984 results
Search Results
2. Assessing validity in written tests of general practice--exploration by factor analysis of candidate response patterns to Paper 1 of the MRCGP examination.
- Author
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Munro, Neil, Rughani, Amar, Foulkes, John, Wilson, Andrew, and Neighbour, Roger
- Subjects
EXAMINATIONS ,GENERAL practitioners - Abstract
ObjectiveTo investigate the content validity of Paper 1 of the MRCGP examination. MethodExploratory factor analysis was carried out on candidate responses to Paper 1 of the May and October MRCGP examination in 1998. Contribution of each test question across factors was assessed using a pattern matrix of the oblique rotation. Common dimensions and variations between factor sets were identified. Key testing areas were then matched against the ‘domains of competence’ intended to be assessed by Paper 1 (as defined within the examination blueprint matrix). ResultsWhilst critical appraisal, disease prevention/evidence-based medicine and clinical management emerged as areas tested consistently, content variation was observed between factor sets extracted from both sittings. In addition, some overlap, in terms of domains tested, was seen among other assessment instruments used within the examination. ConclusionPaper 1 conforms to the majority of its stated intentions. However, further development of techniques for investigating validity will be required in order to minimize content variation between both sittings of the examination as well as to help more closely define areas of competence to be tested by Paper 1 of the MRCGP examination. [ABSTRACT FROM AUTHOR]
- Published
- 2000
- Full Text
- View/download PDF
3. Evaluation of a postgraduate examination for primary care: perceptions and performance of general practitioner trainers in the multiple choice paper of the Membership Examination of the Royal College of General Practitioners.
- Author
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Dixon, Hilton, Blow, Carol, Irish, Bill, Milne, Paul, and Siriwardena, Niroshan
- Subjects
- *
GENERAL practitioners , *FAMILY medicine education , *PRIMARY care , *EXAMINATIONS , *UNIVERSITIES & colleges - Abstract
This study aimed to investigate the performance of a sample of general practitioner (GP) trainers in the multiple choice paper (MCP) of the Membership Examination of the Royal College of General Practitioners (MRCGP) and to obtain their views of the content of the paper and its relevance to general practice using a written knowledge test and self-administered questionnaire. The participants were volunteer GP trainers in the Northern, Wessex, Kent, Surrey and Sussex (KSS) and Northwest deaneries of the UK. The trainers completed a shortened version of an MRCGP MCP paper under examination conditions and provided feedback immediately afterwards. Of 191 trainers invited to participate, 86 (45%) sat the paper and of these, 81 completed the questionnaire. Most trainers believed that the paper assessed knowledge of common or important topics relevant to general practice, that the majority of questions were appropriate, clear and unambiguous and that time pressure was not a problem. Trainers performed significantly better compared to registrars overall, and in questions on medicine related to general practice and practice administration but not research methodology or critical appraisal. They did so without making prior preparation. The findings from this group of trainers lend support to the face validity and content validity of the MRCGP MCP examination as an assessment of applied knowledge of general practice. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
4. Main Plenary Sessions: Summaries of Papers.
- Subjects
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DERMATOLOGY , *FAMILY medicine , *GENERAL practitioners , *MEDICAL care - Abstract
The article presents the summaries of papers on dermatology presented at the main plenary sessions. The National Health Service (NHS) Plan 2000 proposed the development of specialist general practitioners (GPs) to take referrals from other GPs in specialties including dermatology. The NHS Modernization Agency Action on Dermatology program funded pilot site studies of dermatology GPwSI, services and preliminary results were encouraging. By the end of 2005, all referrals from primary care will be performed electronically using a referral template. Currently only a proportion of referrals are electronic, allowing comparison with established paper referrals.
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- 2005
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5. Consensus paper: Resources for teaching critical appraisal.
- Author
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Coughlin, Sean and Molyneux, David
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EVIDENCE-based medicine , *MEDICAL practice , *GENERAL practitioners - Abstract
The article offers information on the significance of critical appraisal in ensuring the reliability and efficiency of using research evidence in evidence-based medicine in Great Britain. It mentions that the Royal College of General Practitioners (RCGP) introduced its Critical Reading Question paper in 1990. It notes that the evidence-based medicine asks a clinical question, locate the evidence, appraise the evidence, and interpret the evidence in the context of everyday medicine practice.
- Published
- 2010
- Full Text
- View/download PDF
6. Review your reading: How to prepare for the CRQ paper.
- Author
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Milne, Paul
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GENERAL practitioners ,EXAMINATIONS - Abstract
Discusses suggestions in preparing for the Critical Reading Question paper for general practitioners in Great Britain. Selecting reading material; Maximizing the use of the material.
- Published
- 1996
7. Responses by general practitioners in Avon to proposals for general practice in the white paper Working for Patients.
- Author
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Whitfield, Michael, Wood, Neil, and Wright, Fiona
- Subjects
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GENERAL practitioners , *MEDICAL care - Abstract
Examines the reaction of general practitioners towards the proposals contained in the white paper 'Working for Patients' in Great Britain. Rejection of the proposals by general practitioners; Criticisms on the implementation of fixed budgets for specified surgical operations; Concerns on the cost effectiveness of the National Health Service.
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- 1989
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8. White paper's proposals overlook community services.
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PUBLIC health , *GENERAL practitioners , *HOSPITALS - Abstract
Focuses on the criticisms of the Central Committee for Community Medicine and Community Health on the white paper 'Working for Patients' in Great Britain. Prevalence of the concept of short stay services and general practice; Vagueness in the role of private hospitals and community health service; Uncertainty in the impact of the structure on public health doctors.
- Published
- 1989
9. Further plethora of paper from ministers.
- Subjects
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CONTRACTS , *GENERAL practitioners , *CONFERENCES & conventions - Abstract
Features the white paper and the details to the government contract for general practitioners in Great Britain. Reduction of the working hours of junior doctors; Views of rural practitioners of the new contract; Discussion on the anxiety among honorary secretaries of the British Medical Association on the annual gathering.
