Are online GP consultations the solution to increasing patient access to health care, while reducing GP workloads?

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by Dr Jeremy Horwood and Professor Chris Salisbury, Centre for Academic Primary Care and NIHR CLAHRC West

NHS England’s long-term plan released on 7 January sets out a commitment that over the next five years every patient will get the right to telephone or online GP consultation as part of its ‘digital first primary care offer‘.

Online consultations are seen as a solution to improve patient access to primary care, increase convenience (saving time waiting and travelling) and reduce face-to-face appointments, freeing up GP time. But our research has found that unless these systems are carefully implemented, the benefits policy makers are hoping for in relation to reductions in GP workload and increases in available appointments for patients might not be realised.

The Centre for Academic Primary Care-led Alt-Con study examined how a variety of technological alternatives to face-to-face GP consultations were being used in … Read more

What’s normal in children’s respiratory infections? Bristol parents helped us find out

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by Dr Emma Anderson
Senior Research Associate
Centre for Academic Primary Care

As any parent knows, children get coughs, colds and ear infections all the time. Symptoms of these respiratory infections – including runny nose, cough and sore throat – can seem never-ending.

In the EEPRIS Study, led by Professor Alastair Hay from the University of Bristol’s Centre for Academic Primary Care, we recruited parents across Bristol to tell us about their children’s respiratory symptoms as they became ill. Gathering information in the community means we are able to find out more about common respiratory illnesses than when we study those who have decided to consult their GP. It also gives us a more accurate picture of how likely parents are to consult for these common illnesses, something which has been surprisingly unclear.

Two of our main findings were that:

  • it takes up to three weeks for most
… Read more

Is it possible to detect future risk of psychosis from a patient’s primary care consultation history?

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By Dr Sarah Sullivan
Research Fellow
Centre for Academic Primary Care

Psychosis is a serious and long-term mental illness. Unfortunately, for many sufferers the outcomes are poor. Many may relapse again after recovery, suffer long-term residual symptoms and have poor social functioning.

Primary care is an important part of the care pathway for patients with psychosis, so GPs need to be able to accurately identify those at high risk. The task is difficult because high-risk symptoms are frequently not specific to psychosis.

We also know that the greater the delay between someone’s first psychotic symptom and receiving specialist mental health treatment is associated with poorer outcomes. GPs play an important role in this, because most people are referred to mental health services by their GP.

In a study recently published in JAMA Network Open, we set out to find out if people had previously consulted their GP … Read more

Can a programme of supervised exercise improve the quality of life of men with advanced prostate cancer?

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Dr Eileen Sutton

 

by By Dr Eileen Sutton
Senior Research Associate, Qualitative Lead on the STAMINA Study
Centre for Academic Primary Care

STAMINA is a five-year study funded by the NIHR’s Programme Grants for Applied Research scheme and is led by researchers from Sheffield Hallam University, with collaborators from Sheffield Teaching Hospitals, University of Leeds, University of Sheffield, Queen Mary University London, University of Bristol, University of York, Cardiff University, University of Edinburgh and Queen’s University, Belfast in partnership with Nuffield Health.

Why are we doing the research?

Prostate cancer is the most common cancer in men in the UK, with around 47,000 cases diagnosed each year. Androgen deprivation therapy (ADT) is a standard treatment for men with advanced prostate cancer but it is associated with significant side-effects which include fatigue, depression, sexual dysfunction, impairment of memory and concentration, increased fat mass and loss of muscle strength. ADT also increases the risk … Read more

Domestic violence and abuse: ‘If we all work together, it will make a difference’

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Guest blog by Medina Johnson (left), Chief Executive
and Lucy Downes (right), National Implementation Manager
IRIS Interventions

 

 

As we gear up for events and conversations to mark the 16 Days of Activism against Gender-based Violence, it’s timely to reflect on the importance of the healthcare response to gender-based violence. IRISi’s vision is a world in which gender-based violence is consistently recognised and addressed as a health issue.

