Primary Medical Care in Seychelles

1992 ◽  
Vol 22 (3) ◽  
pp. 100-104
Author(s):  
F M Sullivan ◽  
C Shamlaye
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Western Europe ◽  
Health Problems ◽  
Standard Of Living ◽  
Tropical Country ◽  
Current Health ◽  
The Republic ◽  
The Uk

This paper describes some of the current health problems faced by a tropical country whose standard of living and lifestyle is approaching that of many countries in Western Europe. Long-term health problems such as cardiovascular diseases and diabetes have become at least as important as infectious diseases. A change in approach to a more proactive style of primary care is needed to allow the contribution of community doctors to be effective. The system of primary care in the Republic of Seychelles is based on the UK model of general practice where recent improvements in education and organization are raising standards. How some of these improvements might be transferred elsewhere is discussed.

The context of healthcare

2020 ◽  
pp. 1-34
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Northern Ireland ◽  
Healthcare Services ◽  
Health Profile ◽  
Long Term Conditions ◽  
Key Concepts ◽  
The Uk

This chapter begins by covering the UK health profile, then defines the key concepts in primary care and public health, and outlines the generic long-term conditions model. It provides a brief overview of the National Health Service, including differences in England, Northern Ireland, Scotland, and Wales. It covers current NHS entitlements for people from overseas, commissioning of services, and public health in a broader context. It also describes health needs assessment, and provides an overview of the services in primary care, the role of general practice, and other primary healthcare services. Further services, including those to prevent unplanned hospital admission, aid hospital discharge, those that support children and families, housing, social support, and care homes are all covered.

Benzodiazepines: Dependence and addiction in general practice

2019 ◽  
Vol 12 (11) ◽  
pp. 656-663
Author(s):  
Denise Gleeson
Keyword(s):  
General Practice ◽  
Diagnostic Criteria ◽  
Management Strategies ◽  
Optimal Management ◽  
Benzodiazepine Dependence ◽  
The Uk

Benzodiazepines are only recommended for short periods (2–4 weeks), yet there is evidence of substantial long-term use across the UK. Poor availability of services is one major challenge in supporting withdrawal. Confusion about terminology can lead to inaccurate or inadequate diagnosis of benzodiazepine dependence and addiction, and sub-optimal management of these patients. This article provides an overview of benzodiazepines, diagnostic criteria and available management strategies.

scholarly journals Experiences of support from primary care and perceived needs of parents bereaved by suicide: a qualitative study

2020 ◽  
Vol 70 (691) ◽  
pp. e102-e110 ◽  
Author(s):  
Verity Wainwright ◽  
Lis Cordingley ◽  
Carolyn A Chew-Graham ◽  
Nav Kapur ◽  
Jenny Shaw ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Qualitative Study ◽  
Support Needs ◽  
Structured Interviews ◽  
Perceived Needs ◽  
The North ◽  
Suicide Bereavement ◽  
Additional Support ◽  
The Uk

BackgroundPeople bereaved by suicide are a vulnerable group, also at risk of dying by suicide. The importance of postvention support (intervention after suicide) has recently been highlighted; however, little is known about the support needs of parents bereaved by suicide in the UK, and the role played by general practice.AimTo explore the perspectives, experiences, and support needs of parents bereaved by suicide.Design and settingThis was a qualitative study, with semi-structured interviews conducted between 2012 and 2014 in the north of England and the Midlands, with parents bereaved by their son or daughter’s suicide.MethodInterviews explored parents’ experiences of suicide bereavement following the death of their son or daughter, with a focus on their experiences of support from primary care. Interviews were analysed thematically using constant comparison.ResultsTwenty-three interviews were conducted. Three themes were identified from the data: the importance of not feeling alone; perceived barriers to accessing support; and the need for signposting for additional support. Some parents reported having experienced good support from their general practice; others described a number of barriers to accessing help, including triage processes. Primary care was considered to be an important avenue of support but GPs were often perceived as uncertain how to respond. The need for information, signposting to avenues of support, and the helpfulness of group support were also highlighted.ConclusionParents believed it was important that people working in general practice have an awareness of suicide bereavement and understanding of their needs, including knowledge of where to direct people for further support.

