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EventuntilNHS Resolution’s Safety and Learning team in collaboration with the NW panel law firms, are hosting a virtual forum series on learning from claims to promote reflection and improve patient care. The purpose is to raise awareness of the support offered by NHS Resolution as your General Practice indemnifier along with the North West panel firms; Weightmans, Hempsons and Hill Dickinson. This will be of interest to both clinical and non-clinical staff involved in patient care across primary and urgent care . The format is interactive, with presentations followed by questions and panel discussion. Session 4: Pitfalls to prescribing better care Event programme: The invaluable role of pharmacists Common medicine error claims recommendations Q&A panel discussion Contributors: Joanne Hughes- Partner | Hill Dickinson Dr Anwar Khan - Senior Clinical Advisor for General Practice |NHS Resolution Register
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EventuntilNHS Resolution’s Safety and Learning team in collaboration with the NW panel law firms, are hosting a virtual forum series on learning from claims to promote reflection and improve patient care. The purpose is to raise awareness of the support offered by NHS Resolution as your General Practice indemnifier along with the North West panel firms; Weightmans, Hempsons and Hill Dickinson. This will be of interest to both clinical and non-clinical staff involved in patient care across primary and urgent care . The format is interactive, with presentations followed by questions and panel discussion. Session 3: Dissecting a claim part 2 Event programme: Exploration through the use of an illustrative case studyQ&A panel discussion Contributors: Chris Dexter - Partner | Weightmans Alison Brennan - Principal associate |Weightmans Register
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EventNHS Resolution’s Safety and Learning team in collaboration with the NW panel law firms, are hosting a virtual forum series on learning from claims to promote reflection and improve patient care. The purpose is to raise awareness of the support offered by NHS Resolution as your General Practice indemnifier along with the North West panel firms; Weightmans, Hempsons and Hill Dickinson. This will be of interest to both clinical and non-clinical staff involved in patient care across primary and urgent care . The format is interactive, with presentations followed by questions and panel discussion. Session 2: Helping general practice manage and learn from claims part 1 Event programme: Exploration through the use of an illustrative case study Q&A panel discussion Contributors: Chris Dexter - Partner | Weightmans Alison Brennan- Principal associate |NHS Resolution Register
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Content ArticleThis study in BMJ Open aimed to describe the experiences and opinions of GPs in England about patients having access to their full online GP health records. 400 registered GPs in England completed an online survey. The results revealed some key findings: 91% GPs believed a majority of patients would worry more. 85% said they though patients would find their GP records more confusing than helpful. 60% believed a majority of patients would find significant errors in their records. 70% believed patients would better remember their care plan. 60% said patients would feel more in control of their care. 89% believed they will/already spend more time addressing patients’ questions outside of consultations. 81% said that consultations will/already take significantly longer. 72% said they will be/already are less candid in their documentation after online records access. 62% believed patients having access to their records would increase their litigation.
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Content ArticleError management is a systematic approach aimed at identifying and learning from critical incidents by reporting, documenting and analysing them. However, almost nothing is known about the incidents doctors in outpatient care consider to be critical and how they deal with them. This interview study aimed to to explore outpatient doctors’ views on error management, discover what they regard as critical incidents and find out how error management is put into practice in ambulatory care.
