Care in the community

2020 ◽  
pp. 351-384
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Side Effects ◽  
Joint Pain ◽  
Voluntary Sector ◽  
Musculoskeletal Condition ◽  
Red Flags ◽  
Primary Care Teams ◽  
Telephone Advice ◽  
The Social

This chapter provides an outline of some of the specific issues that primary care teams see in general practice and aids the practitioner in recognizing some of the causes that may be related to an underlying musculoskeletal condition or side effects of treatment. Examination tips and red flags to guide the primary care teams are provided and the management of patients with co-morbidities and joint pain is also briefly discussed. Managing the frail and elderly and those with skin and continence issues are also a challenge in care and these topics are discussed in the context of musculoskeletal conditions. When referral is not required and yet there are practical issues that the patient would like help with, the chapter offers tips on what can be offered to the patient and signposting to supports such as the social and voluntary sector, exercises, and access to aids and devices. The use of telephone advice lines and support for the primary care teams are then covered with some patient scenarios for the primary care team to consider how they would manage such patients in their clinical setting.

scholarly journals New teams in general practice

2018 ◽  
Vol 11 (9) ◽  
pp. 506-512 ◽  
Author(s):  
Kamila Hawthorne ◽  
Ben Jackson ◽  
Danielle Fisher
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Continuity Of Care ◽  
Healthcare Professionals ◽  
Hospital Admissions ◽  
Healthcare Outcomes ◽  
Complex Patients ◽  
Primary Care Teams ◽  
A Priority ◽  
Parallel Stream

The NHS is seriously under-doctored, with general practice being one of the worst-affected specialties. GPs are a highly trusted and valued profession by patients. In addition, the ‘gatekeeping’ function and continuity of care they provide is critical to the efficiency of the services as a whole, keeps hospital admissions down, and produces better healthcare outcomes for communities and populations. Major efforts are being made to recruit new GPs and retain existing GPs, but there are serious implications for the future of primary care, and general practice in particular, as GPs struggle to cope with increased workloads. Increasing the number of GPs in the workforce is critical, and this work continues as a priority. However, a parallel stream of work has developed to consider ways in which tasks ‘traditionally’ undertaken by a GP might be diverted to new healthcare professionals within primary care teams, freeing up GPs to concentrate on the care and management of their more complex patients.

Hunter and New England Diabetes Alliance: innovative and integrated diabetes care delivery in general practice

2019 ◽  
Vol 25 (3) ◽  
pp. 219 ◽  
Author(s):  
Shamasunder Acharya ◽  
Annalise N. Philcox ◽  
Martha Parsons ◽  
Belinda Suthers ◽  
Judy Luu ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Diabetes Care ◽  
Care Delivery ◽  
Health District ◽  
Specialist Care ◽  
Care Model ◽  
Improvement Program ◽  
Process Measures ◽  
Primary Care Teams

Evidence-based standardised diabetes care is difficult to achieve in the community due to resource limitations, and lack of equitable access to specialist care leads to poor clinical outcomes. This study reports a quality improvement program in diabetes health care across a large health district challenged with significant rural and remote geography and limited specialist workforce. An integrated diabetes care model was implemented, linking specialist teams with primary care teams through capacity enhancing case-conferencing in general practice supported by comprehensive performance feedback with regular educational sessions. Initially, 20 practices were recruited and 456 patients were seen over 14 months, with significant improvements in clinical parameters. To date 80 practices, 307 general practitioners, 100 practice nurses and 1400 patients have participated in the Diabetes Alliance program and the program envisages enrolling 40 new practices per year, with a view to engage all 314 practices in the health district over time. Diabetes care in general practice appears suboptimal with significant variation in process measures. An integrated care model where specialist teams are engaged collaboratively with primary care teams in providing education, capacity enhancing case-conferences and performance monitoring may achieve improved health outcomes for people with diabetes.

Life, Death and the Power of Powerlessness

2001 ◽  
Vol 34 (1) ◽  
pp. 153-167 ◽  
Author(s):  
Alfred Garwood
Keyword(s):  
Primary Care ◽  
General Practice ◽  
The Self ◽  
Psychological Aspects ◽  
Starting Point ◽  
The Social

In this article I endeavour to explore and clarify how the simple starting point of the biological given, the instinct for self-preservation, in part explains man's response to life, death and powerlessness, and how sensitization to primal psychic agony has shaped the development of man's psyche and civilization. General practice exposes the clinician to major events of life from birth to death. Training now addresses the social and psychological aspects of the patient's `management'. The broad mixture of disciplines and experiences struggled with in primary care has shaped and informed this article. In addition, the hypotheses and arguments are derived from my researches into Holocaust trauma in which annihilation threat, powerlessness, loss and the self-preservative instinct are central.

