The impact and potential value for medical students of implementing social prescribing projects in primary care

2019 ◽  
Vol 31 (1) ◽  
pp. 57-59
Author(s):  
Sarah Chitson ◽  
Ann Wylie
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Social Prescribing ◽  
Potential Value ◽  
The Impact

scholarly journals COVID-19 at the Deep End: A Qualitative Interview Study of Primary Care Staff Working in the Most Deprived Areas of England during the COVID-19 Pandemic

2021 ◽  
Vol 18 (16) ◽  
pp. 8689
Author(s):  
Claire Norman ◽  
Josephine M. Wildman ◽  
Sarah Sowden
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Care Staff ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Social Prescribing ◽  
Qualitative Interview Study ◽  
The Impact ◽  
Primary Care Staff ◽  
Deprived Areas

COVID-19 is disproportionately impacting people in low-income communities. Primary care staff in deprived areas have unique insights into the challenges posed by the pandemic. This study explores the impact of COVID-19 from the perspective of primary care practitioners in the most deprived region of England. Deep End general practices serve communities in the region’s most socioeconomically disadvantaged areas. This study used semi-structured interviews followed by thematic analysis. In total, 15 participants were interviewed (11 General Practitioners (GPs), 2 social prescribing link workers and 2 nurses) with Deep End careers ranging from 3 months to 31 years. Participants were recruited via purposive and snowball sampling. Interviews were conducted using video-conferencing software. Data were analysed using thematic content analysis through a social determinants of health lens. Our results are categorised into four themes: the immediate health risks of COVID-19 on patients and practices; factors likely to exacerbate existing deprivation; the role of social prescribing during COVID-19; wider implications for remote consulting. We add qualitative understanding to existing quantitative data, showing patients from low socioeconomic backgrounds have worse outcomes from COVID-19. Deep End practitioners have valuable insights into the impact of social distancing restrictions and remote consulting on patients’ health and wellbeing. Their experiences should guide future pandemic response measures and any move to “digital first” primary care to ensure that existing inequalities are not worsened.

scholarly journals Use and impact of social prescribing: a mixed-methods feasibility study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037681
Author(s):  
Anant Jani ◽  
Harshana Liyanage ◽  
Uy Hoang ◽  
Lucy Moore ◽  
Filipa Ferreira ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Data Extraction ◽  
Evidence Base ◽  
Advisory Group ◽  
Framework Analysis ◽  
Sentinel Network ◽  
Social Prescribing ◽  
Study Results ◽  
The Impact

IntroductionSocial prescribing aims to address social determinants of health, which account for 80%–90% of health outcomes, but the evidence base behind it is limited due to a lack of data linkingsocial prescribing activity and outcomes.Methods and analysisThe objective of the quantitative component of this feasibility studyisto identify the characteristics of individuals who receive social prescriptions and describe the use and estimate the impact of social prescribing; the latter will be done on a homeless subgroup. We will use the Oxford Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care sentinel network, whose general practicescover a population of over 4 000 000 patients. Social prescribing data will be extracted onall recorded patients for 5 years up to 31 January 2020. The objective for the qualitative component of the study isto explore approaches to understand the contextual factors that will have influenced our quantitative findings to identify mechanisms to encourage adoption of social prescribing in primary care while improving data quality. Itwill comprise up to three 90–120 minute advisory group meetings for six to eight participants. Participants will be recruited based on their experience of delivering primary care within Oxfordshire and Surrey. The advisory group outputs will be analysed using framework analysis and will be used to create a survey instrument consisting of statements that surveyees, who will consist of primary care practitioners within the RCGP RSC, can agree or disagree with.Ethics and disseminationAll RCGP RSC data are pseudonymised at the point of data extraction. No personally identifiable data are required for this investigation. This protocol follows the Good Reporting of a Mixed Methods Study checklist. The study results will be published in a peer-reviewed journal and the dataset will be available to other researchers.

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 1117. An HIV Primary Care Rotation Improved HIV and STI Knowledge, Enhanced Sexual History-Taking Skills, and Increased Interest in a Career in Infectious Diseases among Medical Students and Residents

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S589-S589
Author(s):  
Darcy Wooten ◽  
Austin Marshall
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Infectious Diseases ◽  
Clinical Care ◽  
Educational Experiences ◽  
Sexual History ◽  
Care Clinic ◽  
Clinical Rotations ◽  
Hiv Primary Care ◽  
The Impact

