"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
The reporting of a limited set of nationally important diagnoses, some risk factors and some quantitative measures leaves a lot more of the work invisible. It is this invisible work that holds the health system together, argues Tim Senior.
"More validation should be given to the therapeutic benefits of listening closely and bearing witness to somebody’s suffering." – Rupal Shah and colleagues continue their hermeneutic series, focusing on the importance of relational care in general practice ...
Alongside Germany, GPs in the UK experienced some of the highest levels of stress, with 71% of GPs saying that their job is ‘extremely’ or ‘very stressful’, with stress levels increasing by 11% since 2019. Nada Khan discusses…
The effects of the earthquakes on child health in Türkiye are substantial, multifaceted and, without urgent intervention, deeply enduring throughout the life course. Richard Armitage reports from the scene.
The independent contractor model for general practice is one of the under-rated aspects of the NHS that rarely hits the headlines. It is particularly important for our professional autonomy and business flexibility.
s anyone else doing the maths here for parents needing to juggle childcare costs for one or more children? What happens when the cost of childcare outstrips salary? Nada Khan runs the numbers.
Teams are the talk of the town in practice transformation circles. They are extolled as the solution for many of our deficiencies– from chronic staffing shortfalls to employee burnout. This extended essay by David Loxterkamp gives a perspective from American primary care
When we use a computer scoring chart and tell a patient they have depression and need medication or even psychological therapy we locate the problem firmly in the brain of one individual. Does this prevent the wider solutions?
The place of Medicine in our imagined future, science fiction, tends to be defined by technology. As in science fiction, so in medicine there is a constant tension between the technological and the human, what is possible and what is desirable.
"Practice[s] may need to appreciate that by trying to protect one group of staff, they may be exposing another group to vulnerabilities." - Adnan Saad reflects on subconscious gender discrimination in primary care
…the sparsely populated rural and remote areas of affected provinces, coupled with the precarious and earthquake-damaged transport infrastructure that supplies them, has allowed the construction of very few formal displacement sites within these areas.
Is the ‘human touch’ aspect of care necessary? Perhaps not. But does it change patient experience? For sure. And does it take much time? No. I refuse to believe it would add delays and hinder efficiency. The front-line role of reception and
Will this delegation from Australia be successful in ‘stealing’ GPs away to Australia? For those who have been weighing up the options, it may well act as their trigger point to leave, but not without the context of the other push and
Careful, caring and person-centred application of guidance is required to ensure patients benefit from, and are not harmed by, healthcare. I’d like to talk about Joan, an 86-year-old lady who had rarely visited the surgery. We threw the guidelines at her...
In the surgery, patients still express the hopelessness of their lived reality: lives built around sitting; exercise options that are difficult to access geographically and financially; and the cheapest food options too often the ‘wrong’ choices...
In the First and Second Ages, medicine was transacted between individual patients and doctors at times of illness. The Third Age, in which we find ourselves currently, is associated with the development of a much bigger picture in which this is no
"The conflict in Ukraine has displaced over 7 million people since February 2022. The UK Government has responded by issuing 219 400 visas for Ukrainians through sponsorship schemes. One year on, we feel there is value in reflecting on the health needs
Now imagine, that for the majority of cases being presented, the consultant condescendingly - and unnecessarily - adds, at the end of the majority of cases, that they had been diagnosed and managed wrongly by the 'incompetent' GP prior to coming to
...After a long day being your child’s GP, I come home. I get a few tantrums, followed by a cuddle 10 minutes later. I am a mum, just like you.
Are GP practices equipped to respond to the current mental health crisis? Here, Jonathan Coates and Nick Hartley reflect on a recent pilot of the role of GP clinical psychologists in primary care - "an experienced, senior clinician independently handling undifferentiated presentations
Inhaler prescribing alone accounts for approximately 3% of the NHS’s carbon footprint. Unsurprisingly, this has been targeted by Greener NHS as a priority area. Here, Emma Radcliffe describes a number of success stories of practices reducing their metered dose inhaler (MDI) prescribing,
The first planned strike action will take place for 72 hours in mid-March and will see junior doctors stepping away from their wards, surgical theatres, outpatient clinics, and indeed, for GP registrars, their practices. How do junior doctor strikes impact on general
They are billed as digital solutions, but they simply offer a locum GP, restricted to video. My experience over the last 3 years leading a GP federation has opened my eyes to the long-term perils of short-term solutions such as this.
My parents being immigrants, enforced into us to keep our heads down and work hard, to adopt a ‘don’t cause trouble’ attitude... Being called these occasional names I still performed well academically at school, it never placed limits. Life was good …
With the COVID-19 pandemic there has been a shift to digital technology that has necessitated both GPs and their patients to adapt rapidly. There is concern that older adults will struggle to adapt to this shift due to their low technology usage
In response to recent earthquakes, the UK Emergency Medical Team (UKEMT) is currently providing a variety of clinical services from a field hospital in a heavily-damaged town located around 50 kilometres from Gaziantep in Kahramanmaraş Province. Richard Armitage is there.
...it wasn’t until I became sick myself that I really understood what it meant to be a patient, or indeed those wider principles I tried to root my own practice in. For me, that once watertight seal between clinician and clinic was
A brief check of the notes and it is a patient you don’t know, taking eight different medications for four separate problems. You’ve probably got 10 minutes...
GPs can hide, to a degree, behind the castle walls and beyond the moat consisting of front-line administrative staff. But I ask myself two questions: does that mean we are in an ‘ivory tower’; and do we have a ‘drawbridge mentality’? Emilie
Alex Pavitt argues that we need a systematic shift from focusing on appointment quantity to consider appointment quality as we work towards embracing and combating the overall problem of ‘multimorbidity’.
Foell and colleagues argue that assembly-line approaches in manufacturing rely on accurately measuring the time it takes to perform tasks in a digitalised workplace. They juxtapose this with the concept of time as the time it takes in the mystery of General
The phrase ‘we can’t go on like this’ is frequently banded around on social media in relation to the NHS. However, it seems that the staff working within this organisation can, and are; but at what cost?
Ask any doctor, and they’ll tell you that talking to patients can be difficult. Mind you, ask any patient and they’ll tell you that talking to doctors can be really difficult too. Ben Hoban discusses how we address the problem.
What is my take on carers? They deny they need a medal for what they do. I now have the awareness and the greatest respect for these unsung heroes. For me. I will continue to care for Mavis, to do whatever I
The worsening relationship between primary and secondary care if this NHS is to be saved, argues Edin Lakasing
For the first time, a coroner in the UK declared domestic abuse as having a causal role in death by suicide. Domestic abuse is a growing public health burden, so what can primary care do to protect individuals experiencing domestic abuse? Here,
How have media depictions of general practice and GPs affected how we work, and healthcare policy in the UK? Nada Khan investigates...
So, is the description of the GP as a ‘gatekeeper’ outdated? I would argue it is. GPs are not trying to block access to specialists. Rather, through their distinct expertise, they provide a safety net for patients who could risk further harm
Imagine having to relive the moment you are told that you have a life-limiting illness every time you need support; every time you feel vulnerable because of a physical or mental complaint that needs attention. Emilie Couchman argues for meaningful informational continuity.
In 'Helgoland,' Carlo Rovelli attempts to bring us up to date with the latest in the bewildering and bewitching subject of quantum physics. One of his main assertions is that the observer will always affect the observed.