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Content ArticleMedication errors are any Patient Safety Incidents (PSI) where there has been an error in the process of prescribing, preparing, dispensing, and administering, monitoring or providing advice on medicines. Medication errors can occur at many steps in patient care, from ordering the medication to the time when the patient is administered the drug. From April 1 2015 to 31 March 2020 NHS Resolution received 1,420 claims relating to errors in the medication process. Of those claims, 487 claims settled with damages paid, costing the NHS £35 million (excluding legal costs). NHS Resolution initial data for medication errors indicates that anticoagulants, opioids, antimicrobials, antidepressants, and anticonvulsants are the most common medications to be implicated in incidents.
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Content ArticleThis editorial in BMJ Quality & Safety looks at the need for urgent improvement in the test result management and communication process in primary care. The authors highlight the inconsistency in tracking and communicating test results and look at potential solutions to reduce the patient safety risks associated with test results. They look at the evidence surrounding automated alerts built into provider IT systems and giving patient direct access to test results through apps, highlighting the growing importance of patients in safeguarding their own care through actively pursuing test results.
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Content ArticleDepression 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.
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Content ArticleThis study in the British Journal of General Practice aimed to examine the impact of Covid-19 on GP contacts with children and young people in England. The authors conducted a longitudinal trends analysis using electronic health records from the Clinical Practice Research Datalink (CPRD) Aurum database. The study found that: GP contacts fell 41% during the first lockdown compared with previous years. Children aged 1-14 years had greater falls in total contacts (≥50%) compared with infants and those aged 15–24 years. Face-to-face contacts fell by 88%, with the greatest falls occurring among children aged 1-14 years (>90%). Remote contacts more than doubled, increasing most in infants. Total contacts for respiratory illnesses fell by 74% whereas contacts for common non-transmissible conditions shifted largely to remote contacts, mitigating the total fall (31%).
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Content ArticleSpecialty referrals—when a clinician refers a patient to a specialist for evaluation or treatment—are on the rise in the US. Despite the introduction of electronic health records (EHRs), the referral process is often hindered by lack of clarity over roles, communication breakdowns, workloads and variations in requirements among specialists. These difficulties can lead to missed or delayed diagnoses, delays in treatment and other lapses in patient safety. This guide from the Institute for Healthcare Improvement offers recommendations that aim to help standardise how primary care practitioners activate referrals to specialists and then keep track of the information over time. It describes a nine-step, closed-loop process in which all relevant patient information is communicated to the correct person through the appropriate channels, in a timely manner.
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Content ArticleRebuild General Practice is a campaign that represents GPs from across England, Scotland and Wales, to call for support to address the severe pressures currently faced by primary care. Rebuild GP is calling for Government action on: Recruitment: The UK Government delivering on its commitment of an additional 6,000 GPs in England by 2024 Retention: Tackling the factors driving GPs out of the profession such as burn out Safety: A plan to reduce GP workload and in turn improve patient safety This video shows highlights of a press conference held to launch the campaign. It features accounts from GPs about the pressures they face and how this is affecting staff and patients, as well as a statement from Jeremy Hunt MP, former Health Secretary. Dr Kieran Sharrock, deputy chair of the BMA GP Committee, calls on the Government to work with GPs to find a solution to the issues faced by primary care.
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Content ArticleIn this blog, Dr Charlotte Paddison, Senior Fellow at the Nuffield Trust, discusses whether the shift towards digital primary care risks making access easier for people with less need and harder for those more likely to be in poorer health. She also describes the actions that would help make access to primary care easier for different groups of patients.
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EventThis Westminster conference will examine policy and funding priorities for general practice. The agenda also looks at wider issues around GP wellbeing, patient access, service integration, and service recovery in the wake of disruptions caused by the pandemic. Stakeholders and policymakers will discuss progress, issues and next steps for ambitions to increase capacity within general practice for urgent same-day care, tackle areas of inefficiency, and improve transparency and accountability - in the context of the NHS Long Term Plan and the Winter Access Fund. Overall, the agenda will bring out latest thinking on priorities and key issues moving forward, including: integration - implementing reforms within the Health and Care Bill and the role of primary care workforce - recruitment and retention, the role of locum and other support staff, supporting mental health and wellbeing, and tackling burnout primary care networks - progress in development and their role in improving local health outcomes innovation and infrastructure - taking forward innovation from the pandemic and how the estate can support innovative working, tackle inefficiencies, and improve patient access going forward personalised care - opportunities and challenges, the role of community services, and ways to improve the delivery of patient-centred care. The conference will be an opportunity for stakeholders to consider the issues alongside key policy officials who are due to attend fromthe DHSC; CQC; the OHID; National Audit Office; and DWP. Agenda Register
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Content ArticleThis study in the International Journal for Equity in Health used an online survey to measure and assess relationships between health behaviours and outcomes, and measures of wealth and civic engagement. The relationships found in the survey results support the interrelationships of constructs within the conceptual model. The model can serve as a guide for future equity research, encouraging a more thorough assessment of equity.
