Category: Organisation and delivery of care

The importance of an inclusive study design – the HepCAPP Study

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Dr Kirsty Roberts

 

 

by Dr Kirsty Roberts, Senior Lecturer in Trials Methodology and Deputy Research Director EDI, Bristol Medical School, University of Bristol

Background

HepCAPP (Hepatitis C Case-finding in Primary Care Pilot) was a pilot oral swab Hepatitis C Virus (HCV) screening study which was funded by NHS England in 2019 and completed in 2023. The study invited over 98,000 people aged 40-64 registered at selected GP practices to take part. 12,216 (12.4%) consented and returned their sample to the UK Health Security Agency (UKHSA) for testing.

The study participants found the approach to testing acceptable and the uptake was better than expected. However, the study also confirmed that those identified could have been found through lower-cost targeted screening. Therefore, we recommended that oral swab HCV screening shouldn’t be rolled out in the NHS.

Were there any groups of people or communities under-represented?

The study found … Read more

Integrating palliative and end-of-life care: working toward equity

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Lucy Selman

 

 

 

By Dr Alice Malpass, Senior Research Fellow, and Lucy Selman, Professor of Palliative and End of Life Care, Centre for Academic Primary Care, University of Bristol

“Death comes equally to us all, and makes us all equal when it comes.” – John Donne

While death is inevitable for everyone, the experience of dying and receiving support through bereavement varies greatly in the UK. Sadly, older people, ethnic minorities, and those living in poverty often face significant barriers to accessing end-of-life care and bereavement support. These challenges include a lack of awareness of available services, discomfort asking for help, discrimination, and a shortage of services tailored to the needs of diverse communities. People living with disadvantage are also more likely to face isolation and receive poorer-quality care during serious illness and bereavement. These disparities were even more pronounced during the COVID-19 pandemic.

Can integration improve … Read more

Navigating perimenopause and menopause as a trans person: challenges, insights, and support

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By Dr Yvette Pyne, GP and NIHR In-Practice Research Fellow, Centre for Academic Primary Care, University of Bristol

Coinciding with the 15th World Menopause Day on 18 October 2024, I am planning my travel to Birmingham for a screening of a film which describes the experiences of LGBTQ+ people going through menopause. As a clinician and an LGBTQ+ menopausal person myself, I was fortunate to be involved in this amazing project and to meet people passionate about providing better information and visibility around this topic. I’m a GP working both in menopause and trans healthcare (with the Welsh Gender Service), and I’m keen to hear and raise the voices of menopausal trans people who are currently not represented by the general discourse about this life stage.

Menopause and perimenopause: some facts

Menopause, which will happen to anyone who was born with ovaries, can occur … Read more

Why doing research with domestic abuse perpetrators is challenging

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Author avatar

 

 

by Dr Helen Cramer, Senior Research Fellow, Centre for Academic Primary Care, University of Bristol

The importance of providing support for victims and survivors of domestic abuse has long been established and a considerable body of research shows what effective support should look like. How to engage with perpetrators of domestic abuse is less well understood. There are a range of interventions of different lengths and purposes such as shorter ones to assess risk, and containment and disruption approaches for the highest risk perpetrators to try to manage that risk.

For lower risk perpetrators, longer (e.g. six month) group programmes aiming to reduce abusive behaviour and offering support to the partners and ex-partners alongside are recommended by Respect, a UK membership organisation that sets standards and accredits perpetrator programmes. However, the evidence for these group programmes is uncertain and there are extensive methodological challenges to … Read more

What do we know about how GPs are used in emergency medical services?

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By Dr Alex Burrell, NIHR Academic Clinical Fellow in General Practice, Centre for Academic Primary Care, University of Bristol

CAPC researchers, Dr Alex Burrell, Dr Grace Scrimgeour and Dr Matthew Booker have conducted a systematic review and narrative synthesis to assess the evidence on how GPs are used in emergency medical services.

