Category: Research

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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URTI, menopause, universal health coverage, and chocolate cravings

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. Childhood upper respiratory tract infection (URTI). Childhood URTI is one of the commonest reasons for parents to consult in primary care. One would think that this makes it an easy type of consultation for doctors to tackle. However, the age-old antibiotic debate still rears its ugly head and has the potential to lead to much miscommunication and misunderstanding. With antimicrobial resistance high on the public health agenda, these interactions have received particular attention recently. In a study published in Patient Education and Counselling, researchers in Bristol interviewed 30 such parents from a variety of socioeconomic areas.1 They found that parents’ perceptions about the credibility of diagnosis and treatment recommendations were highly influenced by clinician communication. They suggest clinicians should focus on symptoms of particular concern to parents and give more precise safety net advice. Interestingly, they found the term ‘viral’ often trivialised the condition and contradicted the parents’ perception of severity. Although an important part of the antibiotic discussion, this explanation needs to be used sensitively with parents. [bctt tweet=”BJGP Blog – parents found the term ‘viral’ often trivialised URTIs and needs...

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Quality indicators for child health in the UK

Peter Gill is a paediatric resident at The Hospital for Sick Children in Toronto, Ontario and an Honorary Fellow at the Centre for Evidence-Based Medicine at the University of Oxford. Follow Peter on Twitter @peterjgill In the December 2014 issue of the British Journal of General Practice, several colleagues and I published a set of paediatric quality indicators for UK primary care.[1] The paper represents the main findings from my doctoral thesis completed under the supervision of Prof David Mant and Anthony Harnden at Oxford University. It is exciting to see the paper in print (it provided a morale ‘boost’ after working a stretch of nights) accompanied by a thoughtful editorial.[2] But having returned to the ‘coal face’, I am reminded of the integral role of quality indicators in clinical practice. Why develop indicators? Caring for children is an important part of UK general practice yet several studies have demonstrated that care quality can be improved. However, only 3% of Quality Outcomes Framework (QOF) markers relate to children and there is no set of child-relevant indicators for UK primary care. For years, the call to develop and integrate child health indicators into QOF has fallen on deaf ears despite evidence that leaving out indicators probably has negatives consequences for care quality. Therefore, we sought to develop a set of quality indicators for children and adolescents which cover a range of paediatric care...

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