Abstract Background Clinical rotations in HIV primary care provide a unique opportunity to teach trainees about the management of HIV and other sexually transmitted infections (STI), and enhance trainees’ skills in obtaining a culturally-competent sexual history. Positive educational experiences in this setting may also influence trainees’ decisions to pursue a career in HIV Medicine and Infectious Diseases (ID). However, little is known about the impact of an HIV clinic rotation on trainees’ fund of knowledge regarding HIV and STI management, confidence in obtaining a sexual history, or interest in HIV and ID as a career choice. Methods Third year medical students and Internal Medicine residents rotate for two to four weeks in UCSD’s HIV primary care clinic. Over a six month period (September, 2019 - February, 2020) trainees were given a pre and post rotation survey to evaluate their fund of knowledge in managing patients with HIV and other STIs, their confidence in taking a sexual history, and their interest in pursuing a career in HIV and ID. Results Twenty-one of the 31 trainees completed both the pre- and post-rotation survey. Residents and medical students comprised 57% (12) and 43% (9) of the cohort, respectively. Fund of knowledge regarding antiretroviral management, HIV transmission, and STI diagnosis and treatment improved following the rotation (Figure. 1). Trainees’ confidence in their ability to manage patients with HIV and obtain a sexual history also improved (Figure. 2). Importantly, there was a substantial increase in the proportion of trainees interested in pursuing a career in HIV and ID after the rotation compared to beforehand (Figure. 2). Fund of Knowledge Pre and Post Rotation Self-Perceived Competency and Interest in HIV Clinical Care Conclusion Clinical rotations in HIV primary care provide valuable learning experiences for trainees by improving their fund of knowledge about HIV and STIs, and their self-efficacy in obtaining a sexual history. These clinical experiences may also be important in recruiting trainees to pursue a career in HIV and ID. Given the importance of these clinical skills and the need to increase the number of trainees entering the field, additional support for educational experiences in HIV primary care clinics is warranted. Disclosures All Authors: No reported disclosures

scholarly journals Medical Student’s Perception of Dementia Assessment and Management Among Rural Veterans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 796-797
Author(s):  
Prasad Padala ◽  
Jessica Stovall ◽  
Matthew Kern ◽  
Jeremy Curtis ◽  
Eugenia Boozer ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Caregiver Burden ◽  
Primary Care Providers ◽  
Case Managers ◽  
Care Providers ◽  
Interdisciplinary Curriculum ◽  
Team Based Learning ◽  
The Impact

Abstract Background: Rural Veterans rely on their caregivers, case managers and primary care providers for dementia management. Providers of such patients need to work closely with caregivers, know the local dementia resources and be comfortable with the multiple facets of dementia assessment and management. Unfortunately, medical students are not particularly well trained in these aspects and huge knowledge gaps exist. The goal was to study the impact of a multi-component, experiential, brief curriculum on attitudes of dementia care. Methods: 108 medical students participated in a curriculum including didactics, clinical, and team-based learning followed by pre-post assessments. Results: Student’s perception of their ability to assess multiple facets of dementia such as behaviors, caregiver burden, and cognition improved significantly (p<0.001). Students’ perception of the role of social worker improved significantly (p=0.002). Conclusion: An interdisciplinary curriculum, improved medical students’ perception of their ability to assess for dementia in a cohort of predominantly rural Veterans.

Primary-care-based social prescribing for mental health: an analysis of financial and environmental sustainability

2015 ◽  
Vol 17 (02) ◽  
pp. 114-121 ◽  
Author(s):  
Daniel L. Maughan ◽  
Alisha Patel ◽  
Tahmina Parveen ◽  
Isobel Braithwaite ◽  
Jonathan Cook ◽  
...  
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Environmental Impacts ◽  
Carbon Footprint ◽  
Secondary Care ◽  
Small Sample ◽  
Environmental Costs ◽  
Healthcare Use ◽  
Social Prescribing ◽  
The Impact

AimTo assess the effects of a social prescribing service development on healthcare use and the subsequent economic and environmental costs.BackgroundSocial prescribing services for mental healthcare create links with support in the community for people using primary care. Social prescribing services may reduce future healthcare use, and therefore reduce the financial and environmental costs of healthcare, by providing structured psychosocial support. The National Health Service (NHS) is required to reduce its carbon footprint by 80% by 2050 according to the Climate Change Act (2008). This study is the first of its kind to analyse both the financial and environmental impacts associated with healthcare use following social prescribing. The value of this observational study lies in its novel methodology of analysing the carbon footprint of a service at the primary-care level.MethodAn observational study was carried out to assess the impact of the service on the financial and environmental impacts of healthcare use. GP appointments, psychotropic medications and secondary-care referrals were measured.FindingsResults demonstrate no statistical difference in the financial and carbon costs of healthcare use between groups. Social prescribing showed a trend towards reduced healthcare use, mainly due to a reduction in secondary-care referrals compared with controls. The associations found did not achieve significance due to the small sample size leading to a large degree of uncertainty regarding differences. This study demonstrates that these services are potentially able to pay for themselves through reducing future healthcare costs and are effective, low-carbon interventions, when compared with cognitive behavioral therapy or antidepressants. This is an important finding in light of Government targets for the NHS to reduce its carbon footprint by 80% by 2050. Larger studies are required to investigate the potentials of social prescribing services further.