Proton pump inhibitors and upper gastrointestinal cancers

2019 ◽  
Vol 12 (9) ◽  
pp. 526-530
Author(s):  
Monica Kumar
Keyword(s):  
Gastric Cancer ◽  
General Practice ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Cost Effective ◽  
Gastrointestinal Cancers ◽  
Increased Risk ◽  
The Uk ◽  
Upper Gastrointestinal

Proton pump inhibitors (PPIs) were introduced in the 1980s. They are now one of the most commonly prescribed drugs in general practice. They are cost-effective when used correctly; however, PPIs are often used beyond accepted clinical indications. Recent published studies performed outside the UK have suggested that adverse effects are associated with long-term use of PPIs; in particular, an increased risk of gastric cancer. This article will aim to systematically assess the evidence and discuss its application to our clinical practice.

Student paramedics' views on placements in general practice as part of a degree

2019 ◽  
Vol 11 (12) ◽  
pp. 519-525
Author(s):  
Alyesha Proctor
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Care Pathway ◽  
Structured Interviews ◽  
Learning And Development ◽  
Alternative Care ◽  
Face To Face ◽  
The Uk ◽  
University Degree

Background: Frontline paramedics are increasingly attending to non-emergency problems and calls that could be managed by a primary care provider. Alongside this, there is a growing pressure to manage patients at home or use an alternative care pathway and reduce hospital conveyance. Student paramedic training, including both placement and taught elements at university, should therefore reflect this. However, placement opportunities for student paramedics in primary care settings is variable across the UK. Aim: To explore student paramedics' views on incorporating a placement within general practice as part of their degree and its effects on their learning and development as an autonomous paramedic. Method: A small pedagogic study as part of a postgraduate certificate in academic practice for higher education, involving a case study, qualitative approach using face-to-face, semi-structured interviews and thematic analysis, was carried out. Findings: Student paramedics feel that incorporating a placement in general practice as part of their degree will significantly help in their learning and development as autonomous paramedics. Specifically, they feel it: will help them understand the role of the GP and what the GP expects of them; will help them to focus their assessments and improve confidence in decisions not to convey patients; may lead to better knowledge of alternative care pathways; and, finally, may provide an insight into the role of the paramedic in general practice as a future career opportunity. There are a few reservations about whether students would be able to use the skills and knowledge gained in this setting, as they feel they do not have access to the tools or the authority in a frontline ambulance service. Students would prefer to have a placement in a GP surgery in the final year of their university degree. Conclusion: Placement within a GP surgery for student paramedics should be included as part of a paramedic science degree as a priority. This is necessary, particularly given the changing role of the contemporary paramedic who attends to non-emergency problems.

scholarly journals Help Seeking and Access to Primary Care for People from “Hard-to-Reach” Groups with Common Mental Health Problems

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
K. Bristow ◽  
S. Edwards ◽  
E. Funnel ◽  
L. Fisher ◽  
L. Gask ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Health Problems ◽  
Structured Interviews ◽  
Care Givers ◽  
Common Mental Health Problems ◽  
Access To Primary Care ◽  
The Uk

Background. In the UK, most people with mental health problems are managed in primary care. However, many individuals in need of help are not able to access care, either because it is not available, or because the individual's interaction with care-givers deters or diverts help-seeking. Aims. To understand the experience of seeking care for distress from the perspective of potential patients from “hard-to-reach” groups. Methods. A qualitative study using semi-structured interviews, analysed using a thematic framework. Results. Access to primary care is problematic in four main areas: how distress is conceptualised by individuals, the decision to seek help, barriers to help-seeking, and navigating and negotiating services. Conclusion. There are complex reasons why people from “hard-to-reach” groups may not conceptualise their distress as a biomedical problem. In addition, there are particular barriers to accessing primary care when distress is recognised by the person and help-seeking is attempted. We suggest how primary care could be more accessible to people from “hard-to-reach” groups including the need to offer a flexible, non-biomedical response to distress.

Childhood cancer in general practice: Is it really that rare?

2017 ◽  
Vol 10 (4) ◽  
pp. 209-217
Author(s):  
Jennifer Kelly
Keyword(s):  
General Practice ◽  
Young People ◽  
Early Diagnosis ◽  
Childhood Cancer ◽  
Signs And Symptoms ◽  
Childhood Cancers ◽  
Children And Young People ◽  
Number Of Children ◽  
The Uk

Childhood cancer is something most GPs think to be rare, yet it is the biggest medical cause of death in children aged between 1 and 14 years. Its incidence is increasing, with just under 4000 children and young people diagnosed with cancer every year in the UK (11 a day). It is important for GPs to know the signs and symptoms suggestive of childhood cancers, in order to help early diagnosis. This, in turn, can save lives and reduce disability in survivors. The number of children surviving cancer is increasing, with over 35 000 survivors now thought to be living in the UK and in need of particular expertise and care. This article aims to provide GPs with the tools and knowledge to diagnose childhood cancer, and a framework to support children with cancer and their families long-term in the community.

