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Showing results for tags 'Primary care'.
Found 194 results
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Content ArticleRates 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.
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Content ArticleCheshire and Merseyside Health and Care Partnership has published this consensus document on the interface between primary and secondary care. It aims to ensure healthcare providers ensure access to the right care to give patients the best outcomes. It contains a set of clinically-led principles to ensure pathways have a common structure of good quality, patient-centred communication. It includes a number of guiding principles that encourage staff to ensure: the patient is at the centre of decision making actions taken are completed in a timely way actions are undertaken by the most appropriate individual or team decisions and actions are understood by all.
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EventThis conference focuses on investigating and learning from deaths in the community/primary care. The conference focuses on the extension of the Medical Examiner role to cover deaths occurring in the community and the role of the GP in working with the Medical Examiner to learn from deaths and to identify constructive learning to improve care for patients. The conference will also focus on implementation of the new Patient Safety Incident Response Framework and learning from a primary care early adopter. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/investigation-of-deaths-community or email nicki@hc-uk.org.uk hub members receive a 20% discount. Email info@pslhub.org for discount code. Follow on Twitter @HCUK_Clare #LearningfromdeathsPC
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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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News ArticleProposals for primary care networks to evolve into more collaborative “integrated neighbourhood teams” to improve access to care have been broadly welcomed. A “stocktake” report commissioned by NHS England, published on 26 May, called for urgent same day appointments to be dealt with by “single, urgent care teams” for every neighbourhood with greater use of a range of health and social care professionals. The report, written by Claire Fuller, a general practitioner and chief executive of Surrey Heartlands Integrated Care System, undertaken by Dr Claire Fuller, Chief Executive-designate Surrey Heartlands Integrated Care System and GP on integrated primary care, looks at what is working well, why it’s working well and how we can accelerate the implementation of integrated primary care (incorporating the current 4 pillars of general practice, community pharmacy, dentistry and optometry) across systems. Doctors’ leaders welcomed many of the report’s recommendations but emphasised that they could only work if the government resourced primary care practices better and tackled workforce shortages. Read full story (paywalled) Source: BMJ, 27 May 2022
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Content ArticleThis is the final report of the stocktake undertaken by Dr Claire Fuller, Chief Executive-designate Surrey Heartlands Integrated Care System and GP on integrated primary care, looking at what is working well, why it’s working well and how we can accelerate the implementation of integrated primary care (incorporating the current 4 pillars of general practice, community pharmacy, dentistry and optometry) across systems.
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Content ArticleThis animation by The King's Fund explains the changes that are happening to the way the NHS in England is organised and run. It outlines the key organisations that make up the NHS and how they can collaborate to deliver joined-up care. It describes the impact of the Health and Care Act 2022 and talks about how Integrated Care Systems foster collaboration between healthcare and other local services to improve people's experience and health outcomes.
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Content Article
Hospitals are rejecting GP referrals for investigations and outpatient treatment at an increasing rate. In this blog, Patient Safety Learning looks at the patient safety issues caused by rejected referrals and lack of capacity in outpatient specialities. We call for the government and NHS leaders to investigate the problem and take action to mitigate risks to patient safety. -
News Article
Three quarters of GPs report rising patient abuse, MDO warns
Patient Safety Learning posted a news article in News
Three in four GPs have reported facing increasing patient abuse last year, according to a major survey by a medical defence organisation. The Medical and Dental Defence Union of Scotland (MDDUS) surveyed almost 2,000 members across the UK, including 668 GPs, about their experiences last year compared with 2020. It revealed that 76% of GPs reported an increase in verbal abuse from patients towards them and their practice staff. Half of these (38%) said this had ‘significantly increased’ and the other half that it had ‘somewhat increased’ throughout 2021. Female GPs were more likely to face verbal abuse or aggression than their male counterparts, with 81% reporting an increase in this compared with 72% of their male colleagues. The survey found that this has led to a ‘huge increase in work-related stress’, MDDUS said. Among GPs who experienced verbal abuse or aggression in the workplace, 83% said they felt ‘more stressed’ than they did in 2020. MDDUS chief executive Chris Kenny said: ‘The pandemic has stretched our healthcare professionals to the limit. For those at the very frontline, it is clear now that the levels of stress have reached an almost unsustainable point. ‘GPs urgently need recognition, reassurance and realism to support them so they can reset their relationship with patients.’ Read full story Source: Pulse, 22 April 2022 -
