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Found 37 results
  1. News Article
    New guidance requires GPs to offer at least some face-to-face appointments, amid reports that some had completely eliminated them, sparking ‘significant incidents’. NHS England’s instructions for the third phase of the NHS response to COVID-19 were issued on Friday, including the call that “all GP practices must offer face to face appointments at their surgeries” along with remote triage and remote consultations. Most appointments in primary care have been carried out remotely since the NHS instituted new operating procedures in response to covid, with practices offering a mix of remote consultations over the telephone or video, with a diminished number face-to-face. However, there have been reports of some GP practices not offering any face-to-face appointments at all, and continuing this approach following the peak of cases in the spring. A letter to GPs last month told them they must offer appointments in person “where clinically appropriate”, now reiterated in the phase three guidance. The letter added: “It should be clear to patients that all practice premises are open to provide care, with adjustments to the mode of delivery. No practice should be communicating to patients that their premises are closed.” Read full story Source: HSJ, 4 August 2020
  2. News Article
    All GP appointments should be done remotely by default unless a patient needs to be seen in person, Matt Hancock has said, prompting doctors to warn of the risk of abandoning face-to-face consultations. In a speech setting out lessons for the NHS and care sector from the coronavirus pandemic, the health secretary claimed that while some errors were made, “so many things went right” in the response to Covid-19, and new ways of working should continue. He said it was patronising to claim that older patients were not able to handle technology. The plan for web-based GP appointments is set to become formal policy, and follows guidance already sent to GPs on having more online consultations. But the Royal College of GPs (RCGP) hit back, saying it would oppose a predominantly online system on the grounds that both doctors and patients benefited from proper contact. Read full article here
  3. News Article
    A third of GPs believe it will take up to a year or longer for their practice to return to pre-Covid levels of capacity, even with ‘no future spikes’ of the virus. The data comes from the BMA’s latest COVID-19 tracker survey, which polled almost 2,000 GPs in England and Wales. GPs have previously warned that they are battling a backlog of referrals and patients who have been ‘overlooked’ during the coronavirus crisis. Around 26% of the 1,770 GP respondents said consultations would take between three and 12 months to return to normal when asked how quickly their practice will ‘return to full pre-Covid levels of capacity... assuming there are no future Covid spikes’. And a further 7% of GPs believed it could take ‘longer’ than a year or that consultations would ‘never’ return to pre-Covid levels. Read full story Source: Pulse, 23 July 2020
  4. News Article
    GP systems will now be updated in 'near-real time' to reveal the result of Covid-19 tests taken by all of their patients. GPs will not need to act on the information, which will be visible on systems whether the patient tested positive or negative. This will apply to all patients where it has been possible to identify the patient's NHS number, NHS Digital said. EMIS Health chief medical officer Shaun O’Hanlon said: "Technology has played a pivotal role in the response to COVID-19 across the board and keeping the medical record up to date with COVID-19 test results means everyone who can share that record has a full picture of the patient’s health, including the patient themselves via Patient Access." "This will not only help day to day patient care, and it will also help on a wider population health level, as data-led insight relies on full and complete medical records as analysts continue to research COVID-19 and its short- and long-term impact on the nation." Read full story Source: Pulse, 20 July 2020
  5. News Article
