GP News

'Innovative' single-hander wins GP of the Year award

Practice Business News from Pulse Today - Mon, 12/03/2018 - 12:03
A single-handed GP in Hull has won Pulse's GP of the Year award for providing 'innovative' care to the largest council estate in Europe.
Categories: Business News, GP News

College calls for greater efforts to keep existing GPs in the profession delivering patient care

The survey of 1,094 GPs in England found:
  • 31 percent of GPs said they are unlikely to be working in general practice in five years with stress and retirement cited as the main reasons for this.
  • 5 percent of GPs* report that their practice is likely to close in the next year. These are not practices that are merging with others.
  • 37 percent of GPs* said that in the practice where they work, there are GP vacancies that have been open for more than three months. 
Efforts to retain the workforce need to replicate the 'excellent' work that has gone into increasing recruitment to general practice, which has seen more GPs in training than ever before, the College is saying. It has also analysed the latest provisional workforce data from NHS Digital for September 2018, published last month, which showed an increase of 41 from September 2017**. However, looking back to September 2015 – the last set of workforce data before NHS England's GP Forward View was announced, with a pledge of 5,000 more GPs by 2020 – the total number has dropped by 460. Taking the data at Clinical Commissioning Group-level, it has identified where in the country has seen the biggest increase in GP numbers – with one area seeing an extra 87 GPs since September 2015 – and where has seen the biggest decrease. Areas with biggest increases in GP numbers between Sept 2015-Sept 2018:
  • NHS Liverpool CCG (87)
  • NHS Northern, Eastern and Western Devon CCG (67)
  • NHS Kernow CCG (54)
  • NHS Lambeth CCG (45)
  • NHS Gloucestershire CCG (41)
Areas with biggest decreases in GP numbers between Sept 2015-Sept 2018:
  • NHS Horsham and Mid Sussex CCG (-52)
  • NHS Walsall CCG (-33)
  • NHS Portsmouth CCG (-29)
  • NHS Hull CCG (-22)
  • NHS Thanet CCG (-19)
The College says that a primary factor in GPs leaving the workforce prematurely is excessive workload, which has risen substantially in recent years both in volume and complexity, yet the share of the NHS England budget general practice receives is less than it was a decade ago, and GP numbers are lower than they were three years ago. Last month the College renewed its long-standing calls for general practice to receive 11% of the overall NHS budget as part of the forthcoming 10-year plan for the NHS. The recent announcement that £3.5bn of the promised £20.5bn NHS uplift would be allocated for primary and community care shows a commitment to supporting healthcare services closer to home for patients. However, general practice currently receives 9.5%*** of the NHS England budget, and the College has called for assurances that general practice, specifically, will be a key recipient of this new funding. It says 11% of the budget for general practice would enable:
  • Larger practice teams, which would enable GPs to spend more time than the standard 10-minute consultation with patients who need it.
  • A wider range of healthcare professionals to provide a wider range of clinical services in GP surgeries.
  • IT systems allowing more surgeries to use video consultations as part of a standard range of consultation options, and to enable joined-up care across the NHS. 
  • Modernised, fit-for-purpose surgeries as the 'hub' of the community
  • A bigger workforce, where more healthcare professionals will choose general practice as a career and are supported by better-funded training placements in the community.
Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: "All GPs are overworked, many are stressed, and some are making themselves seriously ill working hours that are simply unsafe, for both themselves and their patients - it is making them want to leave the profession. It is forcing some GPs to hand back their keys and close their surgeries for good. "This is having a serious impact on many of our patients, who are waiting longer and longer to secure a GP appointment. But it also means we don't have the time we need with patients – particularly the growing number living with multiple, complex conditions – so the standard 10-minute appointment is simply unfit for purpose. GPs often find ourselves fire-fighting by prioritising the urgent cases, whereas the strength of general practice is to prevent disease and identify conditions in the early stages, to avoid them becoming more serious – and costlier to the health service. "About a third of the GPs we surveyed said they were unlikely to be working in general practice in five years' time. This is gravely concerning. We are talking about highly-trained, highly-skilled doctors, that the NHS is at risk of losing – some will retire, which is to be expected, but many are planning to leave earlier than they otherwise would have done because of stress and the intense pressures they face on a day to day basis, whilst simply trying to do their best for their patients. "These GPs are the ones we need to be focussing our energy on – to make their working situation safer and more sustainable. "NHS England and Health Education England have done excellent work, supported by the RCGP and others, to encourage more doctors to specialise in general practice and we now have more GPs in training than ever before. But GP specialty-training takes three years, and if as many GPs are leaving the profession as entering it, we are fighting an uphill battle, when realistically we need thousands more. "We need to see this level of effort replicated in initiatives to retain GPs already in the profession, to reduce our escalating and often unnecessary workload, and to support GPs and our teams' own health and wellbeing. "The RCGP is calling for general practice to receive 11% of the overall NHS budget as part of the forthcoming 10-year plan for the NHS. Investing in general practice is investing in the entire NHS. It is an investment in good patient care."
Categories: GP News

