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Found 290 results
  1. News Article
    It is ‘not right to normalise’ the current workload in general practice as numbers of GPs and practices goes down, the RCGP chair told delegates at Pulse Live this week. Professor Kamila Hawthorne highlighted the pressure GPs are under with general practice appointments increasing most last year, compared to A&E and outpatients. She also said her priority from a new GP contract would be better resourcing for GPs working in deprived areas. Her speech looked at the challenges facing general practice and imagined what the future could look like, including what the college can do to bring about change. Professor Hawthorne said: ‘The workload that we’re facing – it’s not right to normalise it. The sort of work days that we have in general practice, it is not right to normalise this. ‘The number of GPs is going down because they’re leaving the profession faster than they’re entering it. The number of practices in England is going down, and compared with affluent areas, GPs in deprived areas earn less but see more patients with more chronic illness.’ Read full story Source: Pulse, 21 March 2023
  2. News Article
    Young people with eating disorders are coming to harm and ending up in A&E because they are being denied care and forced to endure long waits for treatment, GPs have revealed. NHS eating disorders services are so overwhelmed by a post-Covid surge in problems such as anorexia that they are telling under-19s to rely on charities, their parents or self-help instead. The “truly shocking” findings about the help available to young people with often very fragile mental health emerged in a survey of 1,004 family doctors across the UK by the youth mental health charity stem4. The shortage of beds for children and young people with eating disorders is so serious that some are being sent hundreds of miles from home or ending up on adult psychiatric wards, GPs say. “The provision is awful and I worry my young patients may die,” one GP in the south-east of England told stem4. Another described the specialist NHS services available in their area as “virtually non-existent and not fit for purpose”. Read full story Source: The Guardian, 22 March 2023
  3. News Article
    GPs in the UK have some of the highest stress levels and lowest job satisfaction among family doctors, a 10-country survey has found. British GPs suffer from high levels of burnout, have a worse work/life balance and spend less time with patients during appointments than their peers in many other places. Heavy workloads, seemingly endless paperwork and feelings of emotional distress are prompting many GPs to stop seeing patients regularly or even retire altogether, the research found. Seven in 10 (71%) NHS family doctors find their job “extremely” or “very stressful”, the joint-highest number alongside GPs in Germany among the countries analysed. The Health Foundation, which undertook the survey, said its “grim” findings showed that the “unsustainable” pressures on GPs and number of them quitting pose a threat to the NHS’s future.
  4. Content Article
    Key points The Health Foundation worked with the Commonwealth Fund to survey 9,526 primary care physicians across 10 high-income countries between February and September 2022. This included 1,010 GPs from the UK. They analysed the survey data to understand the experiences of GPs in the UK and how they compare to other countries. A majority of GPs in all countries are dealing with higher workloads than before the pandemic – and many have experienced greater stress and signs of emotional distress. But the experience of GPs in the UK should ring alarm bells for government. 71% say their job is ‘extremely’ or ‘very stressful’ – the highest of the 10 countries surveyed alongside Germany. Things have been getting worse for UK GPs. GPs in the UK were among the most satisfied of any country back in 2012. Now just 24% of UK GPs are ‘extremely’ or ‘very satisfied’ with practising medicine – similar to France but lower than all other countries surveyed. UK GPs are among the most likely to plan to stop seeing patients regularly in the next 1 to 3 years. Half of GPs in the UK think the quality of care they can provide to patients has got worse since the start of the pandemic – and only 14% think it has improved. But the survey also illustrates some of the core strengths of general practice in the UK, including a high proportion of GPs feeling well prepared to manage care for patients with complex needs, and strong performance compared with other countries in use of data to inform care. Decisive policy action is needed to improve the working lives of GPs in the UK – including to boost GP capacity and reduce workload. Policymakers considering options for primary care reform should recognise the strengths of general practice in the UK and work with the profession rather than against it.