    A GP practice serving one of Greater Manchester’s most deprived communities has been banned from operating for four months after regulators uncovered a catalogue of basic failures - including failing to follow up on a child reporting breathing difficulties for three days. Jarvis Medical Practice in Glodwick has had its registration with the Care Quality Commission (CQC) suspended after ‘serious concerns’ passed to the body led to a snap inspection last month. Inspectors found the practice, based at Glodwick Primary Care Centre, was failing 20 separate standards, many of them relating to patient safety. It noted ‘poor quality’ and conflicting records that were sometimes impossible to properly understand and urgent home visits delayed or not carried out at all. In one case a patient with a lump apparently received no physical examination and was not referred for tests or scans ‘due to Covid-19’. Inspectors also found examples of patients with breathing difficulties, including a child, who were not dealt with for days after they got in touch. In one case no further contact was made for 11 working days, with no explanation provided in the patient's notes. The practice, which serves more than 5,000 patients in the Oldham neighbourhood of Glodwick, has now been suspended by the CQC until October 11. Read full story Source: Manchester Evening News, 17 July 2020
  6. News Article
    Almost three quarters of GP partners are concerned about how to keep colleagues safe as numbers of patients attending practices return to pre-pandemic levels - with access to PPE a major worry, a GPonline poll has found. Half of the 185 GP partners responding to the poll said that they were either 'very worried' or 'slightly worried' about the government's ability to supply the PPE that GPs and practice staff needed to keep them as safe as possible through the rest of the pandemic. Only 9% said they were 'very confident' that the government would be able to supply adequate PPE, with a further 20% saying they were 'slightly confident'. Some 73% of GP partners said that they were concerned about how to ensure the safety of practice staff as the number of patients attending the surgery begins to rise. BMA GP committee chair Dr Richard Vautrey said keeping staff safe was 'a challenge for everyone in the NHS'. He told GPonline: 'Even months now into this crisis the government still hasn’t sorted out PPE in a way that means people have absolute confidence that they will have enough to meet their needs, and the growing needs of practices as they will need to be seeing more patients face-to-face for important procedures that can’t be done remotely. Read full story Source: GPonline, 8 June 2020
  7. News Article
    Drugs that could relieve the symptoms of coronavirus in vulnerable patients and help them avoid admission to hospital are to begin trials in homes across the UK. The experiment, led by a team at Oxford University, seeks to test pre-existing treatments for older people in the community who show signs of the disease. Known as Principle, or “Platform Randomised trial of interventions against Covid-19 in older People”, it is the first to take place in primary care settings such as health clinics. Read full story (paywalled) Source: The Independent, 12 May 2020
  8. News Article
    GPs will now be able to access records for patients registered at other practices during the coronavirus epidemic in a major relaxation of current rules. The move will allow appointments to be shared across practices, and NHS 111 staff will also have access to records to let them book direct appointments for patients at any GP practice or specialist centre. The change in policy has been initiated by NHS Digital and NHSX to enable swift and secure sharing of patient records across primary care during the covid-19 pandemic. It means that the GP Connect1 system, currently used by some practices to share records on a voluntary basis, will be switched on at all practices until the pandemic is over. In addition, extra information including significant medical history, reason for medication, and immunisations will be added to patients’ summary care records and made available to a wider group of healthcare professionals. Usually, individuals must opt in but following the changes only people who have opted out will be excluded. Read full story Source: The BMJ, 27 April 2020
  9. Community Post
    HOW SAFE ARE OUR GP PRACTICES during covid-19? For the health care professionals, their patients, and families of patients? I'm a 65-yr old diabetic needing routine B12 injections. My GP tells me to turn up as normal so I don't develop neurological problems. I don't think anyone in the practice has been tested for covid-19. I'm refusing to turn up since I suspect the GP practice to be a covid-19 hot-spot. I don't want to transmit this virus to my frail, elderly asthmatic husband who's undergone cancer treatment and a lot of surgery. I've persuaded the GP to give me a precription for oral B12. Have I done the right thing? How can I help GPs and patients in far worse dilemmas than mine?