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EventuntilThis online conference hosted by the Royal College of General Practitioners (RCGP) is free of charge to RCGP members and £200 for non-members. This is the first in a 2-part series of one-day conferences addressing clinical issues arising from health inequalities and demonstrating how GPs can positively influence health inequalities as practitioners and community leaders. Health inequalities are differences in health across the population and between different groups in society that are systematic, unfair and avoidable. General Practice, with its unrivalled access to the heart of communities, has a key role in addressing both causes and consequences of health inequalities in the UK. General Practice is a diverse profession caring for multiple patient populations and the aim of the conference is to move from conversations to actions, improving patient care in these communities. This programme was put together by RCGP Officers, Faculty Education Leads and expert speakers, who are participating throughout the day and will include examples of best practice, relevant guidance and links to useful resources. Learning objectives: Understand the evidence linking ethnicity, protected characteristics, and health outcomes Acknowledge minority patients' perspectives of health and illness Promote the best clinical management within primary care Promote partnerships working with relevant organisations and community assets to improve patient care Areas to be covered: Incorporating health inequalities into training portfolios Migrant health and asylum seekers in hotels Black women with period issues or fertility concerns Health in gypsy and traveller communities Language discrimination Ramadan clinical management Trans health Social prescribing as a tool for tackling health inequalities Mental health Improving the health and well-being for communities in deprived areas Keynote speaker: Dr Margaret Ikpoh, RCGP Vice Chair Professional Development Register for the conference
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Content ArticleContemporary general practice includes many kinds of remote encounter. The rise in telephone, video and online communication for triage and clinical care requires clinicians and support staff to be trained, both individually and as teams, but evidence-based competencies have not previously been produced for general practice. This study aimed to identify training needs, core competencies and learning methods for staff providing remote encounters.
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Content ArticleThis guide is a self assessment tool to enable Primary Care to become dementia friendly. It includes a checklist for GP practices to help people with dementia and their carers access high quality care and support. People with dementia, carers and staff in GP practices have worked together to co-design and develop this guide. It outlines the benefits for general practice in becoming dementia friendly and includes checklists covering: General practice systems General practice culture Patient diagnosis, care and support Physical environment This guide is adapted from the Alzheimer’s Society’s Guide to Making General Practice Dementia Friendly.
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Content ArticleWith demand for GPs outstripping supply, GP retention must be a priority in tackling the current workforce crisis. The NHS has lost the equivalent of 2,187 full-time fully qualified GPs since 2015, 8% of the current total of full-time fully qualified GPs. GPs in the UK are reporting the highest stress levels and lowest job satisfaction compared to their counterparts in nine other high-income countries. In this article, published by the King's Fund, GP Trainee, Holly Young reflects on a recent roundtable that explored solutions for GP retention, organised by the Royal College of General Practitioners.
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Content ArticleThe model of general practice is changing and, at the core of this, general practice is moving away from a model of 'seeing a GP' to a model that is 'consulting with the multi-disciplinary team'. National Voices set up a project to understand awareness and experience of multidisciplinary teams across two groups: frequent users of primary care services and those who experience health inequalities. This report presents those insights and includes recommendations on how to improve experiences of multidisciplinary teams within general practice amongst populations who experience health inequalities and frequent users of primary care services. In particular, the report highlights how primary care teams can build trust and assure people that general practice has oversight of their care.
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News Article
Ministers reject Hunt’s plans for general practice
Patient Safety Learning posted a news article in News
The Government has rejected several policy proposals to promote “continuity of care” in general practice which were put forward by Jeremy Hunt. The now chancellor championed significant policy changes to strengthen the link between patients and an individual, named GP, when he was Commons health and social care committee chair. However, the government’s response to the report rejects several of the key proposals. The committee under Jeremy Hunt said “NHS England should champion the personal list model” – under which each patient is linked to a particular GP – “rather than dismiss it as unachievable”. The Department of Health and Social Care response said: “The department does not accept this recommendation. We agree that continuity of care is important within general practice but do not agree that requiring a return to the personal list model is the correct approach. Government also rejected recommendations from Mr Hunt’s committee to introduce a new national measure to track continuity of care by practice; and to fund primary care networks to appoint a GP “continuity lead” for a session a week. Read full story (paywalled) Source: HSJ, 24 July 2023 -
Content Article
The King's Fund: Activity in the NHS (19 June 2023)
Patient Safety Learning posted an article in Data and insight
Over the past 10 years, it has often been stated that the NHS treats more than a million people every 36 hours, but is that still true? Here, the King's Fund analyse NHS activity (eg, calls, appointments, attendances and admissions) and explore some of the underlying trends that lie behind these headline statistics. Following the disruption caused by the Covid-19 pandemic, NHS activity has almost returned to pre-pandemic levels. -
Content ArticleNHS services have been under increasing pressure in recent years, particularly since the start of the Covid-19 pandemic. We have previously reported on the NHS’s efforts to tackle the backlogs in elective care and its progress with improving mental health services in England. This report gives an overview of NHS services that may be used when people need rapid access to urgent, emergency or other non-routine health services, and whether such services are meeting the performance standards the NHS has told patients they have a right to expect. It covers: general practice community pharmacy 111 calls ambulance services (including 999 calls) urgent treatment centres accident and emergency (A&E) departments.