New EMIS system will listen to and ‘interpret’ GP-patient conversations

Practice Business News from Pulse Today - Fri, 11/30/2018 - 16:43
The new EMIS-X system will use voice recognition to ‘automatically interpret’ conversations between GPs and their patients, and ‘turn them into medical codes’, EMIS said today.
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Labour Party complains to Prime Minister about Matt Hancock’s Babylon links

Practice Business News from Pulse Today - Fri, 11/30/2018 - 15:28
The Labour Party has complained to Prime Minister Theresa May about health secretary Matt Hancock's links to private GP provider Babylon.
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Half of GPs say patients came to harm from cancelled operations last winter

Practice Business News from Pulse Today - Fri, 11/30/2018 - 09:03
Exclusive GPs have revealed the extent to which patients were put at risk of harm, including death, as a result of hospitals struggling to deal with winter pressures last year.
Categories: Business News, GP News

Half of GPs say patients came to harm from cancelled operations last winter

Practice Business News from Pulse Today - Fri, 11/30/2018 - 09:03
Exclusive GPs have revealed the extent to which patients were put at risk of harm, including death, as a result of hospitals struggling to deal with winter pressures last year.
Categories: Business News, GP News

Half of GPs say patients came to unnecessary harm last year due to winter pressures

Practice Business News from Pulse Today - Fri, 11/30/2018 - 09:03
Exclusive GPs have revealed the extent to which patients were put at risk of harm, including death, as a result of hospitals struggling to deal with winter pressures last year.
Categories: Business News, GP News

Shortage of nurses and pharmacists could hinder Scottish contract roll out

Practice Business News from Pulse Today - Thu, 11/29/2018 - 16:02
Failure to plan for the numbers of new nurses, pharmacists, physiotherapists and other healthcare staff could hinder GP efforts to implement plans outlined in the new Scottish GP contract, doctors leaders have warned.
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College defends GPs against accusations they 'shunt' mental health patients on to police

Sir, Her Majesty's Inspectorate for Constabulary Fire and Rescue Services really needs to check its facts (GPs dump mental health cases on us, complain police – November 27 2018). GPs and our teams have the greatest respect for our emergency services, and we collaborate with them on a daily basis, but to accuse hardworking family doctors of 'shunting' patients after closing our doors at 5pm is disgraceful, disappointing and demeaning. Today alone, over 1m patients will visit their GP surgery, and dedicated GPs and their teams are working harder than ever to try and keep up with rising patient demand at a time when we also have a severe shortage of family doctors. We are managing complex conditions in the community - including serious mental health issues - that even a decade ago would have been automatically referred to hospital consultants. My members routinely report working over 12 hours every  day – indeed at my own surgery in Lichfield on Monday, I had over 100 patient contacts - so to say we close our doors at 5pm is completely untrue and unfair. GP surgery core hours are 8.00-18:30 and all practices in England now offer extended routine services, whether in the evening until 20:00 or at weekends. Outside these hours, GP-led out of hours services will take responsibility for the care of our patients with urgent health needs. Even when our doors are 'closed', we are still working on referrals, following up test results and all the tasks that were once part of our working day but now have to be done in our own time because we are constantly running to catch up. Our emergency services are under enormous pressure, but so is general practice,  and we achieve more for our patients by supporting each other and working together, rather than using GPs as an easy target and apportioning inappropriate blame. Professor Helen Stokes-Lampard, Chair
Royal College of General Practitioners
30 Euston Square
London, NW1 2FB
Categories: GP News