  10. News Article
    The rapid spread of coronavirus has given the NHS a “kick forward” in the need to accelerate technology and ensure staff are digitally prepared, a GP has said. Neil Paul, a Digital Health columnist and GP in Ashfields, said the need to reduce face-to-face appointments to prevent the potential transmission of Covid-19 has forced the NHS, particularly in primary care, to adopt already available technologies. He said practices “still in the stone ages” and “technophobes” were less prepared for the current situation, but that it would force them to move into the digital age. “It’s absolutely made my surgery go ‘right, how do we do online consults’. I think it actually has given people a real kick forward,” he told Digital Health News. “I think in six months’ time my surgery might be very different in that actually we will be doing a lot of online and telephone consults where previously we may have been a bit reluctant." GP practices across the country have been advised to assess patients online or via telephone and video appointments to mitigate the potential spread of coronavirus. In a letter to GPs last week, NHS England urged Britain’s 7,000 GP surgeries to reduce face-to-face appoints for patients displaying symptoms of Covid-19. The preemptive move means millions of patients will now be triaged online, via telephone or video and contacted via text messaging services. Read full story Source: Digital Health News, 13 March 2020
  11. News Article
    Tests for coronavirus are being increased to include people displaying flu-like symptoms at 11 hospitals and 100 GP surgeries across the UK. The tests will provide an "early warning" if the virus is spreading, Public Health England Medical Director Prof Paul Cosford said. Up to now, people were tested only if they displayed symptoms having recently returned from one of the countries where there has been an outbreak, including China, South Korea and northern Italy. However, Prof Cosford said Public Health England was now working with hospitals and GP surgeries to conduct "random" tests. These will target some patients with coughs, fevers or shortness of breath, regardless of whether they have travelled to a place where the virus is spreading. "If we do get to the position of a more widespread infection across the country, then it will give us early warning that's happening," said Prof Cosford. Read full story Source: BBC News, 26 February 2020
  12. Content Article
    Key findings The study findings suggest that the designation of a NE as a NE is dependent on the individual/type of NE and that NEs were reportedly rare. Although GPs were more likely to disagree with the NE label for the more frequently occurring NEs, this was not in proportion to their increased frequency of occurrence. Most GPs remained unconvinced that the risk can be eliminated for any of the NEs. GPs do, however, seem to take the actual and potential occurrence of such events seriously given that 99% stated an intention to undertake a significant event analysis after a NE. Opinions varied widely with some GPs commenting that the risk of serious harm was extremely low, whereas other GPs suggested that the NE should be more stringent. Some GPs felt that the NE description was placing a burden of responsibility on them that was not intended by the description of the NE; for example, that they should be responsible for the actions of a laboratory or the ambulance service. There were differences in opinion about the level of responsibility a GP should take for the actions of non-medical staff.
  13. News Article
    Family doctors are under intense pressure and general practice is running on empty, warns the Royal College of GPs (RCGP). It says severe staff shortages are causing "unacceptable" delays for patients in England. In a letter to Health Secretary Matt Hancock, its chairman says ministers must take urgent action to deal with the lack of GPs. The government said it had recruited a "record number" of GP trainees. Ministers are committed to recruiting 6,000 more GPs in England by 2025. Prof Martin Marshall, who took over as RCGP chairman in November, says GPs are struggling with an escalating workload, which is causing many to burn out and leave the profession. Dr Andrew Dharman, who works at the The Avenue surgery in Ealing, said the stress has got worse because of the enormous workload placed on GPs. He said: "Sometimes it feels like you're drowning. You know you're trying to stay afloat and on top of all the workload. And you're trying to make sure you're providing the kind of care that you envisage when you go to medical school." "You feel frustrated sometimes that you can't necessarily do that because of the amount of work and patients." Read full story Source: BBC News, 9 January 2020
  14. Content Article
    This paper presents a narrative review of the evidence relating to the quality and safety of locum medical practice. Its purpose is to develop our understanding of how temporary working in the medical profession might impact on quality and safety and to help formulate recommendations for practice, policy and research priorities. The authors conclude that there is very limited empirical evidence to support the many commonly held assumptions about the quality and safety of locum practice, or to provide a secure evidence base for the development of guidelines on locum working arrangements. It is clear that future research could contribute to a better understanding of the quality and safety of locum doctors working and could help to find ways to improve the use of locum doctors and the quality and safety of patient care that they provide.
