"The Deep End project demonstrates change can be made by practitioners working together to advocate for primary care to be at its best where it is needed most. As a professional group, we hold more power than we realise. If we do
...while the risk of bear attacks or frostbite is substantially lower than in the popular namesake television series, GP trainees face a range of similar challenges as their TV counterparts – isolation, uncertainty, a steep learning curve, and genuine fear.
General Practice has been diluted by demand and lost all flavour. Young doctors have no taste for it and, with the NHS in free-fall, we need to now undertake some fundamental changes. John Havard and colleagues offer a gin and tonic themed
I left a job today. It was a good job with good people, which is always hard. It’s so much easier to leave when the interpersonal environment is toxic. It’s difficult when colleagues are deeply collegiate, but the structure is exploitative.
Crispin Fisher is a full time GP partner in Herefordshire. He lists what partnership entails. Readers are welcome to add, challenge or embellish his ideas in the comments.
The ARRS is a big step change for how practice teams work to manage their patients and appointments, and it’s naïve to think that implementation of such a wide-ranging scheme wouldn’t have significant impacts and unanticipated consequences for the wider workforce.
Richard Armitage investigates Medwise.ai, an 'AI tool' that claims to empower practitioners with informed decision-making, adherence to guidelines, quick access to answers, and a reduction in burden on GPs for supervision. But are these claims anywhere near the reality?
Wouldn’t it be nice to be able to download the latest updates in your sleep and go to work knowing that you were fully NHS-compliant, and without having to dodge any of those awkward questions about Segawa Syndrome? It certainly feels as
...requests for race-based concordance is a complicated area of medicine, and it is one that is not easily dealt with through formulised policies. Instead, well-reasoned judgements by the care team through a deliberative process, that begin with ethical frameworks, might provide a
nappropriate transfer of workload can go both ways, and it can feel highly frustrating for GPs and hospital specialists alike. But as patient care becomes increasingly fragmented, thinking locally about how to improve collaborative care might help build back those relationships across
Hyperreality describes this tendency for symbols to come adrift from what they represent, and for the distinction between the two to be lost, so that it becomes unclear which is real, and what we should expect from our dinner. We can see
The RCGP is again also calling for a merger of the general practice and specialist registers. What’s the background to this, and what might it mean to rebrand GPs as consultants?
In CS Lewis’s magical classic The Lion, The Witch and the Wardrobe, the heroes found a frozen land of frightened animals, where it is, ‘always winter, but never Christmas.' Could this become a metaphor for the 21st century consultation? Andrew Papanikitas unwraps
Domestic abuse remains a largely concealed phenomenon. It affects healthcare professionals (HCPs), especially women, nurses, and those working in low- and middle-income countries, at an alarmingly disproportionate rate. Vasumathy Sivarajasingam asks us be mindful of its causes and effects.
David Mummery reflects on the professional and political waste land faced by UK general practice and on 'The Waste Land' by TS Eliot
As we approach the end of another year, it’s worth reflecting on Christmases affected by Covid-19 and what we might learn from them as clinicians and as people.
In my 20 years of studying medical generalism, I have seen advanced generalist medicine designed out of medical practice, teaching, and healthcare policy. So, in response, I now lead and help deliver work to restore and reclaim the wisdom of general and
Billed as ‘seven steps to save general practice and safeguard our NHS’, the manifesto reflects the policies the RCGP believes political parties need to take on board to ‘save’ general practice ahead of the next general election. Nada Khan does some unpicking...
Peter McNelly is a mental health nurse and David Fowler is a practice manger in Northern Ireland. They argue that mental health practitioners can be a valuable addition to the multidisciplinary team, if sensibly recruited and deployed.
David Jeffrey argues that clinical curiosity is an essential part of a doctor’s empathy and clinical decision-making. It promotes reflective practice, critical thinking and stimulates lifelong learning.
For something that should be completely unthinkable in our workplace, it is a disturbing truth that sexual misconduct is rife within the NHS. Nada Khan investigates.
When we talk of doctor and patient, we instinctively see both as very separate groups, but stripped back of language and assumed meaning, there ultimately sit two human beings in the same space. The person sitting in the chair telling their story
The General Medical Council’s requirement in its updated guidance Good Medical Practice for doctors to be kind has caused some consternation. How does being kind fit into a professional framework, and is it a luxury or a necessity? Ben Hoban reflects.
This would mean exploring the ideas of Israelis and Palestinians at mass level, listening empathetically and impartially to concerns from both sides, and establishing the realistic expectations of each cohort. A fair, kind, and honest approach...
People with chronic pain need personalised care – an approach offering patients choice and control over their mental and physical health, basing care on what matters to them personally, and focusing on individual strengths and needs. It is possible.
The Prime Minister has proposed new legislation to end cigarette sales to those born on or after 1 January 2009. Is the proposed smoking ban as good an idea as it seems?
The way we talk about mental ill health can end up creating a linguistic black box which we see but cannot see inside. How then can we know what to expect from our distressed patients, and how best to help them? Ben
Kathleen Wenaden looks back at the struggles and successes of her Hackney practice, and of how the work of the staff interweaves with the lives of the patients. She considers too the reinvigorating power of creativity and nature as ways for GPs
This issue focusses on the heart and cardiovascular medicine. Life and Times for its part stresses the metaphysical and metaphorical heart with an eclectic smorgasbord of useful, challenging, and entertaining articles. This includes learning from tragedy, a tongue in cheek glossary, and
I don’t know the answer. But I think I’m feeling the same. I’m exhausted, but I won’t tell you that. It’s a conveyor-belt of emotions. Next customer please! Except this is not transactional. You have a story, and it’s my job to
It’s liberating to imagine a world where GP expertise is recognised and valued. We can start right at the beginning of the Deep End GP meetings. Imagine that! A world with no more reports saying “GPs should…” but lots of “Hey, GPs,
To understand childhood aggression, it is important to understand the neuroscience behind the reactions displayed by children. Hannah Milton reviews an unofficial guide for parents.
BJGP editor Euan Lawson was recently asked (again) to discuss ten 10 interesting papers of the last year at the Royal Society of Medicine's general practice and primary care update. Topics include: heavy menstrual bleeding, hypertension management, suicide and inclusion health... and
The BJGP/BJGPLife team will be among the crowds at this year's RCGP annual primary care meeting in Glasgow. However, we've already done some travelling and picked up some tips to share. Catch up with us in Scotland!
'A relational way of working, thinking and designing is one that creates possibility for change, one that creates abundance – our capacity for relationships, like love, is infinite.’ Emilie Couchman reviews a call for radical reform
Giles Dawnay reflects on the tension between left and right brained view of life and how this might affect the general practitioner's clinical gaze.
Lucy Chiddick argues that promoting school attendance is a complex task, best done by those with appropriate expertise. Where GPs engage with the issue there should be appropriate time and care, recognising that there are many drivers of absenteeism and that attendance
The shocking infant murders by nurse Lucy Letby represent a mercifully rare (we think) class of event. These remain extremely difficult to understand, predict or prevent, much as we must try. David Zigmond reflects on the role of commercially corporatised healthcare culture
Why hasn’t the approach of Centene and Babylon worked? And what’s the history behind corporate acquisition of GP surgeries? Nada Khan investigates.
If we look at continuity without considering the wider context of general practice, we may find ourselves being swept out to sea as we gaze longingly back at the beach. Ben Hoban helps us to reflect on the really useful elements of
Vasumathy Sivarajasingam explores domestic abuse PUNs and DENs as a relevant appraisal topic linked to mandatory safeguarding, with links to learning materials, legislation and further articles.