CCGs tackle winter pressures with extra GP appointments and remote monitoring

Practice Business News from Pulse Today - Thu, 11/29/2018 - 09:30
Commissioners are putting in place a range of measures to help general practice deal with winter pressures over the coming months, including funding extra GP appointments and introducing schemes that involve remote monitoring of care home patients.
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GP workload warning as primary care diagnostic testing increases threefold

Practice Business News from Pulse Today - Wed, 11/28/2018 - 23:30
GPs are ordering three times as many diagnostic tests as they did 15 years ago, a study has found.
Categories: Business News, GP News

Increase in diagnostic tests is 'appropriate' given our growing and ageing population, says RCGP

She said: "GPs are in an incredibly difficult position when it comes to making referrals or ordering blood tests and other investigations, in that we get criticised when we do, and criticised when we don't. Ultimately, our priority is to our patients and we will work in their best interests. "This research looks at the increase of number of requests for tests GPs make, but not the reasons why and whether they were appropriate – and both of those must be key when making a judgement about whether an increase is positive, or not. "The fact that the last 15 years have seen more varied and more accurate diagnostic tests become available in the NHS is a good thing – but these do come at a cost. It's obviously important to consider NHS resources when deciding to make a request for a test, but GPs and their teams don't take the decision lightly, or if they don't think they will genuinely help in narrowing down what might be wrong with a patient. "We're now serving a growing and ageing population, and where many patients are living with multi-morbidities, so, as this report shows, there will be a completely appropriate increase in the number of tests being carried out in the community as these conditions and the medications used to treat them are monitored. We would argue that GPs and our teams need far better access to diagnostic tests in the community, so that we can make a more informed decision about requesting more specialised tests or making a referral to a hospital colleague."
Categories: GP News

Upsides and downsides of drug-based medicine explored in new RCGP art exhibition

What Once Was Imagined (WOWI), named after a quote by William Blake, is the creation of long-time collaborators, textile artist Susie Freeman and Bristol-based GP, Dr Liz Lee – together known as Pharmacopoeia. WOWI will feature 31 installations, many on display for the very first time and some created especially for the exhibition. Each piece explores a different health issue, with some works relating to specific patients: Charlie and Lucy, for example, considers the latest gene therapy being used to treat cystic fibrosis, while Miss Essex is a giant handbag adorned with all the pills one woman hoarded during treatment for her mental health. Many pieces are constructed using real medication and medical devices. For example, Larking About, a handbag decorated with long-acting reversible contraceptives known as LARCS, looks at changing trends in recommended contraception while others, such as Feast, a coat made from the packaging of all the food eaten on Christmas Day, addresses a culture of excess and lifestyle habits that can contribute to long-term health conditions. The new pieces join two that are part of the RCGP's permanent collection, and already on display at 30 Euston Square: Jubilee, a wedding dress made of the number of contraceptive pills a woman could take during her married life, and Armour, made with the empty packets from medicines one of Dr Lee's patients took in the last five years of his life. Some key pieces in the exhibition include:
  • Sonia: a cascading silver muslin coat covered in three years' worth of lupus medication packets. Lupus, an autoimmune disease once considered untreatable, attacks the body's immune system causing multi-organ failure: "taking so many pills is a burden, but it's saving Sonia's life,” says Dr Lee;
  • Steve's Scarf, is made from pills prescribed by Dr Lee to help manage her patient Steve's heart disease, arthritis and diabetes – a stark reminder of the UK-wide rise in patients living with multiple, chronic conditions as people live longer;
  • Wave: a depiction of Freeman's own experience of depression - a delicate stretch of blue fabric decorated with the packets of her own medication: "for some people it presents as 'black dog' but for me it was a deep blue," she explains;
  • Bristol Silver: a waterfall of pill packets for common conditions and chronic disease management, collected from one Bristol pharmacy over the course of a month;
  • WOWI flowers: a series of works depicting colourful flowers made from pills to treat myriad conditions from indigestion to tuberculosis.
Using an analogy of her own father to explain the concept of WOWI, Dr Lee, said: "My father, Dr Alan Baskerville Lee, was one of the first College members, and I have vivid childhood memories of him endlessly taking indigestion tablets. "In the 1980s he tested positive for helicobacter; a bacterium associated with stomach ulcers. He took a one-week course of triple therapy: amoxicillin, metronidazole and omeprazole and his indigestion was cured. "That's an extraordinary example of medical progress and how it has transformed the miserable symptom of indigestion for many millions of people." On the other hand, Dr Lee acknowledges the downside of medication: "It can be a burden. I take statins and can't bear it, although I know it's for a reason. Every evening when I take the tablets it makes me feel old, it's a reminder of my mortality. "GPs are acutely aware that we must be cautious about the medications our patients take. There is an important conversation to be had, and our patients need to be a part of it, about alternatives to medication, as well as what can be done to prevent people becoming sick in the first place." Freeman added: "We often hear about how bad pills are for us, but modern medicine has worked wonders for millions of people and is the reason why so many of us are still here today. "Many of the conditions showcased in our exhibition were once a death sentence, but now, thanks to these tiny tablets, people are living healthier and longer than ever once imagined." Professor Mayur Lakhani, President of the Royal College of GPs, said: "It's an absolute honour to host WOWI at 30 Euston Square, the home of general practice and the headquarters of the RCGP. "Pharmacopoeia is a unique blend of art and medicine, and WOWI explores several pertinent issues for general practice. "It celebrates advances in medical research that mean our patients can live longer, and diseases that were once seen as a death sentence are now treatable. But it also explores emerging challenges facing medicine, such as overdiagnosis, and asks important questions such as 'are we simply prescribing too many pills?' WOWI will be showing at the College from November 28 to May 2019 and is free to visit.
Categories: GP News