Social aspects of primary care

2020 ◽  
pp. 81-110
Author(s):  
Chantal Simon ◽  
Hazel Everitt ◽  
Françoise van Dorp ◽  
Nazia Hussain ◽  
Emma Nash ◽  
...  
Keyword(s):  
Primary Care ◽  
Domestic Violence ◽  
General Practice ◽  
Low Income ◽  
Social Aspects ◽  
Occupational Illness ◽  
The Social ◽  
Victims Of Crime ◽  
And Coping ◽  
Fitness To Work

This chapter in the Oxford Handbook of General Practice explores the social aspects of primary care, from social factors and health to multicultural medicine. It includes the general practitioner’s role in cases of domestic violence and with patients who are the victims of crime. It provides guidance on patients with occupational illness and who need time off work for illness, as well as certification of fitness to work and fitness to make decisions, drive, and other activities. It also looks at dealing with bereavement, grief, and coping with loss, and provides advice for claiming benefits for low-income and sickness and disability, as well as pensions.

scholarly journals The importance of significant event analysis

2020 ◽  
Vol 13 (10) ◽  
pp. 613-617
Author(s):  
Nicola Cooper-Moss ◽  
Neil Smith ◽  
Professor Umesh Chauhan
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Quality Improvement ◽  
Clinical Reasoning ◽  
Healthcare Systems ◽  
Event Analysis ◽  
Quality Improvement Activity ◽  
Primary Care Teams ◽  
Team Based Learning ◽  
Future Patient

Significant event analysis (SEA) is a structured quality improvement activity that is well established in general practice. Participation in SEA prompts primary care teams to reflect on their clinical reasoning, to highlight exemplary care, and to identify any potential improvements in both practice and wider healthcare systems. This article provides an overview of the SEA process and the events surrounding a SEA meeting. Cancer care examples are used to demonstrate how SEA can be used to enhance team-based learning and improve future patient care.

Poisoning

2021 ◽  
pp. 175573802199968
Author(s):  
Rachel Callaghan
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Medication Administration ◽  
Medical Attention ◽  
Accidental Exposure ◽  
Over The Counter ◽  
Common Cause ◽  
Medication Administration Errors ◽  
Telephone Advice ◽  
The Uk

Every day in the UK, hundreds of people seek medical attention after accidental or deliberate exposure to a drug or chemical. Although significant cases of poisoning will be managed in secondary care, many patients will seek help from primary care, either through their GP practice or the NHS telephone advice services. The most common cause of poisoning in adults is deliberate overdose of a drug. Other poisoning scenarios encountered in general practice include accidental exposure (especially in young children), environmental exposure, medication administration errors and therapeutic excess of prescribed or over-the-counter drugs.

Amisulpride in dysthymia: results of a naturalistic study in general practice

1996 ◽  
Vol 11 (S3) ◽  
pp. 145s-147s ◽  
Author(s):  
M Paes de Sousa
Keyword(s):  
General Practice ◽  
Clinical Practice ◽  
Side Effects ◽  
Adverse Events ◽  
Effective Treatment ◽  
Treatment Period ◽  
Global Evaluation ◽  
Low Doses ◽  
Naturalistic Study ◽  
The Social

SummaryA naturalistic study was conducted in general practice in Portugal on the efficacy and tolerance of low doses of amisulpride in the treatment of dysthymia. A total of 109 patients received low doses (50 – 100 mg) of amisulpride for four weeks. A global evaluation showed good or very good efficacy and tolerance in more than 80% of the patients. The social disability observed at baseline was significantly improved after the four-week treatment period. Few adverse events were observed and only four patients dropped out due to side effects. Our results suggest that low doses of amisulpride might be a safe and effective treatment for dysthymia in clinical practice.

Dermatology in primary care: an audit of the proportion of patients who present to general practice with a dermatological problem that could be self-managed

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711053
Author(s):  
Luamar Dolfini ◽  
Yogesh Patel
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Acne Vulgaris ◽  
Clinical Information ◽  
Electronic Record ◽  
Self Management ◽  
Considerable Proportion ◽  
Dry Skin ◽  
Record System ◽  
Common Skin

BackgroundA considerable proportion of GPs’ workload is dermatological. It is important to investigate what common skin conditions encountered in primary care can be self-managed, in an effort to alleviate the burden on primary care.AimThe purpose of the audit was to identify the proportion of consultations that are dermatological in nature and analyse potential for self-management by patients.MethodData was collected using the patient electronic record system (EMIS) in general practice. A search was made for all consultations from the 17 April to 15 May 2019, which included all new presenting complaints that were dermatological in nature. The criteria for self-management included advising over the counter (OTC) medication or reassurance. On the other hand, a case was deemed not self-manageable if prescription only medication (POM) was prescribed or if a referral to dermatology was made.ResultsThere were a total of 2175 consultations, where 246 (11.31%) cases were dermatological. Of the 246, 80 cases (32.5%) could be self-managed. There were 46 different dermatological presenting complaints of which the 5 most common included: rash (51 cases), dermatitis (44 cases), acne vulgaris (13 cases), moles (12 cases), dry skin (11 cases). None of the acne or moles cases could be self-managed, whereas 23%, 68.2%, 72.7% of rashes, dermatitis, and dry skin cases, respectively, could be self-managed.ConclusionCertain dermatological conditions have more potential for self-management than others. Research into teledermatology as a means of addressing patient concern and providing clinical information is important in order to reduce unnecessary consultations.

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