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Found 133 results
  1. Event
    NHS Resolution’s Safety and Learning team in collaboration with the NW panel law firms, are hosting a virtual forum series on learning from claims to promote reflection and improve patient care. The purpose is to raise awareness of the support offered by NHS Resolution as your General Practice indemnifier along with the North West panel firms; Weightmans, Hempsons and Hill Dickinson. This will be of interest to both clinical and non-clinical staff involved in patient care across primary and urgent care . The format is interactive, with presentations followed by questions and panel discussion. Session 1: Seeking support for claims The session will explain how NHS Resolution, and its panel firms, will support you in responding to claims along with an overview of the legal tests used to determine a claim and the steps involved. Event programme: Introduction to the GP Indemnity scheme and clinical negligence Q&A panel discussion Contributors: • Patricia Roe - Partner | Hempsons • Dr Anwar Khan - Senior Clinical Advisor for General Practice, NHS Resolution Register
  2. News Article
    Same-day access hubs will not be mandated in North West London as the Integrated Care Board (ICB) bows to pressure from GPs and patients. In a letter to GP teams, seen by Pulse, the ICB said that their controversial same-day access programme "will not form part of the single offer for enhanced services for 2024/25". Instead, ICB leaders said they want to work with PCNs "to consider how access can be improved" and that they do not have a "presumption" about a "particular model" all PCNs should adopt. They are now aiming for a new model to be implemented from April next year instead. The hub model aimed to "deliver a single point of triage for same-day, low complexity" demand for all 2.1 million residents within the integrated care system, leaving GP practices with only longer-term, "complex" care. But London GP leaders, as well as patients, raised "immense concern" with the plans, including patient safety, quality of care, and logistics. In response to these concerns, the ICB confirmed yesterday that it has "adjusted" the same-day hub programme, and that it wants to "move forward collectively" to address both patient access issues and GP pressures. Read full story Source: Pulse, 6 March 2024
  3. Community Post
    It's rare that I post personal information of any kind on a website such as this, but this really irked me so felt it was worth sharing. Context: I've been an Asthma sufferer since the age of 3 years old. I know exactly how to manage my condition having had it for over 50 years, and have always used a blue ventolin inhaler as and when necessary (perhaps once every 2-3 months). I have not had any serious issues with my Asthma for at least 20 years, and then only in Hayfever season. Issue: I only renew my inhaler when it expires, every 2 years or so. Therefore it is not listed on my repeat medications list. My most recent one had just run out, so I needed a replacement. Action: I emailed the GP's website as I knew I was meant to, and received an automated email back saying that I would receive a response within 5 working days. So far so good. Response: I received another email response 2 days later (pretty good!) saying that the GP would have to call me to run through why I needed a new inhaler. GP call: The GP rang on the set day and within the allocated time window and started asking me how often I used the inhaler, for what, and did I really need that or the preventative one (which I've had before). At the end of our 10 minute call, she agreed that I just needed a replacement blue ventolin inhaler, as I had asked for in the first place. What a waste of the GP's time, and mine!! It made me think that it would be a helpful thing if certain patients with decades of experience in managing their condition(s) in a very stable way could be classed as 'expert patients' on their GP record. This could save a huge amount of wasted time on both sides!! This blog post first appeared on Linkedin on 30 October 2022. I will post some of the responses to it below for added insight.
