Category: Research

Acute primary care in an integrated NHS

Professor Roger Jones is editor of the British Journal of General Practice. The tsunami of chronic disease management – the ageing population, rocketing rates of non-communicable diseases, and increasing complexity – have dominated much of the debate about the future of general practice and of the NHS. The crucial function of general practitioners in making accurate, timely diagnoses in patients presenting with acute symptoms is easily overlooked, yet is at the very core of primary care. The implications of this for mending the fractures in the system and for the design of integrated models of care came home to...

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Altmetrics: now available for BJGP articles

The world of scholarly publishing is changing rapidly, partly in response to digital publication, and also with more focus on the dissemination and implementation of published research. Traditional bibliometrics, such as the impact factor, have been used to measure aggregated citation rates as a proxy measure of journal quality. There is now more interest in looking at article-level and author-level metrics. Peer-review publication is one component of an ‘ecosystem’ of dissemination, which includes, for example, citations, news and media coverage, discussion on social media and websites, and inclusion in practice guidelines. These new metrics – ‘altmetrics’ – defined as anything that is not a citation, can be captured in a number of ways. The BJGP has launched the Altmetric donut, a colourful, arresting image which depicts the various media which have paid attention to a given article, with a numerical score reflecting the number of ‘mentions’. The Altmetric buttons, appearing within the ‘Info’ tab of each article, are not substitutes for traditional bibliometrics, but we think will become a useful addition to understanding how research results ‘get out’ and are incorporated into...

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Seismic changes in GP teaching – where will the new GPs come from?

Alex Harding is a GP and academic based in Exeter. UK General Practitioners are the largest part of the medical workforce, deliver the most care and deliver this care highly effectively. Most people who have ventured abroad and talked about health are surprised at the envious comments from patients and practitioners alike about the UK health system under the NHS. However the UK GP workforce has not kept pace with the increases in healthcare need, increases in similar workforces abroad or increases in other health professionals in the UK. In order to address this and an impending GP workforce crisis the English Department of Health has mandated HEE to ensure that by next year 50% of graduates will opt for GP training. At present however, 19% of final year students want to be GPs and many GP training schemes are struggling to recruit enough graduates. In some parts of the country there are now 40% vacancy rates. There is some good research that shows that exposure to general practice as a medical student has a strong positive effect on future career choice and so appropriate general practice experience as a medical student is an important part of workforce planning. With this in mind, we surveyed the UK medical schools regarding undergraduate and postgraduate teaching provision and how this was supported in financial and academic terms. We used standard methods to...

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Paracetamol, ethnic health inequalities, cerebral palsy, and pornography

Ahmed Rashid is an academic clinical fellow in general practice at the University of Cambridge. He writes the regular monthly column “Yonder” in the BJGP: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature. Twitter: @Dr_A_Rashid You can download the PDF here at BJGP.org. Paracetamol A recent study from South Africa, published in Patient Education & Counselling, is titled ‘But it’s just paracetamol’ — a phrase and sentiment that most GPs will be more than familiar with. The study sought to determine whether caregivers could make informed decisions about administering over-the-counter analgesia to children.1 In...

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Cannabis effects and future health policy

Roy Robertson is Professor of Addiction Medicine at the University of Edinburgh. The paper Cannabis, tobacco smoking, and lung function: a cross-sectional observational study in a general practice population was published in the BJGP this week. Access the full paper here. Cannabis and its effects on health are complicated and wide ranging. Like other drugs with an impact on multiple systems there is a considerable literature about negative features and, as with alcohol when much of the measurable effect is the reason for its ingestion, there are mixed views about its value. Added to the balance of benefits versus damaging side effects is its illegality, at least in most administrations. This is clearly changing in several countries and will allow a naturalistic experiment to be evaluated over the next few years. An upcoming United Nations debate in 2016, sponsored by Mexico and Uruguay, will further expose the legal control system to change and may revolutionise the availability in many western countries including the UK. At the present time it looks like cannabis use may well increase over the next decade and, if commercial interests enter the frame then there may well be a much broader range of people participating in its use. The possibility of major manufacturing and marketing companies taking control raises many spectres for medical services used to managing the ravages of alcohol. For medical people the...

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The British Journal of General Practice and BJGP Open are bringing research to clinical practice. This is where we add the debate and opinion to help ensure everyone benefits from that research.

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