  5. Content Article
    Key recommendations A commitment to a properly funded plan to enable general practice to respond to surges in demand as they occur. Investment in GP practices’ IT and telephone systems, and the support they need to implement upgrades. The urgent roll-out of new and improved, properly funded retention schemes that halt the decline in the GP workforce. A reduction in unnecessary box ticking requirements and unnecessary workload to free up GPs’ time for patient care. A new public education campaign designed by patients and healthcare professionals to advise patients when and how to self-manage illness and when to access general practice or other services.
  6. News Article
    Health Education England (HEE) has outlined a new vision for general practice training which it says will better prepare GPs for future models of care. The programme will have greater focus on areas such as addressing health inequalities and managing the growing proportion of patients with mental health care needs seen in general practice, HEE said. Innovative placements, perhaps with charities, third sector organisations and services such as CAHMS will be explored, the Training the Future GP report said. And it should include educational opportunities around improving cancer detection and referral, the report said, as well as training in the harms of overdiagnosis. Overall the goal is to move to a flexible model of training that meets the needs, skills and experiences of the trainee as well as the area they are working in. HEE said it would also continue to work to address issues of discrimination, prejudice, bias and specifically racism at individual, institutional and systemic levels, and to reduce differential attainment. It will include plans to ensure patients in deprived areas are able to access care, with the development of specific training offers on these issues and prioritising expansion of training capacity to areas in need. Read full story Source: Pulse, 17 March 2023
  7. News Article
    GPs are facing “insurmountable pressures”, experts have said as they warned that the NHS “will not survive” without general practice. A new report into GP pressures suggests one in four staff fear their practice is in danger of closing because of unmanageable workloads and rising demand. The document, from the Royal College of GPs (RCGP), says general practice is “in crisis”, and makes a series of calls to help ease pressures and stop the growing number of GPs from quitting. The report says GPs are bracing for “winter-style pressures” well into spring and summer. “The workload pressures in general practice over this winter have been immense, and high levels of patient demand are set to continue for some time,” the report authors wrote. “General practice is in crisis. We cannot rely on short-term emergency funding pots over winter to try and paper over the cracks." Read full story Source: The Independent, 10 March 2023
  8. Event
    Primary care services are the front door to the NHS – they are the first port of call when we feel unwell and the main coordinator of care when we are living with ill health. The primary care team have an important role in making people feel welcomed, listened to and taken seriously. At National Voices we often hear stories from groups of people who struggle to have their communication needs met within primary care. As just one example, five years after the launch of the Accessible Information Standard, 67 per cent of Deaf people reported that still no accessible method of contacting their GP has been made available to them (Signhealth, 2022). This issue also affects other groups with specific communication needs - people who don't speak English fluently, people with learning disabilities, autistic people, people with dementia, people with low or no literacy, people who are digitally excluded, people living nomadically, people experiencing homelessness and more. We know that these experiences happen within the context of a primary care team under exceptional pressures. This workshop will bring together people with lived experience from all the groups mentioned above, as well as voluntary sector organisations, members of the primary care workforce, primary care policy leads, as well as commissioners and providers to discuss the challenges and co-produce solutions. At the workshop, we hope to build and improve understanding of: The experiences of people with diverse communication needs within primary care. The barriers primary care teams experience in meeting diverse communication needs, especially under existing pressures. Practical ways that we can embed and improve inclusive communications within the primary care setting. Register for the webinar. If you have any questions, please contact aleyah.babb-benjamin@nationalvoices.org.uk
  9. News Article
    Demand for private GPs has soared as patients seek out face-to-face appointments with doctors at short notice. Spire Healthcare, one of the UK’s largest private healthcare providers, saw 32,000 GP appointments booked with it last year – up from 23,000 in 2021. The hospital company, which runs 125 GPs, said revenues from its private doctor appointments rose by 46% in 2022. It said demand was soaring as patients look for “fast access to longer face-to-face appointments with a GP”. On the surge in demand, Spire Healthcare boss Justin Ash told The Telegraph: “Clearly there is a well known problem of GPs being under pressure, the 8am scramble [for appointments] is a thing. People want to be able to book online and they want to be able to book at short notice.” Read full story Source: The Independent, 4 March 2023
  10. News Article
