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Found 383 results
  1. News Article
    More than half of England’s army veterans have experienced mental or physical health issues since returning to civilian life, and some are reluctant to share their experiences, a survey has revealed. The survey of 4,910 veterans, commissioned jointly by the Royal College of GPs (RCGP) and the Office for Veterans’ Affairs (OVA), found that 55% have experienced a health issue potentially related to their service since leaving the armed forces. Over 80% of respondents said their condition had got worse since returning to civilian life. One in seven of those surveyed said they had not sought help from a healthcare professional. A preference for managing issues alone and the belief that their experience would not be understood by a civilian health professional were the most common reasons given. This fear of being misunderstood is demonstrated by the finding that 63% of veterans said they would be more likely to seek help if they knew their GP practice was signed up to the Veteran Friendly Accreditation scheme. More than 3,000 of England’s 6,313 GP practices are accredited, but the survey’s findings have prompted the RCGP – with NHS England and the OVA – to launch an initiative to get more GP practices on to the scheme. Practices that sign up will be provided with a “simple process” for identifying, understanding and supporting veterans and, where appropriate, referring them to dedicated veterans’ physical and mental health and wellbeing services. Read full story Source: The Guardian, 25 March 2024
  2. News Article
    NHS England’s workforce ambitions are based on ‘significant’ substitution of fully qualified GPs with trainees and specialist and associate specialist (SAS) doctors, the public spending watchdog has revealed. In a new assessment of the NHS long-term workforce plan, the National Audit Office (NAO) found that NHS England’s modelling of the future workforce had ‘significant weaknesses’ and that some of its ‘assumptions’ may have been ‘optimistic’. Last year, the national commissioner committed to doubling medical school places to 15,000 and increasing GP training places to 6,000 by 2031. This was based on modelling which predicted that, without these changes, the NHS could face a staffing shortfall of 360,000 and a GP shortfall of 15,000 by 2036. The NAO’s report has examined the robustness of NHS England’s predictions, and made a number of recommendations which could influence the refreshed projections NHSE has committed to publishing every two years. The long-term workforce plan (LTWP) projected only a 4% increase in fully-qualified GPs between 2021 and 2036, compared to a 49% growth in consultants. "The total supply of doctors in primary care is projected to increase substantially over the modelled period but the total number of fully qualified GPs is not," the report said. It found that NHSE’s projected supply growth in general practice "consists mainly of trainee GPs", who accounted for 93%, as well as "making increased use of specialist and associate specialist (SAS) doctors in primary care". Read full story Source: Pulse, 22 March 2024
  3. Content Article
    Doctors working in temporary positions (known as locums) are a key component of the medical workforce and provide necessary flexibility and additional capacity for NHS organisations and services. There have been concerns about the quality and safety of locum practice and the way NHS uses locum doctors. The number of doctors working as locums, and the costs of this to the NHS have caused some concerns nationally in recent years. It has also been suggested that locum doctors may not provide as good a quality of care as permanent doctors. Research carried out by a team at the University of Manchester provided important new information on these issues. The findings indicated that locum working and how locums were integrated into organisations could pose significant challenges for patient safety and quality of care.