  4. News Article
    Areas across England where the highest proportion of ethnic minorities live have the poorest access to GPs, with experts attributing this disparity to an outdated model being used to determine funding. As of October 2023, there were 34 fully qualified full-time-equivalent GPs per 100,000 patients in the areas with the highest proportion of people from ethnic minority backgrounds, according to a Guardian analysis of NHS Digital and census data. This is 29% lower than the 48 general practitioners per 100,000 people serving neighbourhoods with the highest proportion of white British people. Although ethnic minorities tend to be younger than the white British population, minority ethnic areas still have the lowest number of GPs per person even when factors such as age, sex and health necessities are considered. Prof Miqdad Asaria at the London School of Economics department of health policy said it was “very concerning” that ethnic minorities “have systematically poorer access to primary care which is likely to be a key driver of current and future health inequalities”. “Primary care plays a crucial role in preventing disease, diagnosing and treating illness, and facilitating access to specialist or hospital treatment for people who need it,” he added. Read full story Source: The Guardian,15 February 2024
  5. News Article
    Almost one in four people have bought medicine online or at a pharmacy to treat their illness after failing to see a GP face to face, according to a UK survey underlining the rise of do-it-yourself treatment. Nearly one in five (19%) have gone to A&E seeking urgent medical treatment for the same reason, the research commissioned by the Liberal Democrats shows. One in six (16%) people agreed when asked by the pollsters Savanta ComRes if the difficulty of getting an in-person family doctor appointment meant they had “carried out medical treatment on yourself or asked somebody else who is not a medical professional to do so”. Ed Davey, the leader of the Liberal Democrats, said delays and difficulty in accessing GP appointments constituted a national scandal, and face-to-face GP appointments had become “almost extinct” in some areas of the country. He said: “We now have the devastating situation where people are left treating themselves or even self-prescribing medication because they can’t see their local GP.” Dr Richard Van Mellaerts, the deputy chair of the British Medical Association’s GP committee in England, said: “While self-care and consulting other services such as pharmacies and NHS 111 will often be the right thing to do for many minor health conditions, it is worrying if patients feel forced into inappropriate courses of action because they are struggling to book an appointment for an issue that requires the attention of a GP or a member of practice staff.” Read full story Source: The Guardian, 2 January 2024
  6. News Article
    GPs have warned that the extent of verbal abuse directed at them and their practice staff ‘is increasing’, with the majority reporting that things are worse now than during the height of the Covid pandemic. A UK-wide survey of more than 2,000 doctors – of which 617 were GPs – found that 85% of GPs have reported receiving verbal abuse from patients within the last 12 months. The research conducted by Medical and Dental Defence Union of Scotland (MDDUS) also found that 15% of GPs reporting verbal abuse said they ‘had to resort to involving the police’ to deal with abusive patient situations over the past year. In the survey, GPs identified key triggers such as ‘lack of access to a face-to-face consultation’ and ‘complaints about their quality of care’ as the factors that could escalate to verbal abuse. One GP who responded to the survey said: "During a consultation with a young adult, they got very irate and demanded I just give them what they came for. "I explained they had to calm down and we would only proceed then at which they called me an ugly, fat, c**t and threatened to smash my face in. That consultation stayed with me for quite a while after that." Another said: ‘A patient smashed the surgery front door (it needed replacing) because he didn’t get what he wanted when he wanted it. "This was very scary for staff and other patients and the police didn’t even come until the next day. I felt alone, defensive and wondered why we bother to try to provide a service when some patients have already decided it isn’t good enough for them." Read full story Source: Pulse, 7 December 2023
  7. News Article
    Patients are at risk of having serious health conditions missed because of the lack of continuity of care provided by GPs, the NHS safety watchdog says. Investigators highlighted the case of Brian who was seen by eight different GPs before his cancer was spotted as an example of what can go wrong. Brian had a history of breast cancer and had been discharged from the breast cancer service. Two years later he began to have back pain. Over the following eight months, he saw two out-of-hours GPs and six GPs based at his local practices as well as a physio and GP nurse, before he was sent for a hospital check-up in late 2020. A secondary cancer had developed on Brian's spine, but it was too late to offer him curative treatment and he was given end-of-life care. He has since died. The watchdog said the lack of continuity of care resulted in the diagnosis of Brian's cancer being missed. One of the key problems was that the different GPs he saw missed the fact he was attending repeatedly for the same issue. Senior investigator Neil Alexander said Brian's case was a "stark example" of what can happen when there is a breakdown in continuity of care. "He told our team 'when I am gone, no-one else should have to go through what I did'." Read full story Source: BBC News, 30 November 2023
  8. Content Article
    Patients who visit their GP practice with an ongoing health problem may see several different GPs about the same symptoms. To make sure they receive safe and efficient care, there needs to be a system in place to ensure continuity of care. In the context of this report, continuity of care is where a patient has an ongoing relationship with a specific doctor, or when information is managed in a way that allows any doctor to care for a patient. While some GP practices in England operate a formalised system of continuity of care, many do not. This investigation explored the safety risk associated with the lack of a system of continuity of care within GP practices. The investigation focused on: How GP practices manage continuity of care. This includes how electronic record systems alert GPs to repeat attendances for symptoms that are not resolving and how information is shared across the healthcare system. Workload pressures that affect the ability of GP practices to deliver continuity of care. This investigation’s findings, safety recommendations and safety observations aim to prevent the delayed diagnosis of serious health conditions caused by a lack of continuity of care and to improve care for patients across the NHS.