- Published
- 1989
10. A BEME systematic review of UK undergraduate medical education in the general practice setting: BEME Guide No. 32.
- Author
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Park, Sophie, Khan, Nada F., Hampshire, Mandy, Knox, Richard, Malpass, Alice, Thomas, James, Anagnostelis, Betsy, Newman, Mark, Bower, Peter, Rosenthal, Joe, Murray, Elizabeth, Iliffe, Steve, Heneghan, Carl, Band, Amanda, and Georgieva, Zoya
- Subjects
MEDICAL education ,STUDY & teaching of medicine ,EDUCATIONAL evaluation ,CINAHL database ,ERIC (Information retrieval system) ,FAMILY medicine ,MEDICAL information storage & retrieval systems ,PSYCHOLOGY information storage & retrieval systems ,MEDICAL students ,MEDLINE ,PATIENTS ,GENERAL practitioners ,RESEARCH funding ,CLINICAL competence ,SYSTEMATIC reviews ,EDUCATION - Abstract
Background: General practice is increasingly used as a learning environment in undergraduate medical education in the UK. Aim: The aim of this project was to identify, summarise and synthesise research about undergraduate medical education in general practice in the UK. Methods: We systematically identified studies of undergraduate medical education within a general practice setting in the UK from 1990 onwards. All papers were summarised in a descriptive report and categorised into two in-depth syntheses: a quantitative and a qualitative in-depth review. Results: 169 papers were identified, representing research from 26 UK medical schools. The in-depth review of quantitative papers (n = 7) showed that medical students learned clinical skills as well or better in general practice settings. Students receive more teaching, and clerk and examine more patients in the general practice setting than in hospital. Patient satisfaction and enablement are similar whether a student is present or not in a consultation, however, patients experience lower relational empathy. Two main thematic groups emerged from the qualitative in-depth review (n = 10): the interpersonal interactions within the teaching consultation and the socio-cultural spaces of learning which shape these interactions. The GP has a role as a broker of the interactions between patients and students. General practice is a socio-cultural and developmental learning space for students, who need to negotiate the competing cultures between hospital and general practice. Lastly, patients are transient members of the learning community, and their role requires careful facilitation. Conclusions: General practice is as good, if not better, than hospital delivery of teaching of clinical skills. Our meta-ethnography has produced rich understandings of the complex relationships shaping possibilities for student and patient active participation in learning. [ABSTRACT FROM PUBLISHER]
- Published
- 2015
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11. Government publishes NHS working papers.
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Warden, John
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GENERAL practitioners - Abstract
Focuses on the publication of the working papers of the National Health Service (NHS) in Great Britain. Renegotatiation of the contracts of general practitioners; Implementation of the NHS review; Role of the Department of Health in the distribution of the working papers to general practitioners.
- Published
- 1989
12. Counselling in general practice -- does it work? Discussion paper.
- Author
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Corney, R. H.
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COUNSELING ,FAMILY medicine ,HELPING behavior ,GENERAL practitioners ,COUNSELORS - Abstract
The article discusses the effectiveness of counseling of clients in general practice in Great Britain. There are some major problems associated with the effort to assess effectiveness and improvement. It is also difficult to conduct a cost effective analyses. The number of counsellors recruited into general practice is growing.
- Published
- 1990
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13. A pay for performance scheme in primary care: Meta-synthesis of qualitative studies on the provider experiences of the quality and outcomes framework in the UK.
- Author
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Khan, Nagina, Rudoler, David, McDiarmid, Mary, and Peckham, Stephen
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ATTITUDE (Psychology) ,CINAHL database ,CONTINUUM of care ,LABOR incentives ,MEDICAL information storage & retrieval systems ,MEDICAL personnel ,MEDLINE ,PAY for performance ,ORGANIZATIONAL change ,GENERAL practitioners ,PRIMARY health care ,SYSTEMATIC reviews ,ORGANIZATIONAL structure ,PROFESSIONALISM ,PSYCHOSOCIAL factors ,META-synthesis - Abstract
Background: The Quality and Outcomes Framework (QOF) is an incentive scheme for general practice, which was introduced across the UK in 2004. The Quality and Outcomes Framework is one of the biggest pay for performance (P4P) scheme in the world, worth £691 million in 2016/17. We now know that P4P is good at driving some kinds of improvement but not others. In some areas, it also generated moral controversy, which in turn created conflicts of interest for providers. We aimed to undertake a meta-synthesis of 18 qualitative studies of the QOF to identify themes on the impact of the QOF on individual practitioners and other staff. Methods: We searched 5 electronic databases, Medline, Embase, Healthstar, CINAHL and Web of Science, for qualitative studies of the QOF from the providers' perspective in primary care, published in UK between 2004 and 2018. Data was analysed using the Schwartz Value Theory as a theoretical framework to analyse the published papers through the conceptual lens of Professionalism. A line of argument synthesis was undertaken to express the synthesis. Results: We included 18 qualitative studies that where on the providers' perspective. Four themes were identified; 1) Loss of autonomy, control and ownership; 2) Incentivised conformity; 3) Continuity of care, holism and the caring role of practitioners' in primary care; and 4) Structural and organisational changes. Our synthesis found, the Values that were enhanced by the QOF were power, achievement, conformity, security, and tradition. The findings indicated that P4P schemes should aim to support Values such as benevolence, self-direction, stimulation, hedonism and universalism, which professionals ranked highly and have shown to have positive implications for Professionalism and efficiency of health systems. Conclusions: Understanding how practitioners experience the complexities of P4P is crucial to designing and delivering schemes to enhance and not compromise the values of professionals. Future P4P schemes should aim to permit professionals with competing high priority values to be part of P4P or other quality improvement initiatives and for them to take on an 'influencer role' rather than being 'responsive agents'. Through understanding the underlying Values and not just explicit concerns of professionals, may ensure higher levels of acceptance and enduring success for P4P schemes. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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14. Will the white paper slay the dragon?
