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Found 190 results
  1. Content Article
    This article by Rebecca Rosen and Trisha Greenhalgh in the BMJ looks at the safety of remote GP consultations. It begins by looking at the case of student David Nash, who tragically died in 2020 after four telephone consultations with his GP; he was denied an in-person appointment for a painful ear infection that led to a fatal brain abscess. One coroner has raised concerns that this is not a one-off incident, noting that in five inquest reports they wrote during the pandemic, they question whether deaths could have been prevented by in-person consultations. The authors look at the recommendations of the ongoing 'Remote by Default 2' study, which is exploring how best to embed remote consulting in future GP services. They highlight better triage of appointment requests, active listening, checking back, increasing the use of video consulting and better training for clinicians as factors that could improve the safety of remote consultation.
  2. Content Article
    Sarah Kay and Jaydee Swarbrick are involved in the Patient Safety in Primary Care Project in Dorset. In this blog, they summarise a recent event they held to share learning from medicines incidents.
  3. Content Article
    A culture of patient safety is essential for the continual improvement of service and reducing errors. This study in Risk Management and Healthcare Policy aimed to examine how the scores of patient safety culture items impact accreditation compliance percentages in primary care settings in Kuwait.
  4. Content Article
    The objective of this analysis, published in the BMJ, was to determine whether the withdrawal of the Quality and Outcomes Framework (QOF) scheme in primary care in Scotland in 2016 had an impact on selected recorded quality of care, compared with England where the scheme continued.
  5. Content Article
    Wound care is rarely considered a strategic objective within health and care, but it has considerable impact on patients and on health service resources. In this blog, Ameneh Saatchi, Senior Partnerships and Policy Manager at Public Policy Projects looks at the growing burden of wound care on the health service and what can be done to tackle the problem.
  6. Content Article
    Patients benefit from guideline-based preventive, chronic disease, and acute care, but many do not receive it. A limitation to providing high-quality care is insufficient time for primary care providers (PCPs). The aim of this study was to quantify the time needed to provide preventive care, chronic disease care, and acute care for a nationally representative adult patient panel by a PCP alone, and by a PCP as part of a team-based care model. The authors concluded that PCPs do not have enough time to provide the guideline-recommended primary care. With team-based care the time requirements would decrease by over half, but still be excessive.
  7. Content Article
    This report provides a snapshot of the NHS Confederation's work over the last year. It outlines how the NHS Confederation has challenged the government for a fair funding settlement for the NHS, pressed ministers for a long-term workforce strategy, urged the government and unions to end the industrial dispute and made the case for more autonomy for healthcare leaders.
  8. Content Article
    With the NHS often characterised as being trapped in a permacrisis, what can be done to shift the dial? In this NHS Confederation podcast, Daniel Elkeles, chief executive of the London Ambulance Service NHS Trust, talks about improvements in the urgent and emergency care pathway, shifting the narrative on primary care and busting the barriers holding the health and care system back. With industrial action taking a toll, Daniel, who leads the world’s largest ambulance service, sheds light on the untold impact of strikes, the effect on long-term innovation and recovery and why culture change in the ambulance service is top of his mission list.
  9. Content Article
    GP services are the first point of call for many health issues and the gateway to NHS specialist support.  GP teams are highly skilled and may decide that treatment without specialist care is the best action. But when you need specialist support, such as hospital tests or treatment, you may need a referral from your GP team first. New research from Healthwatch highlights that it can be very hard for some people to get a GP referral to another NHS service. And for 21% of people we spoke to, even when they get referrals, they can be lost, rejected or not followed up on. When services don't process referrals properly, it can cause significant frustration, unnecessary anxiety, and even cause harm to patients.  It can also lead to increased demand for either more GP appointments or help from healthcare teams in other parts of the NHS, putting more pressure on already overstretched services.
  10. News Article
    NHS England is raiding a national fund earmarked for improvements in cancer, maternity care and other priority services by up to £1bn this year, to pay for deficits elsewhere, and will cut it by a similar amount in 2023-24, HSJ has learned. The “service development fund” is allocated at the beginning of the year for priority service areas also including primary care, community health, mental health, learning disabilities and health inequalities. Several NHSE directors said it was being tightly squeezed this year, amid major cost pressures from inflation, a pay deal unfunded by government, and higher than expected covid-related costs. One well-placed source said the fund this year was required to underspend by about £1bn against what had been planned, which will help balance overspends elsewhere in the NHS. The cuts are likely to be linked to ministers’ view that the NHS should focus on “core” priorities and cut other activities, including reducing NHSE national programme work which is typically linked to SDF budgets. Patricia Hewitt is looking into giving integrated care systems more “autonomy” from NHSE to set their own priorities. Read full story (paywalled) Source: HSJ, 8 December 2022
  11. Content Article
    The medical symptom 'iceberg' and 'trivia' were defined in terms of people's own perceptions of their symptoms and their subsequent referral behaviour. The data were collected by household interviews of patients registered at a health centre and included information on personal and environmental characteristics. Bivariate and multivariate analysis was used to explore associations between those who were part of the symptom 'iceberg' or 'trivia', and factors which might have caused such incongruous referral behaviour.
  12. 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.
  13. Content Article
    This 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.
  14. Content Article
    This 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.
  15. 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.
  16. Content Article
    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.
  17. Content Article
    Now 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.
  18. Content Article
    This 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.
  19. Content Article
    GP practices are usually run separately from hospitals. In some places in England and Wales, the NHS organisations responsible for managing hospitals are now also running local GP practices. It is difficult in some areas for practices, which are small organisations, to recruit GPs and keep going. It is also desirable to coordinate GP services with hospital care. For these reasons, it may help if the organisations managing hospitals also run GP practices.
  20. Content Article
    Primary 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.
  21. Content Article
    This 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.
  22. Content Article
    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.
  23. Content Article
    Primary 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.
  24. Content Article
    This 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.
  25. Content Article
    In 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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