  4. News Article
    Private hospitals are caring for a record number of patients paying through their own savings or private medical insurance, according to figures from the Private Healthcare Information Network. Helen, a semi-retired frontline worker in south-east England, spent nearly £50,000 of her retirement savings on major spinal surgery to get her life back after two years of debilitating pain. Helen, 56, began experiencing extreme lower back pain and leg pain in September 2021, triggered by a dog colliding with her leg in the park. Though it was not caused by the trigger, she was diagnosed by the NHS with spondylosis in November 2021, and then a pars defect (a condition affecting the lower spine), and offered scans and physiotherapy. She said six months of physiotherapy, beginning in early 2022, resulted in no improvement, and she was offered pain management and a steroid epidural, which she said also did not help. “I rarely ventured out in these two years … due to the extreme pain I was in when sitting, standing or walking. Life effectively stopped in 2021,” she said. Desperate, she booked a consultation in May 2023 with a neurosurgeon and was told she needed an operation. Helen asked whether it would be possible for the neurosurgeon, who also works within the NHS, to do it on the NHS rather than privately. A referral could be made, she was told – but the surgery was likely to involve a waiting time of 18 months to two years. “My husband and I discussed it, and he said: you’ve already had no life for the last two years, do you really want to wait another two?” She had the spinal surgery in August 2023 and is now managing her pain with over-the-counter medication, rather than the stronger painkillers she was on before. It cost her a staggering £48,345. The financial hit has been huge. “I was absolutely gutted to have to go private. This has knocked us both; we didn’t see us in our lives having to pay for something like this. We’ve managed our finances carefully and always saved where we can. But that lump sum [that we] can access when we retire … That lump sum has just gone now.” Read full story Source: The Guardian, 8 March 2024
  5. Content Article
    In this opinion piece for inews, Dr Punam Krishan describes the increasing levels of verbal and physical abuse GPs are experiencing from patients in the NHS. She describes how a shift in the public's perception of GPs since the pandemic has contributed to this increase in aggression and highlights that although it is only a minority of patients who display abusive behaviour, it has a big impact on GPs wellbeing and ability to treat other patients. She goes on to outline stricter measures her practice has had to put in place to crack down on abuse from patients.
  6. News Article
    Patients in parts of England are facing an uphill struggle to see a GP, experts say, after an analysis showed wide regional variation in doctor numbers. The Nuffield Trust think tank found Kent and Medway had the fewest GPs per person, followed by Bedfordshire, Luton and Milton Keynes. It comes as ministers have struggled to hit the pledge to boost the GP workforce by 6,000 this Parliament. But the government said it had plans in place to tackle shortages. However, Dr Billy Palmer, of the Nuffield Trust, said: "Solely boosting the number of staff nationally in the NHS is not enough alone - the next government should set a clear aim of reducing the uneven distribution of key staffing groups and shortfalls to tackle unfairness in access for patients." The think-tank report found while the government had met its target to increase the number of nurses by 50,000 this Parliament, the rises had not been felt evenly, with some specialist nurse posts, such as health visitors and learning-disability nurses, seeing numbers shrink. Dr Palmer said minimum numbers of GPs may have to be set for local areas - and better incentives to attract them to those with the fewest. Read full story Source: BBC News, 8 March 2024
  7. 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
  8. News Article
    GPs do not ‘face huge amounts of complexity’ and most of their appointments are ‘incredibly straightforward’, according to a former Conservative health minister. Speaking to BBC Radio 4 last week, Lord Bethell defended upcoming legislation that will bring physician associates (PAs) under GMC regulation, which could be struck down by the House of Lords this evening. Both the Doctors’ Association UK and the BMA had previously complained about the lack of debate in Parliament. Discussing the role of PAs on Friday, Lord Bethell said he had not seen ‘any evidence’ of patients being confused about whether they were seeing a doctor or an associate. "GPs don’t face huge amounts of complexity. Most interactions are incredibly straightforward. Certainly my own experience over the last 20 years of going to my GP, it really hasn’t required 10 years of training to deal with my small problems," he said. Lord Bethell added: ‘When they are complex, they should be escalated. But there’s a much wider group of people who have professional training who should be respected, celebrated – they shouldn’t be denigrated, they shouldn’t be in any way patronised by other professionals.’ Read full story Source: Pulse, 26 February 2024
  9. Content Article
    Eating Disorders Awareness Week takes place 26 February - 3 March 2024 Eating disorders are complex mental health conditions that affect an estimated 1.25 million people in the UK. There are many unhelpful myths about who eating disorders affect, what the symptoms are and how to support people in recovery. Alongside a current lack of appropriately trained staff and capacity in mental health services, this can make it challenging for people with eating disorders to access the help and support they need. Patient Safety Learning has pulled together ten useful resources shared on the hub to help healthcare professionals, friends and family support people with eating disorders. They include awareness-raising articles, practical tips for patients and their loved ones, and clinical guidance for primary, secondary and mental health providers.