  9. Event
    In this first webinar of the Changes in Primary Care series, Dr Claire Fuller, Medical Director of Primary Care at NHS England will discuss the new reception team alongside frontline general practice staff. Register for the webinar
  10. News Article
    NHS England has taken the unusual move of warning multiple GP practices they are breaching their contract by refusing to give people automatic access to future entries in their record. Under the current national GP contract, practices were ordered to give people on their list automatic access to prospective (future) medical records, via the NHS App, by 31 October. However, the British Medical Association GP committee has urged GPs to instead adopt an “opt in” model, saying it is concerned that giving automatic access could endanger some people. The BMA gave practices a template letter to use to tell their integrated care boards they cannot move ahead with automatic access “due to several risks that cannot be sufficiently mitigated”. NHS England’s own template letter for ICBs to use in response, seen by HSJ, states: “Based on your letter we interpret that the required changes were not implemented by 31 October 2023, thereby putting you in breach of your contractual obligations. We would therefore like to discuss with you your plan, including the timeline to become compliant.” It is an unusual warning from NHSE which could potentially apply to hundreds or thousands of practices. Read full story (paywalled) Source: HSJ, 16 November 2023
  11. News Article
    One in 10 people attempting to contact their GP practice do not manage to get in contact, while a further 6% are only told to try again another day, according to new official survey findings commissioned by the government. The Office for National Statistics has been quietly carrying out the new regular GP access survey since the spring after ministers said they wanted to monitor the impact of their primary care recovery plan. After a sign of slight improvement in the summer, the latest survey results – for October – show no significant change since May. It also found, as did previous rounds, that of those who had tried to contact a GP practice in the past month, 10 per cent said they could not do so (see chart below, ‘Contact with GP practice’). Of those who did make contact, a further 6 per cent reported they were told to try again another day (see chart below, ‘Next step after contact’). The government and NHS England have made it a high priority in recovery plans that patients should no longer be asked to call back another day to book an appointment and should know “on the day” how their request will be managed, which may mean being advised to use a different service. Read full story (paywalled) Source: HSJ, 9 November 2023
  12. Content Article
    People with chronic pain need personalised care – an approach offering patients choice and control over their mental and physical health, basing care on what matters to them personally, and focusing on individual strengths and needs. People in this position need someone to listen and acknowledge that these symptoms are real, not all in their head. They need someone to explain their chronic pain and other symptoms, but also someone for everything else too. As well as medical care, people need time and emotional care. But how on earth can this be achieved in UK primary care in 2023? Is this really the role of a modern GP? Even if it was how can it now be in our over-stretched, fragmented, target-driven services? In North-West London, Selena Stellman and Benjamin Ellis have tested a personalised care model to improve the care offered to patients with fibromyalgia and high impact chronic pain. In this opinion piece in BJGP Life, they discuss the two key changes in their approach.