    Pharmacies do not have the capacity to absorb pressure from GPs unless it comes with additional funding, pharmacy leaders have warned. A new NHS England ad campaign, announced earlier this week, aims to redirect patients from GP practices to local pharmacies for minor conditions such as coughs, aches, cystitis and colds. But community pharmacy negotiating body PSNC has spoken out against the campaign calling it ‘deeply concerning’, ‘irresponsible, ‘extremely unhelpful’ and ‘irritating’. Malcom Harrison, chief executive of the Company Chemists’ Association (CCA) said: ‘Community pharmacies are often the best place for patient to go for help with minor health concerns. ‘However the current situation that many pharmacies find themselves, with a 30% cut in real term funding, the NHS recruiting their pharmacists and technicians to work in general practice and with the continuing increase in the number of medicines prescribed, will mean that there is now a very real risk that when patients visit a pharmacy, they will be faced by exhausted teams and longer than expected waiting times. ‘The NHS policy of moving asking patients to visit their local pharmacy does not address the problem of delays to access in primary care, it simply moves it from one pressurized location to another. The NHS must address the chronic underfunding of primary care, and of pharmacy in particular, if patients are to be able to access the care they need and should rightly expect.’ Read full story Source: Pulse, 28 February 2023
  11. Content Article
    1. People with eating disorders should not face stigma in the health system and barriers to 1 accessing support in 2022 - a blog by Hope Virgo People with eating disorders often find it difficult to get help and treatment from the health system because of pervasive stigma, misinformation and stereotypes around eating disorders. This blog by eating disorder survivor and mental health campaigner, Hope Virgo, looks at the barriers people face when they try to access support for eating disorders in the UK. She talks about her own experience of being told she was ‘not thin enough for support’ and calls for long-overdue action on funding, training and awareness of eating disorders within the NHS. 2. Leaflet - Seeking treatment for an eating disorder If someone suspects they may have an eating disorder, their first step in getting treatment is often a visit to their GP. This leaflet contains guidance for people who have, or suspect they may have, an eating disorder, as well as information for GPs and other people who may be supporting them. It’s based on the guideline on eating disorders from the National Institute for Health and Care Excellence (NICE), which GPs should use when making decisions about patients’ healthcare. 3. Freddie Flintoff: Living with bulimia Eating disorders are often seen as an illness that affects young women, but experts estimate that one in four people with eating disorders are male. As a result, boys and men with eating disorders most often live in silence with the double stigma of having a mental health condition that is not recognised in their gender. In this BBC documentary, former England cricketer and TV presenter Andrew "Freddie" Flintoff goes on a personal journey into the eating disorder he has kept secret for over 20 years – bulimia. He discusses his own experience and meets specialists and young men with eating disorders across the UK. 4. SAPHNA - Eating disorder toolkit This toolkit was co-produced by the School and Public Health Nurses Association (SAPHNA) with school nursing services, mental health campaigners, eating disorder experts, education colleagues and young people with lived-experience of eating disorders. It provides information and guidance for school nurses on how to identify and support students with eating disorders and their families, addressing issues such as consent, confidentiality and referral to specialist services. 5. Tips poster: First signs of symptoms of an eating disorder When someone has an eating disorder, getting early support and treatment can make a huge difference to their recovery. That’s why it's important that everyone can spot the first signs and symptoms of an eating disorder. This poster by the charity Beat Eating Disorders offers tips to help you spot the very first signs of an eating disorder. 6. Myths about eating disorders (HealthTalk.org) This webpage highlights young people with eating disorders talking about how they often come up against misunderstandings about the illness from their family and friends, the media and healthcare professionals. They describe how incorrect ideas about what eating disorders are can make their experience of living with an eating disorder worse. 7. Eating disorders: a guide for friends and family This booklet from Beat Eating Disorders is for anyone supporting someone with an eating disorder. It covers information about eating disorders and treatment, and offers guidance on how you might approach the subject if you’re worried about someone you know and how to support them after diagnosis, as well as looking after yourself. 8. Medical emergencies in eating disorders: Guidance on recognition and management People with eating disorders can reach a crisis point where their condition becomes a medical emergency resulting in serious harm or even death. This guidance from the Royal College of Psychiatrists makes a series of recommendations for primary care, secondary care and mental health services that aim to make preventable deaths due to eating disorders a thing of the past. There are specific recommendations focused on the needs of children with eating disorders, recognising the physiological differences between adults and children. Have your say Are you a healthcare professional who works with people with eating disorders? We would love to hear your insights and share resources you have developed. Perhaps you have received treatment for an eating disorder—what was your experience of healthcare services? We would love to hear from you! Comment below (register for free first) Get in touch with us directly to share your insights