Wearable health gadgets must be reliable, safe, and equitable, says College

She said: "Technology has the potential to transform healthcare, and can play a key role in getting people more involved in their health, and living healthier lives. "Devices can be used to incentivise walking a certain number of steps a day, for example, or for people living with long-term conditions, to monitor things like blood pressure. "However, new technology and gadgets can be expensive, and we must be sure that if we are recommending certain devices to patients that we are sure of the reliability and evidence behind them, and that we are not leaving more socio-economically disadvantaged patients, or even just our less tech-savvy patients behind. "It's also a reality that many patients might not understand how to interpret the data that their devices are feeding to them, and seek help from a healthcare profession to interpret it – in many cases this wouldn’t be a good use of GPs' scarce time. "When we're talking about patients' data – collected via their technological devices – being used to target preventative health interventions to them, it is the case that the more detailed the data we have about patients, the better. But patients must also consent to it being used, and be completely clear what it may be used for - any interventions must also be handled sensitively, so as not to cause unnecessary alarm. "Ultimately, any new innovation or way of working should be rigorously and consistently evaluated in terms of its benefit for patient, and its impact on general practice and the wider NHS – and we have called for a rapid evaluation system in order to do this."
Categories: GP News

‘Insufficient evidence’ that diverting patients from A&E curbs overcrowding

Practice Business News from Pulse Today - Tue, 11/27/2018 - 23:30
Diverting patients who are not seriously ill away from A&E may not improve overcrowding issues, research has found.
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CCG invites struggling GP practices to bid for up to £20k 'crisis' funding

Practice Business News from Pulse Today - Tue, 11/27/2018 - 17:23
A CCG has set up a crisis fund from which its member GP practices can request money if they hit temporary hard times.
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More GP access to diagnostic tests, and more time with patients needed to further improve timely cancer diagnosis, says RCGP