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 ArticleThis study in the British Journal of General Practice aimed to examine trends in prescribing for anxiety in UK primary care between 2003 and 2018. Anxiolytic drugs are a group of medications used to relieve anxiety. The authors analysed data from 2.5 million adults to determine prevalence, incidence rates and treatment duration for prescriptions of any anxiolytic, and also for each drug class. The authors found that, between 2003 and 2018: prevalence of any anxiolytic prescription increased, driven by increases in those starting treatment, rather than more long-term use. incident beta-blocker prescribing increased over the 16 years, whereas incident benzodiazepine prescriptions decreased. long-term prescribing of benzodiazepines declined, yet 44% of prescriptions in 2017 were longer than the recommended four weeks. incident prescriptions in each drug class have risen substantially in young adults in recent years. They conclude that increases in incident prescribing may reflect better detection of anxiety or increasing acceptability of medication. However, they also caution that prescribing approaches may cause unintended harm, as some prescribing is not based on robust evidence of effectiveness and may contradict guidelines. They highlight that there is limited evidence on the overall impact of taking antidepressants long term.
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Content ArticleNow that the national plan to tackle the elective backlog is public, thoughts will be turning to how to achieve the challenging task ahead. A week before the plan was published, the King's Fund held a roundtable, supported by Novartis, with local health care leaders to discuss just that. The overwhelming theme from this discussion was that effective communication within local systems will be essential to success. The national strategy has set out the ambition, but ultimately solutions will be implemented locally. Five relationships stood out as being vital. Local areas and their neighbours. Primary and secondary care. Leaders and their workforce. NHS and patients. Local systems and their data.
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Content ArticleThis article in the British Journal of General Practice aimed to develop a safety-netting intervention to reduce delays in cancer diagnosis in primary care. To develop the tool, patient representatives, GPs and nurse practitioners were invited to a series of co-design workshops. These workshops suggested the intervention format and content should incorporate visual and written communication specifying clear timelines for monitoring symptoms and when to present back. Participants also agreed that they needed to be available in paper and electronic forms, be linked to existing computer systems and be able to be delivered within a 10-minute consultation. The output of this process was the Shared Safety Net Action Plan (SSNAP), a safety-netting intervention to assist the timely diagnosis of cancer in primary care.
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Content ArticlePrimary care is a crucial part of every healthcare system, but the US spends less on primary care and more on specialty care than other high-income countries. The results of this are burnout, high staff turnover and physician shortages. These were all major problems before Covid-19, that have been worsened by the pandemic. In this episode of The Commonwealth Foundation's podcast The Dose, host Shanoor Seervai asks Asaf Bitton, MD, executive director of the health innovation center at Ariadne Labs, what it will take to rebuild the USA's broken primary care system.
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Content Article
BMA - On the edge: GPs in despair (18 March 2022)
Patient-Safety-Learning posted an article in GP and primary care
This article by the British Medical Association (BMA) looks at the pressures GPs face that are leading to an increasing number leaving the profession. Several GPs from around the UK share their personal experience of unsustainable workloads and burnout, and the impact this has had on their health and wellbeing. The article highlights the impact of changes to the system on doctors at different career stages, including the increasing number of older GPs who are retiring early due to the intense pressure of their role. -
Content ArticleThis briefing by The Health Foundation Improvement Analytics Unit looks at recent data around patient preferences for online and face-to-face consultations and examines the impact of the increasing use of online tools on patient access to primary care. The Improvement Analytics Unit examined 7.5 million patient-initiated requests for primary care made using the askmyGP online consultation system between March 2019 and September 2021 at 146 general practices in England. These practices had a combined total list size of 1.35 million patients.