  10. Content Article
    There is currently a lack of research addressing the impact of patient suicide on GPs. This qualitative study in BMJ Open aimed to examine the personal and professional impact of patient suicide, as well as the availability of support and why GPs did or did not use it. The authors found that GPs are impacted both personally and professionally when they lose a patient to suicide, but may not access formal help due to commonly held idealised notions of a ‘good’ GP who is regarded as being unshakable. Fear of professional repercussions also plays a major role in deterring help-seeking. A systemic culture shift which allows GPs to seek support when their physical or mental health requires it is needed, and this may help prevent stress, burnout and early retirement.
  11. Content Article
    This report by The King's Fund argues that the health and care system in England must shift its focus away from hospital care to primary and community services if it is to be effective and sustainable. It looks at a wholesale shift in the focus towards primary and community health and care across leadership, culture and implementation. Successive governments have repeated a vision of health and care services focused on communities rather than hospitals, but that vision is very far from being achieved. The report outlines research that explored the underlying factors that have prevented change, and what might need to be done to achieve the vision. The researchers analysed published evidence and national datasets, and interviewed stakeholders across the health and care system. The report concludes that to achieve community-based care, political and other national leaders will need to completely shift their focus away from hospitals towards primary and community health and care.
  12. Content Article
    Continuity of care, defined as an ongoing therapeutic relationship between a patient and a physician, is a defining characteristic of primary care. However, arranging a consultation with one’s regular doctor is increasingly difficult as practices face physician shortages. Kajaria-Montag et al. studied the effect of declining care continuity on the productivity of physicians by analysing data of over 10 million consultations in 381 English primary care practices over a period of 11 years. Specifically, they examined whether a consultation with the patient’s regular doctor is more productive than with another doctor in the practice. The authors found that the time to a patient’s next visit is on average 18.1% longer when the patient sees the doctor they have seen most frequently over the past two years, while there is no operationally meaningful difference in consultation duration. The data show that the productivity benefit of care continuity is larger for older patients, patients with multiple chronic conditions, and patients with mental health conditions. The authors estimate that the total consultation demand in their sample could have fallen by up to 5.2% had all practices offered continuity of care at the level of the top decile of practices while prioritising patients expected to yield the largest productivity benefits.
  13. News Article
    Seeing the same GP improves patients’ health, reduces doctors’ workloads and could free up millions of appointments, according to the largest study of its kind. Research has previously suggested there may be benefits to seeing the same family doctor. But studies have mostly been small or covered a short period of time. Now University of Cambridge and Insead business school researchers have analysed data from 10m consultations over more than a decade in the most authoritative study on the issue yet. They found that if all GP practices moved to a model where patients saw the same doctor at each visit, it would significantly reduce doctors’ workloads while improving patient health. Multiple benefits emerged when patients had a long-term relationship with their doctor, researchers found. Seeing the same GP – known as continuity of care – meant people waited on average 18% longer between visits, compared with patients who saw different doctors. People did not take up more GP time in each consultation and the findings were particularly strong for older patients, those with multiple chronic illnesses, and people with mental health conditions. Although it will not always be possible for people to see their regular GP, researchers said the findings would translate to an estimated 5% reduction in consultations if all practices provided the level of continuity of care of the best 10% of practices. That suggests millions of appointments could be freed up. The researchers added: “Importantly, if patients receiving care from their regular doctors have longer intervals between consultations without requiring longer consultations, then continuity of care can potentially allow physicians to expand their patient list without increasing their time commitment.” Read full story Source: The Guardian, 23 February 2024
  14. Content Article
    Primary care appointments may provide an opportunity to identify patients at higher risk of suicide. This study in the British Journal of General Practice aimed to explore primary care consultation patterns in the five years before suicide to identify suicide high-risk groups and common reasons for seeing a healthcare professional. The authors found that frequent consultations (more than once per month in the final year) were associated with increased suicide risk. The associated rise in suicide risk was seen across all sociodemographic groups as well as in those with and without psychiatric comorbidities. However, specific groups were more influenced by the effect of high-frequency consultation, including females, patients experiencing less socioeconomic deprivation and those with psychiatric conditions. The commonest reasons that patients who went on to commit suicide requested consultations in the year before their death, were medication review, depression and pain.