  12. Event
    More than 1,400 English GP practices, around one in five, offer patients access to their prospective medical records: that means patients can see new entries to their medical records such as tests results, appointment notes and hospital letters online and through the NHS App and certain other apps. This webinar aimed at patients explains more about NHS England's programme to enable patients to access their medical records via the NHS App. Hear from: Patients Association members Claude and Greta about what the benefits are to them of being able to access their health information digitally GP Dr Brian McMillan, a Senior Clinical Lecturer at the Centre for Primary Care and Health Services Research, University of Manchester, and a Registered Health Psychologist, whose research interests include how digital technology can improve patients' experiences of primary care Registered nurse Tristan Stanton who is Assistant Director of Programmes – Primary Care, at NHS England and leads the programme to give people access to their online health records. The Patients Association's Chief Executive, Rachel Power, will chair the webinar. Sign up for the webinar
  13. News Article
    A new report has condemned ‘serious issues’ with NHS referral processes, amid findings that one in five patient referrals made by GPs went into a ‘black hole’. Healthwatch England said that 21% of people they spoke to with a GP referral to another NHS service were rejected, not followed up on or sent back to general practice. The watchdog said that more support should be given to help GP and hospital teams to reduce the numbers of people returning to general practice due to ‘communication failures’ following a referral. According to the findings, the failures were due to GP teams not sending referrals, referrals going missing between services, or being either booked or rejected by hospitals without any communication. Louise Ansari, Healthwatch England’s national director, said that thousands of people told the watchdog that the process is ‘far from straightforward.’ She said: "Falling into this “referrals black hole” is not just frustrating for patients but ultimately means people end up going back to their GP or visiting crowded A&E departments to get the help they need. "This adds more burden to already stretched services, making things even harder for the doctors and nurses trying to provide care." Read full story Source: Pulse, 20 February 2023
  14. Content Article
    Recommendations Healthwatch have set out actions for the government, NHS England and Integrated Care Systems (ICS) to support GP practices and hospitals with referral processes. 1. Do more to understand the referral process: There is currently no published national data collection on where patient referrals fail and bounce back to general practice for a new referral. NHS England should work with Healthwatch England to add questions to the annual GP Patient Survey to understand people's experiences of the referral process. 2. Improve communication with patients: More support should be given to help GP and hospital teams to reduce the numbers of people returning to general practice due to communication failures following a referral. Communications must be accessible. Failed referrals and missed appointments can sometimes be down to patients receiving information in the wrong format. For example, we've heard from blind patients receiving inaccessible referral letters. We recommend that adaptations are made to the e-referral system or other appropriate care record systems to ensure services record people's communication preferences at the point of referral. Services should support people to update them about their communication needs if they change. Communications must be transparent. All parties should have access to the same centralised information about which stage of the referral process the person has progressed to. This includes patients, along with teams in general practice, referral management centres, hospital admissions teams and other parts of the NHS. This could be through planned updates to the NHS App. However, information should also be available and shared with patients via other communication methods, as noted in their care records. Communications must be collaborative. As well as improving channels for the NHS to update patients about their referral, patients must also have access to care navigators in general practice and a single point of contact at their hospital (or another referral setting). This is so patients can give feedback about their condition while waiting for care, including whether they need to cancel or reschedule appointments or quickly chase up a referral if they have not received information about its progress. 3. Invest in NHS admin staff NHS England and the government should work to improve access to general practice by training and hiring more care navigators, staff who can ensure people's needs are met in the right setting the first time. With more care navigators, the future of general practice could become one with fewer long waits on the phone and 24/7 access to online triage systems. And when people do fall into the referrals black hole, they will be able to flag these issues more quickly and access required support as soon as possible.