"GPs take their role in the timely diagnosis of cancer extremely seriously, and we're often the first port of call for patients wanting to get symptoms checked or who are simply after reassurance. 
"However, as this report highlights, a key factor in being able to diagnose patients in a timely way comes down to having access to the right diagnostic tests – and GP access to appropriate tests in the community is currently amongst the lowest in Europe. 
"The report is also right to acknowledge that GPs are in a very difficult position when it comes to referral and face harsh criticism if they refer too many patients to specialist care, and complaints if they don't refer enough.
"Despite these difficult circumstances, GPs are doing a good job of detecting cancer – something that can be very hard in general practice, particularly within the constraints of the standard 10-minute consultation, as several cancers start with very vague, non-specific symptoms which are similar to many other, more common conditions.
"Figures show that 75% of patients found to have cancer are referred after only one or two consultations, and in the last five years the proportion of cancers diagnosed as an emergency has dropped from 25% to 20%. A higher proportion of patients are also being diagnosed at an earlier stage of the disease.
"But without access to the right tests, this is simply not sustainable. We desperately need for GPs and our teams to have better access to high quality diagnostic tools in the community and the appropriate training to use them.
"Cancer must be a priority in the forthcoming NHS Long-Term Plan, but so too must general practice as a whole. Investing in general practice is an investment in the entire NHS - by having more resources and more GPs in the community, we can deliver the best possible care to all our patients, including those with cancer, and those we suspect of having cancer."
Categories: GP News

Urgent care company collapse leaves GPs just 10 days to find out-of-hours cover

Practice Business News from Pulse Today - Mon, 11/26/2018 - 16:37
A number of GP practices are being forced to urgently seek replacement out-of-hours cover after the private company providing services on their behalf gave them just 10 days' notice of ceasing operations.
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Royal College of GPs backs ‘People’s Vote’ on Brexit

The Council also passed a motion to oppose the UK’s exit from the European Union. The full text of the motion that was passed was: “Recognising that leaving the European Union may damage the recruitment and retention of the healthcare professional workforce in the United Kingdom; Recognising that leaving the European Union may potentially damage the mutual recognition of the qualifications of healthcare professionals between the European Union and the United Kingdom; Recognising that leaving the European Union may damage recruitment to, and retention of, the social care workforce; Recognising that leaving the European Union may damage cross-border arrangements for healthcare between Northern Ireland and the Republic of Ireland; Recognising that leaving the European Union may damage reciprocal healthcare arrangements between the European Union and the United Kingdom, including eligibility for the European Health Insurance Card; Recognising that leaving the European Union may damage public health in the United Kingdom and international cooperation on public health; Recognising that leaving the European Union may damage the United Kingdom’s access to medicines, devices and radioisotopes; Recognising that leaving the European Union may damage scientific collaboration, scientific and medical research programmes, participation in international clinical trials, including pharmaceutical research studies; free movement of scientists, including medical researchers; and collaboration between universities in the United Kingdom and the European Union; Recognising the need for the facts about the damage to the UK healthcare professional workforce, public health, access to medicines, devices and radio-isotopes, and damage to the National Health Service, science, research and universities to be put before the citizens of the United Kingdom; The Council of the Royal College of General Practitioners believes that the objective, non-partisan evidence in relation to the deleterious effects of Brexit on health and healthcare means that the College should oppose Brexit,  because the object for which the College is incorporated is  ‘to encourage, foster and maintain the highest possible standards in general medical practice’; because the College is obliged  ‘to take or join with others in taking any steps consistent with the charitable nature of that object’; and that object would be grievously undermined by Brexit. The Council of the Royal College of General Practitioners believes that the public should have a final say on the Brexit deal, including the options of accepting the deal, rejecting the deal, and remaining within the European Union.” Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: “The College has considered carefully the implications of taking a view on Brexit, particularly given our status as a registered charity. “We are also a membership body with more than 52,000 members, all of whom will have their own views on the UK exiting the European Union, but the level of feeling by UK Council – who have been elected by the membership to represent their interests – was that the risks of Brexit to the NHS and patient safety and care were significant enough to take a stance. “The motion to oppose Brexit was passed with 46 voting for, 11 voting against and 6 abstaining. The motion to support a People’s Vote was passed with 38 voting for, 18 voting against and 7 abstaining. “We will now consider how the College can take these decisions forward.”
Categories: GP News

GP leaders vote against limiting practice lists to 1,500 patients per GP

Practice Business News from Pulse Today - Fri, 11/23/2018 - 15:13
GP leaders have voted against limiting the number of patients a practice can have on their list to 1,500 per full-time equivalent GP.
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