scholarly journals A qualitative investigation of the views of primary care dentists on participating in prospective studies in the North-West of England

BDJ ◽  
2011 ◽  
Vol 210 (11) ◽  
pp. E18-E18 ◽  
Author(s):  
L. Hopper ◽  
L. Morris ◽  
P. Brocklehurst ◽  
M. Tickle
Keyword(s):  
Primary Care ◽  
Prospective Studies ◽  
Qualitative Investigation ◽  
North West ◽  
The North

scholarly journals P145 A review of vitamin D testing in primary care: significant savings to be made

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Emily Riding ◽  
Elizabeth MacPhie
Keyword(s):  
Primary Care ◽  
Vitamin D ◽  
High Risk ◽  
British Society ◽  
Repeated Testing ◽  
North West ◽  
The North ◽  
Number Of Patients ◽  
Vitamin D Levels ◽  
Lower Limb Pain

Abstract Background Vitamin D deficiency is common in the UK due to a lack of sunlight over the winter months. Risk factors include darker skin and reduced exposure to sunlight (e.g. housebound/institutionalised patients or those who cover skin for religious reasons). As part of the Choosing Wisely campaign, the British Society for Rheumatology recommend that vitamin D testing should be reserved for people at high risk of deficiency and avoided as part of routine investigation of widespread pain alone. They also recommend that repeat testing isn’t usually necessary in patients who are taking vitamin D supplements. The aim of this project was to review the testing of Vitamin D in a Primary Care setting. Methods An EMIS search was conducted for patients who had their vitamin D levels tested in September and October 2017. The following information was collected for each patient: indication for testing, vitamin D level, whether vitamin D had been tested previously or subsequently, treatment offered and the patient’s residence. Results 96 patients had their vitamin D levels checked. Of these, 8 were excluded as they had been tested on the advice of secondary care. Of the remaining 88 patients, 6 (6%) were vitamin D deficient and 34 (38%) had insufficient vitamin D levels. The most common indication for testing was tiredness in 26 patients (30%) followed by generalised aching/lower limb pain 19 (22%). 8 (9%) patients were tested due to pain at specific sites including a single joint or abdominal pain, 5 (6%) due to neurological symptoms, 4 (5%) due to a diagnosis of CKD and 3 (3%) due to skin and hair problems. There was no clearly documented indication for testing levels in the remaining 3 (3%) patients. 35 (40%) patients had previously had their vitamin D levels tested and 19 (22%) patients had subsequent testing. Of the patients with abnormal vitamin D levels, 22 (25%) were prescribed treatment, 16 (18%) advised to buy over the counter and no advice was documented in 16 (18%) patients. None of the patients lived in residential or nursing homes. Conclusion This project identified a range of indications for vitamin D testing and a large number of patients who had repeated testing. This highlights a potential area for education in primary care surrounding the value in both initial and repeated testing of vitamin D levels. The findings show a need for an improvement in documentation as some patients had no clear linked reason for testing and no evidence that abnormal levels were actioned. However, there were limitations to determining whether BSR guidelines were followed as some factors that would lead to patients being at high risk of deficiency (such as skin colour) could not be collected from EMIS. Disclosures E. Riding None. E. MacPhie Other; EM is the secretary of the North West Rheumatology Club; meetings are supported by an unrestricted educational grant from UCB.

scholarly journals Evaluating the Effectiveness of a Local Primary Care Incentive Scheme: A Difference-in-Differences Study

2021 ◽  
pp. 107755872110352
Author(s):  
Esmaeil Khedmati Morasae ◽  
Tanith C. Rose ◽  
Mark Gabbay ◽  
Laura Buckels ◽  
Colette Morris ◽  
...  
Keyword(s):  
Primary Care ◽  
Hospital Admissions ◽  
Financial Incentive ◽  
Emergency Admission ◽  
Difference In Differences ◽  
Emergency Admissions ◽  
North West ◽  
Admission Rates ◽  
The North ◽  
Improvement Scheme

National financial incentive schemes for improving the quality of primary care have come under criticism in the United Kingdom, leading to calls for localized alternatives. This study investigated whether a local general practice incentive-based quality improvement scheme launched in 2011 in a city in the North West of England was associated with a reduction in all-cause emergency hospital admissions. Difference-in-differences analysis was used to compare the change in emergency admission rates in the intervention city, to the change in a matched comparison population. Emergency admissions rates fell by 19 per 1,000 people in the years following the intervention (95% confidence interval [17, 21]) in the intervention city, relative to the comparison population. This effect was greater among more disadvantaged populations, narrowing socioeconomic inequalities in emergency admissions. The findings suggest that similar approaches could be an effective component of strategies to reduce unplanned hospital admissions elsewhere.