  13. News Article
    Britain’s top family doctor is calling for a “black alert” system to be introduced in general practice so that doctors can warn when surgeries are dangerously over capacity. It comes as a report reveals that almost half of GPs can no longer guarantee safe care for millions of patients, as a shortage of medics means they are unable to cope with soaring demand. Prof Kamila Hawthorne, the chair of the Royal College of General Practitioners (RCGP), which represents 54,000 family doctors across the UK, wants a patient safety alert system introduced that is modelled on the operational pressures escalation levels (Opel) warnings – known as “black alerts” – already used by hospitals. It would enable practices and GPs to flag unsafe levels of workload, triggering support from their local health system. GP surgeries would be able to temporarily suspend non-priority activities – including some regular health checkups, certain routine but mandatory staff training and non-urgent paperwork – during periods of excessive workload. This would allow surgeries to reprioritise routine and non-urgent activity and ensure patient safety is prioritised. Hawthorne said: “General practice is a safety-critical industry yet GPs have none of the mechanisms that other safety-critical professions, such as the air traffic industry, have in place to protect them. “Our number one priority is the safety of our patients, but GPs are doing more and more to try to meet the rising demand for our services. When you’re fatigued, you’re more likely to make mistakes and our survey shows that many GPs are no longer able to guarantee that the care they are providing to their patients is as safe as it could be.” Read full story Source: The Guardian, 17 October 2023
  14. News Article
    The UK's biggest chain of GP practices lets less qualified staff see patients without adequate supervision, an undercover BBC Panorama investigation has found. Operose Health is putting patients at risk by prioritising profit, says a senior GP. The company, with almost 600,000 NHS patients, is owned by US healthcare giant Centene Corporation. BBC Panorama sent undercover reporter Jacqui Wakefield to work as a receptionist at one of the UK company's 51 London surgeries. A GP working at the practice said they were short of eight doctors. The practice manager said they hired less qualified medical staff called physician associates (PAs), because they were "cheaper" than GPs. Physician associates were first introduced by the NHS in 2003, so that doctors could deal with more complex patient needs. PAs are healthcare professionals who have completed two years of post-graduate studies on top of a science degree, as opposed to 10 years education and training for GPs. They support GPs in the diagnosis and management of patients, but should have oversight from a doctor. Panorama gathered evidence that PAs were not being properly supervised at the Operose practice. The PAs told the undercover reporter they saw all sorts of patients, sometimes without any clinical supervision. They said the practice treated them as equivalent to GPs. Prof Sir Sam Everington, a senior practising GP at an unconnected partner-run practice, reviewed BBC Panorama's undercover footage and said he was concerned for patient safety. During the undercover investigation at the London practice, administrative workers also revealed a backlog of thousands of medical test results and hospital letters on Operose computer systems. One worker said they were tasked with getting through 200 documents a day, deciding which were important enough to be seen by a GP or pharmacist and which would be filed to the patient's records. One member of staff, worried about making mistakes said they sometimes used Google to help them work out what to do with the documents. Read full story Source: BBC News, 11 June 2022
  15. Content Article
    During the pandemic, reports of abuse directed at doctors’ surgery staff and community pharmacy teams across West Yorkshire have increased. In response, the West Yorkshire Health and Care Partnership has launched a new insight driven campaign called ‘leaving a gap’ to make people think about the consequences of abusive behaviour. Co-produced with staff and patients, the campaign recognises that services are extremely busy, and it can be frustrating for people accessing care. The campaign reminds people we’re all here to help each other and the importance of all round understanding and kindness. A series of striking images created as part of the campaign aim to make people think about the gap that will be left if staff leave their role due to abuse. Please share the 'Leaving a gap' campaign message by displaying it in your public spaces, publishing it on your website and via social media. You can use the assets provided on this page to help; there are A4 and A5 size posters as well as social media images, a website banner and hero image and an animated video you can download.
  16. Content Article
    Even those at the top admit the NHS can’t do what is being asked of it today. But it is far from unsalvageable – we just need serious politicians who will commit to funding it, writes Gavin Francis, who shares his experience as a GP in this Guardian long read.
