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
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
By Louis Davenport, Medical Student, Bristol Medical School, University of Bristol
My name is Louis Davenport, and I am a second-year medical student at the University of Bristol. I am the organiser of ‘Our First Year Heard’, a student art collection showcasing the effects of COVID-19 on first-year medical students.
The seed of the idea came from an extremely intense, one might say uncomfortable, experience that I had in the dissection room in my first year at medical school. While I am not particularly artistic myself, I made use of poetry to help process the experience and wrote several drafts of what would become What’s in front of you. From there I thought, why not collect the experiences of first-year medical students who might similarly wish to share them with other medical students and the wider public? Capturing the unique experiences of people who … Read more
by Professor Alastair Hay, Centre for Academic Primary Care, University of Bristol
This article was first published in the British Journal of General Practice.
As a teacher and researcher, I have learned that, unless my aim is clear, I will confuse myself, my students, my clinical colleagues, and my co-investigators. And yet, as a GP I often wonder, ‘Can I summarise my objective?’
The June edition of the UK’s British Journal of General Practice included articles describing an existential crisis in primary care (asking ‘What is the essence of general practice?’), a novel study describing some of the most complex work undertaken by GPs (largely invisible to most people most of the time), and other articles asking how we should deliver care post-COVID. However, the common thread for me was: ‘What is our aim?’
And why is it important to be able to explain our … Read more
by Dr Ryann Sowden, Research Assistant, Population Health Sciences, Bristol Medical School and Dr Lucy Selman Senior Research Fellow, Centre for Academic Primary Care, University of Bristol
In a paper published recently in PLOS One, we explore the coverage of COVID-19 in British newspapers with a focus on key media narratives about the virus.
COVID-19 and media narratives
COVID-19 has caused over 120,000 deaths in the UK, leaving over a million people bereaved. Although death is often described as a societal taboo in British culture, it remains ever-present in the public realm of news and media which COVID-19 has dominated for the past 12 months.
In the spring of 2020, as the COVID-19 pandemic began to claim a large number of lives in the UK, newspapers reported on the threat, damage and bereavement caused by the virus, as well as providing a … Read more
by Sophie Park, Professor of Primary Care and Medical Education, Research Department of Primary Care and Population Health, University College London, Yathavan Premadasan, BSc Medical Student, University College London and Chris Salisbury, Professor of Primary Health Care, Centre for Academic Primary Care, University of Bristol
The COVID-19 pandemic has changed primary care dramatically, with most consultations conducted remotely by telephone, video or online messaging. But is this a short-term adjustment or the future norm? In general practice, clinical care has been based on long term face-to-face contact, establishing trusting relationships through continuity of care, and using knowledge of patients’ personal circumstances and social context to provide holistic support. Now, these fundamental principles are challenged.
Matt Hancock (UK Health Secretary) has welcomed rapid changes towards digitalised clinical practice as an overdue development, stating that wherever possible, all future consultations should be conducted remotely. But is the … Read more
by Kelly Cheng, Medical Student, University of Bristol
“Cancelled due to COVID-19” – a rare opportunity to practise lifesaving pre-hospital emergency medicine skills in the French Alps was abruptly transformed into another cancellation email, as with many other glorious plans for 2020. Before I knew it, hospital placements had also been suspended until further notice. Instead, I found myself back home, huddled before my laptop, about to embark on a 6-week long student choice project working with highly-experienced academics for the first time – over Zoom, of course.
In this post, I share my experience as a third year medical student undertaking a research project alongside Dr Lorna Duncan from the Centre of Academic Primary Care (CAPC), and explore the methods we used to successfully gather primary data from all regions of England amid a national lockdown. Ironically, the chance to carry out a project focused on … Read more
by Dr Alex Burrell, Foundation Year 2 doctor, North Bristol NHS Trust and Dr Lucy Selman, Senior Research Fellow, Centre for Academic Primary Care, University of Bristol
Restrictions on funeral attendance have been put in place to try to prevent the spread of COVID-19. We conducted a rapid systematic review to try to understand what impact these restrictions might have on the bereaved. We found that the impact of funeral practices was not clear-cut: observational studies assessed different outcomes and their results varied. However, there were important lessons from qualitative research. What seems to be most important is helping people create a meaningful personal ritual which provides a sense of social support however they mourn, whether together in person or virtually.
COVID-19 has caused hundreds of thousands of deaths around the world, with over 45,000 confirmed deaths in the UK as of 23 July … Read more
by Dr Lucy Pocock, GP Career Progression Fellow, Centre for Academic Primary Care, University of Bristol
Before COVID-19, there were around 10,000 deaths in care homes in England and Wales every month. Then, between March 27 and April 24 2020, the number more than doubled to 23,113.
The Office for National Statistics (ONS) later reported 17,422 deaths of care home residents from COVID-19 between the end of March and June 5, accounting for 47% of the total number of deaths caused by the virus.
So it is unsurprising that the pandemic has led to much greater interest in what happens inside care homes. As well as the significant increase in the number of residents dying, concerns have been raised about a lack of access to testing and personal protective equipment (PPE), the discharge of coronavirus-positive patients from hospital to care homes, rationalisation of the health … Read more
by Chris Salisbury, Mairead Murphy and Polly Duncan, Centre for Academic Primary Care, University of Bristol
Because of the COVID-19 pandemic, general practices have rapidly shifted to offering consultations remotely by telephone, video or online messaging rather than face-to-face. Many general practices are considering whether they should continue these new ways of working into the future and some commentators are arguing that general practice will be changed forever. Remote consultations could be more convenient for patients and reduce workload pressures on general practices.
Just before the COVID-19 pandemic we wrote a paper which modelled how an increasing use of online, video and telephone consultations would affect GPs’ workload. Our conclusion was that a reduction in workload should not be assumed, and remote consulting could instead lead to an increase in GP workload over time. It all depends on how remote consultations are used.
The paper … Read more