Clearly in some GP Practices no robust thought has been given to having a Mental Health Practitioner (MHP), or their role and scope of practice. Those GPs who have requested and take 'ownership' of the MHP, are best placed to integrate them
So, is the description of the GP as a ‘gatekeeper’ outdated?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.
Richard Armitage reviews two self-help books by controversial psychologist Jordan Peterson
Digital medicine is a priority for modern general practice and is a core theme for NHS England strategy. As a recent Topol Digital Health Fellow, Bilal Salman describes ...
The Canadian Centre on Substance Use and Addiction (CCSA), in new guidelines endorsed by Health Canada, recommend that Canadians should have no more than two alcohol-containing drinks per week. Nada Khan explores alcohol advice in primary care.
Is it because people are getting older and sicker, developing more and more chronic diseases as they age and then expecting a magic cure-all that doesn’t exist? Expectations for such, we have all likely fed into.
When someone asks you whether you’re telling them it’s all in their head, the most accurate answer is: Yes, but isn’t everything?
Finding the right partner is critical. With a generation of senior and capable partners retiring and not being replaced at the same rate, there is a huge concern of seeing this post continue to diminish. Here, Adnan Saad outlines how best to
As the latest cohort in the Oxford International Primary Care Research Leadership Programme, we present the ‘10 things we wish we had known’ for anyone considering a career in academic primary care.
Richard Armitage highlights a selection of issues in tension with public health and respiratory communicable diseases both pre and post the outbreak of COVID-19.
We can use concepts and language to share ideas/help us see things we might overlook. We can use the narratives of others to extend our own experiences of the world. The dangers from being intellectually and morally passive compel us to embrace
Labour seems to have its own version of a disruptor in Wes Streeting, the shadow health secretary, who declared that he wants to phase out the system of GP partners, & scrap the gatekeeping model of primary care, but how many of
It is well known that the life expectancy of people with severe mental illness (SMI) is reduced by 15–20 years compared to the general population, but what is less well known is that people with SMI also experience serious inequalities in oral
"When a patient who happens to be a barber comes to see me for a consultation, that is precisely what – and only what – he gets. When I go to see my barber for a haircut, however, not only do I
Piecework is advantageous for production where output volume is a reliable proxy for productivity and monitoring and incentivising output volume does not compromise quality. Lara Shemtob and colleagues argue this is inappropriate for general practice.
Apichai Wattanapisit reminds us that lifelong learning is a crucial element to maintain the standard of practices and develop the future career.
The results of a recent BMA survey, which asked junior doctors what they felt about leaving the NHS, should send a shudder to the heart of the NHS, including through general practice upon which the health system stands.
Ben Hoban suggests that GPs can keep track of more in the consultation by not worrying about keeping track of so much, but instead choosing what to focus on.
Tim Senior argues that without GPs we systemically remove the part of the health system that has researched and trained in handling relationships and complexity, and is capable of doing this well. We need to be able to describe what health systems
What are safe workload limits in general practice, and how can these limits be implemented in practice? Nada Khan investigates.
in 2022 Richard Armitage altruistically donated a kidney. He discusses what GPs need to know in order to support patients who choose to go through this process themselves.
...despite all that science has to tells us in general terms about people and how to care for them, it is often harder to pin down on specifics...
Ayesha Siddiqui has compiled a list of a few basic steps each member of GP practice staff (clinical and non-clinical) can adopt in our day to day working lives towards reducing our carbon foot print.
Over the last 50 years society has become progressively diverse as the needs of the population continue to change. As these diversities become increasingly recognised, it has resulted in differences becoming more pronounced and the possibility of discrimination thus becoming more prominent.
ChatGPT is an online program allowing a user to ask any question and receive an answer, which can be incredibly detailed, in under 10 seconds. However, what does this mean for primary care? Richard Armitage investigates and puts ChatGPT to the test,
For 30 years advocates1 for social justice and the environment (have called for full cost accounting with a triple bottom line2 where all the consequences of a business are made transparent. These are its social, environmental and economic impacts and outcomes.
The idea of excess deaths is of course just an attempt to make sense of what’s happening in a complex system with a view to allocating resources appropriately.
"The cost-of-living crisis is descending like a dark cloud and its heavy weight is palpable. As a Deep End GP, every day I see the real impact poverty is having on my patients ... "
Seeing patients once and referring them for imaging offers advantages to busy GPs and busy patients alike, but given the tendency of any test to throw up results of unclear significance, wouldn’t we simply be delegating the management of uncertainty en masse
Richard Armitage finds that general anaesthesia is in fact quite unlike sleep in its most fundamental components.
Recent data suggest on average 13 600 beds in NHS hospitals across England are occupied every day by patients whom doctors say are ‘medically fit for discharge’. Is it that simple? Here, Peter Levin delves into the complexity of the term 'medically
Occasionally, the worlds of media and healthcare can clash in a way that has pronounced consequences in the real world. Whilst the media may intend to inform, they invariably end up influencing a somewhat frenzied, albeit predictable, behaviour in the public.
Assessing the effectiveness of each charitable project and directing financial donations to the one that ranks highest is certainly a task of gargantuan proportions. Richard Armitage explains.
New research by Kathryn B Cunningham and colleagues presents three key elements concerning the process of connection in indirect route social prescribing schemes (those involving link workers). Here, the authors summarise their findings ...
NHS chiefs and policy-makers should be cautious about assuming that diverting patients to the private sector will take pressure off the NHS and reduce NHS waiting times.
Today is my third “Cancerversary..." I am so lucky to be working in a great practice. With a supportive team – clinicians who truly care. But I just don’t know if this is enough...
Internet shutdowns are government interventions motivated to intentionally disrupt access to, and the use of, online information and communication systems. These measures pose a novel and growing threat to various elements of global public health.
Why have poverty and fuel poverty become medicalised? We know that social determinants of health shape and drive health outcomes. Poverty and fuel poverty are increasingly positioned within a biopsychosocial model of medicine and health.