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Showing results for tags 'Primary care'.
Found 194 results
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Content ArticleThis practice pointer in The BMJ provides an update on treating Long Covid in primary care and outlines how healthcare professionals might respond to questions that patients ask about the condition. The article provides information on: Definition of Long Covid Epidemiology Symptoms and case definition Questions patients ask Further resources for patients and healthcare professionals
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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 Royal College of General Practitioners has put together useful resources for GPs during the coronavirus pandemic.
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Content ArticleThe Royal College of General Practitioners have put together guidance for those working in primary care.
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Content ArticleIn this study, Avery et al. estimated the incidence of avoidable significant harm in primary care in England, and describe and classify the associated patient safety incidents and generate suggestions to mitigate risks of ameliorable factors contributing to the incidents. The study found there is likely to be a substantial burden of avoidable significant harm attributable to primary care in England with diagnostic error accounting for most harms. Based on the contributory factors we found, improvements could be made through more effective implementation of existing information technology, enhanced team coordination and communication, and greater personal and informational continuity of care.
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Content ArticleAsaf Bitton, is Executive Director of Ariadne Labs and a global expert on primary care policy and delivery. In this interview with the Institute for Healthcare Improvement (IHI), Bitton talks about both the losses and the opportunities presented by COVID-19 and the rapid expansion of telehealth.
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Content ArticlePhysicians and patients have concerns associated with a shift toward virtual medicine. This interview with a Dr Paul Hyman, a primary care physician, highlights how the loss of physical touch and in-person communication could negatively affect care and the patient/physician relationship.
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Content Article
UCL Partners: Proactive care frameworks
Patient Safety Learning posted an article in Care pathways
UCL Partners have developed a series of proactive care frameworks to restore routine care by prioritising patients at highest risk of deterioration, with pathways that mobilise the wider workforce and digital/tech, to optimise remote care and self-care, while reducing GP workload. The frameworks include atrial fibrillation, high blood pressure, high cholesterol, type 2 diabetes, asthma and COPD. -
Content ArticleA sub-group of rare but serious patient safety incidents, known as ‘never events,’ is judged to be ‘avoidable.’ There is growing interest in this concept in international care settings, including UK primary care. However, issues have been raised regarding the well-intentioned coupling of ‘preventable harm’ with zero tolerance ‘never events,’ especially around the lack of evidence for such harm ever being totally preventable. Bowie et al. consider whether the ideal of reducing preventable harm to ‘never’ is better for patient safety than, for example, the goal of managing risk materialising into harm to ‘as low as reasonably practicable,’ which is well-established in other complex socio-technical systems and is demonstrably achievable. They reflect on the ‘never event’ concept in the primary care context specifically, although the issues and the polarised opinion highlighted are widely applicable. Recent developments to validate primary care ‘never event’ lists are summarised and alternative safety management strategies considered, e.g. Safety-I and Safety-II.
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Content ArticleThe Royal College of General Practitioners has updated its guidance on online consultations. The resource gives a useful set of questions to consider when using online consultations, such as which provider is used, the standard of patient care, and ensuring equitable access.
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Content ArticlePatients with respiratory disease deserve a correct diagnosis and guideline driven care that is standardised, patient focussed and delivered by a healthcare professional with suitable training and experience in a site and timeframe to meet their needs. Sadly, patient groups such as the BLF and Asthma UK have recognised that this is often not the case. The Respiratory Service Framework (RSF) attempts to demonstrate what that excellence is – and how it may be delivered at a population level. Developed by the PCRS Service Development Committee, the Respiratory Service Framework helps those looking to design a patient focussed respiratory service working across all sectors of out of hospital care to see the ideal components for a given population of patients. It has been designed to be applicable and helpful to those delivery care at a PCN or ICS level.
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Content ArticleMost primary care clinicians are well aware that the climate crisis is a health crisis and of the immediate and significant health co-benefits of climate action, such as through reduced air pollution. However, when it comes to taking action, in our experience many clinicians do not make the link with clinical practice. This is perhaps a result of extrapolating from actions to reduce one’s personal carbon footprint in areas like energy, waste, and transport. Yet, the majority of general practice’s carbon footprint results from clinical activity. In this article, Aarti Bansal and Grant Blashki focus on clinical practice and outline six practical steps that primary care can take towards sustainable healthcare that align with evidence-informed and person-centred practice.
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Content ArticleWhile there is growing awareness of the risk of harm in ambulatory health care, most patient safety efforts have focused on the inpatient setting. The Comprehensive Unit-based Safety Program (CUSP) has been an integral part of highly successful safety efforts in inpatient settings. In 2014 CUSP was implemented in an academic primary care practice. As part of CUSP implementation, staff and clinicians underwent training on the science of safety and completed a two-question safety assessment survey to identify safety concerns in the practice. The concerns identified by team members were used to select two initial safety priorities. The impact of CUSP on safety climate and teamwork was assessed through a pre-post comparison of results on the validated Safety Attitudes Questionnaire. CUSP is a promising tool to improve safety climate and to identify and address safety concerns within ambulatory health care.
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Content ArticleThis article, published in the British Medical Journal, is intended for primary care clinicians and relates to the patient who has a delayed recovery from an episode of COVID-19 that was managed in the community or in a standard hospital ward. Broadly, such patients can be divided into those who may have serious sequelae (such as thromboembolic complications) and those with a non-specific clinical picture, often dominated by fatigue and breathlessness.
