scholarly journals Capturing pharmacists’ impact in general practice: an e-Delphi study to attempt to reach consensus amongst experts about what activities to record

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Georgios Dimitrios Karampatakis ◽  
Kath Ryan ◽  
Nilesh Patel ◽  
Graham Stretch
Keyword(s):  
General Practice ◽  
Delphi Study ◽  
Consensus Method ◽  
Specific Medication ◽  
Previous Round ◽  
Medication Reviews ◽  
Rank Codes ◽  
Electronic Activity ◽  
The Uk ◽  
Individual Choices

Abstract Background In the UK, there is ongoing integration of pharmacists into general practice as a new healthcare service in primary care. Evaluation of the service involves national measures that require pharmacists to record their work, on the general practice clinical computer systems, using electronic activity codes. No national agreement, however, has been established on what activities to record. The purpose of this study was to attempt to reach consensus on what activities general practice-based pharmacists should record. Methods The e-Delphi method was chosen as it is an excellent technique for achieving consensus. The study began with an initial stage in which screening of a general practice clinical computer system and discussion groups with pharmacists from two ‘pharmacists in general practice’ sites identified 81 codes potentially relevant to general practice-based pharmacists’ work. Twenty-nine experts (pharmacists and pharmacy technicians from the two sites along with experts recruited through national committees) were then invited by e-mail to participate as a panel in three e-Delphi questionnaire rounds. In each round, panellists were asked to grade or rank codes and justify their choices. In every round, panellists were provided with anonymised feedback from the previous round which included their individual choices along with their co-panellists’ views. Final consensus (in Round 3) was defined as at least 80% agreement. Commentaries on the codes from all e-Delphi rounds were pooled together and analysed thematically. Results Twenty-one individual panellists took part in the study (there were 12 responses in Round 1, 18 in Round 2 and 16 in Round 3). Commentaries on the codes included three themes: challenges and facilitators; level of detail; and activities related to funding. Consensus was achieved for ten codes, eight of which related to activities (general and disease specific medication reviews, monitoring of high-risk drugs and medicines reconciliation) and two to patient outcomes (presence of side effects and satisfactory understanding of medication). Conclusions A formal consensus method revealed general practice-based pharmacists’ preferences for activity coding. Findings will inform policy so that any future shaping of activity coding for general practice-based pharmacists takes account of pharmacists’ actual needs and preferences.

scholarly journals A Delphi Study Investigating Clinicians’ Views on Access to, Delivery of, and Adaptations of MBCT in the UK Clinical Settings

Mindfulness ◽  
2021 ◽  
Author(s):  
Kate Williams ◽  
Samantha Hartley ◽  
Peter Taylor
Keyword(s):  
Delphi Study ◽  
Good Practice ◽  
Evidence Base ◽  
Clinical Settings ◽  
Training Support ◽  
Decision Making Processes ◽  
Complex Decision Making ◽  
Complex Decision ◽  
The Uk ◽  
Clinical Populations

Abstract Objectives Mindfulness-based cognitive therapy (MBCT) is a well-evidenced relapse-prevention intervention for depression with a growing evidence-base for use in other clinical populations. The UK initiatives have outlined plans for increasing access to MBCT in clinical settings, although evidence suggests that access remains limited. Given the increased popularity and access to MBCT, there may be deviations from the evidence-base and potential risks of harm. We aimed to understand what clinicians believe should be best clinical practice regarding access to, delivery of, and adaptations to MBCT. Methods We employed a two-stage Delphi methodology. First, to develop statements around best practices, we consulted five mindfulness-based experts and reviewed the literature. Second, a total of 59 statements were taken forward into three survey rating rounds. Results Twenty-nine clinicians completed round one, with 25 subsequently completing both rounds two and three. Forty-four statements reached consensus; 15 statements did not. Clinicians agreed with statements regarding sufficient preparation for accessing MBCT, adherence to the evidence-base and good practice guidelines, consideration of risks, sufficient access to training, support, and resources within services, and carefully considered adaptations. The consensus was not reached on statements which reflected a lack of evidence-base for specific clinical populations or the complex decision-making processes involved in delivering and making adaptations to MBCT. Conclusions Our findings highlight the delicate balance of maintaining a client-centred and transparent approach whilst adhering to the evidence-base in clinical decisions around access to, delivery of, and adaptations in MBCT and have important wide-reaching implications.

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.

Prevalence and predictors of lipid abnormalities in patients treated with statins in the UK general practice

2009 ◽  
Vol 202 (1) ◽  
pp. 225-233 ◽  
Author(s):  
H. Phatak ◽  
C. Wentworth ◽  
V. Sazonov ◽  
T. Burke
Keyword(s):  
General Practice ◽  
The Uk ◽  
Lipid Abnormalities

How do junior doctors spend their time in an Acute Medical Unit?

