scholarly journals Modifications to the delivery of NHS face-to-face general practice consultations during the COVID-19 pandemic in England

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 261 ◽  
Author(s):  
Lorna J. Duncan ◽  
Kelly F.D. Cheng
Keyword(s):  
Health Care ◽  
General Practice ◽  
Health Care Services ◽  
List Item ◽  
Home Visits ◽  
List Type ◽  
Face To Face ◽  
Care Services ◽  
Beneficial Elements

Background: In order to minimise transmission of SARS-CoV-2, the virus causing COVID-19, delivery of English general practice consultations was modified in March 2020 to enable the separation of patients with diagnosed or suspected COVID-19 from others. Remote triage and consultations became the default, with adapted face-to-face contact used only when clinically necessary. Face-to-face delivery modifications were decided locally and this study aimed to identify the different models used nationwide in spring/summer 2020. Methods: In June 2020, a survey was sent by email to the 135 Clinical Commissioning Groups (CCGs) responsible for planning and commissioning NHS health care services in England to identify the local organisation of face-to-face general practice consultations since March 2020. Results: All CCGs responded. Between March and July 2020, separation of patients with diagnosed or suspected COVID-19 (‘COVID-19 patients’) from others was achieved using the following models: zoned practices (used within 47% of CCGs), where COVID-19 and other patients were separated within their own practice;‘hot’ or ‘cold’ hubs (used within 90% of CCGs), separate sites where COVID-19 or other patients registered at one of several collaborating practices were seen;‘hot’ and ‘cold’ home visits (used within 70% of CCGs). For around half of CCGs, either all their GP practices used zoning, or all used hubs; in other CCGs, both models were used. Demand-led hub availability offered flexibility in some areas. Home visits were mainly used supplementally for patients unable to access other services, but in two CCGs, they were the main/only form of COVID-19 provision.  Conclusions: Varied, flexible ways of delivering face-to-face general practice consultations were identified.  Analysis of the modified delivery in terms of management of COVID-19 and other conditions, and other impacts on staff and patients, may both aid future pandemic management and identify beneficial elements for practice beyond this.

scholarly journals Modifications to the delivery of NHS face-to-face general practice consultations during the COVID-19 pandemic in England

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 261
Author(s):  
Lorna J. Duncan ◽  
Kelly F.D. Cheng
Keyword(s):  
Public Health ◽  
General Practice ◽  
List Item ◽  
Home Visits ◽  
List Type ◽  
Face To Face ◽  
Delivery Models ◽  
Beneficial Elements

Background: To minimise transmission of SARS-CoV-2, the virus causing COVID-19, delivery of English general practice consultations was modified in March 2020 to enable separation of diagnosed or suspected COVID-19 patients from others. Remote triage and consultations became the default, with adapted face-to-face contact used only when clinically necessary. This study aimed to identify the modified face-to-face delivery models used nationwide in spring/summer 2020. Information was also sought concerning COVID-19 outbreaks linked to English general practice. Methods: In June 2020, a survey was sent by email to the 135 Clinical Commissioning Groups (CCGs) in England to identify local organisation of face-to-face general practice consultations since March 2020. An email was  sent to Public Health England (PHE) requesting data on COVID-19 outbreaks linked to general practice. Results: All CCGs responded. Between March and July 2020, separation of COVID-19 patients from others was achieved using combinations of the following models: zoned surgeries (reported by 47% of CCGs), where COVID-19 and other patients were separated within their own practice;‘hot’ or ‘cold’ hubs (reported by 90% of CCGs), separate sites where COVID-19 or other patients registered at one of several collaborating practices were seen;‘hot’ and ‘cold’ home visits (reported by 70% of CCGs). One of seven combinations of these models was used across each CCG, with some flexibility shown according to changing demand through hub availability. PHE data indicated 25 possible or confirmed COVID-19 outbreaks or clusters in English general practice to July 31st 2020. Conclusions: Varied, flexible ways of delivering face-to-face general practice consultations were identified.  Analysis of the modified delivery in terms of management of COVID-19 and other conditions, and impacts on staff and patients, together with learning from investigations into confirmed COVID-19 outbreaks, may both aid future pandemic management and identify beneficial elements for practice beyond this.