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MEDICAL appointments , *GENERAL practitioners - Abstract
Relates the experience of the author on medical appointment with general practitioner in Great Britain. Failure of the receptionist to allocate medical schedules; Improvement of patient choice in the National Health Service reform; Provision of medical prescription.
- Published
- 1990
15. GPs resort to pen and paper as IT systems are shut down.
- Author
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Torjesen, Ingrid
- Subjects
COMPUTER viruses ,DOCUMENTATION ,GENERAL practitioners ,WRITING ,DATA security ,DATA security failures - Published
- 2017
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16. Managing drug addiction in general practice--the reality behind the guidelines: discussion paper.
- Author
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Martin, Edwin
- Subjects
TREATMENT of drug addiction ,FAMILY medicine ,DRUG abusers ,SUBSTANCE use of teenagers ,GENERAL practitioners - Abstract
The article focuses on the management of drug addiction in general practice in Great Britain. A report published by the British government titled "Guidelines of Good Clinical Practice in the Treatment of Drug Misuse" has shown that drug abusers came from a heterogeneous group which ranges from adolescents to people who have been dependent for many years. It is claimed that most general practitioners who manage drug misuse have no ready access to the support of a drug dependency unit.
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- 1987
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17. Benefits of appraisal as perceived by general practitioners.
- Author
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Mugweni, Kudzai, Kibble, Sharon, and Conlon, Maurice
- Subjects
FAMILY medicine ,QUALITY assurance ,CONTINUING medical education ,CERTIFICATION - Abstract
The article presents a study which explores the perceptions by general practitioners (GPs) of the benefits of appraisal. The study has undertaken brief review of literature to highlight past studies on the benefits of appraisals as perceived by GPs. Results show that appraisal will help promote reflection by GPs in a consistent way and provide assurance of their fitness to practice.
- Published
- 2011
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18. GPs condemn NHS review and reject new contract.
- Author
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MacPherson, Gordon
- Subjects
GENERAL practitioners ,PAPER ,PHYSICIANS' attitudes - Abstract
Focuses on the rejection of the general practitioners of the government's National Health Service (NHS) in Great Britain. Rejection of the government's proposal for general practitioners; Views regarding the white paper of the NHS; Compatibility of the concepts of the white paper with the principles of the NHS.
- Published
- 1989
19. Consultations to seek opinions on NHS white paper shake-up.
- Subjects
HEALTH care rationing ,NATIONAL health services ,GENERAL practitioners ,PRIMARY health care ,MANAGEMENT - Abstract
The article reports on the consultation being launched by the government in the nursing sector over a plan to dismantle primary care trusts and to commission the 80-billion pound health services to consortia of general practitioners (GP) in Great Britain.
- Published
- 2010
- Full Text
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20. Solidarity or dissonance? A systematic review of pharmacist and GP views on community pharmacy services in the UK.
- Author
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Hindi, Ali M. K., Jacobs, Sally, and Schafheutle, Ellen I.
- Subjects
CINAHL database ,CONFIDENCE ,HOSPITAL pharmacies ,INCOME ,MEDICAL information storage & retrieval systems ,PSYCHOLOGY information storage & retrieval systems ,INTERPROFESSIONAL relations ,MANAGEMENT ,MEDLINE ,ONLINE information services ,PHARMACISTS ,GENERAL practitioners ,PRIMARY health care ,EMPLOYEES' workload ,SYSTEMATIC reviews ,JOB performance ,OCCUPATIONAL roles ,PSYCHOSOCIAL factors ,ACCESS to information ,COMMUNITY services ,PHYSICIANS' attitudes - Abstract
There has been a strong policy emphasis over the past decade on optimising patient‐centred care and reducing general practitioners' (GPs') workload by extending community pharmacy services and collaboration between pharmacists and GPs. Our aim was to review current evidence of pharmacists' and GPs' views of extended community pharmacy services and pharmacists' roles in the United Kingdom (UK). A systematic review was undertaken looking at UK studies investigating pharmacists' and/or GPs' views of community pharmacy services or roles from 2005 to 2017. A range of databases were searched including EMBASE, PubMed, Scopus, Web of Science, International Pharmaceutical Abstracts (IPA), PsycINFO, Science Direct and The Cumulative Index to Nursing and Allied Health Literature (CINAHL). In addition, reference lists of included studies were screened and grey literature was searched. Following the application of inclusion/exclusion criteria, the quality of papers was critically analysed, findings were extracted into a grid and subjected to narrative synthesis following thematic analysis. The search strategy yielded a total of 4,066 unique papers from which 60 were included. Forty‐seven papers covered pharmacists' views, nine combined both pharmacists' and GPs' views and four covered GPs' views. Study designs included interviews (n = 31, 52%), questionnaire surveys (n = 17, 28%) and focus groups (n = 7, 12%). Three main themes emerged from the data: "attitudes towards services/roles", "community pharmacy organisations" and "external influences". Pharmacists and GPs perceived a number of barriers to successful implementation and integration of pharmacy services. Moreover, collaboration between pharmacists and GPs remains poor despite the introduction of extended services. Overall, extending community pharmacy services require quality‐driven incentives and joint working between community pharmacists and GPs to achieve better integration within the patient's primary care pathway. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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21. Changes in public satisfaction with GP services in Britain between 1998 and 2019: a repeated cross-sectional analysis of attitudinal data.
