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Showing results for tags 'Primary care'.
Found 194 results
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Content ArticleGeneral practice has always been the foundation and gateway to the NHS, but this part of the healthcare system is now under strain due to greater demand from an increasingly complex patient profile, and a stretched workforce. Lack of staff and coherent planning means that the current model is not fit for purpose, and this has resulted in a recent decrease in patient satisfaction. This proposal by the think tank Policy Exchange outlines the reforms that could help the NHS develop a model of general practice to better meet the needs and interests of patients and healthcare workers.
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Content ArticleThis study in Risk Management and Healthcare Policy aimed to explore healthcare workers’ perceptions of patient safety culture at primary healthcare centres in the Eastern Province of Saudi Arabia, and the factors that influence them. It also aimed to identify the challenges of adopting patient safety culture in these centres. The study findings highlight a number of areas for improvement, particularly in relation to event reporting, non-punitive responses, and openness in communication. The authors highlight that error reporting should not just be considered a means of learning from mistakes, but should also be considered the first step towards preventing injury and improving patient safety. They highlight the need to eliminate three crucial elements associated with errors - blame, fear, and silence - in order to build a safety culture.
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Content ArticleIn this article in The BMJ, Farah Hameed highlights that the backlog of care in the aftermath of the Covid-19 pandemic is having a significant and detrimental effect on primary care services, not just elective hospital treatment. The combined impact of patients not coming forward for treatment during the pandemic, and hospitals having to cancel non-urgent procedures and routine clinics, has led to a huge backlog of patients living with conditions that are gradually getting worse. It is primary care that has to support these patients in the absence of capacity in secondary care. Consultant-led hospital services rejecting GP referrals due to lack of capacity is a major problem, with the number of GP referrals rejected due to lack of slots jumping from 238,859 in February 2020 to 401,115 in November 2021. Farah argues that emphasis must be placed on how tackling the build-up of care in our communities can help the wider system. For example, making GP continuity of care a policy priority would be a cost-effective way of improving patient outcomes and reducing the burden on other parts of the healthcare system, including secondary 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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Content ArticleThis article in the British Journal of General Practice examined GP perspectives and concerns about safeguarding during the Covid-19 pandemic, focusing on the challenges and opportunities created by remote consultation. GPs interviewed for the study expressed concern about missing observational information during remote consultations, with pooled triage lists seen as further weakening safeguarding opportunities. They were also worried that conversations might not be private or safe. Remote consultations were seen as more ‘transactional’, with reduced opportunities to explore ‘other reasons’ including new safeguarding needs. Remote consultation was seen as more difficult and draining and associated with increased GP anxiety and reduced job satisfaction. However, GPs also recognised opportunities that remote consulting offers, including providing more opportunities to interact with vulnerable patients.
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Content ArticleThis report by The Health Foundation reviews attempts to tackle inequities in the supply of general practice services in England over the past 30 years. The ‘inverse care law’ was first defined by the GP Julian Tudor Hart 50 years ago and describes how people who most need health care are least likely to receive it. The report looks at policies on general practice funding, workforce, premises, contracts and commissioning, examining recent evidence on differences in GP services between more and less deprived areas of England and assessing past national policies to reduce inequities. The report then looks at the implications of this analysis and outlines policy recommendations for addressing the inverse care law in general practice.
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Content ArticleSurgery is lifesaving or life-enhancing for millions of patients every year. However, the operation is not in itself an isolated ‘event’: it is part of a process which includes preparation and recovery. Ensuring the quality of the entire perioperative pathway is important to achieving the best possible outcome for every patient. This guidance is intended to be used by primary care, surgeons, anaesthetists, perioperative teams and preoperative assessment (POA) services. It applies to all patients who are being considered for surgery, or are on a waiting list for surgery in the non-emergency setting, irrespective of the magnitude of procedure or the type of anaesthesia contemplated. Its recommendations will support the care of individual patients, the recovery of elective services, and achieving key goals of the NHS Long Term Plan including reducing health inequalities and preventing serious health deterioration.
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Content ArticleIn this article for The Independent, Hannah Fearn looks at the issues women face when seeking treatment for urinary tract infections (UTIs). New research from Garmin has found that 40% of young women say they have been accused of over-exaggerating symptoms or being “over dramatic” about their wellbeing when seeing a doctor. The author highlights several personal stories of women who have experienced debilitating recurring urinary tract infections (UTIs), describing dismissive and discriminatory treatment from both GPs and secondary care doctors. She also looks at the work of the UK's only dedicated research centre focused on recurrent UTIs for women, based at London’s Whittington Hospital, and highlights new treatments that are becoming available for women with recurrent UTIs.