scholarly journals Modifications to the delivery of NHS face-to-face general practice consultations during the COVID-19 pandemic in England

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 261
Author(s):  
Lorna J. Duncan ◽  
Kelly F.D. Cheng
Keyword(s):  
Public Health ◽  
General Practice ◽  
National Survey ◽  
Small Proportion ◽  
List Item ◽  
Home Visits ◽  
List Type ◽  
Face To Face ◽  
Delivery Models ◽  
Future Management

Background: To minimise transmission of SARS-CoV-2, the virus causing COVID-19, delivery of general practice consultations has been modified to enable the separation of diagnosed or suspected COVID-19 patients from others. Remote triage and consultations are currently the default model, with adapted face-to-face contact used when clinically necessary. This study aimed to identify the modified face-to-face delivery models used across England, and evidence for their effectiveness. Methods: In June 2020, a national survey was sent by email to the 135 Clinical Commissioning Groups (CCGs) in England to identify local organisation of face-to-face general practice consultations since March 2020. An email was sent to Public Health England (PHE) requesting information about COVID-19 outbreaks or clusters linked to general practice. Results: All CCGs responded. Separation of COVID-19 patients from others was achieved using combinations of the following models: zoned surgeries (used in 47% of CCGs), where COVID-19 and other patients are separated within their own practice;‘hot’ or ‘cold’ hubs (used in 90% of CCGs), separate sites where COVID-19 or other patients registered at one of several collaborating practices are seen;‘hot’ and ‘cold’ home visits (used in 70% of CCGs). One of seven model combinations was used across each CCG, with some flexibility according to changing need shown through hub availability. Concomitant PHE data showed less than 2% of COVID-19 outbreaks or clusters in England were linked to general practice. Conclusions: Varied, flexible ways of delivering face-to-face general practice consultations were identified. While COVID-19 outbreaks or clusters linked to general practice constituted a small proportion of totals, their investigation, together with evaluations of the modified delivery models in terms of management of COVID-19 and other conditions and impacts on staff and patients, may aid future management of the pandemic and identify aspects of adapted practice of benefit beyond this.

scholarly journals Living large: the experiences of large-bodied women when accessing general practice services

2013 ◽  
Vol 5 (3) ◽  
pp. 199 ◽  
Author(s):  
Nicola Russell ◽  
Jenny Carryer
Keyword(s):  
Health Care ◽  
General Practice ◽  
Health Care Providers ◽  
Health Care Services ◽  
Point Of Care ◽  
Social Stigma ◽  
Care Providers ◽  
Care Needs ◽  
Care Services ◽  
Verbal Insults

INTRODUCTION: Numerous studies report high levels of stigma and discrimination experienced by obese/overweight women within the health care system and society at large. Despite general practice being the most utilised point of access for health care services, there is very little international or national exploration of the experiences of large-bodied women (LBW) accessing these services. The aim of this study was to explore LBW’s experiences of accessing general practice services in New Zealand. METHODS: This is a qualitative, descriptive, feminist study. Local advertising for participants resulted in eight self-identified, large-bodied women being interviewed. A post-structural feminist lens was applied to the data during thematic analysis. FINDINGS: The women in this study provided examples of verbal insults, inappropriate humour, negative body language, unmet health care needs and breaches of dignity from health care providers in general practice. Seven themes were identified: early experiences of body perception, confronting social stereotypes, contending with feminine beauty ideals, perceptions of health, pursuing health, respecting the whole person, and feeling safe to access care. CONCLUSION: Pressure for body size vigilance has, in effect, excluded the women in this study from the very locations of health that they are ‘encouraged’ to attend – including socialising and exercising in public, screening opportunities that require bodily exposure, and accessing first point of care health services. KEYWORDS: General practice; obesity; primary health care; social stigma; women

