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

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

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

Creating a data archive of GP consultations – the motivations and challenges

One in a million logoBy Dr Rebecca Barnes
Senior Research Fellow
Centre for Academic Primary Care

Nearly 14 years ago in summer school at University of California Santa Barbara, Professor Don Zimmerman provided my introduction to the analysis of institutional, in particular medical, interaction.

Those studies set the benchmark for my own research ambitions but the main obstacle I faced was getting access to data.

For all the right reasons, medical consultations data are challenging to collect. Where ethical approval is in place for reuse it is often restricted to the original research team. Sometimes retrospective approvals for reuse of existing data are possible but even then, consultations data that has been collected without reuse in mind is often of variable quality; the process of data collection and participant characteristics are not well-documented, recordings can be incomplete and they are often audio-only.

The idea for the Primary Care Consultations Archive was born with this … Read more

Why GPs need training about domestic violence and children

Eszter Szilassy2by Eszter Szilassy
Senior Research Associate
Centre for Academic Primary Care

While violence against men continues to fall in the UK, women affected by violence and domestic abuse are bearing the brunt of a hidden rise in violent crime. This rise coincides with the austerity-led cutting of domestic violence services.

Domestic violence and abuse (DVA) damages physical and mental health resulting in increased use of health services by survivors of abuse. The prevalence of DVA among women attending general practice is higher than in the wider population. Women experiencing DVA are more likely to be in contact with GPs than with any other professionals. Reduced investment in specialist domestic violence services further increases the demand for direct general practice responses to DVA. Although victims tend not to disclose spontaneously to their GP, they have an expectation, often unfulfilled, that doctors can be trusted with disclosure, and can offer them … Read more

Who do GPs go to when they need help?

johanna-spiersBy Johanna Spiers
Research associate
Centre for Academic Primary Care

GPs often say they make the worst patients, but who do they turn to when they need help? That’s what I aim to find out on a new research project about GPs with mental health issues.

My new job is firmly at the centre of the zeitgeist. GPs are all over the news on a daily basis. Doctors are judged by journalists and picked apart by politicians for running unsafe surgeries, for closing their doors to new patients, and for long waiting lists. If you read (and believe) certain sectors of the UK press, you might be forgiven for thinking that GPs have a lot to answer for.

The reality is, of course, way more complex than the Daily Fail might have us believe. Yes, GPs are retiring early. Yes, many practices are unable to add new names … Read more

Why are so many children given antibiotics for a cough?

Christie CabralBy Dr Christie Cabral
Research Associate
Centre for Academic Primary Care

When I first started researching infectious cough in children, lots of clinicians told me they couldn’t understand why so many parents brought in children who were well enough to turn the consulting room upside down before they even started the examination. As a parent of two young children myself, I had some idea, but as a qualitative researcher, I was keen to get a balanced view.

In the TARGET Programme* we wanted to answer two questions. Given that most coughs will get better on their own:

1) Why do so many parents consult when their child has a cough?
2) Why do so many clinicians prescribe antibiotics for children with coughs?

We conducted five qualitative studies and began to notice common themes, not just across the studies but also shared by parents and clinicians. We found normative beliefs Read more