- Author
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Aljohani M, Donnelly M, and O'Neill C
- Subjects
- Aged, Cross-Sectional Studies, Delivery of Health Care, Humans, United Kingdom epidemiology, General Practitioners, Personal Satisfaction
- Abstract
Background: Between 1998 and 2019, the structure and process of general practitioner services in Britain underwent a series of reforms and experienced distinct funding environments. This paper examines changes in satisfaction with GP services over time against this backdrop., Methods: Data were extracted from the British Social Attitudes Survey for the period 1998-2019. Logistic regression analyses investigated changes in overall satisfaction and among specific population sub-groups differentiated by socio-demographic characteristics whilst taking account of time trend and interaction effects between sub-group membership and time trend., Results: Sustained and significant changes in satisfaction coincided closely with changes to the funding environment. Distinct patterns were evident among sub-groups. Satisfaction appeared to fall more sharply during austerity for low income groups, older people and people who had fewer formal qualifications/years in education., Conclusion: While a series of policy initiatives were adopted over the period examined, public satisfaction seemed to move in a manner consistent with levels of government expenditure rather than exhibiting distinct breaks that coincided with policy initiatives. As services recover from the pandemic it will be necessary to invest in a significant and sustained way to rebuild public satisfaction., (© 2022. The Author(s).)
- Published
- 2022
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22. Research for commissioners: filling a black hole in the NHS White Paper.
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Graffy, Jonathan
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MEDICAL research ,GENERAL practitioners ,MEDICAL care - Abstract
The author comments on the White Paper from the National Health Services (NHS) of Great Britain, titled "Equity and Excellence: Liberating the NHS," which proposes changes in the way decisions about health services are made. The author points out the lack of clarity on how the NHS Commissioning Board will promote involvement in research and the use of research evidence. The author discusses how research is funded and facilitated, topics for research, and the involvement of general practitioners (GPs).
- Published
- 2011
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23. What do GPs feel about sickness certification? A systematic search and narrative review.
- Author
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Wynne-Jones, Gwenllian, Mallen, Christian D., Main, Chris J., and Dunn, Kate M.
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GENERAL practitioners ,FAMILY medicine ,PRIMARY care ,CERTIFICATION ,PHYSICIAN-patient relations ,PROFESSIONAL ethics - Abstract
Objective. To identify GPs' attitudes towards sickness certification. Design. Systematic search and narrative review identifying themes around attitudes towards sickness certification. Results. Eighteen papers were identified for inclusion in the review; these included qualitative, quantitative, and systematic reviews. The papers were predominantly from Scandinavia and the UK. Three themes were identified from the literature: conflict, role responsibility, and barriers to good practice. Conflict was predominantly centred on conflict between GP and patients regarding the need for a certificate, but there was also conflict between all stakeholders. Role responsibility focused on the multiple roles GPs had to fulfil, and barriers to good practice were identified both within and outside the healthcare system. Conclusion. Any potential for changing the certification system needs to focus on reducing the potential for conflict, clarification of the roles of all stakeholders, and improving access to specialist occupational health and rehabilitation services. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
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24. Getting to Grips with Evidence-Based Practice: the Ten Commandments.
- Author
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Bannigan, Katrina and Birleson, Angela
- Subjects
PHYSICIAN practice patterns ,MEDICAL personnel ,OCCUPATIONAL therapist & patient ,MEDICAL practice ,MEDICAL care ,GENERAL practitioners ,CLINICAL medicine ,PUBLIC health - Abstract
There is an expectation that all occupational therapists will be evidence-based practitioners. This paper reports on an education intervention that has helped therapists working in clinical practice to respond to the challenges posed by evidence-based practice. The intervention was developed for a group of clinicians who had already undertaken an evidence-based practice course. The aim was to enable them to apply evidence-based practice skills to their practice settings. The intervention, which used the problem of evidence-tinged practice as a focus, is described and the ten commandments generated by the clinicians involved are presented for others as a potentially useful tool. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
25. Journal watch.
- Author
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Faux, Dominic
- Subjects
RESEARCH ,PROFESSIONALISM ,GENERAL practitioners ,CONTINUING medical education ,PROFESSIONAL education ,MEDICAL care ,OCCUPATIONAL training - Abstract
The article presents evaluations of research related to the professional development of healthcare providers in Great Britain. The critic says that the article "The Training Service Continuum: Exploring the Training Service Balance of Senior House Officer Activities" was an interesting paper, however, it has flaws. In the article "Cross-Cultural Medicine," the critic states that it contains a number of resources. "Teaching Professionalism Artfully" used different media to teach professionalism.
- Published
- 2006
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26. Barriers and facilitators to GP-patient communication about emotional concerns in UK primary care: a systematic review.
- Author
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Parker, Daisy, Byng, Richard, Dickens, Chris, Kinsey, Debbie, and McCabe, Rose
- Subjects
PRIMARY care ,META-analysis ,GENERAL practitioners ,PATIENT-professional relations ,THEMATIC analysis ,RESEARCH ,RESEARCH methodology ,SYSTEMATIC reviews ,MEDICAL cooperation ,EVALUATION research ,QUALITATIVE research ,PRIMARY health care ,COMPARATIVE studies ,COMMUNICATION ,RESEARCH funding ,EMOTIONS - Abstract
Background: In the UK, general practitioners (GPs) are the most commonly used providers of care for emotional concerns.Objective: To update and synthesize literature on barriers and facilitators to GP-patient communication about emotional concerns in UK primary care.Design: Systematic review and qualitative synthesis.Method: We conducted a systematic search on MEDLINE (OvidSP), PsycInfo and EMBASE, supplemented by citation chasing. Eligible papers focused on how GPs and adult patients in the UK communicated about emotional concerns. Results were synthesized using thematic analysis.Results: Across 30 studies involving 342 GPs and 720 patients, four themes relating to barriers were: (i) emotional concerns are difficult to disclose; (ii) tension between understanding emotional concerns as a medical condition or arising from social stressors; (iii) unspoken assumptions about agency resulting in too little or too much involvement in decisions and (iv) providing limited care driven by little time. Three facilitative themes were: (v) a human connection improves identification of emotional concerns and is therapeutic; (vi) exploring, explaining and negotiating a shared understanding or guiding patients towards new understandings and (vii) upfront information provision and involvement manages expectations about recovery and improves engagement in treatment.Conclusion: The findings suggest that treatment guidelines should acknowledge: the therapeutic value of a positive GP-patient relationship; that diagnosis is a two-way negotiated process rather than an activity strictly in the doctor's domain of expertise; and the value of exploring and shaping new understandings about patients' emotional concerns and their management. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
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27. GPs and Contracts: Bringing General Practice into Primary Care.
