scholarly journals 96 Will Routine Frailty Identification by GPS Improve Patient Care? A Review of the 2017 GMS Contract For General Practitioners (GPS) Using Pestle Analysis Tool

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i30-i32
Author(s):  
M Kaneshamoorthy
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
Improve Patient Care ◽  
Cost Effective ◽  
Alternative Methods ◽  
Analysis Tool ◽  
Frail Patients ◽  
The Government ◽  
Improve Patient ◽  
Work Burden

Abstract Introduction It is well established in the literature that frailty is associated with high health costs (Bock 2016, England: BioMed Central). Early identification improves patient outcomes. The 2017 GMS contract for General Practioners’ (NHS England 2017) had tried to implement this. This is a result from the government wanting to improve care for frail patients from the “Five Year Forward Review”. This is first policy worldwide to introduce a policy on frailty screening (Reeves, 2018, BMJ, 362, pp. k3349). Majority of frail patients’ first contact with the NHS is through Primary Care. However, with ever reducing number of GPs and increasing work burden, is it appropriate to ask GPs to undertake this? Methods This review uses the policy analysis tool PESTLE (Political, Economical, Social, Technological, Legal, and Environmental) (Visconti 2016, Corporate Ownership and Control,13), to assess the implications of this new contract obligation on GPs and patients. Results Once frail patients are identified, it is advised that they are reviewed by GPs annually. Whether this actually benefits patients are not clear (Page 2017 British Journal of Clinical Pharmacology, 82(3), pp. 583–623). The evidence for interventions being cost-effective is also inconsistent (Hamilton 2017, BMJ, 358, pp. j4478). Alternative methods include implementing a nurse-led community frailty service, has shown some benefit in Netherlands (Bleijenberg 2017, JAMDA). Clinical Pharmacist can aid with medication reviews and focusing on Geriatrician “outreach” clinics in primary care can improve patient care and outcomes (Goldstein 2014, CJEM, 16(5), pp. 370). Due to the work burden, GPs are often seen to be reactive rather than proactive (Goodwin 2010, The King’s Fund). The shift in focus on frailty can simulate more constructive dialogue between primary care, secondary care, patients and their carers. The BMA has also tried to reassure GPs this is not an added burden, but this is controversial (BMA 2017). Conclusions To successfully implement such a policy, emphasis on clear objective outcomes and strategy is needed. There is a risk of frailty identification becoming a tick box exercise.

Practice Management—Improve Patient Care and Reduce Overhead

1995 ◽  
Vol 112 (5) ◽  
pp. P43-P43
Author(s):  
K.J. Lee
Keyword(s):  
Patient Care ◽  
Improve Patient Care ◽  
Cost Effective ◽  
Practice Management ◽  
Educational Objectives ◽  
Improve Patient

Educational objectives: To take better care of patients and to reduce overhead and be more cost-effective.

Prescribing Pattern in Acute Diarrhoea in Three Districts in Bangladesh

1993 ◽  
Vol 23 (4) ◽  
pp. 165-166 ◽  
Author(s):  
A K Azad Chowdhury ◽  
M A Matin ◽  
M Amirul Islam ◽  
Omar Faruk Khan
Keyword(s):  
Patient Care ◽  
Acute Diarrhoea ◽  
Improve Patient Care ◽  
Drug Supply ◽  
Prescribing Pattern ◽  
Standard Drug ◽  
Rational Use ◽  
The Government ◽  
Improve Patient ◽  
Children Under 5

Irrational use of drugs is a serious problem in the management of diarrhoea in developing countries. Many studies have been conducted in many different countries to document the prescribing pattern in diarrhoeal diseases in the hope of promoting rational use of drugs and thereby improve patient care. In only a few of these studies have standard drug use indicators been used to quantify the extent and nature of irrational prescribing. We report here the findings of a prescribing survey in acute diarrhoea (prescriptions written by graduate doctors) in the government health facilities (GHF) and private dispensaries (PD) in the districts of Dhaka, Tangail and Serajgonj of Bangladesh. In the study a set of standard indicators concerning prescribing, patient care and drug supply developed by the International Network for Rational Use of Drugs (INRUD; and later adopted by WHO) has been employed. Twelve prescriptions given in acute diarrhoea cases in children under 5 years old were prospectively collected on a random basis from each of the 10 centres from three districts. They were analysed by the methods suggested in the INRUD manual.

scholarly journals Acute General Practice – the 7 year itch

2015 ◽  
Vol 14 (3) ◽  
pp. 132-135
Author(s):  
Ben Jameson
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Patient Care ◽  
Secondary Care ◽  
Primary Care Physicians ◽  
Service Design ◽  
Improve Patient Care ◽  
Medical Assessment ◽  
Improve Patient

The Acute GP Service has operated in Plymouth for the last 7 years. We have a mandate to improve patient care through supporting community GPs and their patients at the point of need for urgent medical assessment. I outline our service design and delivery and make the argument for the use of primary care physicians to help manage the interface between primary and secondary care.

Sign in / Sign up

Export Citation Format

Share Document