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.

scholarly journals A cross-sectional survey of general practitioners’ experiences with, views of, and attitudes towards, practice-based pharmacists

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i24-i25
Author(s):  
A H Ibrahim ◽  
H Barry ◽  
C M Hughes
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Northern Ireland ◽  
General Practitioners ◽  
Response Rate ◽  
Clinical Skills ◽  
Community Pharmacists ◽  
Care Practice ◽  
Full Time ◽  
General Practices

Abstract Introduction Five-year pilot schemes were announced in both England and Northern Ireland (NI) to integrate practice-based pharmacists (PBPs) into general practices. The NI scheme anticipates that there will be 300 whole time equivalent PBPs in post by the end of the pilot (2020/2021).[1] There is little existing UK literature on PBPs’ role evolution and few studies have explored general practitioners’ (GPs) experiences of pharmacist integration into primary care practice. Aim To investigate GPs’ experiences with PBPs, their views about the PBP role and its impact upon patients and GPs, and their attitudes towards collaboration with PBPs. Methods A paper-based self-administered questionnaire was mailed to all general practices (n=329) across Northern Ireland (NI) on two occasions during September and October 2019, and was completed by one GP in every practice who had most contact with the PBP. The questionnaire was developed following a comprehensive literature review and comprised four sections (Table 1). Descriptive analyses were conducted using SPSS v26 and responses to open-ended questions were analysed thematically. Results The response rate was 61.7% (203/329). Respondents had a median age of 52.0 years and there was at least one PBP per general practice. All GPs had face-to-face meetings with PBPs, with three-quarters (78.7%, n=159) meeting with the PBP more than once a week. GPs reported that two-thirds of PBPs (62.4%, n=126) were qualified as independent prescribers, with 76.2% of prescribers (n=96) currently prescribing for patients. The most common PBP activities were medication reconciliation and medication reviews. The majority of GPs reported that PBPs always/very often had the required clinical skills (83.6%, n=162) and knowledge (87.0%, n=167) to provide safe and effective care for patients. However, only 31.1% (n=61) stated that PBPs sometimes had the confidence to make clinical decisions. The majority of GPs (>85%) displayed largely positive attitudes towards collaboration with PBPs. Most respondents agreed/strongly agreed that PBPs will have a positive impact on patient outcomes (95.0%, n=192) and can provide a better link between general practices and community pharmacists (96.1%, n=194). However, 24.8% of GPs (n=50) were unclear if the PBP role moved community pharmacists to the periphery of the primary care team. Thematic analysis of the open comments indicated that GPs were in favour of more PBP sessions and full-time posts. Conclusion This study has revealed that the majority of GPs had positive views and attitudes about the PBP role, its impact in primary care and collaboration with PBPs. The findings may have implications for future developments in order to extend integration of PBPs within general practice, including the enhancement of training in clinical skills and decision-making. Our target sample included all general practices within NI and the response rate enhanced generalisability at the practice level. However, the study sample was limited to NI, and some findings may not be relevant to other parts of the UK. Further work is required to explore PBPs’, community pharmacists’ and patients’ views of this role in general practice to corroborate study findings. References 1. Strategic Leadership Group for Pharmacy. Practice-based pharmacists' statement. 2016. (Online) Available at: https://www.health-ni.gov.uk/sites/default/files/publications/health/practice-based-pharmacists.pdf (accessed 06 Oct 2020). 2. Van C, Costa D, Mitchell B, Abbott P, Krass I. Development and validation of a measure and a model of general practitioner attitudes toward collaboration with pharmacists. Res Soc Adm Pharm. 2013; 9(6): 688–699.

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.

Training clinicians online to be e-therapists: the ‘Anxiety Online’ model

2010 ◽  
pp. 459-468 ◽  
Author(s):  
David Austin ◽  
Britt Klein ◽  
Kerrie Shandley ◽  
Lisa Ciechomski
Keyword(s):  
Training Program ◽  
Clinical Assessment ◽  
Treatment Service ◽  
Clinician Training ◽  
Low Intensity ◽  
Assessment And Treatment ◽  
Virtual Clinic

Chapter 49 considers Anxiety Online - a 'virtual' online clinical assessment and treatment service, and describes an online clinician training program for online low intensity practitioners (‘etherapists’) to work ‘in’ the Anxiety Online virtual clinic, and the challenges and solutions involved.

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.

