Alex Burrell is a GP in Bristol and Associate Editor at BJGP Open.
Yonder: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature
Talking to a GP about suicide
There were 7055 deaths by suicide registered in the UK in 2023, the highest rate since 1999. Contact with primary care in the time leading up to suicide is common, with general practice being the most common last point of contact before completed suicide: identifying those at highest risk is crucial. How do patients experience talking to a GP about suicide? This study in England surveyed participants with lived experience of suicidality.1 Disclosure was difficult, with a fear of a loss of control and possible consequences. Participants felt they could be overmedicalised and treated as a case rather than a person, and expressed concern over limited options for services available for GPs to refer to. Continuity and familiarity aided disclosure, with space for open dialogue greatly appreciated: ‘Listened, empathised, was totally human and honest with me. When you have a relationship built on mutual respect and honesty this is pretty life changing … ‘
GP–minister networks
In Denmark, local networks between GPs and parish ministers have been developed to ‘strengthen existential and spiritual support in primary care’. I am yet to have the option to refer to local clergy of any faith in the UK, so I was very interested to see this focus group study exploring the experiences of GPs and ministers in these networks.2 Collaboration prompted both groups to re-evaluate their own professional identifies and practices, prompting this powerful insight from a GP: ‘I’ve been reminded that I don’t have to fix everything. We fix, fix, fix all the time — and if we can’t fix something, we try again … But it’s okay to say: “I can’t fix this.” It’s okay just being with the patient in that difficult situation without solving it.’ Ministers found new challenges were brought into their pastoral care with life crises in all forms, prompting focus on pastoral identity and recognising their own limitations. Building relationships was a foundational element of the collaboration, with the work built on the aim of better serving their patients and community. In some areas, ministers had started holding consultations in health centres. Something to explore in the UK?
Practice managers as partners
Despite being under attack, the partnership model provides good value for money, freedom to innovate, and accountability to local communities. However, the proportion of the fully-qualified GP workforce working as partners fell from 75% in 2016 to 62% in 2023. Non-clinical professionals are increasingly becoming partners in general practices, with 335 practices reporting having a managing partner in 2022, up from zero in 2015. This study in England aimed to estimate the impact of the appointment of a practice manager as a partner using primary care data from 2015/2016 to 2022/2023.3 Following the appointment of a managing partner, practices tended to increase full-time equivalent numbers of administrative staff and non-GP or nursing clinical staff. Practices also seemed to be less likely to subsequently merge or close. The authors suggest manager partnership ‘has the potential to preserve small practices while easing physicians’ financial and administrative burden.’ Further work exploring how and why these changes might occur would be useful, as would exploring the impact on GP partners’ work.
Welsh as first language
In the 2021 Census, 29% of the population of Wales spoke Welsh. In North and West Wales, Welsh speaker rates are 52%–76%. While all Welsh speakers are considered able to speak English and Welsh, consulting in one’s first language is preferable and reduces the risk of misinterpreted information and adverse outcomes. Most GPs in Wales are not required to offer bilingual services and patients cannot demand Welsh-medium health care. This survey and focus group study explored Welsh speakers’ perceptions of Welsh-language use in primary care.4 Only 18% of the 337 participants surveyed felt their need to use Welsh was taken seriously in healthcare settings, with 71% reporting not being offered the option, though Welsh provision was higher in Welsh-speaking regions (32% versus 14% non-Welsh speaking). There was a tension between language rights and service accessibility. Participants recognised the challenge in a general lack of healthcare workers particularly in rural areas, let alone bilingual staff specifically.
References
1. Fedorowicz S, Dempsey RC, Ellis N, Gidlow C. “Hopeless but supported in that hopelessness”: a qualitative study of how people experience talking to a GP about suicide. Front Psychiatry 2026; 17: 1744949.
2. Vesterdal L, Juhl IU, Simonÿ C, et al. Local general practitioner-parish minister networks for existential care in Danish primary care-what did we learn? A Ricoeur-inspired focus group study. Int J Environ Res Public Health 2026; 23(2): 175.
3. Urwin S, Walker B, Anderson M. Shared stakes in English general practice: the impact of practice managers as partners on outcomes. J Health Econ 2026; 106: 103122.
4. Edwards ME, Bodger O, Brown M, et al. Patient experience and perception of first language usage in healthcare: the Welsh perspective. J Patient Exp 2026; 13: 23743735261417165.
Featured photo by Catrin Ellis on Unsplash.