Impact of the New McGill Undergraduate Medical Curriculum on Medical Students' Diagnostic Accuracy of Common Dermatoses Encountered in Primary Care

2020 ◽  
Vol 24 (5) ◽  
pp. 453-456 ◽  
Author(s):  
Wai Kiu Larry Cheung ◽  
Kevin Pehr
Keyword(s):  
Primary Care ◽  
Standard Deviation ◽  
Medical Students ◽  
Diagnostic Accuracy ◽  
Medical Curriculum ◽  
Average Score ◽  
Undergraduate Medical Curriculum ◽  
Significant Difference ◽  
New Curriculum ◽  
The Impact

Background The McGill Faculty of Medicine implemented a new undergraduate medical curriculum in 2013 with additional preclinical lectures in dermatology. At the time of writing, no Canadian prospective study has been published on undergraduate dermatology training in the context of a complete curricular renewal. Objectives Our study was designed to determine the impact of increasing preclinical teaching in dermatology on medical students’ diagnostic accuracy and learning retention of common dermatoses encountered in primary care. Methods A standardized questionnaire was administered to the Classes of 2015, 2016, 2017, and 2018 in 6 versions for a total of 6 times over their 4 years of training. Each version featured 10 photographs of common dermatoses encountered in primary care. Students were invited to participate anonymously and on a voluntary basis. Results A small absolute, but statistically significant difference, of 3% was detected in the fourth and final year of training between the old curriculum (average score = 70%, standard deviation = 15%) and the new curriculum (average score = 73%, standard deviation = 15%), P = .03. Furthermore, the Class of 2018’s performance improved year by year over the entire 4 years of the new curriculum. Conclusions Additional preclinical lectures in dermatology do improve medical students’ diagnostic accuracy of common dermatoses encountered in primary care. Furthermore, they do retain their learning throughout the preclinical and clerkship years.

scholarly journals The impact of social prescribing services on service users: a systematic review of the evidence

2019 ◽  
Vol 30 (4) ◽  
pp. 664-673 ◽  
Author(s):  
Julia V Pescheny ◽  
Gurch Randhawa ◽  
Yannis Pappas
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Grey Literature ◽  
Evidence Base ◽  
Service Users ◽  
Health And Wellbeing ◽  
Medical Needs ◽  
Social Prescribing ◽  
Health And Social Care ◽  
The Impact

Abstract Background Social prescribing initiatives are widely implemented in the UK National Health Service to integrate health and social care. Social prescribing is a service in primary care that links patients with non-medical needs to sources of support provided by the community and voluntary sector to help improve their health and wellbeing. Such programmes usually include navigators, who work with referred patients and issue onward referrals to sources of non-medical support. This systematic review aimed to assess the evidence of service user outcomes of social prescribing programmes based on primary care and involving navigators. Methods We searched 11 databases, the grey literature, and the reference lists of relevant studies to identify the available evidence on the impact of social prescribing on service users. Searches were limited to literature written in English. No date restrictions were applied, and searches were conducted to June 2018. Findings were synthesized narratively, employing thematic analysis. The Mixed Methods Appraisal Tool Version 2011 was used to evaluate the methodological quality of included studies. Results Sixteen studies met the inclusion criteria. The evidence base is mixed, some studies found improvements in health and wellbeing, health-related behaviours, self-concepts, feelings, social contacts and day-to-day functioning post-social prescribing, whereas others have not. The review also shows that the evaluation methodologies utilized were variable in quality. Conclusion In order to assess the success of social prescribing services, more high quality and comparable evaluations need to be conducted in the future. International Prospective Register of Systematic Reviews number: CRD42017079664

scholarly journals Implementation of social prescribing to reduce frequent attender consultation rates in primary care

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X703109
Author(s):  
Adam Jeyes ◽  
Laura Pugh
Keyword(s):  
Primary Care ◽  
Well Being ◽  
Social Needs ◽  
High Risk Population ◽  
Computer Search ◽  
Social Risk ◽  
Consultation Rate ◽  
Post Intervention ◽  
Social Prescribing ◽  
The Impact

BackgroundThe impact of social determinants on health has been established. Evidence shows that addressing social needs through link workers can improve wellbeing and consultation rates. This is of importance since demand on primary care appointments is high and access to primary care is pivotal to the NHS as a whole.AimTo evaluate whether frequently-attending patients who might benefit from social prescribing, can be recognised through a computer search of risks for isolation, loneliness, or social pressures and whether a social intervention has an effect on wellbeing and consultation rate.MethodPatients highlighted as frequent attenders (≥20 GP/nurse practitioner [NP] appointments in past 12 months) were screened for appropriateness of referral to link worker. A social risk tool was applied to select patients most at risk of social isolation. Patients who agreed had a pre- and post-intervention wellness score calculated. Number of appointments pre- and post-intervention were also recorded and matched by month. Post-intervention questionnaires allowed collation of qualitative data analysing patient opinions of the scheme.ResultsThere was an average increase in wellbeing score post-intervention of 0.8/5. The average reduction in appointments for GPs and NPs combined was 5.1 appointment/patient (37% reduction) at 6 months and 12.9 appointments/patient at 1 year (53% reduction).ConclusionThe numbers in this project are small, but it supports the growing evidence that social prescribing can improve patient well-being and sustained reduced demand for GP and NP appointments. It supports the suggestion that computer searches can delineate a high-risk population.

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