain her abscess,” she says. “It’s not acceptable for GPs to have to deal with this crisis not of our doing.”
  12. News Article
    Doctors and nurses often “weight-shame” people who are overweight or obese, leaving them feeling anxious, depressed and wrongly blaming themselves for their condition, research has found. Such behaviour, although usually the result of “unconscious weight bias”, leads to people not attending medical appointments, feeling humiliated and being more likely to put on weight. Dr Anastasia Kalea and colleagues at University College London analysed 25 previous studies about “weight stigma”, undertaken in different countries, involving 3,554 health professionals. They found “extensive evidence [of] strong weight bias” among a wide range of health staff, including doctors, nurses, dieticians, psychologists and even obesity specialists. Their analysis found that a number of health professionals “believe their patients are lazy, lack self-control, overindulge, are hostile, dishonest, have poor hygiene and do not follow guidance”, said Kalea, an associate professor in UCL’s division of medicine. She added: “Sadly, healthcare, including general practice, is one of the most common settings for weight stigmatisation and we know this acts as a barrier to the services and treatments that can help people manage weight. “An example is a GP that will unconsciously show that they do not believe that the patient complies with their eat less/exercise more regime they were asked to follow as they are not losing weight." “The result is that patients are not coming back or they delay their follow-up appointments, they avoid healthcare prevention services or cancel appointments due to concerns of being stigmatised due to their weight.” Read full story Source: The Guardian, 10 August 2022
  13. News Article
    A 27-year-old man died from complications linked to diabetes after GPs failed to properly investigate his rapidly deteriorating health. Lugano Mwakosya died on 3 October 2020 from diabetic ketoacidosis, a build-up of toxic acids in the blood arising from low insulin levels, two days before he could see a GP in person. His mother, Petronella Mwasandube, believes his death could have been avoided if doctors at Strensham Road Surgery, in Birmingham, had given “adequate consideration” to Lugano’s diabetic history and offered face-to-face appointments following phone consultations on 31 July and 16 and 30 September. An independent review commissioned by NHS England found two doctors who spoke to Lugano did not take into account his diabetes or “enquire in detail and substantiate the actual cause of the patient’s symptoms”. The review raised concern over the “quality and brevity” of the phone assessments and said the surgery should have offered Lugano an in-person appointment sooner. Read full story Source: The Independent, 7 August 2022
  14. News Article
    The number of patients unable to get a hospital appointment after being referred by their GP is up more than 50% in two years amid the record NHS backlog, official data show. NHS Digital figures show no appointments were immediately available for 2.3 million referrals made in the first six months of this year – up 51% on the same period in 2020. Appointment slot issues occur when a patient is referred by their GP through the NHS e-Referral Service but no appointment is available to book. The referral is then forwarded or deferred to a patient’s chosen provider, but if an appointment is not made within 180 days it will automatically be removed from the system, according to NHS Digital. Patient safety campaigners have said the scale of the problem must be “urgently investigated” by NHS England to ensure the safety of patients is not being compromised while they wait for appointments. Helen Hughes, the chief executive of the Patient Safety Learning charity, said: “We have significant concerns about the safety of patients who are facing increasingly long waits for treatment, particularly those on high priority cancer pathways and urgent referrals.” She said patients needed to be assured that they will “not be lost in a failing, complex system”, adding: “We believe that NHS England needs to urgently investigate, quantify the scale of the problem and take action if we are to prevent these capacity and system issues resulting in avoidable harm for patients.” Some GPs told Patient Safety Learning they had experienced difficulties getting referrals accepted. One GP, based in the North East, said: “There is an ever-creeping transfer of management of complex conditions from secondary to primary care, without adequate training or resources to manage this safely.” Read full story (paywalled) Source: The Telegraph, 7 August 2022 You may also be interested in Patient Safety Learning's blog: Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs
  15. Content Article
    The health and care system in the UK is under intense pressure and as a result, patient and public satisfaction with services has dropped significantly, prompting debate and discussion about the future of health and care services. In this article, Charlotte Wickens, Policy Adviser at The King's Fund, looks at five 'myths' perpetuated about the NHS by politicians and the media. She analyses the extent to which each myth can be backed up or debunked by the available data and evidence. The myths she analyses are: The NHS is a bottomless pit, demanding more and more money The NHS is inefficient GPs aren't working hard enough to meet demand for appointments The government has 'fixed' social care The NHS is being privatised
  16. Content Article
    Depression is one of the most common mental health issues and GPs often diagnose and treat patients with the condition. In this blog, Dr Ed Beveridge offers his top tips for the assessment, management and treatment of adults with depression in primary care. It provides information on: assessing and screening people with depression for underlying conditions. pharmacological and nonpharmacological treatment options. when to refer to secondary care or seek specialist advice.
  17. Content Article
    This research explores how the COVID-19 pandemic has changed the ways doctors make end-of-life decisions, particularly around Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR), treatment escalation and doctors’ views on the legalisation of euthanasia and physician-assisted suicide.
