Why GPs should teach

by Simon ThorntonSimon Thornton
GP Engagement Lead
Centre for Academic Primary Care

Encourage more GP practices to teach medical students‘.

Sounds simple doesn’t it? That was the brief for me starting as GP Engagement Lead in September 2016. Teaching is something I’m passionate about and is one of the highlights of my week in practice. It’s always a good day at work when I’ve had students with me and I love to share my enthusiasm for teaching with other GPs.

However, encouraging GPs to take on new work, as exciting and rewarding as it is, is difficult at a time of unprecedented workload and pressure in general practice. Enter ‘Step up and Teach’ – a campaign we’re running to highlight the benefits to practices of teaching medical students. The question we want practices to ask themselves is ‘can we afford not to teach?’.

Reasons to teach

We already know that … Read more

‘Researchers: To make an impact, write less and talk more!’

by Lesley Wye
Knowledge Mobilisation Fellow & Senior Research Fellow
Centre for Academic Primary Care

I have been a researcher for over two decades. In that time, lamentations about the limited influence of research evidence have grown. But I think we researchers are largely to blame. We steadfastly insist on disseminating our knowledge in ways that we know don’t work.

Researchers usually write scientific papers, because publication is a key career performance metric. But scientific papers are read and digested by other scientists, not those who can act on our findings. Our ethnographic study showed how and why research doesn’t reach policymakers, like healthcare commissioners.

We found that local healthcare commissioners cannot retrieve papers from many scientific journals, as they often do not have passwords or subscriptions. Although open access publication helps, commissioners usually use Google, where scientific papers often do not appear – even if open access. If a … Read more

World Health Day 2017 – ‘Depression: let’s talk’

By Dr David Kessler
Reader in Primary Care
Centre for Academic Mental Health &
Centre for Academic Primary Care

 

 

 

 

 

 

There has been a transformation in social and scientific attitudes to depression in my working lifetime. It is no longer acceptable to stigmatise mental illness or psychological distress. The idea that the common mental disorders of depression and anxiety are an inescapable part of being human has been replaced by a belief that these disabling extremes of sadness and worry are treatable conditions.

Changes in the treatment of depression have been part of wider cultural changes. There is an increased openness about sadness and distress, and a widespread belief, beginning with Freud, that at the very least ‘neurotic misery can be transformed into ordinary unhappiness’. The invention of psychotherapy has spawned numerous schools and sub-disciplines, but all hold to the common belief that with help, … Read more

Why gender can’t be ignored when dealing with domestic violence

by Gene Feder and Lucy Potter
Centre for Academic Primary Care

First published in The Conversation

Domestic violence is a violation of human rights with damaging social, economic and health consequences. It is any incident of controlling, coercive, threatening behaviour, violence or abuse. That abuse can be psychological, emotional, physical, sexual and financial.

The “domestic” element refers to abuse between people aged 16 or over who are, or have been, intimate partners or family members, regardless of gender or sexuality. Men, women or transgender people in straight, gay or lesbian relationships can perpetrate or experience it. So does this mean domestic violence is gender neutral? Is gender irrelevant to prevention efforts and to responding to survivors’ needs? We do not think so.

Globally, direct experience of being subjected to domestic violence is greater among women then among men. In the UK, 27% of women and 13% of men … Read more

The doctor will Skype you now: the value of telehealth in managing long-term conditions

by Dr Padraig Dixon
Senior Research Associate in Health Economics
Centre for Academic Primary Care

People are increasingly living with long-term health conditions. Management of these conditions is expensive, and their increased prevalence challenges health system sustainability and current service models. Can alternative models of care meet the needs of patients with long-term conditions at an acceptable cost?

One growing area of healthcare that could serve as a replacement or adjunct to traditional care models is telehealth, which is the remote provision of healthcare by a variety of communication tools. Telehealth advocates argue that the wider use of technology and a greater reliance on self-management in supporting patients with long-term conditions may produce the same or better health outcomes, but at a lower cost, than traditional care modalities. Is this optimism justified, and might telehealth be good value for the NHS?

Recent work, funded by the National Institute for Health Read more

What is the ‘3D approach’ for managing multiple long-term conditions?

by Dr Mei-See Man
Trial Manager
Centre for Academic Primary Care

The 3D study, led by researchers from the Centre for Academic Primary Care (CAPC), is examining a new approach for GP practices to manage patients with multiple long-term health problems.

Meeting a need

Existing treatment is based on guidelines for each separate condition meaning that patients often attend multiple appointments for each disease which can be repetitive, inconvenient and inefficient. They see different nurses and doctors who may give conflicting advice. These patients frequently get depressed and they also sometimes complain that no-one treats them as a ‘whole person’ or takes their views into account.

The 3D approach was developed by patients and GPs together to address these issues. Based around patient-centred care, the approach focuses on three ‘D’s: Depression, Drugs and the patient’s Dimensions of health, such as their quality of life, priorities and … Read more

How do we support GPs providing end of life care?

by Dr Lucy SelmanDr Lucy Selman
Research Fellow (Qualitative Research in Randomised Trials)
Centre for Academic Primary Care

GPs are vital to the delivery of end of life care. They coordinate care, provide generalist palliative care, help prevent unnecessary hospital admissions, and, in England, commission local health and social care services. Crucially, they help shift care from hospitals to the community, which is where most people would prefer to die.

But providing good care at the end of life is not always straightforward. There’s evidence that GPs can find it challenging, and that the quality of end of life care by GPs can be problematic. The Royal College of General Practitioners and the House of Commons Health Committee therefore recognise the urgent need for evidence-based education in end of life care for GPs. However, the evidence base for GP training in end of life care is unclear, and no rigorous evaluations … Read more

Are some patients more equal than others? Looking back at the Cancer Drugs Fund

Padraig Dixonby Dr Padraig Dixon
Senior Research Associate
Centre for Academic Primary Care

Imagine being given £400m of taxpayers’ money to spend on drugs for the benefit of NHS cancer patients. How would you decide which therapies to fund? Would you decide that all cancer patients should benefit equally, or would you decide to spend more on particular types of cancer, or on particular types of patient?

These issues were confronted by the Cancer Drugs Fund (CDF), the 2014/15 expenditures of which were £416m (against a budget of £280m). The CDF was created to make available to patients in England cancer drugs not recommended by the National Institute of Health and Care Excellence (NICE) on the basis of cost-effectiveness, not yet appraised by NICE or which were being used outside market authorisations.

The effects of the CDF on population health are controversial: one estimate is that the CDF has caused five times … Read more