  15. Content Article
    “Yes.” This was the dismaying response of consultant breast surgeon, Mr Hemant Ingle, when asked at a talk, hosted by the Centre for Health and the Public Interest (CHPI), whether he thought another scandal on the scale of that caused by Ian Paterson could unfold today. Disgraced breast surgeon Paterson is currently serving a 20-year sentence after unnecessarily operating on over 1,200 patients at NHS and private hospitals in the West Midlands area between 1997 and 2011. Three months into my first year of General Practice Specialty Training, I sat in that auditorium utterly stunned at Mr Ingle’s candour. Was it pessimism or devastating realism? Having watched the appalling events unfold in a screening of the ITV documentary ‘Bodies of Evidence: The Butcher Surgeon’, we were honoured to be joined by a panel of experts, including Debbie Douglas, one of the indescribably courageous patients who helped to expose Paterson. Over the next hour, the panel unpacked the factors deemed to have enabled Paterson’s actions, his potential motives and the consequences of the subsequent inquiry for society at large. It made for disturbing listening. Having trained entirely within the public sector, as all new medical graduates must do in the UK, I was completely ignorant to the circumstances within private hospitals which had catalysed Paterson’s reign of terror. I had no idea that private hospitals bore no responsibility for the patients treated within their walls, that doctors working in such hospitals often had no requirement to adhere to otherwise national guidance on healthcare provision, that private hospitals may have no facility to provide adequate emergency treatment to those suffering medical complications after procedures performed on their own premises. Before that evening, I had never before heard a patient state so heartbreakingly that they struggled to trust medical professionals. That disquieting symposium was not my first exposure to the sinister side of medicine. Seeking supplementary education in a field strikingly neglected in my own core undergraduate and postgraduate medical education, I had, just a few weeks before the CHPI event, joined a webinar hosted by the British Society of Sexual Medicine (BSSM). One of the presenters was a patient who had experienced first-hand the pernicious effects of vaginal mesh insertion. Whilst her story had a positive outcome, other vaginal mesh patients have not been so fortunate. Thousands of women continue to suffer from chronic pain, fatigue and urinary dysfunction, amongst countless other symptoms. Through subsequent investigations, it has emerged that vaginal mesh manufacturers had significant financial links to clinicians, researchers and Royal Colleges, and that side effects and complications were widely under-reported. Campaigns such as Sling The Mesh, founded by Kath Sansom, ensure that this landscape is changing, but it should not have come to this. I’m not sure how to feel any more. I’ve spent a lot of time with doctors over the last eleven years. At sixth form, I would send countless unsolicited emails to consultants at local hospitals, pleading for the chance to observe their surgeries, to shadow their ward rounds. Throughout university, I scribbled down every word of juniors, registrars, consultants, hoovering each crumb of knowledge that might make me the best doctor that I could be. Since I graduated in 2020, and started working as a Foundation Year Doctor in London, these professionals have become my peers, my colleagues, my 'bosses'. Whilst of course, some have been more personable, more welcoming, than others, I have thankfully never had the misfortune of encountering a character like Paterson. In Ipsos' 'Global Trustworthiness Index', most recently released in October 2021, doctors were ranked highest in 28 countries, with over 70% of UK respondents believing us to be the most reliable of all professionals. This was the mindset in which I trained; I felt comfortable and worthy of such an accolade. I want to be the person that patients can rely on at their most vulnerable, that relatives feel they can approach with any worry, large or small. To hear now that, for entirely good reason, the implicit confidence that the public had in their medical professionals is no longer a guarantee, made me feel rather unsteady. How do I feel about being part of a profession in which such deceit can go unchallenged? Do I want to be associated with 'experts' who fail to acknowledge the legitimate anxieties of their patients? I'm not going to leave medicine. Fortunately, the Patersons of the world are hugely outnumbered by respectable, conscientious, genuine, caring doctors – those that do earn the premier spot in an Ipsos poll. However, I do think that I have been naïve. Whilst Paterson’s actions are deplorable, a single ‘rogue’ surgeon can be