  15. Content Article
    In this interview, Professor Martin Marshall, former GP and Chair of the Royal College of General Practitioners, shares his concerns for the future of general practice in the UK. He outlines the danger that more of the workforce will turn to private practice due to current pressures facing NHS GPs.
  16. 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.
  17. News Article
    England’s largest hospital trust has written to GPs warning their patients face 15-week waits for routine MRIs, ultrasound and CT scans. Guy’s and St Thomas’ Foundation Trust in central London said it was prioritising suspected cancer and other “urgent cases”, meaning “unfortunately waiting times for routine patients are now an average of 15-16 weeks for an appointment against a target of six weeks”. This is much worse than national averages, which December figures showed were 3.2 weeks, 2.5 weeks and 3.3 weeks for MRI, CT and ultrasound waits respectively. It its letter to GPs in Lambeth and Southwark – its main patches – GSTT said: “Current imaging referral demand outstrips capacity, despite these services consistently delivering near 120 per cent levels of activity compared to 2019-20. “The radiology service is exploring multiple routes to increase imaging capacity, including increased weekend working, insourcing and outsourcing contracts, but there is still a significant shortfall of slots every week.” In particular, it said primary care staff should expect long waits for the reporting of routine MRI scans. Read full story (paywalled) Source: HSJ, 13 February 2024
  18. News Article
    Online services for GPs across Surrey leave many patients feeling "helpless and lost", a new report says. Healthwatch Surrey said some patients felt "defeated" by online systems and that issues were worse in certain groups. This included people with English as a second language and those less confident with technology. Online services include booking appointments, requesting repeat prescriptions and viewing test results. Healthwatch Surrey, which gathers the views of local people on health and social care services in the county, said: "Confusion around the appointment booking process and a perception that appointments are hard, or even impossible, to book online is the issue people tell us most about." One Epsom and Ewell resident was asked by their surgery to book a blood test online. They told Healthwatch: "I tried but I couldn't understand how to do it and so I called back. "I'm in my 80s and I try to be as independent as I can, but some of these processes defeat me." Sam Botsford, contract manager at Healthwatch Surrey, said communication was key in ensuring patients knew how to use online services. She said: "People feel they're being pushed online, and that spans a range of different demographics. "It's really important for practices to identify the needs of their patients and how they can best meet those." Read full story Source: BBC News, 2 February 2024
  19. Content Article
    This study in the British Journal of General Practice aimed to assess the risk of poor respiratory outcomes for people with resolved asthma compared to those with active asthma and people without asthma. The authors used three retrospective cohorts of around 16,000 patients each, in the following groups: Active asthma cohort (patients with an asthma-specific diagnostic code at any point in their GP record, and >1 asthma medication prescription). Resolved asthma cohort (patients with >1 resolved asthma code, followed from date of first resolved asthma during the study period to the earliest data of an asthma prescription, the end of the study period, date of transfer out of practice or death). Non-asthma cohort (population-based patients without active or resolved asthma or chronic obstructive pulmonary disease). The results showed that compared to the active asthma cohort, the resolved asthma cohort had fewer GP consultations for asthma exacerbations and fewer asthma hospital admissions. However, compared with non-asthma patients, resolved asthma patients had more GP consultations, greater rates of respiratory tract infections and higher rates of antibiotic use. The authors highlighted a lack of guidance around care pathways for patients with a record of resolved asthma. They concluded that patients with resolved asthma may need a more comprehensive respiratory assessment if they present with symptoms of lower respiratory tract infection, in order to assess symptom burden, airway obstruction and the potential value of inhaled treatment.
