The transgender patient in primary care

2021 ◽  
pp. 175573802110451
Author(s):  
Charles Holden ◽  
Duncan Shrewsbury
Keyword(s):  
Primary Care ◽  
General Practice ◽  
General Practitioners ◽  
Gender Dysphoria ◽  
Training Curriculum ◽  
Key Topics ◽  
The Uk ◽  
Patients Experience ◽  
Transgender Patient ◽  
General Practice Training

The number of people who identify as transgender or non-binary in the UK is increasing. The RCGP has identified that many transgender patients’ experience of healthcare is poor, and that general practitioners may lack experience in the assessment, referral and management of patients with gender dysphoria. This article seeks to cover the key topics in the general practice training curriculum relating to the care of transgender and non-binary adults to allow trainees to practice confidently, safely and compassionately within this field.

scholarly journals The rise of primary care in Japan and new postgraduate general practice training in the UK

2011 ◽  
Vol 34 (4) ◽  
pp. 308-316
Author(s):  
Noriaki Sawa ◽  
Akihiro Tanaka ◽  
Satoshi Kanke ◽  
Hitoshi Takeda ◽  
Tomohiko Ukai ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
The Uk ◽  
General Practice Training

scholarly journals Community end-of-life care during the COVID-19 pandemic: Initial findings of a UK primary care survey

2021 ◽  
Author(s):  
Sarah Mitchell ◽  
Phillip Oliver ◽  
Clare Gardiner ◽  
Helen Chapman ◽  
Dena Khan ◽  
...  
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
General Practice ◽  
End Of Life ◽  
General Practitioners ◽  
End Of Life Care ◽  
Life Care ◽  
Face To Face ◽  
The Uk ◽  
Remote Consultations

AbstractBackgroundThousands of people in the UK have required end-of-life care in the community during the COVID-19 pandemic. Primary healthcare teams (general practice and community nursing services) have provided the majority of this care, alongside specialist colleagues. There is a need to learn from this experience in order to inform future service delivery and planning.AimTo understand the views of general practitioners and community nurses providing end-of-life care during the first wave of the COVID-19 pandemic.Design and SettingA web-based, UK-wide questionnaire survey circulated via professional general practice and community nursing networks during September and October 2020.MethodResponses were analysed using descriptive statistics and an inductive thematic analysis.ResultsValid responses were received from 559 individuals (387 community nurses, 156 General Practitioners (GPs) and 16 unspecified role), from all regions of the UK. The majority reported increased involvement in providing community end-of-life care. Contrasting and potentially conflicting roles emerged between GPs and community nurses. There was increased use of remote consultations, particularly by GPs. Community nurses took greater responsibility in most aspects of end-of-life care practice, particularly face-to-face care, but reported feeling isolated. For some GPs and community nurses, there has been considerable emotional distress.ConclusionPrimary healthcare services are playing a critical role in meeting increased need for end-of-life care in the community during the COVID-19 pandemic. They have adapted rapidly, but the significant emotional impact, especially for community nurses, needs addressing alongside rebuilding trusting and supportive team dynamics.How this fits in (4 sentences)This study provides insights into experiences of delivering end-of-life care in the community during the first wave of the COVID-19 pandemic from the perspectives of UK general practitioners (GPs) and community nurses.Services have changed and adapted rapidly to meet increased need in terms of both volume and complexity, with community nurses taking greater responsibility for most areas of palliative care clinical practice, and GPs undertaking more care planning conversations.While GPs and specialist palliative care services conducted more remote consultations, community nurses carried out face-to-face end-of-life care and reported a feeling of isolation.As the pandemic progresses, and the increased need for end-of-life care in the community persists, more effective service models and multi-disciplinary teamwork in primary care are urgently needed.

scholarly journals Quality improvement in general practice: what do GPs and practice managers think? Results from a nationally representative survey of UK GPs and practice managers

2021 ◽  
Vol 10 (2) ◽  
pp. e001309
Author(s):  
Jennifer Gosling ◽  
Nicholas Mays ◽  
Bob Erens ◽  
David Reid ◽  
Josephine Exley
Keyword(s):  
General Practice ◽  
Quality Improvement ◽  
General Practitioners ◽  
Service Improvement ◽  
Protected Time ◽  
Routine Work ◽  
Professional Interest ◽  
Quality And Outcomes ◽  
Nationally Representative ◽  
The Uk