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Content ArticlePatient safety is a quality indicator for primary care and it should be based on individual needs, and not differ among different social groups. Nevertheless, the attention on social disparities in patient safety has been mainly directed towards the hospital care, often overlooking the primary care setting. This paper, published in the International Journal for Equity in Health, aims to synthesise social disparities in patient safety in the primary care setting. The results of this systematic review suggest that vulnerable social groups are likely to experience adverse patient safety events in primary care. Enhancing family doctors’ awareness of these inequities is a necessary first step to tackle them and improve patient safety for all patients. Future research should focus on social disparities in patient safety using socioeconomic indicators, such as income and education.
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Content ArticleThis Royal College of General Practitioners (RCGP) report calls on the four governments of the UK to each produce a comprehensive plan to support GPs in managing the longer-term effects of COVID-19 in the community.
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Content ArticlePrimary care services provide an entry point into the health system which directly impact's people well-being and their use of other healthcare resources. Patient safety has been recognised as an issue of global importance for the past 10 years. Unsafe primary and ambulatory care results in greater morbidity, higher healthcare usage and economic costs. According to data from World Health Organization (WHO), the risk of a patient dying from preventable medical accident while receiving health care is 1 in 300, which is much higher than risk of dying while travelling in an airplane. Unsafe medication practices and inaccurate and delayed diagnosis are the most common causes of patient harm which affects millions of patients globally. However, the majority of the work has been focused on hospital care and there is very less understanding of what can be done to improve patient safety in primary care. Provision of safe primary care is priority as every day millions of people use primary care services across the world. The paper from Kuriakose et al., published in the Journal of Family Medicine and Primary Care, focuses on various aspects of patient safety, especially in the primary care settings and also provides some potential solutions in order to reduce patient harm as much as possible. Some important challenges regarding patient safety in India are also highlighted.
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Content Article
Mental Health inpatient discharge V2.1
Claire Cox posted an article in Transfers of care
People with mental health problems need good, joined up physical and mental health care, both in hospital and the community. Successful joined up care depends on GPs, community and acute mental health care teams and social care professionals all having access to timely information about a persons care and treatment. The Professional Records Standards Body (PRSB) has developed the mental health discharge summary standard to ensure that relevant information is shared, so professionals can provide continuity of care when an adult is discharged from mental health services. It includes information on patient history and social context, medications, the details of their hospital admission, as well as current and previous diagnoses. The mental health discharge summary will improve professional communication between the patient's secondary care providers to their GP. It is very important to recognise the different nature of mental illness to physical illness and disease including the different methods of treatments and imperative follow-up care after discharge. The language used in the headings and in the clinical descriptions has been modified, where necessary, to be more inclusive and sympathetic to the nature of mental illness and processes of care. This project supports the NHS Digital and NHS England interoperability work -
Content ArticleThe aim of this study, published by the British Dentistry Journal, was to identify and develop a candidate 'never event' list for primary care dentistry.
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Content ArticleThe Health Foundation commissioned the London School of Hygiene and Tropical Medicine to survey over 2,300 GPs and 1,400 practice managers across the UK, alongside qualitative interviews. The research shows that most GPs and practice managers see quality improvement as a core aspect of their work, with 99% reporting undertaking QI activities, and many working collaboratively with neighbouring practices to improve services. However, there are many issues making it difficult to deliver improvement, including high patient demand and staff shortages; demands of other NHS agencies, lack of protected time and level of improvement capability.
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Content ArticleBuilding on published patient safety research literature, this paper from the OECD, aims to broaden the existing knowledge base on safety lapses occurring in primary and ambulatory care settings.
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Content ArticleThis paper, published in BMJ Quality and Safety, investigated how often patient safety incidents occur in primary care and how often these were associated with patient harm.
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Content ArticleEngaging with general practices during inspections gives valuable insight into their experiences. Feedback shows that although inspection reports highlight the areas of concern and risk that need to improve, practices want to know more about how to actually improve from a rating of 'requires improvement' or 'inadequate'. The Care Quality Commission (CQC) selected 10 practices throughout the country that had each made significant improvements from their initial inspection to their most recent, and whose overall rating had improved. These 10 case studies highlight some clear actions that other practices can use to help them learn and improve.
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Content ArticleSafety and Improvement in Primary Care: The Essential Guide is ideal for frontline clinicians, managers and healthcare administrators needing practical guidance on safety and is also highly recommended for improvement advisers, patient safety officers, clinical governance facilitators, risk managers and health services researchers wanting a critical review of theory and evidence. Primary care educators, too, will find much of interest in relation to designing and delivering training to help trainee doctors, established clinicians, managers and other colleagues meet the demands and obligations of specialty training, appraisal and revalidation, routine contractual requirements and continuing professional development. It provides reading for healthcare policy makers seeking implementation evidence on interventions for improving quality and safety at the professional, team and organisational levels.
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Content ArticlePrimary care services provide an entry point into the health system which directly impact's people well-being and their use of other health care resources. Patient safety has been recognised as an issue of global importance for the past 10 years. Unsafe primary and ambulatory care results in greater morbidity, higher healthcare usage and economic costs. According to data from World Health Organisation (WHO), the risk of a patient dying from preventable medical accident while receiving health care is 1 in 300, which is much higher than risk of dying while travelling in an airplane. Unsafe medication practices and inaccurate and delayed diagnosis are the most common causes of patient harm which affects millions of patients globally. However, majority of the work has been focussed on hospital care and there is very less understanding of what can be done to improve patient safety in primary care. Provision of safe primary care is priority as every day millions of people use primary care services across the world. This paper, published in The Journal of Family Medicine and Primary Care, focuses on various aspects of patient safety, especially in the primary care settings and also provides some potential solutions in order to reduce patient harm as much as possible. Some important challenges regarding patient safety in India are also highlighted.