  20. News Article
    One in 20 patients has to wait at least four weeks to see a GP at a time when funding for family doctor services is falling, NHS figures show. In November 2023, 1.5m appointments in England at a GP surgery took place four weeks or more after they were booked, 4.8% of the 31.9m held that month. In one in six appointments, 5.4m (17.3%), the patient was forced to wait at least two weeks after booking it to see a GP, practice nurse or other health professional. “Millions of people are being left anxious or waiting in pain because they can’t get an appointment with their GP,” said Ed Davey, the leader of the Liberal Democrats, who highlighted the latest evidence underlining the long delays that many patients face to see a GP. “Staggering” numbers of patients now have to wait a long time, he said. GP leaders blamed the situation on the widespread shortage of family doctors, which they said was making it impossible to keep up with the rising demand for appointments. Burnout due to intense workloads is prompting more GPs to work part time. Read full story Source: The Guardian, 22 January 2024
  21. News Article
    Long Covid costs the UK at least an extra £23m in GP and other primary care consultations each year, according to estimates in a new study. The University of Birmingham said extra appointments cost between £23m and £60m a year. The study examined more than 950,000 electronic healthcare records since the start of the global pandemic. People with Long Covid report symptoms including persistent coughs and brain fog. The condition is defined as having symptoms three months after the initial infection, which last for two months or more. Factors found to increase primary care costs included being older, female, white, obese or someone with long-term health conditions. Co-lead author Dr Shamil Haroon, from the university, said: "We might expect that patients who are older or who have long-term health conditions will need additional primary care support, but we have also seen additional costs associated with being white and female." Read full story Source: BBC, 11 January 2024
  22. Content Article
    The economic impact of managing Long Covid in primary care is unknown. In a study published in BMC Primary Care, Tufts et al. estimated the costs of primary care consultations associated with Long Covid and explored the relationship between risk factors and costs. The study found that costs of primary care consultations associated with Long Covid in non-hospitalised adults are substantial. Costs are significantly higher among those diagnosed with Long Covid, those with Long Covid symptoms, older adults, females, and those with obesity and comorbidities.
  23. Event
    until
    This online conference hosted by the Royal College of General Practitioners (RCGP) is free of charge to RCGP members and £200 for non-members. Health inequalities are differences in health across the population and between different groups in society that are systematic, unfair and avoidable. General Practice, with its unrivalled access to the heart of communities, has a key role in addressing both causes and consequences of health inequalities in the UK. General Practice is a diverse profession caring for multiple patient populations and the aim of this conference is to move from conversations to actions, improving patient care in these communities. The programme was put together by RCGP Officers, Faculty Education Leads and expert speakers, who are participating throughout the day and will include examples of best practice, relevant guidance and links to useful resources. Learning objectives: Understand the evidence linking ethnicity, protected characteristics, and health outcomes Acknowledge minority patients' perspectives of health and illness Promote the best clinical management within primary care Promote partnerships working with relevant organisations and community assets to improve patient care Areas to be covered: Health inequalities in learning disabilities Health inequalities in South Asian women in the UK Exploring and remediating unconscious bias Tackling health inequalities in African and Caribbean communities Barriers to accessing health services for migrant and ethnic minorities patients Panel discussion: improving screening uptake in minority ethnic groups End of life care and bereavement Pain management in populations with high levels of health inequality Ethnicity and disease Issues affecting the LGBTQIA+ community Keynote Speaker: Professor Kamila Hawthorne MBE, Chair of Council, RCGP Register for the conference
  24. 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
  25. News Article
    An alarming number of Britons are turning into “DIY doctors” because of the struggle to get an NHS GP appointment in 2023, new polling has revealed. Some 23% of those surveyed said they could not get an appointment, while three in 10 (33 per cent) said they had given up on booking one altogether, according to a Savanta poll commissioned by the Liberal Democrats. Many said they had resorted to “DIY” medical care or gone to A&E instead. One in seven (14 per cent) said they had been forced to treat themselves or ask someone else untrained to do so, with the same proportion seeking emergency care. One in five people said they had bought medication online or at a pharmacy without advice from a GP, and one in three had delayed seeing a doctor despite being in pain, as pressure on the NHS mounts. Liberal Democrat leader Sir Ed Davey described the figures as “utterly depressing” and said they should serve as an “urgent wake-up call for ministers asleep on the job”. Read full story Source: The Independent, 1 January 2024
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