- Author
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Glendinning, Caroline
- Subjects
GENERAL practitioners ,PRIMARY care ,COMMUNITY health services ,FAMILY medicine - Abstract
This paper argues that the terms on which GPs entered the NHS, as self-employed contractors, have proved remarkably resistant to the managerial pressures which have come to dominate other sections of the National Health Service. However, this traditional mode of financing and organizing the delivery of a key element of the National Health Service has become increasingly incompatible with wider health policy objectives — the development of an integrated network of good-quality, equitable and well-coordinated primary and community health services which are responsive to local needs. Furthermore, primary health services have themselves come to play a crucially important role in securing other strategic changes in the wider health policy arena, such as securing and sustaining a shift in the traditional balance between hospital and community-based health services and controlling expenditure in a needs-led service. The paper argues that, notwithstanding the change of government, the 1997. NHS (Primary Care) Act and the White Paper "The New NHS" are both integral to the achievement of wider strategic health policy objectives, such as improving the quality and coherence of services, and increasing professional accountability for the financial consequences of clinical decisions. However, the greatest significance of these and other related measures is that they shift the emphasis of health policy from commissioning and purchasing by primary care to commissioning and contracting for primary care. They thereby extend the exposure of GP-based services to managerialist scrutiny and control. [ABSTRACT FROM AUTHOR]
- Published
- 1999
- Full Text
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28. Last-minute preparation for the written MRCGP papers.
- Author
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Clarke, Patrick
- Subjects
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GENERAL practitioners , *PATIENTS , *MEDICAL ethics - Abstract
Focuses on the preparation for the written MRCGP examination of the general practitioners in Great Britain. Knowledge on the basics of the hierarchy of papers; Explanation of differential diagnosis to patients; Medical ethics including beneficence, confidentiality and equity.
- Published
- 2003
29. 'I'm just ringing to get a repeat prescription for my contraceptive pill, doctor': developing authentic simulated telephone consultations for medical students.
- Author
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Beddows J, Abdalla M, Blanchard D, Hammond E, Hay F, Webb M, and Protheroe J
- Subjects
- COVID-19, Contraceptives, Oral therapeutic use, Female, Humans, Self-Injurious Behavior, Students, Medical, United Kingdom, Education, Medical, Undergraduate methods, General Practitioners education, Patient Simulation, Telephone
- Abstract
Within normal surgery hours telephone consultations have been previously shown to make up between 10-20% of patient contacts with General Practitioners (GPs) and to comprise a large proportion of a GP's daily workload. Although obviously very useful, such doctor-patient interactions can be fraught with risk. The General Medical Council (GMC) requires that newly graduated doctors should be adaptable to the challenge of delivering treatment advice and management remotely. Yet, currently, there is limited specific training in telephone consultation skills in both undergraduate and postgraduate curricula.Authentic and properly supervised exposure of medical students to GP telephone consultations can be difficult to achieve in clinical placements. Therefore, we have developed emergency telephone consultations within our primary care Safe and Effective Clinical Outcomes (SECO) clinics which are simulated GP surgeries organised for our final year students. We have expanded the range of patients presenting in these clinics by including trained, simulated patients requesting an urgent telephone consultation with a GP. In doing so we aim to enhance our student's skills and confidence in conducting telephone consultations.This teaching exchange paper aims to describe the ideas behind the construction of simulated patient telephone scripts together with the difficulties and successes encountered in introducing telephone consultations into our GP SECO clinic. We hope these ideas and processes will stimulate and enable others to help students prepare for this challenging area of clinical medicine made increasingly significant by the Covid-19 pandemic.
- Published
- 2021
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30. Quality improvement in general practice: what do GPs and practice managers think? Results from a nationally representative survey of UK GPs and practice managers.
- Author
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Gosling J, Mays N, Erens B, Reid D, and Exley J
- Subjects
- Attitude of Health Personnel, Humans, Quality Improvement, State Medicine, Surveys and Questionnaires, United Kingdom, General Practice, General Practitioners
- Abstract
Background: This paper presents the results of the first UK-wide survey of National Health Service (NHS) general practitioners (GPs) and practice managers (PMs) designed to explore the service improvement activities being undertaken in practices, and the factors that facilitated or obstructed that work. The research was prompted by growing policy and professional interest in the quality of general practice and its improvement. The analysis compares GP and PM involvement in, and experience of, quality improvement activities., Methods: This was a mixed-method study comprising 26 semistructured interviews, a focus group and two surveys. The qualitative data supported the design of the surveys, which were sent to all 46 238 GPs on the Royal College of General Practitioners (RCGP) database and the PM at every practice across the UK (n=9153) in July 2017., Results: Responses from 2377 GPs and 1424 PMs were received and were broadly representative of each group. Ninety-nine per cent reported having planned or undertaken improvement activities in the previous 12 months. The most frequent related to prescribing and access. Key facilitators of improvement included 'good clinical leadership'. The two main barriers were 'too many demands from external stakeholders' and a lack of protected time. Audit and significant event audit were the most common improvement tools used, but respondents were interested in training on other quality improvement tools., Conclusion: GPs and PMs are interested in improving service quality. As such, the new quality improvement domain in the Quality and Outcomes Framework used in the payment of practices is likely to be relatively easily accepted by GPs in England. However, if improving quality is to become routine work for practices, it will be important for the NHS in the four UK countries to work with practices to mitigate some of the barriers that they face, in particular the lack of protected time., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2021
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31. GPs' use of gut feelings when assessing cancer risk: a qualitative study in UK primary care.