2015 ◽  
Vol 14 (2) ◽  
pp. 57-60
Author(s):  
Eirini V Kasfiki ◽  
◽  
Mamoon Yusaf ◽  
Jivendra Gosai ◽  
Makani Purva ◽  
...  
Keyword(s):  
General Practice ◽  
Hospital Admission ◽  
Postgraduate Training ◽  
Junior Doctors ◽  
Bed Occupancy ◽  
Medical Unit ◽  
Admission Rates ◽  
The Past ◽  
Acute Medical Unit ◽  
The Uk

In the UK, postgraduate training for doctors has undergone significant changes over the past decade general practice, etc. During this period, hospital admission rates and bed occupancy have also increased.

Managing heart failure – home or hospital?

1992 ◽  
Vol 30 (16) ◽  
pp. 61-63
Keyword(s):  
Heart Failure ◽  
General Practice ◽  
General Population ◽  
Mortality Rates ◽  
The Usa ◽  
The Uk

In the USA, heart failure affects about 1% of people in their 50s, rising to 10% of those in their 80s,1 and the figure is probably higher in the UK. The symptoms are distressing, usually relentless, and associated with mortality rates four to eight times greater than those in the general population of the same age.1 This article reviews the treatment of uncomplicated heart failure, concentrating on its management in general practice.

scholarly journals Assessing patient satisfaction with a microsuction service in general practice: a comparative study

BJGP Open ◽  
2019 ◽  
Vol 3 (2) ◽  
pp. bjgpopen19X101649 ◽  
Author(s):  
Ruairi Hasson ◽  
Eoin McDermott ◽  
Karena Hanley ◽  
Camilla Carroll ◽  
Claire Collins
Keyword(s):  
General Practice ◽  
Patient Satisfaction ◽  
Data Collection ◽  
Comparative Study ◽  
Usual Care ◽  
Intervention Group ◽  
Hospital Setting ◽  
Patient Acceptability ◽  
Prospective Comparative Study ◽  
The Uk

BackgroundIn the UK, about 2.3 million people each year require intervention for wax impaction, while otitis externa accounts for just over 1% of general practice consultations. Aural microsuction of debris from the ear canal is a commonly performed procedure within the ear, nose, and throat (ENT) outpatient clinic. This article examines the patient acceptability of an aural microsuction service delivered in general practice.AimTo determine patient satisfaction following the introduction of a new microsuction service in general practice compared with a hospital-delivered service.Design & settingThis is a prospective comparative study in two rural general practices in Ireland and the emergency department (ED) of the Royal Victoria Eye and Ear Hospital (RVEEH), Dublin.MethodA 3-month period of data collection on usual care of 56 patients in general practice was followed by a 3-month period of GP-intervention data collection on 67 patients. Comparative data were collected on 37 patients who attended the RVEEH for the same intervention procedure. Patients completed a validated patient satisfaction questionnaire (PSQ-18).ResultsBoth general practice groups scored significantly higher in all seven aspects of medical care than the RVEEH cohort. Patients in the GP-intervention group scored significantly higher in terms of satisfaction with procedure technique compared with the usual care GP group.ConclusionThe provision of microsuction as a service in general practice confers as much or more patient satisfaction as the provision of the service in a hospital setting.

scholarly journals Medical students’ perceptions of a career in general practice

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X702773
Author(s):  
Kimberley Banner ◽  
Hugh Alberti ◽  
Jane Stewart
Keyword(s):  
General Practice ◽  
Longitudinal Study ◽  
Medical Students ◽  
Family Life ◽  
Personal Narratives ◽  
Career Intentions ◽  
Form Part ◽  
Training Programmes ◽  
The Uk ◽  
Gp Training

BackgroundRecruitment into general practice is falling and many training programmes in the UK have unfilled training posts. In 2016 NHS England pledged to increase the number of graduates entering GP training to 50%. However in 2017 only 15.3% of foundation year 2 doctors commenced general practice.AimThis work aims to understand medical students’ perceptions of a career in general practice, and how this may affect their career intentions.MethodAs part of a larger, longitudinal study at four UK universities. First and fourth year students were invited to a focus group to discuss their perceptions of a career in general practice. The recordings were transcribed and content analysis was performed.ResultsThe perceptions discussed could be broadly grouped into three categories. ‘The GP’ highlighted students’ ideas of the GP as someone who was dedicated, could create rapport, and wanted a family life. The ‘Job of the GP’ indicated students were positive about the continuity of care the job offered, but felt the work was isolating and paperwork heavy. Finally, external factors such as denigration and the ‘GP land’ concept also had an impact on students’ perceptions.ConclusionFurther work is needed to understand how these perceptions develop, how this may impact students career intentions, and how this research could be used to improve GP recruitment. This data will form part of a wider longitudinal study, the results of which will be analysed for themes and personal narratives of the students.

Sign in / Sign up

Export Citation Format

Share Document