scholarly journals Long-term evidence for the effect of pay-for-performance in primary care on mortality in the UK: a population study

The Lancet ◽  
2016 ◽  
Vol 388 (10041) ◽  
pp. 268-274 ◽  
Author(s):  
Andrew M Ryan ◽  
Sam Krinsky ◽  
Evangelos Kontopantelis ◽  
Tim Doran
Keyword(s):  
Primary Care ◽  
Population Study ◽  
Pay For Performance ◽  
The Uk

scholarly journals An evaluation of the clinical skills and experience within an orthopaedic Integrated Clinical Assessment and Treatment Service

BJGP Open ◽  
2017 ◽  
Vol 1 (4) ◽  
pp. bjgpopen17X101217
Author(s):  
Simon Feist-Wilson ◽  
Neil Heron
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Northern Ireland ◽  
Clinical Assessment ◽  
Clinical Skills ◽  
Treatment Service ◽  
Exercise Medicine ◽  
Assessment And Treatment ◽  
The Uk ◽  
High Level

BackgroundGeneral practice in the UK is ‘in crisis’. With 20% of GP workload relating to musculoskeletal (MSK) problems, an orthopaedic Integrated Clinical Assessment and Treatment Service (ICATS) could help support assessment of these patients in primary care, alleviating pressure on GPs. However, practitioners in ICATS must be trained appropriately to ensure its effectiveness.AimThis evaluation aimed to identify the training levels of doctors in one Northern Ireland orthopaedic ICATS system, what their future training needs are, and suggestions for how this service could be improved to better support general practice.Design & settingA questionnaire study in an orthopaedic ICATS, Northern Ireland.MethodAll seven doctors working within the Southern Trust orthopaedic ICATS were asked to complete a questionnaire detailing their training and experience in MSK medicine. Their views on how the service could be improved were elicited.ResultsSix of seven questionnaires were returned. All responders were Members of the Royal College of General Practitioners (MRCGP), while five of six held a Diploma in Sports and Exercise Medicine (Dip SEM). Half of responders suggested that MSK ultrasound could be beneficial within ICATS. However, it was viewed that extensive training would be required before paediatric MSK patients could be included.ConclusionHigh levels of training and experience were reported by responders, suggesting ICATS provides a high-level MSK service. Furthermore, it was noted that inclusion of MSK ultrasound and paediatric patients into this service could be beneficial but not without undertaking further training. With appropriate funding and support the ICATS service has the potential to expand the clinical services it offers to general practice, helping to reduce work pressures in primary care at this time of crisis for UK general practice.

The success of the Rapid Diagnostic Clinic (RDC) detecting new cancers in patients with non-localizing symptoms.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 303-303
Author(s):  
Jan Sindhar ◽  
Sabine Martin ◽  
Loay Rahman ◽  
Sifan Zheng ◽  
Yaseen Mukadam ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Diagnosis ◽  
Primary Care Physicians ◽  
Early Stage ◽  
Recovery Phase ◽  
Referral Criteria ◽  
Anti Cancer ◽  
Set Up ◽  
The Uk

303 Background: Rapid Diagnostic Clinics (RDC) are being set up across the UK allow primary care physicians to refer patients with symptoms concerning for cancer that do not fulfil tumour-specific two week wait urgent referral criteria. Guy’s RDC was established to address the high cancer related mortality in our network. There is little data assessing the effectiveness of RDC models is available in a British population. Methods: We evaluated all patients referred to Guy’s RDC pilot scheme between December 2016-June 2019 (n=1,341) to assess the rate and type of cancer diagnosed and clinical outcomes. Results: Of 1341 patients, 96 cancers were diagnoses (7.2%). Most common were lung (16%), haematological (13%) and colorectal (12%). A third were at early stage (I-II) and 40% received radical treatment. Median time to cancer diagnosis 28 days (IQR 15-47) and treatment 56 days (IQR 32-84). 75% of patients were suitable for anti-cancer treatment: surgery (26%), systemic (24%) and radiotherapy (14%). We plan to present updated data on > 2000 patients referred until June 2020. Overall 6% of patients were diagnosed with pre-malignant conditions. Conclusions: RDCs provide a streamlined pathway for complex vague symptoms patients which are challenging for primary care. The 7% rate of cancer diagnosis exceeds many tumour specific urgent pathways which supports the need for rapid tailored diagnostics. The detection of pre-malignant conditions in 6% allows surveillance and intervention to potentially improve long-term outcomes. RDCs are likely to be pivotal in the cancer recovery phase of the COVID-19 pandemic.

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