- Author
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Smith CF, Kristensen BM, Andersen RS, Hobbs FR, Ziebland S, and Nicholson BD
- Subjects
- Attitude of Health Personnel, Emotions, Humans, Primary Health Care, Qualitative Research, Referral and Consultation, United Kingdom, General Practitioners, Neoplasms diagnosis, Neoplasms therapy
- Abstract
Background: The use of gut feelings to guide clinical decision making in primary care has been frequently described but is not considered a legitimate reason for cancer referral., Aim: To explore the role that gut feeling plays in clinical decision making in primary care., Design and Setting: Qualitative interview study with 19 GPs in Oxfordshire, UK., Method: GPs who had referred patients to a cancer pathway based on a gut feeling as a referral criterion were invited to participate. Interviews were conducted between November 2019 and January 2020, and transcripts were analysed using the one sheet of paper method., Results: Gut feeling was seen as an essential part of decision making that facilitated appropriate and timely care. GPs distanced their gut feelings from descriptions that could be seen as unscientific, describing successful use as reliant on experience and clinical knowledge. This was especially true for patients who fell within a 'grey area' where clinical guidelines did not match the GP's assessment of cancer risk, either because the guidance inadequately represented or did not include the patient's presentation. GPs sought to legitimise their gut feelings by gathering objective clinical evidence, careful examination of referral procedures, and consultation with colleagues., Conclusion: GPs described their gut feelings as important to decision making in primary care and a necessary addition to clinical guidance. The steps taken to legitimise their gut feelings matched that expected in good clinical practice., (© The Authors.)
- Published
- 2021
- Full Text
- View/download PDF
32. Key stakeholder perspectives on primary care for young people with an eating disorder: A qualitative study.
- Author
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Malson, Helen, Tischner, Irmgard, Herzig, Hugh, Kitney, Danielle, Phillips, Catherine, Norweg, Sanni, Moon, Jasmin, Holmes, Su, Wild, Katie, and Oldham‐Cooper, Rosie
- Subjects
FOCUS groups ,CAREGIVERS ,STAKEHOLDER analysis ,INTERVIEWING ,MEDICAL care ,PHYSICIANS' attitudes ,PRIMARY health care ,QUALITATIVE research ,PATIENTS' attitudes ,QUESTIONNAIRES ,SOUND recordings ,THEMATIC analysis ,EATING disorders - Abstract
This paper examines the provision of primary care for young people with an eating disorder within the UK from the perspectives of three key stakeholder groups: young people with an eating disorder, carers of young people with an eating disorder and General Practitioners (GPs). Twenty‐two young people with an eating disorder (aged 16–25) and 10 carers completed qualitative questionnaires or participated in interviews about their experiences of seeking primary care from GPs. Forty‐one GPs participated in either focus groups or interviews about delivering care to young people with eating disorders. Interviews and focus groups were audio‐recorded and transcribed verbatim. All data were then analysed qualitatively using thematic analysis. Our analysis indicates that GPs often felt they lacked the necessary knowledge and/or resources to provide adequate support to young people with an eating disorder who they also often viewed as a "difficult" patient group. Young people and carers expressed mixed but predominantly negative experiences; reporting that GPs often lacked adequate understanding of eating disorder, failed to take participants' concerns seriously, and delayed referring patients to specialist services. Our findings indicate a need for interventions that will improve primary care provision and access to appropriate support for young people with an eating disorder. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
33. Research Paper of the Year Award: Are you sure, doctor?
- Author
-
Rubin, Greg
- Subjects
MEDICAL research ,GENERAL practitioners ,UNCERTAINTY ,SURGERY - Abstract
The author asserts that the recipient of the Royal College of General Practitioners' Paper of the Year award addresses the challenges being encountered by general practitioners (GP) in Great Britain. He says that he understands that general practice is about managing uncertainty. The author claims that most medical studies become the tipping point and open the eyes to the problems in surgery.
- Published
- 2007
34. Micro-costing and a cost-consequence analysis of the ‘Girls Active’ programme: A cluster randomised controlled trial.
- Author
-
Charles, Joanna M., Harrington, Deirdre M., Davies, Melanie J., Edwardson, Charlotte L., Gorely, Trish, Bodicoat, Danielle H., Khunti, Kamlesh, Sherar, Lauren B., Yates, Thomas, and Edwards, Rhiannon Tudor
- Subjects
PHYSICAL activity ,QUALITY of life ,SEDENTARY behavior ,SCHOOL nursing ,GENERAL practitioners ,EARLY death - Abstract
Physical inactivity has been identified as a leading risk factor for premature mortality globally, and adolescents, in particular, have low physical activity levels. Schools have been identified as a setting to tackle physical inactivity. Economic evidence of school-based physical activity programmes is limited, and the costs of these programmes are not always collected in full. This paper describes a micro-costing and cost-consequence analysis of the ‘Girls Active’ secondary school-based programme as part of a cluster randomised controlled trial (RCT). Micro-costing and cost-consequence analyses were conducted using bespoke cost diaries and questionnaires to collect programme delivery information. Outcomes for the cost-consequence analysis included health-related quality of life measured by the Child Health Utility-9D (CHU-9D), primary care General Practitioner (GP) and school-based (school nurse and school counsellor) service use as part of a cluster RCT of the ‘Girls Active’ programme. Overall, 1,752 secondary pupils were recruited and a complete case sample of 997 participants (Intervention n = 570, Control n = 427) was used for the cost-consequence analysis. The micro-costing analysis demonstrated that, depending upon how the programme was delivered, ‘Girls Active’ costs ranged from £1,054 (£2 per pupil, per school year) to £3,489 (£7 per pupil, per school year). The least costly option was to absorb ‘Girls Active’ strictly within curriculum hours. The analysis demonstrated no effect for the programme for the three main outcomes of interest (health-related quality of life, physical activity and service use).Micro-costing analyses demonstrated the costs of delivering the ‘Girls Active’ programme, addressing a gap in the United Kingdom (UK) literature regarding economic evidence from school-based physical activity programmes. This paper provides recommendations for those gathering cost and service use data in school settings to supplement validated and objective measures, furthering economic research in this field. Trial registration: -ISRCTN, . [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
35. Lord Horder and the new White Paper.
- Author
-
Chant, A. D. B.
