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Showing results for tags 'Primary care'.
Found 194 results
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Content ArticleAdvice and guidance on the health needs of migrant patients from Ukraine for healthcare practitioners.
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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 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 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. -
Content ArticleDiagnosis is one of the most important tasks performed by primary care doctors and the World Health Organization (WHO) has highlighted diagnostic errors in primary care as a high-priority patient safety problem. In this narrative review in BMJ Quality & Safety, the authors discuss the global significance, burden and contributory factors related to diagnostic errors in primary care.
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Diagnostic Errors: Technical Series on Safer Primary Care (2016)
Patient-Safety-Learning posted an article in WHO
This document from the World Health Organization raises awareness about strategies that could reduce diagnostic errors in primary care. It highlights the importance of examining diagnostic errors, identifies the most common types of diagnostic error in primary care and describes potential solutions. -
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 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.
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Content ArticleThis 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.
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Content ArticleZiebland et al. consider what might be learned from the unintended, apparently unanticipated, consequences of the use of digital health (including alternatives to face to face consultations, electronic medical records, use of apps and online monitoring) in primary care.
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Content ArticleClinical guidelines advise GPs in England which patients need urgent referral for suspected cancer. This study in BMJ Quality & Safety used linked primary care, secondary care and cancer registration data to assess: how often GPs follow the guidelines on cancer referral whether certain patients are less likely to be referred how many patients were diagnosed with cancer within one year of non-referral. The study included patients who presented for the first time with blood in the urine, breast lump, difficulty swallowing, iron-deficiency anaemia and post-menopausal or rectal bleeding during 2014–2015. The authors found that the majority of patients presenting with common possible cancer symptoms were not being referred by GPs in line with clinical guidelines. They also found that a significant number of these patients went on to develop cancer within a year, and suggest that improvement is needed in the cancer diagnosis process.
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Content ArticleIn this editorial for BMJ Quality & Safety, Dr Tamasine Grimes makes the case for greater patient involvement in managing medication, particularly at points of transition in care. She comments on a recent report on the effects of MARQUIS2, an evidence-based toolkit trialled in North American hospitals to help manage complex medication. The report found that interventions that involved patients in managing their medication had a significant effect in decreasing medication discrepancies, while purely system-level interventions did not.
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Content ArticleThe authors of this research study, published in BMJ Quality & Safety looked at the issues of hazardous prescribing and inadequate monitoring in patients with mental health issues being managed in primary care. They identified a lack of data in this area, despite most patients with mental illness receiving treatment in a primary care setting. The study found that: 9.4% of patients ‘at risk’ triggered at least one indicator for potentially hazardous prescribing. The risk was greatest for patients aged 35–44, females and those receiving more than 10 repeat prescriptions. 90.2% of patients ‘at risk’ triggered at least one indicator for inadequate monitoring. The risk was particularly high in people under the age of 25, females and those with one or no repeat prescription. The authors of the study hope their findings will support providers to reduce risk and improve care for patients who receive mental health treatment in primary care.
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Content ArticleThis study, published in the European Journal of General Practice, explores the type and nature of patient safety incidents in French primary care settings during the first wave of the Covid-19 pandemic. Its findings suggest that constraints of the first wave of the pandemic contributed towards patient safety incidents during non-Covid-19 care, with the authors suggesting a national primary care emergency response plan to support practitioners could have mitigated many of the non-Covid-19 related patient safety incidents during this period.
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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 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 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 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 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 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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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.