Violence against women is a global health problem of epidemic proportions. Dr Margaret Chan, World Health Organization Director-General

The IRIS programme is our flagship intervention working with primary care to change and improve clinical practice and to provide patients affected by domestic abuse with access to specialist advice and support. It provides training and support to GPs, practice nurses and other primary care clinicians to help them identify and refer women with experience of domestic violence and abuse (DVA) to … Read more

Why it’s important to pre-test patient-reported questionnaires

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Insights from testing MYMOP and PEI

Dr Mairead Murphy

 

by Dr Mairead Murphy
Senior Research Associate
Centre for Academic Primary Care

In research studies, we use patient-reported questionnaires a lot to test if healthcare interventions work or not. Given that the correct completion of these questionnaires underpins our research conclusions, it’s important to know how patients interpret them.

We decided to look more closely at how people interpreted questionnaires. We asked people who had recently visited their GP to complete two commonly-used questionnaires in primary care and tell us their thought processes as they did this. The questionnaires we chose were:

  1. The patient enablement instrument (PEI): This questionnaire has six questions, all related to how “enabled” a patient feels following a GP consultation. It asks patient to rate their improvements in coping, understanding, self-help and other aspects of “enablement”.
  2. Measure Yourself Medical Outcomes Profile (MYMOP): This questionnaire measures symptoms, daily activities
… Read more

Medicines have revolutionised treatment in the NHS – can this progress be sustained?

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Dr Rupert Payne

 

by Dr Rupert Payne
Consultant Senior Lecturer in Primary Health Care
Centre for Academic Primary Care

The seventieth anniversary of the NHS has made me reflect on how proud I am to have contributed to its work for over the past twenty-odd years. Founded on 5 July 1948, the service continues to this day to operate to the same three core principles – meeting the needs of everyone, free at the point of delivery, and based on clinical need.

Aside from providing comprehensive, high-quality healthcare services to virtually the entire UK population, the other thing that the NHS is known for is the constant political bickering that carries on in the background, with criticisms about chronic under-funding and stealth privatisation. However, these are not new issues, with medicines an important reason for the challenges the NHS now faces.

In a response to concerns about rising costs, perhaps the first … Read more

Can we eliminate human papilloma virus?

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by Dr Sam Merriel
GP and Honorary Lecturer
Centre for Academic Primary Care

and

 

Dr Joanna Kesten
Senior Research Associate
NIHR Health Protection Research Unit in Evaluation of Interventions

Researchers from the Centre for Academic Primary Care and Population Health Sciences, Bristol Medical School, with colleagues from Queens University Belfast, Ulster University, and Southampton University, have published an editorial in the British Journal of General Practice (BJGP) in response to Public Health England’s (PHE) recommendation to roll out a targeted Human papillomavirus (HPV) vaccination programme for men who have sex with men (MSM) through genitourinary medicine (GUM) and HIV clinics across England. 

The editorial argues that although this announcement is a positive step, it would be more effective to follow more recent recommendations to introduce gender neutral HPV vaccination to achieve total elimination of HPV, rather than a reduction. The PHE proposal means MSM who do … Read more

Penicillin was discovered 90 years ago – and despite resistance, the future looks good for antibiotics

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by Professor Alastair Hay
Professor of Primary Care
Centre for Academic Primary Care

When the NHS turned 70 this year, I was reminded of another anniversary which has had an enormous impact on healthcare over many years. Penicillin is 90 this year.

Discovered in September 1928 by Alexander Fleming, it was first used as a cure when George Paine treated eye infections with it in 1930. A method for mass production was devised by Howard Florey and Ernst Chain in 1940, and it was first mass produced in 1942, with half of that total supply used for one patient being treated for streptococcal septicaemia.

In 1944, 2.3m doses were produced in time for the Normandy landings of World War II. And it was then that the miracle of penicillin became clear. Soldiers who had previously died from septicaemia were surviving.

Expectations rose. If penicillin could cure septicaemia, what … Read more