scholarly journals The impact of brief quality improvement (QI) projects by medical students in primary care in Gauteng or the North West Province, South Africa

2012 ◽  
Vol 4 (1) ◽  
Author(s):  
Claire Van Deventer ◽  
Nontsikelelo Sondzaba
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Medical Students ◽  
Clinical Skills ◽  
Theory And Practice ◽  
North West ◽  
The North ◽  
North West Province ◽  
The University ◽  
The Impact

Background: The Integrated Primary Care (IPC) rotation is undertaken over six weeks by final year medical students at the University of Witwatersrand. Students are placed in either rural or urban primary health care centres based in Gauteng or the North West Province. As part of the IPC rotation, students undertake short quality improvement (QI) projects. The purpose of this study is to evaluate the impact of the QI projects undertaken over the period stretching from 2006 to 2010. Methods: An observational study of QI reports done by students. Project reports assessed and compared to site marks, indicators of learning assessed and individual and group marks compared.Results: Of 274 projects undertaken, 223 (81.4%) were available for evaluation. Geographical placements and QI themes were categorised. Management issues were most frequently identified as being problematic followed by chronic illnesses. Understanding and applying the principles of QI was partially achieved and gaps were identified for future projects. The most common intervention was training of personnel and design and distribution of posters or pamphlets.Conclusions: Most QI projects were well thought out and relevant to the chosen setting. In the majority of cases, a great deal of effort and creativity went into the process and skills other than clinical skills were employed such as writing, presentation of data in graphs and tables. Integration of theory and practice was achieved only partially.

scholarly journals Impact of COVID-19 on psychiatric services and presentations in north-west Edinburgh

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S74-S75
Author(s):  
Ritika Devadas ◽  
Douglas Murdie ◽  
Idris Thomas ◽  
Rhona Hannah ◽  
Wiktoria Karbowniczek ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Hospital Admissions ◽  
Early Recognition ◽  
Psychiatric Services ◽  
Severe Illness ◽  
Healthcare Provision ◽  
North West ◽  
The North ◽  
The Impact

AimsCOVID-19 has had a significant impact on healthcare provision, accessibility and psychiatric presentations. We aim to investigate the impact of the pandemic on psychiatric services and the severity of presentations in Edinburgh, with a particular focus on the North-West Edinburgh Community Mental Health Team (NW CMHT).MethodMeasures of the impact of the pandemic on NW CMHT were identified as referral numbers from primary care and Did Not Attend (DNA) rates. Royal Edinburgh Hospital admissions, detentions under the Mental Health (Care and Treatment) (Scotland) Act 2003 (MHA) and Out of Hours (OOH) contacts were used as proxy measures to explore the severity and urgency of presentations.Quantitative data focussing on these parameters for patients aged 18–65 years in NW CMHT in 2019 and 2020 were collected from NHS Lothian Analytical Services. OOH data were only available Edinburgh-wide. All data were anonymised in line with NHS Lothian Information Governance Policy.In order to assess the impact on staff, a questionnaire was created and disseminated, with qualitative data returned anonymously.ResultReferrals to NW CMHT decreased by 9.3% in 2020 (n = 2164) compared to 2019 (n = 2366). Referrals in April (n = 81) and May (n = 102) 2020 were far below the monthly average across the two years (n = 188).Appointment numbers were very similar in 2019 (n = 3542) and 2020 (n = 3514). Despite this, DNA and cancellation rates decreased by 3.94% in 2020. Questionnaire results illustrated some of the challenges for staff of working during a pandemic.Admissions to hospital reduced by 6.8% in 2020 (n = 219 vs n = 235). While MHA detentions in NW Edinburgh increased by only 1.8% (n = 173 vs n = 170), new Compulsory Treatment Orders (CTO) increased by 60%. Furthermore, OOH contacts across Edinburgh increased by 45.2% when compared to 2019.ConclusionThe COVID-19 pandemic altered the way patients accessed healthcare. Uncertainty of the public in accessing primary care services early in the pandemic may have contributed to reduced referral numbers.The increase in CTOs is suggestive of severe relapses in previously stable patients or new episodes of illness. The pandemic may have contributed to a reduction in early recognition, and referral, of those with major mental disorders resulting in more protracted or severe illness episodes. The increase in OOH crisis contacts supports such a hypothesis.Despite what would be expected, DNA and cancellation rates in NW CMHT reduced. The contribution of telemedicine to this warrants further exploration as a means of delivering healthcare in an efficient and accessible way.

Sign in / Sign up

Export Citation Format

Share Document