International work and leadership in UK general practice

2014 ◽  
Vol 27 (2) ◽  
pp. 87-103 ◽  
Author(s):  
Peter Young ◽  
Chris Smith ◽  
Luisa Pettigrew ◽  
Ha-Neul Seo ◽  
David Blane
Keyword(s):  
General Practice ◽  
Clinical Skills ◽  
High Income ◽  
Service Improvement ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Content Type ◽  
International Work ◽  
Low Middle Income Countries ◽  
The Uk

Purpose – The purpose of this paper is to present an exploration of the leadership competencies developed by UK GPs through having undertaken international work and the ability to transfer these competencies back to the UK. Design/methodology/approach – The approach taken is a cross-sectional survey. Findings – A total of 439 UK-based, ranging from GP specialty trainees to retired GPs who had worked overseas, responded to an online survey of UK general practice and international work. Doctors were asked to report competency development through international work using the domains of the Medical Leadership Competency Framework (MLCF). The most common competencies developed, to a “moderate or significant” degree, related to “personal qualities” (89 per cent) and “working in teams” (87 per cent). To a lesser extent Doctors developed competencies in “setting direction” (60 per cent), “managing services” (59 per cent), and “service improvement” (56 per cent), and found these competencies harder to transfer back to the UK. A common reason for limited transfer of competency was the lack of leadership opportunities for Doctors when returning to UK locum roles. Overseas posts were more common in low/middle income countries, and these Doctors reported a greater range of leadership roles, including in health policy, management and teaching, compared to high-income countries. Most doctors felt that they were able to develop their clinical skills overseas whilst relatively few Doctors performed research, especially in high-income countries. Originality/value – To the authors' knowledge this is the first cross-sectional survey exploring the international work of UK GPs and leadership development using the MLCF domains.

scholarly journals GP and parent dissonance about the assessment and treatment of childhood eczema in primary care: a qualitative study

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019633 ◽  
Author(s):  
Kingsley Powell ◽  
Emma Le Roux ◽  
Jonathan Banks ◽  
Matthew J Ridd
Keyword(s):  
Primary Care ◽  
Topical Therapy ◽  
Complementary Therapy ◽  
Treatment Decisions ◽  
Snowball Sampling ◽  
Qualitative Interview Study ◽  
Assessment And Treatment ◽  
Incurable Condition ◽  
Poor Outcomes ◽  
The Uk

ObjectivesTo compare parents’ and clinicians’ perspectives on the assessment and treatment of children with eczema in primary care.DesignQualitative interview study with purposive and snowball sampling and thematic analysis.Setting14 general practices in the UK.Participants11 parents of children with eczema and 15 general practitioners (GPs) took part in semistructured individual interviews.ResultsWe identified several areas of dissonance between parents and GPs. First, parents sought a ‘cause’ of eczema, such as an underlying allergy, whereas GPs looked to manage the symptoms of an incurable condition. Second, parents often judged eczema severity in terms of psychosocial impact, while GPs tended to focus on the appearance of the child’s skin. Third, parents sought ‘more natural’ over-the-counter treatments or complementary medicine, which GPs felt unable to endorse because of their unknown effectiveness and potential harm. Fourth, GPs linked poor outcomes to unrealistic expectations of treatment and low adherence to topical therapy, whereas parents reported persisting with treatment and despondency with its ineffectiveness. Consultations were commonly described by parents as being dominated by the GP, with a lack of involvement in treatment decisions. GPs’ management of divergent views varied, but avoidance strategies were often employed.ConclusionsDivergent views between parents and clinicians regarding the cause and treatment of childhood eczema can probably only be bridged by clinicians actively seeking out opinions and sharing rationale for their approach to treatment. Together with assessing the psychosocial as well as the physical impact of eczema, asking about current or intended use of complementary therapy and involving parents in treatment decisions, the management of eczema and patient outcomes could be improved.

If GPs who teach medical students were assisted to be good role models might this influence the medical career the students choose?

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711281
Author(s):  
Jonathan White
Keyword(s):  
General Practice ◽  
Medical Students ◽  
Student Teaching ◽  
Role Models ◽  
Role Model ◽  
Clinical Skills ◽  
Workforce Planning ◽  
Medical Schools ◽  
Positive Role ◽  
The Uk

BackgroundMost patients are cared for in the community by GPs, and workforce planning for the UK NHS suggests that 50% of medical school graduates need to train as GPs. While there is pressure on medical schools to provide more student teaching in general practice, general practice must be prepared for this increase in workload and teachers should have appropriate training.AimThis study examined the influence that teachers as role models can have on the development and career choices of medical students and whether GPs who teach medical students might benefit from assistance in developing positive attributes.MethodA literature search was carried out. Relevant papers were those that examined the influence of a doctor as teacher role model for medical students, both in assisting in professional development and clinical skills, and in influencing career choice.ResultsThe review identified eleven papers. There was evidence of association between a student having an influential role model as teacher and choosing specialty training in that area, although evidence of a causative connection is less convincing. A recurring theme is the recommendation that teachers should be aware of the influence they can have as role models, both positive and negative.ConclusionAs medical student teaching moves into general practice GPs who teach will need to be helped to understand and develop positive role model attributes, to promote general practice as an attractive career to the students. Further research needs to identify the extent of assistance required and whether medical schools are prepared for this extra responsibility.

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