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Content ArticleThis study in the British Journal of General Practice aimed to examine the relationship between empathy and patient-reported satisfaction, consultation quality, and patients’ trust in their physicians. It also sought to determine whether this relationship is moderated by a physician’s gender. The authors found that doctors self-reported more gender differences in measures of empathy than were observed in external measures, which included a facial recognition test, observations and a Synchrony of Vocal Mean Fundamental Frequencies (SVMFF), which measures vocally coded emotional arousal. SVMFF significantly predicted all patient outcomes, and could be used as a cost-effective proxy for relational quality.
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Content ArticleProfessor Ahmet Fuat, North East and North Cumbria Cardiac Network Heart Failure Lead, shares how one tool is helping reduce the current pressures and deliver better outcomes for patients. NT-proBNP testing – a NICE recommended diagnostic tool – is being used to rule out heart failure in primary care. In the North East and North Cumbria, patients must have an NT-proBNP test to be referred for an echocardiogram. This mandated testing helps them to streamline the diagnosis journey for heart failure patients by confirming or ruling out heart failure at the earliest possible opportunity, and reducing unnecessary referrals for echos. For patients, this saves time and distress, and for GPs and Nurse Practitioners, which reduces the number of repeat visits these patients often need to make.
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Content ArticleIn this second podcast focusing on the Care Quality Commission's (CQC) GP Inequalities Project, Annabelle Stigwood, joint project lead, talks to Dr Faizan Ahmed, National Clinical Advisor at the CQC, and Dr Bola Olowabi, Director - Health Inequalities at NHS England and NHS Improvement. The guests discuss health inequalities and how they impact on the ability of GP practices to do their job. They discuss what we mean by health inequalities, why it's so important to focus on them in health and social care, and the role of providers, systems and regulators in addressing them. Listen to the first episode which introduces the project
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Content ArticleIn this opinion piece for The BMJ, Partha Kar, consultant endocrinologist and NHS England National Specialty Advisor for Diabetes, looks at the crisis facing primary care in the UK. He highlights that many primary care professionals are feeling burnt out due to the intense pressure and negative attention GPs are currently experiencing. The cost of relying on primary care for the vaccination programme is that treatment for mental health and long term conditions has been neglected. GPs are at the receiving end of patients' frustrations about delays to their care. Partha highlights the need to: prepare well in advance for potential future waves of Covid-19, including by developing a vaccine delivery workforce that is not reliant on primary care. ensure vaccines are distributed to less developed countries, and move away from seeing vaccination as an issue of nationalism. increase funding for primary care in a focused and sustained way.
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Content ArticleThis guide by the University of Birmingham's Institute for Mental Health is designed to help young people prepare to talk with their GP about self-harm and suicidal experiences. It contains advice about what to do before, during and after a GP visit.
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News Article
NHS given its 10 priorities for 2022
Patient Safety Learning posted a news article in News
NHS England has set out 10 priorities for 2022-23 in its annual planning guidance. NHSE chief executive Amanda Pritchard makes clear in an introduction that many of its goals remain contingent on covid, stating: ”The objectives set out in this document are based on a scenario where covid-19 returns to a low level and we are able to make significant progress in the first part of next year.” The 10 priorities are: Workforce investment, including “strengthening the compassionate and inclusive culture needed to deliver outstanding care”. Responding to COVID-19. Delivering “significantly more elective care to tackle the elective backlog”. Improving “the responsiveness of urgent and emergency care and community care capacity.” Increasing timely access to primary care, “maximising the impact of the investment in primary medical care and primary care networks”. Maintaining “continued growth in mental health investment to transform and expand community health services and improve access”. Using data and analytics to “redesign care pathways and measure outcomes with a focus on improving access and health equity for underserved communities”. Achieving “a core level of digitisation in every service across systems”. Returning to and better “prepandemic levels of productivity”. Establishing integrated care boards and collaborative system working, and “working together with local authorities and other partners across their ICS to develop a five-year strategic plan for their system and places”. Read full story (paywalled) Source: HSJ, 24 December 2021 -
Content ArticleNHS England has set out 10 priorities for the 2022-23 financial year in its annual planning guidance. NHSE chief executive Amanda Pritchard makes clear in the introduction that many of its goals remain contingent on covid, stating: ”The objectives set out in this document are based on a scenario where covid-19 returns to a low level and we are able to make significant progress in the first part of next year.”
