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Found 46 results
  1. Content Article
    This 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.
  2. Content Article
    Error 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.
  3. Event
    until
    This 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
  4. Content Article
    Contemporary 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.
  5. Content Article
    This 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.
  6. Content Article
    With 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.
  7. Content Article
    The 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.
  8. News Article
    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
  9. News Article
    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
  10. Content Article
    To 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.
  11. Content Article
    In 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.
  12. Content Article
    Rebuild 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.
  13. Content Article
    In 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.
  14. Content Article
    This 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.
  15. Content Article
    This 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'.
  16. Content Article
    This 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.
  17. Content Article
    The 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.
  18. Content Article
    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)  
  19. Content Article
    This 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.
  20. Content Article
    In 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.
  21. Content Article
    This 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.
  22. Content Article
    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.
  23. Content Article
    NHS 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.
  24. Content Article
    Guidance 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."
  25. Content Article
    A 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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