- Subjects
GENERAL practitioners ,MEDICAL care costs ,PATIENTS - Abstract
The author reflects on the dilemmas of general practitioners (GPs) in taking decisions for patient care in view of a new health care policy of the British National Health Service. The policy emphasizes both effectiveness and cost of patient care. However, it becomes difficult for GPs to decide what is best for patients and what is cost effective for the government. Physician Lord Horder's view on the training of general practitioners has also been considered as a solution to the problem.
- Published
- 1990
- Full Text
- View/download PDF
36. Purchasing Health Care Services: Information Sources and Decisional Criteria.
- Author
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Laing, Angus W. and Cotton, Seonaidh
- Subjects
MEDICAL care ,PURCHASING ,HEALTH maintenance organizations ,MARKETING ,PUBLIC health ,GENERAL practitioners ,MEDICAL care costs ,ORGANIZATIONAL goals ,DECISION making - Abstract
The introduction of a market mechanism into the National Health service in the UK was underpinned by the belief that decentralised purchasing would both improve the quality of health care provision and restrain spiralling costs, through purchasers exercising their ability to choose between alternative providers. Focusing on budget holding General Practitioners, that is those practices responsible for purchasing hospital services for their practice populations, this paper explores the evolving purchasing behaviour of these professional intermediaries. Drawing on empirical evidence gathered as part of a broader study of the purchasing behaviour of GP Fundholders in Scotland, specifically it examines the key information sources and decisional criteria utilised by these professional intermediaries in selecting health care providers for their practice population. Utilising relational models of market behaviour, it addresses both the contextually specific issue of whether the market mechanism within the NHS is achieving the twin objectives of improving health care provision and restraining cost pressures, and the broader conceptual issue of the purchasing behaviour of professional intermediaries within a service sector environment. [ABSTRACT FROM AUTHOR]
- Published
- 1996
- Full Text
- View/download PDF
37. What will the white paper mean for GPs?
- Author
-
Roland, Martin
- Subjects
- *
GENERAL practitioners , *PUBLIC health , *MEDICAL quality control , *MEDICAL care - Abstract
The author argues that the National Health Service (NHS) in Great Britain needs general practitioners (GP) who are focused on patient-centered values. He emphasizes the role of GP in providing high quality care. He claims that the GP leaders needed by the NHS are those who are motivated to improve patient care and those who are committed to care for individual patients. The author also suggests ways in which GP can perform their commissioning responsibility under the British government's practice-based commissioning scheme.
- Published
- 2010
- Full Text
- View/download PDF
38. Doubts on White Paper's pledges.
- Subjects
- *
MEDICAL practice , *FAMILY medicine , *SURGERY , *WORKING hours , *GENERAL practitioners - Abstract
The article reports on doubts expressed by General Practice Committee negotiators regarding the ability of the government to bring in flagship elements of its Our Health, Our Care, Our Say White Paper, in Great Britain. The paper included proposals to extend surgery opening hours and allow patients to register near their workplace instead of home.
- Published
- 2006
39. Adapt or die: White Paper's warning to GPs.
- Author
-
Finch, Rob
- Subjects
- *
HEALTH services administration , *PUBLIC health administration , *HEALTH planning , *GENERAL practitioners , *MEDICAL practice , *PRIVATE companies - Abstract
The article focuses on the competition between general practitioners (GP) and private companies to provide more and better services in Great Britain. Significantly, new health providers and GP practices will have more incentives to serve a wider area and take on hospital work. The "Our Health, Our Care, Our Say" White Paper unilaterally changed the contracts by forcing GP practices to be either opened or closed. Health experts talked about the significance as well as the implications of the implementation of the White Paper.
- Published
- 2006
40. Imagining genomic medicine futures in primary care: General practitioners' views on mainstreaming genomics in the National Health Service.
- Author
-
Mwale, Shadreck and Farsides, Bobbie
- Subjects
INTERVIEWING ,MEDICAL care ,PRIMARY health care ,NATIONAL health services ,QUALITATIVE research ,GENOMICS ,POLICY sciences - Abstract
Genomic medicine has captured the imaginations of policymakers and medical scientists keen to harness its health and economic potentials. In 2012, the UK government launched the 100,000 Genomes Project to sequence the genomes of British National Health Service (NHS) patients, laying the ground for mainstreaming genomic medicine in the NHS and developing the UK's genomics industry. However, the recent research and reports from national bodies monitoring genomic medicine's roll‐out suggest both ethical and practical challenges for health‐care professionals. Against this backdrop, this paper, drawing on qualitative research interviews with general practitioners (GPs) and documentary analysis of policy, explores GPs' views on mainstreaming genomic medicine in the NHS and implications for their practice. Analysing the NHS's genomic medicine agenda as a 'sociotechnical imaginary', we demonstrate that whilst sociotechnical imaginaries are construed as collectively shared understandings of the future, official visions of genomic medicine diverge from those at the forefront of health‐care service delivery. Whilst policy discourse evokes hope and transformation of health care, some GPs see technology in formation, an unattainable 'utopia', with no relevance to their everyday clinical practice. Finding space for genomics requires bridging the gap between 'work as imagined' at the policy level and 'work as done' in health‐care delivery. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