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News Article
NHS cannot be used as vaccination service every few months, jab chief warns
Patient Safety Learning posted a news article in News
The national chief for the Covid vaccination programme has warned that the NHS cannot become a vaccination service every few months. Emily Lawson also told healthcare staff in a briefing on Wednesday: “I have fed back to the Department of Health yesterday that I think realistically we don’t have the capacity to do anything else new over the next two-and-a-half weeks. “And that when we plan for things and have the right lead-up to them, we deliver them more effectively, which in the end is very critical for public confidence.” Her warning comes after the government announced plans on Sunday to rapidly accelerate the national Covid vaccination programme by offering all adults a booster jab by the new year. On Monday, NHS England sent letters to hospital chiefs, GPs and local healthcare leaders setting out plans to speed up the programme, and said the first priority for primary care would be delivering vaccines. Healthcare leaders were told they could drop non-urgent care in efforts to support the vaccine drive, however specific details on what treatments can be dropped are yet to be finalised. Read full story Source: The Independent, 15 December 2021 -
Content ArticleThis study in the British Journal of General Practice aims to identify and understand the unintended consequences of online consultations in primary care. The authors interviewed 19 patients and 18 general practice staff at eight general practices using online consultation tools in South West and North West England between February 2019 and January 2020. The study found the following unintended consequences of online consultation: Creation of difficulties for some patients in communicating effectively with a GP. The system disadvantaged digitally-excluded patients. Patient uncertainty about how their queries were dealt with, and whether practices used online consultations as their preferred method for patients to contact the practice. Creation of additional work for some staff. Isolation and dissatisfaction for some staff.
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Content ArticleIn this blog Dr Peter Green, CVDPREVENT Workstream Clinical Lead for the NHS Benchmarking Network, looks at the importance of understanding how demographic factors impact the risk of cardiovascular disease, which is a leading risk factor for premature death. He discusses how the CVDPREVENT audit will help primary care healthcare professionals work with their patients to achieve better outcomes for all.
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Content ArticleThis is the first annual report for CVDPREVENT, an audit commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). It presents analysis of data recorded by GPs up to March 2020, providing a pre-pandemic baseline for indicators of cardiovascular disease (CVD) prevention. The analysis focuses on understanding variation in identification, diagnosis and management of people at risk of CVD against metrics of deprivation, age, sex, and ethnicity. There has also been further analysis undertaken on comorbidities amongst those with conditions that put them at a higher risk of cardiovascular disease.
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Content ArticleIn this podcast for the Care Quality Commission (CQC), Dr Ayisha Ashmore and Dr Faizan Ahmed discuss the CQC's GP Inequalities Project which is investigating the concern that GPs from an ethnic minority background receive poorer CQC ratings or regulatory outcomes.
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Content ArticleThis research gives insights into the views of doctors who were previously practising in the UK but who are not currently doing so, in terms of their characteristics, motivations and likelihood to return to clinical practice in the UK. A survey of over 13,000 doctors was carried out between 21 January 2020 and 10 March 2020. This report was developed in partnership between the General Medical Council (GMC), Health Education England (HEE), The Department of Health (Northern Ireland), NHS Education for Scotland (NES) and Health Education and Improvement Wales (HEIW).
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Content ArticleThis report by the Primary Care Foundation considers the question: 'Is the drive to improve outcomes and the quality of integrated urgent care being compromised by poor data quality?' The report highlights that monitoring the performance of NHS contracts is vital to allow commissioners to understand and compare the effectiveness of services, and that this monitoring cannot occur without accurate data. The authors conducted a detailed study of current data before exploring how issues in the system might be overcome. The report aims to build consensus for change within the urgent care sector.
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Content ArticleIn this episode of the podcast Health on the Line, Professor Trish Greenhalgh, professor of primary care health sciences at the University of Oxford provides a scientific take on the COVID-19 pandemic and its implications on primary care and scientific innovation. The world-renowned professor and trained GP also offers her view on virtual care, vaccine inequity and why innovation happens at times of turbulence.
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Content ArticleResearch shows that patients who stayed registered with the same GP over many years have fewer out-of-hours appointments and acute hospital admissions, as well as a reduced risk of death. Helen Salsibury in this BMJ article discusses the benefits of continuity of care not only for the patient but also the doctor.
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Content ArticleThis article in Social Science & Medicine examines how GPs and patients explore medical and existential uncertainty in consultations. The authors analysed 20 naturally occurring clinical consultations between general practitioners and patients in England, focusing on interactions and how they negotiated uncertainty. They found that the doctor-patient dynamic contributes significantly to the way in which medical uncertainty is discussed. By conceptualizing uncertainty in an indirect and depersonalized manner, GPs manage to safeguard against clinical errors without compromising their authority and credibility.