dealt with. This is not to downplay the absolute devastation and anguish that he has caused his patients and their loved ones, and not to diminish the fact that his ousting took far too many attempts from those bold enough to question him, and not nearly enough support from those who should have held him accountable. It is the systemic failures which allowed Paterson to operate unmonitored, which enabled vaginal mesh surgeries to continue unchecked, which permitted side effects to go unrecorded, that I find so unsettlingly insidious. Whether these repeated failures in the healthcare system are underpinned only by financial motives, by greed, as seems the most obvious explanation, we may never know, and perhaps finding reason should not be our priority. As a doctor, my duty is to advocate. Fortuitously for themselves and those whom they are now able to advise and support, both Debbie Douglas and the patient featured in the BSSM webinar are intelligent, well-spoken, confident women. Others affected by the scandals mentioned here, and countless more that are not, may not be so well-equipped. Those who are perhaps older, less educated, who do not speak English as a first language, with other medical conditions rendering them less able to campaign, rely on others to do so on their behalf. This is only one piece of the jigsaw – in order for patients to request help, they must know who is able to help them, and must feel secure and empowered to ask for assistance. Similarly, doctors must feel emboldened in discussing issues with appropriate colleagues. This is not necessarily easy. A conversation after the CHPI panel discussion highlighted how GPs in particular, often mistakenly viewed as lesser doctors, may feel pressured to maintain respect for themselves within the medical profession and, thus, be reluctant to escalate patient concerns for fear of ridicule from secondary or tertiary care. It goes without saying that such anxiety should never alter the care we provide to patients. However, this perceived imbalance of medical aptitude, resulting in such a discrepancy in the level of esteem to which medical professionals are held, is just one example of a saddening toxic facet of the medical world. This is also reflected in the response to whistleblowers, both in the moment and through the lasting effect on a professional’s career, as exemplified by Mr Hemant Ingle speaking of the hospital that previously employed both himself and Paterson: “They don’t like me, of course they don’t”. Only by changing this mindset, and curating a more supportive, protective, transparent culture, where healthcare professionals of all levels and types can freely voice concerns, can we ever hope to avoid such disasters in the future. So, in real terms, what should I do as a training GP? Put simply, I must abide by the GMC’s ‘Duties of a Doctor’. Firstly, I must remain aware and knowledgeable of current biomedical and medicolegal affairs to ensure that I do not inadvertently, even if innocently, reassure or dismiss patient concerns through ignorance. Attending regular knowledge update courses and accessing appropriate journal articles are more formal avenues of learning, but I should supplement these by keeping abreast of health news in popular media, such that I may pre-empt problems with which patients may present. This is all with the understanding that I must never act beyond the limits of my competence and must never allow fear of criticism to prevent me from seeking advice, whether this is from more senior colleagues, supervisors or specialist doctors. For my patients, and indeed for colleagues who may come to me with their own queries, I should reciprocate by remaining approachable and sympathetic. My interactions with colleagues and patients alike should take place in a partnership model – while of course there are many times when hierarchy can be appropriate, I aspire to be the doctor who equips her patients to become experts in their own health and to advocate for themselves. I will strive to communicate with patients in formats appropriate to each individual. Once a patient has chosen to trust me, I must be mindful of the fact that trust can just as easily be lost as gained. I shall keep patient safety at the fore by following GMC guidance on raising and acting upon concerns, reporting any adverse effects of medication or treatment that are divulged to me, obeying my duty of candour if I believe a patient to have been placed at risk, not allowing any conflicts of interest to influence patient care, and acting with overarching honesty and integrity. Yes, another Paterson-level scandal could, and will almost certainly, unfold again. However, if I aspire to achieve each aim outlined above, I will indeed become the kind of doctor that sixteen-year-old me held in such high regard. Until we fix the system, all I can do is my best.