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Content ArticleThis article in the British Journal of General Practice looks at what will happen to public engagement in healthcare following the Covid-19 vaccine rollout. The author, Datapwa Mujong, argues that the successes of community-centred approaches employed in response to the pandemic could be lost without sustained funding and policy to embed these services in healthcare provision. He warns of the dangers of 'initiative decay' and expresses concern that disadvantaged groups may be further disenfranchised by the short-term nature of engagement for the purpose of the vaccine rollout. He argues that in order to tackle inequalities, sustainable solutions are needed, rather than short-term interventions, even though these may require fewer resources.
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Content ArticleIn this blog for the British Journal of General Practice comment and opinion website, BJGP Life, GP Will Mackintosh discusses the impact of health inequalities on patients' ability to play an active role in their care. He calls for training for all GPs to understand the constraints and pressures that may be affecting their patients, so that they can better assess the causes of health issues and therefore treat them more effectively. The article examines concepts of freedom for both GP and patient, and argues that a purely evidence-based approach does not help patients from deprived backgrounds overcome health issues. The author highlights that GPs operate in a 'grey zone' between the medical and the non-medical, and argues that this means they are well placed to understand and help tackle the root causes of health disparities.
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Content ArticleThis study in The British Journal of General Practice aimed to quantify the time GPs spend on different activities during clinical sessions, to identify the number of operational failures they encounter and to define the nature of operational failures and their impact for GPs.
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Content ArticleThis report by the British Red Cross highlights the impact of deprivation and inequality on high intensity use of accident and emergency services (A&E), and the additional cost and strain this puts on these services. It shows that people from the most deprived areas of the UK and people with mental health issues are more likely to be in poor health and are most likely to attend A&E frequently. The report calls for better support for people who frequently attend A&E because they feel they have 'nowhere else to turn'.
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Sodium Valproate is a treatment for epilepsy and bipolar disorder. It can cause an increased risk of developmental, physical and neurological harms to the human embryo or fetus. This NHS letter is a reminder of information that every woman and girl of childbearing age should receive from their doctors when the drug is first prescribed. It contains important reminders of safety considerations, including around contraception, pregnancy and regular prescribing reviews. Further recommended reading: Sodium Valproate: The Fetal Valproate Syndrome Tragedy Analysing the Cumberlege Review: Who should join the dots for patient safety? (Patient Safety Learning) Findings of the Cumberlege Review: informed consent (Patient Safety Learning) First Do No Harm. The report of the Independent Medicines and Medical Devices Safety Review Regulatory flaws: Women were catastrophically failed in the mesh, Primodos and Sodium Valproate tragedies (Kath Sansom) -
Content ArticleThe Remote by Default research study, a collaboration between the Universities of Oxford and Plymouth and the Nuffield Trust, has been exploring how technology can be harnessed to support excellent primary care. Using workshops, interviews, and focus groups of clinicians, service users, and other stakeholders, they have begun to map the multiple interacting influences on the choice of consultation modality.
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In this article, published in Guidelines in Practice, Dr Ashish Chaudhry and Dr Harsha Master offer nine top tips for recognising and managing Long COVID-19 symptoms in primary care. This article aims to help clinical colleagues learn about: lingering or new symptoms after an acute case of COVID-19, known as ‘Long COVID’ identifying patients with Long COVID managing or referring patients who need active intervention and investigation. -
Content ArticleThis cross-sectional survey in the British Journal of General Practice looks at the availability and use of emergency admission risk stratification (EARS) tools across the UK and aims to identify factors that influence their implementation. The authors identified 39 different EARS tools in use. They found that the most important factors in encouraging general practices to use EARS tools were: promotion by NHS commissioners involvement of clinical leaders engagement of practice managers. High workloads and information governance were significant barriers to their use. The authors highlight the need to align policy and practice with research evidence.
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Content ArticleThis video from NHS Resolution looks at the criteria that need to be met in order for patient consent to be legally valid. Advice is provided on how to ensure practitioners obtain legally valid consent.
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Content ArticleThis is a guide to end of life care symptom control when a person is dying from COVID19 for General Practice Teams, prepared by the Royal College of General Practitioners (RCGP) and the Association for Palliative Medicine.
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Content ArticleThis resource on managing contraceptive provision without face to face consultations has been produced by the Primary Care Women’s Health Forum to help primary care clinicians support women with their contraceptive needs during the coronavirus pandemic. It covers hormonal contraception including pills, patches, combined hormonal ring, IUD, IUS, implant, depo provera and emergency contraception.
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Content ArticleThis FAQ resource from the Royal College of General Practitioners, provides information about a number of topics relevant to general practice and how to keep patients and staff safe during the coronavirus pandemic.
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Content ArticleA short video to show you how to have a video consultation with your GP surgery after receiving an invitation via text message.
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Content Article
Royal College of General Practitioners: COVID-19 advice
Patient Safety Learning posted an article in Guidance
The Royal College of General Practitioners is closely monitoring the situation and developing practical resources and support for GPs and their teams. They have launched specific guidance for general practice, including out-of-hours. This will be updated as the situation develops but things are extremely fast moving so please make sure you are using the latest version. -
Content ArticleThis publication presents UK-focused analysis of The Commonwealth Fund’s 2019 International Health Policy Survey of Primary Care Doctors in 11 Countries. This includes responses to several UK-specific questions funded by the Health Foundation. The Health Foundation present their analysis of the data, including comparisons with the 2015 survey where possible, under three main themes: how GPs view their job what care GPs are providing and how it is changing how GPs work with other professionals and services.
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