  15. Content Article
    The toolkit is designed to be used by the whole primary care team within the GP practice or out of hours setting. These resources can be used flexibly, either as standalone materials or as part of an integrated package. The Royal College of General Practitioners do recommend that all resources are used if this is feasible. Using the TARGET Antibiotics Toolkit resources will enable primary care organisations to demonstrate compliance with the Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance.
  16. Content Article
    I am a GP in Northampton and for some time, around 2006, I was concerned that my practice did not have a robust system for monitoring patients on dangerous drugs such as methotrexate and azathioprine. We tried to keep a manual database for our patient register, but with patients stopping and starting these drugs, moving in and out of the practice, and needing different tests at different time intervals, it was a really difficult task, and I suspected that we were missing patients and, therefore, it was hard to keep track of who needed reminding regarding tests. I tried working with my Practice Manager to create a more sophisticated spreadsheet in Microsoft Excel, then when that failed, within Microsoft Access. Again, we kept on coming across problems and I knew we hadn’t cracked the problem yet. Then I started talking to Tim – Tim is an IT software developer and, while we were watching our children’s swimming lesson, I was explaining to him the complexities of what I was trying to achieve, and he immediately took up the challenge and promised to write me a bespoke programme. Two years later and many Sunday afternoons spent drinking oodles of cups of tea, Neptune was created. We have been successfully running Neptune in my GP surgery since 2008, following which we introduced it to four beta testing sites. The system worked remarkably well from the start and very quickly we expanded to other local practices. Over the past 2 years we have been fortunate enough to roll out across the whole of Leeds Clinical Commissioning Groups (CCGs)(approximately 100 GP practices). Neptune’s success lies in its simplicity. It is a relational database that stores information about as many drugs as you would like, such as generic and brand name, BNF category and what monitoring tests are required. It uses three simple reports from the GP practice system to upload patient, drug and testing information and then puts this all together into a reminder list and either prints reminder letters, sends an email through a secure nhs.net account or produces an SMS text alert via MJOG. If the patient does not respond to their reminder, then a second reminder and then a third reminder is sent, with the final reminder being an alert to the prescribing GP. Like all new developments, we have faced a few challenges along the way. Not least was how to roll out to 100 practices in Leeds which is a long way from Northampton. We brought other members on to our team, and now have two trainers and two other software support as well as me and Tim. We love going into GP practices and seeing how everyone has tackled this problem differently, or not at all in some places. We have found, in general, the better the system already in place, the more Neptune is appreciated as the practice already appreciates what a difficult task this is. Neptune continually evolves and we love to change according to user feedback. We are now on to version 4, with version 5 just around the corner. Our current project is to include not just CCG defined amber drugs for the Near Patient Testing Direct Enhanced Service, but all drugs that require monitoring such as diuretics, ACE inhibitors and thyroid drugs. This will increase the patient population that Neptune monitors considerably, but the impact on patient safety will be immeasurable and, hopefully, will improve safety, reduce hospital admissions and, ultimately, iatrogenic harm and even death. We would love to roll out Neptune to as many practices as possible as we believe this is the best, most accurate and efficient way of performing this challenging task.
  17. Content Article
    Results: Participants who had experienced some level of harm were able to comment more extensively on safety aspects of care. Several key themes related to safety were identified from the analysis of all participant narratives. An assumed sense of safety in general practice was predominant, and was influenced by participants' level of risk awareness and trust in their general practitioner. Additional unique themes included feelings of vulnerability, desire for an explanation and apology, a forgiving view of mistakes, and preference for GP interpersonal skills over competence. Conclusions: This study revealed new insights into the factors that influence patients' and carers' perspectives of safety, and demonstrated the value of incorporating the patient voice into safety research. An assumed sense of safety due to a default position of trust, coupled with limited risk perception, directly contests the current literature on patient involvement in safety. Further exploration is required to determine how patients and carers can effectively engage in and assist with improving safety in general practice.
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