The working model of doctors should be changed immediately

2011 ◽  
Vol 26 (S2) ◽  
pp. 1725-1725
Author(s):  
X. Han-You
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
General Practice ◽  
Family Medicine ◽  
Health Care Services ◽  
Standards Of Care ◽  
Working Model ◽  
Care Services ◽  
The World

PurposeThe paper is to improve the quality of life and health of the peoples of the world by fostering and maintaining high standards of care in general practice/family medicine and other clinicians.MethodBy comparing the general practitioners/family physicians with the other clinicians of specialities, summarizing the shortcomings of present health care services of clinicians of specialities, the proposals for promoting health care services and the working model of doctors around the world were suggested.ResultsThe article initiates that the values of general practice/family medicine should be fostered into other clinicians when all the clinicians take care of the patients in any conditions, critical or ordinary, by adopting to the values of general practice/family medicine. While the clinicians also take into account of their own specialities. The author outlines how the working model of doctors will be changed.ConclusionsIn applying these proposals, a healthy world and high quality of life of the peoples of the world will come soon after the working model of doctors is changed into right. So the quality of life and health of the peoples of the world can be promoted and enhanced.

scholarly journals Stroke follow-up in primary care: a discourse study on the discharge summary as a tool for knowledge transfer and collaboration

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rune Aakvik Pedersen ◽  
Halfdan Petursson ◽  
Irene Hetlevik ◽  
Henriette Thune
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Discourse Analysis ◽  
Knowledge Transfer ◽  
Health Care Services ◽  
Discharge Summary ◽  
Care Services ◽  
Discharge Summaries

Abstract Background The acute treatment for stroke takes place in hospitals and in Norway follow-up of stroke survivors residing in the communities largely takes place in general practice. In order to provide continuous post stroke care, these two levels of care must collaborate, and information and knowledge must be transferred between them. The discharge summary, a written report from the hospital, is central to this communication. Norwegian national guidelines for treatment of stroke, issued in 2010, therefore give recommendations on the content of the discharge summaries. One ambition is to achieve collaboration and knowledge transfer, contributing to integration of the health care services. However, studies suggest that adherence to guidelines in general practice is weak, that collaboration within the health care services does not work the way the authorities intend, and that health care services are fragmented. This study aims to assess to what degree the discharge summaries adhere to the guideline recommendations on content and to what degree they are used as tools for knowledge transfer and collaboration between secondary and primary care. Methods The study was an analysis of 54 discharge summaries for home-dwelling stroke patients. The patients had been discharged from two Norwegian local hospitals in 2011 and 2012 and followed up in primary care. We examined whether content was according to guidelines’ recommendations and performed a descriptive and interpretative discourse analysis, using tools adapted from an established integrated approach to discourse analysis.  Results We found a varying degree of adherence to the different advice for the contents of the discharge summaries. One tendency was clear: topics relevant here and now, i.e. at the hospital, were included, while topics most relevant for the later follow-up in primary care were to a larger degree omitted. In most discharge summaries, we did not find anything indicating that the doctors at the hospital made themselves available for collaboration with primary care after dischargeof the patient. Conclusions The discharge summaries did not fulfill their potential to serve as tools for collaboration, knowledge transfer, and guideline implementation. Instead, they may contribute to sustain the gap between hospital medicine and general practice.

scholarly journals The impact of the COVID-19 pandemic on the delivery of primary health care services

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
Samya Ahmad Al-Abdulla ◽  
Robin O’Dwyer
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Call Center ◽  
Health Care Services ◽  
Health Centers ◽  
Face To Face ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
Alternative Means