BackgroundThis paper presents the results of the first UK-wide survey of National Health Service (NHS) general practitioners (GPs) and practice managers (PMs) designed to explore the service improvement activities being undertaken in practices, and the factors that facilitated or obstructed that work. The research was prompted by growing policy and professional interest in the quality of general practice and its improvement. The analysis compares GP and PM involvement in, and experience of, quality improvement activities.MethodsThis was a mixed-method study comprising 26 semistructured interviews, a focus group and two surveys. The qualitative data supported the design of the surveys, which were sent to all 46 238 GPs on the Royal College of General Practitioners (RCGP) database and the PM at every practice across the UK (n=9153) in July 2017.ResultsResponses from 2377 GPs and 1424 PMs were received and were broadly representative of each group. Ninety-nine per cent reported having planned or undertaken improvement activities in the previous 12 months. The most frequent related to prescribing and access. Key facilitators of improvement included ‘good clinical leadership’. The two main barriers were ‘too many demands from external stakeholders’ and a lack of protected time. Audit and significant event audit were the most common improvement tools used, but respondents were interested in training on other quality improvement tools.ConclusionGPs and PMs are interested in improving service quality. As such, the new quality improvement domain in the Quality and Outcomes Framework used in the payment of practices is likely to be relatively easily accepted by GPs in England. However, if improving quality is to become routine work for practices, it will be important for the NHS in the four UK countries to work with practices to mitigate some of the barriers that they face, in particular the lack of protected time.

scholarly journals Mental Illness in Primary Care Settings

1985 ◽  
Vol 9 (1) ◽  
pp. 12-13 ◽  
Author(s):  
Greg Wilkinson
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
General Practice ◽  
Social Security ◽  
General Practitioners ◽  
Research Unit ◽  
Practice Research ◽  
Policy Makers ◽  
Department Of Health ◽  
Primary Care Settings

A Conference on the above topic took place at the Institute of Psychiatry, London, on 17 and 18 July 1984. The Conference was sponsored by the Department of Health and Social Security and was organized by the General Practice Research Unit. Over 100 invited clinicians, research workers and policy-makers took part. The majority of the participants were either psychiatrists or general practitioners, but representatives of all relevant disciplines attended.

Recognition of and Response to Dementia Syndrome in Primary Care: Part 1

2009 ◽  
Vol 2 (4) ◽  
pp. 230-236 ◽  
Author(s):  
Steve Iliffe ◽  
Priya Jain ◽  
Jane Wilcock
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Cognitive Function ◽  
General Practitioners ◽  
Function Tests ◽  
Dementia Syndrome

The theme of this article is the recognition of and response to dementia in general practice. Its aim is to clarify the tasks of diagnosing dementia, to advise on the use of cognitive function tests, to suggest ways of establishing the subtype of dementia where possible and to assist general practitioners in talking about dementia with their patients and their families.

Evaluation of a brief psychological treatment for emotional disorders in primary care

1991 ◽  
Vol 21 (4) ◽  
pp. 1013-1018 ◽  
Author(s):  
J. Catalan ◽  
D. H. Gath ◽  
P. Anastasiades ◽  
S. A. K. Bond ◽  
A. Day ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Problem Solving ◽  
Randomized Trial ◽  
Emotional Disorders ◽  
General Practitioners ◽  
Poor Prognosis ◽  
Psychological Treatment ◽  
Recent Onset

SYNOPSISA randomized trial in general practice compared: (i) a brief psychological treatment (problem-solving) given by a psychiatrist; (ii) any treatment of the GP's choice, whether psychological or pharmacological. The patients had recent onset emotional disorders of poor prognosis. Patients in the problem-solving group showed significantly greater reductions in symptoms. Problem-solving as given by a psychiatrist was feasible in primary care and acceptable to patients. Problem-solving is now being evaluated as given by general practitioners trained in the method.

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.

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 The United Kingdom 2009 Swine Flu Outbreak As Recorded in Real Time by General Practitioners

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Hershel Jick ◽  
Dean S. MacLaughlin ◽  
Pascal Egger ◽  
Peter Wiggins
Keyword(s):  
General Practice ◽  
United Kingdom ◽  
Real Time ◽  
General Practitioners ◽  
Swine Flu ◽  
Practice Research ◽  
Research Database ◽  
Planning Stage ◽  
The United Kingdom ◽  
The Uk

Background. Initially the course of the 2009 swine flu pandemic was uncertain and impossible to predict with any confidence. An effective prospective data resource exists in the United Kingdom (UK) that could have been utilized to describe the scope and extent of the swine flu outbreak as it unfolded. We describe the 2009 swine flu outbreak in the UK as recorded daily by general practitioners and the potential use of this database for real-time tracking of flu outbreaks. Methods. Using the General Practice Research Database, a real-time general practice, electronic database, we estimated influenza incidence from July 1998 to September 2009 according to age, region, and calendar time. Results. From 1998 to2008, influenza outbreaks regularly occurred yearly from October to March, but did not typically occur from April to September until the swine flu outbreak began in April 2009. The weekly incidence rose gradually, peaking at the end of July, and the outbreak had largely dissipated by early September. Conclusions. The UK swine flu outbreak, recorded in real time by a large group of general practitioners, was mild and limited in time. Simultaneous online access seemed feasible and could have provided additional clinical-based evidence at an early planning stage of the outbreak.

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