  16. News Article
    GPs are attempting to deal with up to 3,000 patients each, amid worsening staff shortages, according to new analysis commissioned by the Liberal Democrats. The research shows that the number of patients per GP has risen sharply, as rising numbers of doctors reduce their hours, or opt for early retirement. The figures, which track the number of “full-time equivalent” fully qualified GPs, show the number has fallen from 29,320 in 2016 to 27,372 last year. The trend follows a rise in part-time work, with the average GP now working a three-day week. On average, there are now 2,273 patients per fully qualified doctor, up from 1,981 in 2016, the research commissioned by the Liberal Democrats shows. While the total number of GPs fell by almost 2,000, the number of registered patients grew from 58 million to 62.2 million, according to the House of Commons Library. Professor Kamila Hawthorne, chairwoman of the Royal College of GPs, said the research “shows yet again how GPs and our teams are working above and beyond to deliver care to an ever-growing patient population, with falling numbers of fully qualified, full-time equivalent GPs.” Read full story (paywalled) Source: The Telegraph, 14 February 2023
  17. News Article
    GPs have raised concern about a new colorectal cancer pathway aimed at reducing referrals into one of England’s largest acute hospital trusts. The pathway was implemented in December 2022 to tackle long waiting lists at United Lincolnshire Hospitals Trust (ULHT) by reducing the number of referrals from primary care. But the Lincolnshire LMC and Primary Care Network Association both raised concerns about the pathway and its impact on general practice in a letter to their ICB earlier this month. Read full story Source: Pulse, 13 February
  18. News Article
    Charging for GP appointments will worsen patient safety and drive more people to A&E, the head of a national safety watchdog has warned. Dr Rosie Benneyworth, the chief investigator for the Healthcare Safety Investigation Branch (HSIB), was responding to a suggestion by former health secretary Sajid Javid who said the present model of the NHS was “unsustainable”. He said “extending the contributory principle” should be part of radical reforms to tackle growing waiting times. But Dr Benneyworth said it would only drive more people to seek help from already overstretched services. She said: “I don’t want to be drawn into the politics around this but I believe in free at the point of delivery NHS and my concern would be [if] we charge people that people would not come forward early for their care and that would leave people needing more urgent and emergency care, because of delayed presentations.” Dr Benneyworth said there needed to be a bigger focus on patient safety in services outside of A&E, such as NHS 111 and out-of-hours services. Read full story Source: The Independent, 26 January 2023
  19. News Article
    Two-thirds of GPs feel ‘advice and guidance’ is preventing patients who really need a referral to secondary care from getting one, according to the findings of a snapshot survey of Pulse readers. Advice and guidance (A&G) services, which involve GPs accessing specialist advice before making a referral, have become a major part of NHS England’s plans for clearing the pandemic backlog. But of the 366 GP survey respondents in England who said they had used advice and guidance, 68% said they felt the pathway is blocking necessary referrals. The survey also found that of those 366 GPs who had used A&G services: Around half (49%) said A&G was reducing referrals; More than three-quarters (78%) said it was increasing their workload; Just over half (60%) said it was requiring them to work beyond their competence; Two-thirds (68%) said A&G was resulting in patients complaining because their wish to see a consultant had been diverted. One GP who wished to remain anonymous commented: "An increasing number of referrals are being rejected for secondary care service pressure reasons rather than clinical need. [This] often duplicates GP admin work as we need to re-refer, rewriting the referral and/or enclosing further information or tests results in order to get a referral accepted." Read full story Source: Pulse, 25 January 2023 Further reading on the hub: Rejected outpatient referrals are putting patients at risk and increasing workload pressure on GPs Patient referrals and waiting lists: A ticking time bomb A child left waiting for ‘urgent’ surgery, a blog by Clare Rayner