  17. News Article
    Criminal acts of violence at GP surgeries across the UK have almost doubled in five years, new figures reveal, as doctors’ leaders warn of a perfect storm of soaring demand and staff shortages. Police are now recording an average of three violent incidents at general practices every day. Staff are facing unprecedented assaults, abuse and aggression by patients, with surgeries struggling to cope with “unmanageable levels of demand” after years of failure to recruit or retain sufficient numbers of family doctors. Security measures such as CCTV, panic buttons and screens at reception are now increasingly being rolled out across GP surgeries, the Guardian has learned, with senior medics claiming ministers perpetuate a myth that services are “closed”. Last night, Britain’s two most senior doctors condemned the wave of violence and called for urgent action to finally resolve the workforce crisis. “It is unacceptable that GPs and their staff are afraid and at risk of being verbally or physically abused, when they are working amid exceptional pressures and striving to do their best for patients,” said Dr Chaand Nagpaul, chair of the British Medical Association. “GP practices are facing unmanageable levels of demand with 2,000 fewer GPs than in 2015.” He added it was “no surprise” that patients were struggling to get appointments because of the national “lack of capacity” and “lack of historic investment in general practice”. Read full story Source: The Guardian, 31 May 2022
  18. News Article
    Proposals 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
  19. News Article
    A number of London GP practices are training their receptionists to do blood tests, Pulse has learned. Professor Sir Sam Everington, a GP and chair of Tower Hamlets CCG, told Pulse that ‘lots of practices’ in the area have taken the step, including his own. Training a receptionist to carry out blood tests – which can be done in just six weeks – provides much-needed support to pressured practices, he said. Dr Everington told Pulse: ‘A lot of our receptionists have signed up to be phlebotomists and they love it because actually, phlebotomy is not just about taking blood. "You get to know all the patients with long-term conditions and so our phlebotomists know all these patients." He added that reception teams are a ‘fertile recruitment ground’ for a phlebotomist. They can ‘manage even the most terrified patients’ and have ‘amazing’ clinical skills. Dr Everington suggested that training receptionists as phlebotomists can help build trust with patients who are suspicious about having to describe their symptoms for triage by reception staff. But he said that the extra role just ‘acknowledges’ that all members of practice staff are ‘part of the clinical team’. He told Pulse: "In our practice, we all train together. We have meetings together, the whole team, and it’s acknowledging in this modern world that actually every member of your staff is a clinician – part of the clinical team – because there are always things they will do or can do that will have an impact clinically." "There isn’t a hidden supply of GPs out there in the next few years. It takes 10 years to train GPs so actually help is going to come from a wider team base." Read full story Source: Pulse, 31 March 2022
  20. News Article
    More than 80% of GPs believe that patients are being put at risk when they come into their surgery for an appointment, a new survey shows. A poll of 1,395 GPs found only 13% said their practice was safe for patients all the time. Meanwhile, 85% expressed concerns about patient safety, with 2% saying patients were “rarely” safe, 22% saying they were safe “some of the time” and 61% saying they were safe “most of the time”. Asked if they thought the risk to patient safety was increasing in their surgery, 70% said it was. Family doctors identified lack of time with patients, workforce shortages, relentless workloads and heavy administrative burdens as the main reasons people receiving care could be exposed to risk. The survey, which was self-selecting, also found that: 91% said more GPs would help improve the state of general practices. 84% have had anxiety, stress or depression over the past year linked to their job. 31% know a colleague who was physically abused by a patient in the last year. 24% know of a member of general practice staff who has taken their own life due to work pressures. Read full story Source: The Guardian, 21 March 2022
  21. News Article
    GP surgeries must open for routine appointments between 9am and 5pm on Saturdays and during weekday evenings, NHS bosses have said. From October, patients will be able to book weekend and evening slots with “the full multi-disciplinary team” in a local practice, including for services such as screening, vaccinations and health checks. The British Medical Association said it was “bitterly disappointed” by the changes, which had been imposed without its agreement. A letter tells GPs the appointments must be made available at least two weeks in advance. Same-day online booking should be possible “up until as close to the time slot as possible”. Any unused slots should be available for NHS111 to allocate to callers. Some may be remote appointments, but networks are told to “ensure a reasonable number” of appointments are face-to-face consultations. Rachel Power, chief executive of the Patients Association, said: “There’s a great deal in this letter that patients will welcome, given the struggles they have had since the start of the pandemic to see their GPs face-to-face or even get through to their surgeries.” Read full story (paywalled) Source: The Times, 2 March 2022