Emergency medical services in the UK are under significant pressure. A considerable proportion of their workload relates to problems that could be dealt with by a GP. Using GPs in emergency medical services, such as the ambulance service, might reduce the number of people being taken to Accident and Emergency (A&E) and may more appropriately meet these patients’ needs. This could also free up ambulances and paramedics to respond to life-threatening emergency calls.

Different roles

GPs have been used in emergency medical services in a number of countries. In some countries, … Read more

Arts and Sciences – researching the history of antibiotics in primary care

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Dr Barbara Caddick
Dr Barbara Caddick

 

 

This article was originally published by the Elizabeth Blackwell Institute for Health Research. Reproduced here with kind permission.

 

The prevalence of antibiotic use in modern society is well established. Antibiotics have revolutionised medicine and how society sees – and deals with – disease. Along with concerns regarding the rise of antibiotic resistant bacteria, thought to be exacerbated by their over-use in many areas, there is a need to understand the history of their adoption and use, especially in primary care. Comprehending the many-tendrilled circumstances and behaviours that led to this point might help to inform future choices, and give some insight into future best practice.

Dr Barbara Caddick, Senior Research Associate at the Centre for Academic Primary Care (CAPC) at the University of Bristol, is well qualified for such an undertaking, with a PhD in History and extensive experience in research in … Read more

Contraception: what women (over 40) want

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Dr Jo Burgin

 

 

 

by Dr Jo Burgin, Centre for Academic Primary Care, University of Bristol

Over a third of all pregnancies in women over 40 result in therapeutic abortion. This is one of the highest rates of abortion compared to live births in any age group. This suggests an unmet need for contraception. I interviewed women over 40 about their views and experience with contraception to find out more.

“I couldn’t do another child”

Previous studies have attributed the relatively low use of reliable contraception in women over 40 to women’s perceptions of themselves as low risk of pregnancy. However, participants in this study felt pregnancy was a real possibility and that an unplanned pregnancy would have a significant negative impact on their lives. Some had completed their families or had other caring responsibilities. While others knew they did not want any children and did not want to … Read more

Improving consultations for patients and GPs: The Consultation Open and Close Study

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Dr Mairead Murphy

 

 

 

by Dr Mairead Murphy, Honorary Research Fellow, Centre for Academic Primary Care, University of Bristol and Evaluation Lead, South West Academic Health Science Network

“I think everyone’s been in the situation where they go to a doctor to talk about something that they find hard to talk about or they might find it difficult to voice their concerns.”

“I just couldn’t get a word in edgewise, sometimes you find you’ve just arrived and the GP is writing the prescription you know?”

These are some of the things patients said to us when we interviewed them for the Consultation Open and Close (COAC) study. Patients felt that, in the 10-minute consultation, particularly when it was by telephone, the GP did not always have time to get to the root of their problems.

This is not new or surprising. The 10-minute GP consultation is the shortest in Europe… Read more

How do we provide high quality palliative care in the community?

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By Dr Tanuka Palit, NIHR Academic Clinical Fellow in Primary Care, Centre for Academic Primary Care, University of Bristol

“You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die.” Dame Cicely Saunders

Many people express a wish to die at home. The proportion of deaths that occurred in the community (including private homes and care homes) rose significantly during the pandemic and has been sustained. As a consequence, the need to fund and improve our community palliative care services has never been more important. Earlier this year, this was recognised by a change in the Health and Social Care Bill to fund palliative care services in all areas. This will hopefully remove the postcode lottery that currently exists in the UK for … Read more

Lessons from lockdown: NHS general practice changes and public perceptions

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by Dr Lorna Duncan, Centre for Academic Primary Care, University of Bristol

 

How did England’s National Health Service (NHS) change at the start of the COVID-19 pandemic?

Dr Lorna Duncan and Kelly Cheng wrote two companion pieces for F1000Research, exploring how the NHS modified general practice (GP) consultations to minimize the spread of COVID-19 and what the public thought about those changes. F1000Research spoke to Dr. Duncan about what they discovered and the potential implications for primary care. You can read the full blog on their website.… Read more