  20. News Article
    A law student who died after four remote GP consultations might have lived had he been given a face-to-face appointment, a coroner ruled. David Nash, 26, died in November 2020 from a bone infection behind his ear that caused an abscess on the brain. Over a 19-day period leading up to his death, he had four phone consultations with his GP. The coroner, Abigail Combes, said the failure to see him meant he underwent surgery ten hours later than it could have been. Andrew and Anne Nash fought for more than two years to find out whether their son would have lived if he had been seen in person by clinical staff at Burley Park Medical Centre in Leeds. Yesterday they said they were “both saddened and vindicated by the findings that the simple and obvious, necessary step of seeing him in person would have saved his life” and wanted to make sure “others don’t die as David did”. Read full story (paywalled) Source: The Times, 21 January 2023
  21. News Article
    "I got my cervical screening letter in November and I've been putting it off because I don't want to do it - I don't think any girl really wants it done to them." Elena Coley Perez is 26 and due to have her first cervical screening - or smear test - that examines the opening to your womb from your vagina. NHS records show 4.6 million women - or 30% of those who are eligible - have never been screened for cervical cancer or are not up to date with their tests. Women are sometimes too embarrassed to come forward or put it off because they are anxious, surveys have found. Struggling to book their tests due to GP backlogs will not help the situation, say charities. Elena has told the BBC she was already worried about having a smear test, and the difficulty she experienced in booking one put her off even more. "I got another letter in December so I went to book online because with my local GP you have to go through this long-winded form," she said. "I typed in cervical screening and nothing was coming up, so I ended up waiting 35 minutes on the phone to be told they had no appointments for the rest of the year and to phone back in the new year." Elena then tried again in January and was told there was no availability. "At this point I was like, 'what's the point?' - you're trying to do something that can hopefully prevent you from getting cancer and you get to the doctor's surgery and you just get a 'no' - it's really off-putting," she says. Read full story Source: BBC News, 25 January 2023 Further resources on the hub: For patients: Having a smear test. What is it about? (Jo's Cervical Cancer Trust) Cervical cancer symptoms (Jo's Cervical Cancer Trust) For staff: RCN guidance: Human papillomavirus (HPV), cervical screening and cervical cancer
  22. Content Article
    How to offer safety-netting advice Build safety-netting into the entire consultation; it should not be rushed at the end. Use simple terms and avoid jargon and abbreviations (but include appropriate technical terms); tailor advice and address potential sources of anxiety (for instance being young or a first-time parent). Consider grouping chunks of information to help the patient remember the advice. Give people the opportunity to share their expectations and concerns, and address these in the safety-netting plan. What advice to give: the safety-netting plan Explain and discuss uncertainties and the follow-up plan. Offer an initial diagnosis, explain how long you expect symptoms to last (or how they might change), give practical tips for self-care and symptom management (which give people a sense of control) and instructions for when they should be concerned. Personalise someone’s risk based on their characteristics (such as age or medical history) and not on population data. The plan should also be personalised and address factors that might make an individual less likely to follow advice (for instance if they have had a previous missed diagnosis). Give the patient the opportunity to ask questions and to share in decision-making. Actively check the patient’s understanding. Acknowledge the patient’s ability to make judgements about their own health, and to change their mind about a plan.