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Content ArticlePrimary care providers (PCPs) serve as most people’s first point of contact with the healthcare system. These clinicians build relationships with their patients over time and help coordinate care delivered by other health care providers. Evidence shows that a strong foundation of primary care yields better health outcomes overall, greater equity in health care access and outcomes, and lower per capita health costs. But in the United States, decades of underinvestment and a low provider supply, among other problems, have limited access to effective primary care. This Commonwealth Fund brief highlights gaps in the US primary care system by comparing its performance to systems in 10 other high-income countries.
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Content ArticleIn this opinion piece for BJGP Life, GP Chris Lowe explores potential problems with electronic access to primary care. He describes his own experience of e-consultation and warns of the potential of such technologies to make life harder for staff. He also raises concerns that rather than widen access to GPs, online access makes appointments less accessible for certain populations, and that introducing too many new technologies too quickly may cause experienced GPs to retire early.
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Content ArticleThis is the report and formal minutes of a House of Commons Public Accounts Committee session that examined the issues surrounding NHS backlogs and waiting times in England. The session particularly focused on accountability in how NHS England and the Department for Health and Social Care manage workforce and resources. At the end of December 2021, 6.07 million patients were waiting for elective care, the biggest waiting list since records began. Only 64% (3.87 million) of these patients had been waiting for less than 18 weeks, compared with the performance standard which requires 92% to have been waiting for less than 18 weeks. Similarly, in December 2021, only 67% of patients with an urgent referral for suspected cancer were treated within 62 days compared with a requirement for 85% to be treated within that time. The report highlights that although the Covid-19 pandemic had a significant effect on the backlog, NHS waiting time performance had declined steadily in the years before the pandemic.
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Content Article
Blog - Why do I have to wait? (12 July 2021)
Patient-Safety-Learning posted an article in GP and primary care
This blog by GP Dr Abbie Brooks examines rising patient demand for GP services and the need to manage patient expectations around appointment waiting times. It looks at the impact of the pandemic, and how patients can help primary care cope with increased demand by ensuring they are using the appropriate NHS service for their needs and being patient while waiting for initial and follow up appointments. -
Content ArticleAdvice and guidance on the health needs of migrant patients from Ukraine for healthcare practitioners.
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Content ArticleFocused practice is an approach to primary care where a family doctor or GP chooses one or more specific clinical areas as a major part-time or full-time component of their practice. In recent years, there has been a global increase in focused practice and a decline in offering a comprehensive scope of practice in primary care. This Canadian study in the British Journal of General Practice looked at factors influencing family doctors' decisions to work in focused practice. The authors of the study concluded that: both early-career and resident family doctors unanimously saw focused practice as a way to avoid the burnout or exhaustion they associated with comprehensive practice in the current structure of the healthcare system. more research is needed to understand the implications of family physician choices of focused practice within the physician workforce.
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Content ArticleThe Additional Roles Reimbursement Scheme (ARRS) was introduced in England in 2019 as a key part of the government’s manifesto commitment to improve access to general practice. The aim of the scheme is to support the recruitment of 26,000 additional staff into general practice. This is a huge ambition and requires significant and complex change across general practice. While primary care networks (PCNs) have swiftly recruited to these roles, they are not being implemented and integrated into primary care teams in an effective way. This research by The King's Fund focused on four roles to examine the issues related to their implementation: social prescribing link workers first contact physiotherapists paramedics pharmacists. The research examined the experiences of people working in these roles, and of the people managing them. It found a lack of shared understanding about the purpose or potential contribution of the roles, combined with ambiguity about what multidisciplinary working would mean for GPs. If the scheme is to be successfully implemented, it will require extensive cultural, organisational and leadership development skills that are not easily accessible to PCNs.
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Content ArticleThis guidance from the British Medical Association (BMA) covers frequently asked questions around prescribing in primary care and informs GPs of the BMA general practice committee’s policies in prescribing.
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Content Article
BMA NHS backlog data analysis
Patient-Safety-Learning posted an article in Coronavirus (COVID-19)
This webpage from the British Medical Association (BMA) contains analysis of NHS data and is updated monthly. It highlights the growing backlogs across the NHS and includes operations data and information on the cancer waiting list, GP referrals and A&E waiting times.