  22. News Article
    Face-to-face GP appointments have continued to fall, despite a rallying cry for doctors to restore normal services. The proportion of GP appointments held in person fell for the third month in a row to 60.3% in January, latest data show. Data published by NHS Digital on Thursday show about 25.6 million appointments were carried out in January. Of these, some 15.4 million were face-to-face. The last time it fell below this level was August 2021, when just 57.6% of appointments were face-to-face. Pre-pandemic, the proportion of GP appointments held in person was about 80%. Dr Nikki Kanani, NHS England’s medical director of primary care, told doctors last month to “restore routine service” following the successful rollout of the booster jab campaign. Writing to GPs, she said: “It is now important that all services across the NHS, including in primary care, are able to restore routine services where these were paused in line with the Prime Minister’s request to focus all available resource on the omicron national mission.” But patient groups say the “situation hasn’t improved” and patients are still struggling to see their doctor in person. Dennis Reed, from patient group Silver Voices, said the figures were “worrying” but not surprising. “I'm still getting complaints on a daily basis that people are struggling to see their GP,” he said. Read full story Source: The Telegraph, 24 February 2022
  23. News Article
    Patients at all general practices across England will soon benefit from new digital phone lines designed to make booking GP appointments easier. Backed by a £240 million investment, more than 1,000 practices have signed up to make the switch from analogue systems - which can leave patients on hold and struggling to book an appointment - to modern, easy-to-use digital telephones designed to make sure people can receive the care they need when they need it. It is expected every practice in the country will have the new system in place by the end of this financial year, helping put an end to the 8am rush - a key pillar of the Prime Minister’s primary care recovery plan to improve patient access to care. Patients will be able to contact their general practice more easily and quickly - and find out exactly how their request will be handled on the day they call, rather than being told to call back later, as the government and NHS England deliver on the promises made in the primary care recovery plan announced in May. If their need is urgent, they will be assessed and given appointments on the same day. If it is not urgent, appointments should be offered within 2 weeks, or patients will be referred to NHS 111 or a local pharmacy. The upgraded system will bring an end to the engaged tone, see care navigators direct calls to the right professional, and the use of online systems will provide more options and help those who prefer to call to get through. Read press release Source: Department of Health and Social Care, 18 August 2023
  24. News Article
    Patients in all but one integrated care system found it more difficult to contact their GP practice by phone this year compared to last year. GP patient survey data, published this month, showed the proportion of patients who found it “very” or “fairly easy” to get through by phone had fallen across almost every ICS by as much as seven percentage points. The measure fell nationally from 53 to 50%. The drop in performance comes as NHS England and the government ramp up focus on ease and speed of access to GPs as part of the primary care recovery plan, published in May. An NHSE spokesperson said: ”Despite GP teams experiencing record demand for their services, with half a million more appointments delivered every week compared to before the pandemic, the GP survey found that the majority of patients have a good overall experience at their GP practice. “However, the NHS recognises more action is needed to improve access for patients, which is why it published a recovery plan in May.” Read full story (paywalled) Source: HSJ, 31 July 2023
  25. News Article
    GP services "will collapse in Wales and the NHS will follow" soon after unless urgent support is provided, the British Medical Association (BMA) has warned. As patient levels rise, numbers of GP surgeries and doctors are falling amid inadequate resources and unsustainable workloads, BMA Cymru Wales has claimed. It has written to the Welsh government, urging more funding and staff help. The Welsh government said it was acting to cut pressure on GPs and increasing services by community pharmacists. Launching its Save Our Surgeries campaign, the BMA said the number of GP practices in Wales had decreased by 18% in the past decade from 470 to 386. Read full story Source: BBC News, 28 June 2023
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