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 Dr Jessica Watson, NIHR Clinical Lecturer in General Practice, Centre for Academic Primary Care, University of Bristol
Have you ever found yourself looking at blood test results and wondered why the test was done in the first place?
Why Test? – It seems like a simple question. Yet despite increasing access to research databases such as Clinical Practice Research Datalink (CPRD), which contain millions of test results, there is no easy way to find out why these tests are being performed in the first place. How many are for monitoring, screening or diagnosis? Which symptoms trigger testing? To explore this, we are launching the Why Test study using the Primary Care Academic CollaboraTive (PACT).
Currently, only a tiny proportion of primary care clinicians have a formal academic contract with a University. PACT aims to open up opportunities for non-academic primary care clinicians to get … Read more
by Dr Cindy Mann, Research Fellow, Centre for Academic Primary Care, University of Bristol
Cindy Mann, a former nurse and now Research Fellow at the Centre for Academic Primary Care, University of Bristol, shares the twists and turns in her career, and encourages nurse colleagues to consider research as a future path and not be put off by setbacks.
A long and varied career
I have had a long career, starting in 1975, when I did my nurse training at Leeds General Infirmary. In 1977 I got married and after completing training followed my husband to Oxford where I took a job as a staff nurse at John Radcliffe Hospital in Oxford. I then decided to do a Philosophy degree in Oxford, and really enjoyed the peace and quiet of working in a library, in contrast to ongoing shifts for the nurse bank. In the following years, up … Read more
by Alastair Hay, Professor of Primary Care, Centre for Academic Primary Care, University of Bristol
This article was first published in the BMJ.
The tests have potential but more evidence is needed.
Given the global concerns(1) about antibiotic resistance, antimicrobial stewardship is essential to preserve the future effectiveness(2) of antibiotics. Healthcare practitioners must balance public and patient health, ensuring that only patients who need antibiotics receive them, and that they receive an antibiotic to which their infection is susceptible, at the optimum time, dose, and duration. Whether to prescribe an antibiotic is a key issue for clinicians treating respiratory infections in the community.
Point-of-care tests provide results in time to inform treatment. For respiratory infections, the tests can identify the presence of a microbe(3-5) or measure markers of a host’s response to a microbe, such as C reactive protein or procalcitonin, in finger prick quantities … 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 Rupert Payne, Consultant Senior Lecturer in Primary Health Care, Centre for Academic Primary Care, University of Bristol
Dr Rupert Payne reflects on the highlights of the two-day Society for Academic Primary Care (SAPC) Annual Scientific Meeting, which was held virtually this year from 30 June to 1 July. This blog was first published on the SAPC website.
Another year, another conference! The last time I attended a SAPC conference was the regional South-West one that we hosted in Bristol – about a week before the first lockdown kicked in, and normality abruptly ended. Indeed, I suspect it was actually the last big face-to-face meeting many of us attended. This time, Leeds beckoned. But rather than jumping on the train to the “grim north”, I descended the stairs to my rather grimmer basement (yes, my wife has kicked me out the dining room), for … Read more
by Charlotte Archer, Senior Research Associate in Primary Care Mental Health, and Katrina Turner, Professor of Primary Care Research, Centre for Academic Primary Care, University of Bristol
Research has shown that fewer people in primary care are now being diagnosed with anxiety than in the past, despite reports that rates of anxiety have increased in the general population. Individuals with anxiety may be reluctant to seek help for their symptoms. They may also find it difficult to talk to their GP about their mental health or may normalise their symptoms.
Although most anxiety is managed in primary care by GPs, we know very little about whether GPs and patients think it is important to diagnose and manage anxiety disorders. Knowing this might help us identify possible reasons for the decline in their recording, and the potential impact of this on patient care and … Read more
As a research centre, we are proud to host a fantastic team specialising in sexual and domestic violence and abuse and their impacts on health. What better way to mark this year’s International Women’s Day than to focus on the work of an outstanding member of the team, Dr Alison Gregory, whose recent investigations have focused on the role of friends, family, neighbours and colleagues (informal supporters) in the lives of domestic abuse survivors.
In this Q&A, Alison reflects on the challenges of working on a sensitive topic with a vulnerable population group, made all the more critical during this time of pandemic and the ‘shadow’ pandemic, which has seen rates of domestic abuse soar globally.
Your research activities have focused on Covid-19 recently. Could you tell us a little more?
I’ve been researching the role of friends, family members, neighbours, and colleagues (informal supporters) in the lives of … Read more
by Dr Eszter Szilassy, Research Fellow, Centre for Academic Primary Care, University of Bristol
Primary care plays a key role in responding to patients experiencing or perpetrating domestic violence and abuse regardless of their gender, age, sexuality, or experience. There is, however, uncertainty about the value and effectiveness of integrated training and support programmes addressing the needs of all patients affected by domestic abuse.
IRIS (Identification and Referral to Improve Safety) is a broadly commissioned, evidence-based primary care training and support programme designed to reach female survivors of domestic violence and abuse through general practice. The IRIS+ (Enhanced Identification and Referral to Improve Safety) study tested the feasibility of an adaptation of IRIS for all patients affected by domestic abuse, including men and children.
Reaching everyone in general practice?
Challenges to applying the IRIS domestic violence model to other patient groups have been highlighted by the … Read more
by Peter Tammes, Mairead Murphy and Chris Salisbury, Centre for Academic Primary Care, University of Bristol
Decreasing trend of continuity of care
Seeing the same GP over time is highly valued by most patients and GPs in the UK. This is known as ‘continuity of care’ and it is linked with lower healthcare costs, more satisfied patients, fewer emergency hospital admissions and even with reduced mortality.
Given these multiple benefits, one would expect it to be highly prioritised. However, our recently published study in the British Journal of General Practice shows that continuity of care declined steadily between 2012 and 2017. On average, the percentage of patients who reported to have a preferred GP declined by nine percentage points and the percentage who can usually see their preferred GP declined by 10 percentage points.
Is decreasing continuity of care a concern?
Decreasing continuity is … Read more