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Content ArticleGuidance needs to be applied in a careful, caring and person-centred way to ensure that patients benefit from, and are not harmed by, healthcare. In this blog, Dr Sam Finnikin, an academic GP in Sutton Coldfield, uses the story of 86 year-old Joan to illustrate the importance of shared decision-making in ensuring patients receive the most appropriate care. Joan was prescribed multiple medications by the hospital cardiology team after being diagnosed with acute coronary syndrome and a severely impaired left ventricle, but the medications made her feel very unwell and inhibited her quality of life. Joan then reached out to her GP surgery as she wanted to stop taking them, and Dr Finnikin realised that she and her family were unaware of the the reason each medication had been prescribed and the potential benefits and side effects of each one. After a long conversation about her priorities, Joan stopped the medications that were not benefitting her symptoms and died in peace and comfort at home a few weeks later. Dr Finnikin argues that shared decision-making is not an optional extra, but must be considered a vital part of healthcare, stating that "omitting shared decision making can be just as harmful to patients as being ignorant of clinical recommendations."
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Content ArticleA group of patients and families with experience of end-of-life care worked with researchers from the Nuffield Trust to review findings from its research investigating the effect of the pandemic on people who were receiving end-of-life care at home. This web page summarises the research findings from the perspective of patients and family.
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News Article
Older patients on medley of drugs ‘at higher risk of adverse reactions’
Patient Safety Learning posted a news article in News
Older women are at higher risk than older men of experiencing adverse reactions to drugs prescribed by their family doctor, and older patients taking more than 10 medicines are at higher risk than those taking fewer, according to a study. Overall, one in four older people experience adverse drug reactions (ADRs) to pills prescribed by their GP, the research published in the British Journal of General Practice suggests. It has prompted calls for GPs to consider deprescribing ineffective medications and prioritise patients taking lots of drugs for a regular review of their prescriptions. The medicines most commonly associated with ADRs included those used to treat high blood pressure and other cardiac conditions, strong painkillers such as tramadol, and antibiotics such as amoxicillin, according to the study. The study monitored 592 patients aged 70 and older across 15 general practices in the Republic of Ireland over a six-year period. One in four experienced at least one ADR. Patients prescribed 10 or more medicines had a threefold increased risk of experiencing a reaction, researchers said. Women were at least 50% more likely to have ADRs than men, the study found. “ADRs can be difficult to identify in medically complex older adults as they often present as non-specific symptoms,” the researchers wrote in the British Journal of General Practice. “GPs are well placed to detect the occurrence of ADRs from drugs prescribed in primary care as well as in other care settings. Deprescribing of ineffective medications and those no longer clinically indicated is one approach to reducing the risk of ADRs in older patients.” Read full story Source: The Guardian, 24 January 2023 -
Content ArticleTo date, research on adverse drug reactions (ADRs) has focused on secondary care, and there is limited studies that have prospectively examined ADRs affecting older adults in general practice. This study from Doherty et al. examined the cumulative incidence and severity of ADRs and associated patient characteristics in a sample of community-dwelling older adults. They found that over one-quarter of older adults experienced an ADR over a 6-year period. Polypharmacy is independently associated with ADR risk in general practice and older adults on ≥10 drug classes should be prioritised for regular medication review.
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Content ArticleIn this opinion piece for the Daily Mail, journalist Tom Utley recounts his recent experience of a seven hour wait at A&E after receiving abnormal blood test results from his GP. He argues that fear of litigation is causing GPs to refer patients on to A&E unecessarily, contributing to the overcrowding happening at emergency departments. He also highlights inefficiencies in the system and states that lack of staff capacity to tell him he didn't require any treatment meant he stayed an additional hour and a half in the waiting room.