Background: In response to the COVID-19 global pandemic the Primary Health Care Corporation (PHCC) in Qatar recognized the need to limit face-to-face consultations within health centers in order to prevent unnecessary spread of the virus by offering an alternative solution for patients to access primary health care. PHCC responded by establishing teleconsultation services (telephone and video) within health centers and establishing a community call center offering teleconsultations for family medicine, ophthalmology, and dentistry services, with a nursing tele-triage service operating 24 hours a day, 7 days a week. Methods: All previously booked appointments within health centers were converted to outbound telephone consultations. The community call center was widely advertised and received incoming patient inquiries. This led to an analysis of the teleconsultation service utilization on a daily, weekly, and monthly basis. Results: The 27 health centers successfully provided 703,845 teleconsultations (via video and telephone calls) between 1st April and 31st October 2020 compared to 964,285 in-person consultations. A significant percentage of patients continue to opt for a telephone consultation rather than a face-to-face visit. Between 29th March and 28th November 2020, the community call center received a total of 159,137 calls with 61% of calls managed and resolved by a nurse, without the need for a consultation by a physician. Conclusion: The rapid response by PHCC to find alternative means to offer primary health care services during a pandemic was activated early and the public responded positively. Teleconsultation services within Qatar have been widely accepted by patients who have more choices to access primary care services. Since April 2020, when teleconsultations were fully implemented in PHCC, to October 2020, 42% of all consultations have been via teleconsultation . Teleconsultation services both within health centers and the community call center, offer an alternative means of care delivery, empowering patients.

scholarly journals An Investigation of Somali Women’s Beliefs, Practices, and Attitudes about Health, Health Promoting Behaviours and Cancer Prevention

2014 ◽  
Vol 6 (1) ◽  
pp. 1-12 ◽  
Author(s):  
S. A. Francis ◽  
F. M. Griffith ◽  
K. A. Leser
Keyword(s):  
Health Care ◽  
Cancer Prevention ◽  
Health Care Services ◽  
Oral Traditions ◽  
Culturally Appropriate ◽  
Face To Face ◽  
Care Services ◽  
Health Promoting ◽  
Open Coding ◽  
Somali Women

This pilot study examined Somali women's perception of health/access to care, examined their knowledge and attitudes about cancer prevention, and discussed strategies to improve service provision and education. Using a multidisciplinary approach, twelve face-to-face interviews were conducted with Somali women ages 18 and older, residing in a mid-western city. Open coding was used to categorize and reflect the interview statements and to identify reoccurring themes. Somali women are concerned about a variety of health issues and cited the role of culture and religion in developing prevention strategies.   Participants emphasized the use of religious leaders, health care advocates, oral traditions, and translators in providing culturally appropriate health care services. Religion and culture play a prominent role in the Somali community and impact beliefs about health and wellness.  Health practitioners need to work closely with individuals and community leaders to tailor services that are culturally appropriate and accessible.       

scholarly journals Patient Knowledge and Understanding of Home Health Services Criteria

2019 ◽  
pp. 14-19
Author(s):  
Philip Collins ◽  
Stuti Jha ◽  
Alison Mancuso ◽  
John Bertagnolli ◽  
Sondra De Antonio ◽  
...  
Keyword(s):  
Health Care ◽  
Home Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Home Visits ◽  
Home Health ◽  
Patient Knowledge ◽  
Eligibility Criteria ◽  
Care Services ◽  
Definition Of

Context: This study was conducted to gain a better understanding of patients’ understanding of homebound criteria and house call eligibility. Objective: To date, little empirical data exists assessing patient knowledge of home health care services. This study is designed to examine patients’ understanding of home health care services, eligibility criteria, costs, and interest in house calls. Methods: This study used an anonymous survey developed by the researchers and provided to patients in four separate office locations at a large academic Family Medicine practice. Questions about homebound criteria, eligibility, out of pocket cost, and patient interest were asked. Results: In total 393 surveys were collected. Approximately 47 percent of all respondents in the survey showed interest in having a home care visit by a healthcare professional, while only 59.6 percent were able to accurately identify the definition of homebound status. Approximately 60 percent of all respondents believe that they will have to pay more out of pocket for home visits, and the subgroup of respondents who have an interest in home visits showed that 63.4 percent of that group think that they will have to pay more out of pocket for such visits. Conclusion: These data have the potential to inform medical providers of a lack of understanding among patients regarding homebound criteria and home health care in general. While further studies could examine more specific details of this potential knowledge gap, the information provided by this study could prompt providers to begin educating patients on the possibility of home care.

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