  18. Event
    Join this Royal Society of Medicine conference to learn some of the key medico-legal issues that impact upon GPs/primary care. The overarching aim is to improve patient safety in both primary and secondary care via learning from incidents and better understanding the indemnity provisions in place for GPs/primary care and how that feeds back into learning. The aim of this meeting is to review and promote an understanding of recent legal and regulatory developments, with a specific emphasis on inquests, clinical negligence and incidents in the primary care sector, and their impact upon patient safety. Additionally, we will also discuss issues that those in secondary care should also be aware of. Register
  19. News Article
    NHS England will ask GP practices to make ‘reasonable adjustments’ for patients with a learning disability or autism such as giving them ‘priority appointments’. They could also be asked to provide ‘easy-read appointment letters’ to the group, the Department of Health and Social Care (DHSC) said yesterday in a new strategy on strengthening support for autistic people and those with a learning disability. It said the measures aim to support Government plans to reduce reliance on mental health inpatient care, with a target to reduce the number of those with a learning disability or autism in specialist inpatient care by 50% by March 2024 compared with March 2015. The policy paper said: ‘We know that people experience challenges accessing reasonably adjusted support which may prevent them from having their needs met.’ It added: ‘To make it easier for people with a learning disability and autistic people to use health services, there is work underway in NHS England to make sure that staff in health settings know if they need to make reasonable adjustments for people." NHS England is also developing a ‘reasonable adjustments digital flag’ that will signal that a patient may need reasonable adjustments on their health record, it said. It plans to make this flag, which is currently being tested, available across all NHS services, it added. Read full story Source: Pulse 15 July 2022
  20. News Article
    Patients are increasingly avoiding seeing their GP because they find it too difficult to book an appointment, the latest data show. Results from the 2022 GP Patient Survey also show that satisfaction with family doctors in England has dwindled since the previous year. The findings come as the Government and the NHS struggle to retain GPs and boost recruitment to meet rising patient demand and an ageing population. The survey found that overall satisfaction ratings have declined over the past 2 years, although most patients who responded to a questionnaire reported a good overall experience with their GP practice, had confidence and trust in the healthcare professional who saw them, and considered they received good care and treatment. The results also revealed an increase in the barriers patients faced in getting an appointment in the first place, with 55.4% who needed one in the last 12 months saying they had avoided making one – an increase of 13.1% since the last survey. The most common reason given was that they found it too difficult, cited by 26.5% of respondents, and a huge increase on last year's figure of 11.1%. Commenting on the results, Beccy Baird, senior fellow at The King's Fund said: "For many of us, general practice is the front door to the NHS – these results show that patients are finding that door increasingly hard to push open. "GPs are working harder than ever before, yet these findings show a dramatic fall in patients' experience of getting an appointment." She said recruitment of GPs, nurses, and other professionals to meet rising levels of need was proving tough "because in many cases those staff simply don’t exist". Read full story Source: Medscape, 14 July 2022
  21. Content Article
    The GP Patient Survey (GPPS) is an England-wide survey of patients aged 16+. It provides GP practice-level data about patients’ experiences of general practice.
  22. Content Article
    There has been an increase in the use of video group consultations (VGCs) by general practice staff, particularly since the beginning of the Covid-19 pandemic, when in-person care was restricted. This qualitative study in the British Journal of General Practice aimed to examine the factors affecting how VGCs are designed and implemented in general practice. Through semi-structured interviews with practice staff and patients, the authors found that: in the first year of the pandemic, VGCs focused on supporting those with long-term conditions or other shared health and social needs. most patients welcomed clinical and peer input, and the opportunity to access their practice remotely during lockdown. not everyone agreed to engage in group-based care or was able to access IT equipment. significant work was needed for practices to deliver VGCs, such as setting up the digital infrastructure, gaining team buy-in, developing new patient-facing online facilitation roles, managing background operational processes, protecting online confidentiality, and ensuring professional indemnity cover. national training was seen as instrumental in capacity building for VGC implementation.
  23. News Article
    The NHS must be more welcoming to patients who often feel they should not bother doctors, the new patient safety commissioner for England has urged. Dr Henrietta Hughes, who takes up the role this week, said it was vital that patients had time to ask questions, despite pressures on the health service. Clinicians and managers need to put themselves in the shoes of their patients, she said, highlighting “highly inappropriate” interactions between doctors and patients that showed “a total lack of care and respect”. Hughes said it was not a surprise that all the groups affected in the Cumberlege report were women. “That’s something which is a societal problem, and it’s really important that the voices of all patients, including those of women, are listened to and taken really seriously,” she said. “Because otherwise untold harm happens and it can not only extend to the individual patient themselves, but to their families, to their children, to their livelihoods. This role is a real opportunity for championing patients’ voices, and also making sure those who are in charge who are able to make the changes, listen and respond appropriately." Read full story (paywalled) Source: The Times, 14 July 2022
  24. Content Article
    Rates of blood testing in primary care are rising. Communicating blood test results generates significant workload for patients, GPs, and practice staff. This study from Watson et al. explored GPs’ and patients’ experience of systems of blood test communication. The study found that methods of test result communication varied between doctors and were based on habits, unwritten heuristics, and personal preferences rather than protocols. Doctors expected patients to know how to access their test results. In contrast, patients were often uncertain and used guesswork to decide when and how to access their tests. Patients and doctors generally assumed that the other party would make contact, with potential implications for patient safety. Text messaging and online methods of communication have benefits, but were perceived by some patients as ‘flippant’ or ‘confusing’. Delays and difficulties obtaining and interpreting test results can lead to anxiety and frustration for patients and has important implications for patient-centred care and patient safety.
  25. News Article
    Patients are being put at risk because GPs wrongly assume they will actively seek their test results, a study says. Researchers from the University of Bristol said the mismatched expectations could harm patients, with delayed diagnosis a likely result. The study found: “Doctors expected patients to know how to access their test results. In contrast, patients were often uncertain and used guesswork to decide when and how to access their tests. Patients and doctors generally assumed that the other party would make contact, with potential implications for patient safety.” Dr Jessica Watson, a GP and doctoral research fellow at the Centre for Academic Primary Care at the university, who led the study, said: “GPs have a medico-legal and ethical responsibility to ensure they have clear, robust systems for communicating test results.” Watson added: “Relying on patients to get in contact and making assumptions about their knowledge of how to do so were particular risks highlighted.” Read full story (paywalled) Source: The Times, 12 July 2022
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