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Content ArticleSince 2013/14, there has been a growth in the volume and value of clinical negligence claims involving patients with diabetes-related lower limb complications. The majority of claims have involved patients with a diabetic foot ulcer who went on to undergo a major lower limb amputation. This thematic review by Nicole Mottolini, Clinical Fellow at NHS Resolution, looks at 92 claims of negligence for lower limb problems involving patients with diabetes. The author used qualitative analysis to identify recurrent clinical themes leading to patient harm including unacceptable delays in diagnosis, delayed referral to specialised care and failures in the Multidisciplinary Diabetic Foot Team (MDFT). Her report highlights shortcomings in diabetes foot care in England, makes recommendations to improve patient care and proposes certain standards which should be put into practice and regularly audited.
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Content ArticleThis Health and Social Care Select Committee report examines the pressure currently facing general practice, which is leading to low morale, GPs leaving the profession and problems recruiting new GPs. In turn, patients are increasingly dissatisfied with the level of access they receive. The root cause of the situation is that there are not enough GPs to meet the ever-increasing demands on the service, coupled with patients presenting with increasing complexity due to an ageing population. The report outlines the Committee's assessment of the key issues, including the problems with reliance on locum doctors and lack of continuity of care, and outlines what the Government should do to equip general practice for the future.
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Content Article
NHSE - Commitment to carers
Patient-Safety-Learning posted an article in NHS England
With 1.4 million people providing 50 or more carer hours a week for a partner, friend or family member, carers make a significant contribution to society and the NHS. NHS England has developed 37 commitments to carers spread across eight key priorities, that have been developed in partnership with carers, patients, partner organisations and care professionals. Some of the areas covered include: raising the profile of carers education and training person-centred coordinated care primary care This webpage contains information on: Supporting carers in general practice: a framework of quality markers How to identify and support unpaid carers Supporting commissioners End of year progress summary -
Content ArticleThe Covid-19 pandemic triggered a very sudden and widespread shift to remote consulting in general practice. Many patients and healthcare professionals have welcomed the convenience, quality and safety of remote consulting, but there are inherent tensions in choosing between remote and face-to-face care when capacity is limited. This report by the Nuffield Trust explores the opportunities, challenges and risks associated with the shift towards remote consultations, and the practical and policy implications of recent learning.
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Content ArticleMost of the contact that people have with the NHS is with general practice: there are an estimated 300 million appointments each year. These services provide the first step in diagnosing and treating most patients’ health conditions. Due to changes in the data, trends in general practice staff are limited to 2015 at the earliest. The data do not include staff working in prisons, army bases, educational establishments, specialist care centres including drug rehabilitation centres and walk-in centres. From July 2019, primary care networks (PCNs) will offer services to patients and employ new specialist staff such as clinical pharmacists, social prescribing link workers, physiotherapists, physician associates and paramedics. NHS Digital has started to publish information on the PCN workforce, but the data does not presently cover all PCNs. Based on the PCN data that is available, the Nuffield Trust has estimated the number of certain primary care staff groups employed by PCNs across England,.
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Content ArticleThe pandemic has had an enormous impact on health and care services in the UK. In this article, Nuffield Trust fellows Jessica Morris and Sarah Reed take a closer look at access and waiting times before and after the start of the Covid-19 pandemic. They highlight that before the pandemic, pressure on the system was already reducing access to NHS services and making waiting times longer. Covid-19 has made the situation significantly worse due to the need for heightened infection control practices, rising levels of staff sickness and burnout, the cancellation of routine care and redirection of staff. Enabling services to recover will be challenging given these ongoing pressures and real-term budget cuts for the NHS this year. The article examines the impact of the pandemic on waiting times relating to: General practice Elective (planned) care Diagnostic testing Cancer care A&E Ambulance
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Content ArticleGPOnline 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.