41. GP appraisal: an evaluation of generational differences on the utility of GP appraisal.
- Author
-
Hopayian K and Sherifi J
- Subjects
- Attitude of Health Personnel, Education, Medical, Continuing, Employee Performance Appraisal standards, Humans, State Medicine, Surveys and Questionnaires, Time Factors, United Kingdom, Employee Performance Appraisal methods, General Practitioners psychology, General Practitioners standards
- Abstract
Background: A number of studies have previously been published on the benefits of GP appraisal. Ours is the first study that compares the views of doctors registered before and after the introduction of appraisals on various core elements of the appraisal process., Aim: This study aimed to explore potential differences, between GPs qualifying before and those after the introduction of NHS appraisals, on the utility of the appraisal process. Additionally, to discover the perceived impact of appraisals on interaction with colleagues and patients., Design and Setting: Suffolk appraisers were recruited to distribute a paper questionnaire, in two sections, for each appraisal undertaken over a 12-month period. The first part of the questionnaire related to that specific appraisal. The second part, seven questions using Likert scales and free-text comments, asked about the appraisal process in general. The feedback from the second part forms the data for this study., Results: Overall, doctors tended to agree that appraisals had a beneficial impact in the core areas investigated. However, there was a significant difference between generations: those registered before 1998 were less likely to find NHS appraisals beneficial. Both groups reported that preparation took up too much time. Opinions regarding the impact of appraisals on interaction were evenly divided amongst appraisees, with the older cohort more likely to report negatively., Conclusions: There is a generational difference amongst GP in the perceived utility of NHS appraisal. Current plans to redesign the process to make appraisals less onerous will be welcomed by both groups.
- Published
- 2020
- Full Text
- View/download PDF
42. Advanced Clinical Practitioners in Primary Care in the UK: A Qualitative Study of Workforce Transformation.
- Author
-
Evans C, Pearce R, Greaves S, and Blake H
- Subjects
- Humans, Qualitative Research, United Kingdom, Workforce, General Practitioners, Primary Health Care
- Abstract
Escalating costs and changing population demographics are putting pressure on primary care systems to meet ever more complex healthcare needs. Non-medical 'advanced clinical practitioner' (ACP) roles are increasingly being introduced to support service transformation. This paper reports the findings of a qualitative evaluation of nursing ACP roles across General Practices in one region of the UK. Data collection involved telephone interviews with 26 participants from 3 different stakeholder groups based in 9 practice sites: ACPs ( n = 9), general practitioners ( n = 8) and practice managers ( n = 9). The data was analysed thematically. The study found a high degree of acceptance of the ACP role and affirmation of the important contribution of ACPs to patient care. However, significant variations in ACP education, skills and experience led to a bespoke approach to their deployment, impeding system-wide innovation and creating challenges for recruitment and ongoing professional development. In addition, a context of high workforce pressures and high service demand were causing stress and there was a need for greater mentorship and workplace support. System wide changes to ACP education and support are required to enable ACPs to realise their full potential in primary care in the UK.
- Published
- 2020
- Full Text
- View/download PDF
43. Predicting GP visits: A multinomial logistic regression investigating GP visits amongst a cohort of UK patients living with Myalgic encephalomyelitis.
- Author
-
Walsh RS, Denovan A, Drinkwater K, Reddington S, and Dagnall N
- Subjects
- Attitude of Health Personnel, Attitude to Health, Communication Barriers, Female, Humans, Male, Middle Aged, Patient Preference, United Kingdom, Ambulatory Care statistics & numerical data, Disease Management, Fatigue Syndrome, Chronic epidemiology, Fatigue Syndrome, Chronic psychology, Fatigue Syndrome, Chronic therapy, General Practitioners ethics, General Practitioners psychology, Physician-Patient Relations ethics, Trust psychology
- Abstract
Background: Myalgic Encephalomyelitis (ME) is a chronic condition whose status within medicine is the subject of on-going debate. Some medical professionals regard it as a contentious illness. Others report a lack of confidence with diagnosis and management of the condition. The genesis of this paper was a complaint, made by an ME patient, about their treatment by a general practitioner. In response to the complaint, Healthwatch Trafford ran a patient experience-gathering project., Method: Data was collected from 476 participants (411 women and 65 men), living with ME from across the UK. Multinomial logistic regression investigated the predictive utility of length of time with ME; geographic location (i.e. Manchester vs. rest of UK); trust in GP; whether the patient had received a formal diagnosis; time taken to diagnosis; and gender. The outcome variable was number of GP visits per year., Results: All variables, with the exception of whether the patient had received a formal diagnosis, were significant predictors., Conclusions: Relationships between ME patients and their GPs are discussed and argued to be key to the effective delivery of care to this patient cohort. Identifying potential barriers to doctor patient interactions in the context of ME is crucial.
- Published
- 2020
- Full Text
- View/download PDF
44. Stratified primary care versus non-stratified care for musculoskeletal pain: qualitative findings from the STarT MSK feasibility and pilot cluster randomized controlled trial.
- Author
-
Saunders B, Hill JC, Foster NE, Cooper V, Protheroe J, Chudyk A, Chew-Graham C, and Bartlam B
- Subjects
- Adult, Aged, Clinical Decision-Making, Feasibility Studies, Female, General Practice, Humans, Male, Middle Aged, Pilot Projects, Pragmatic Clinical Trials as Topic, Prognosis, Qualitative Research, Randomized Controlled Trials as Topic, United Kingdom, Attitude of Health Personnel, Attitude to Health, General Practitioners, Musculoskeletal Pain therapy, Primary Health Care
- Abstract
Background: Stratified care involves subgrouping patients based on key characteristics, e.g. prognostic risk, and matching these subgroups to appropriate early treatment options. The STarT MSK feasibility and pilot cluster randomised controlled trial (RCT) examined the feasibility of a future main trial and of delivering prognostic stratified primary care for patients with musculoskeletal pain. The pilot RCT was conducted in 8 UK general practices (4 stratified care; 4 usual care) with 524 patients. GPs in stratified care practices were asked to use i) the Keele STarT MSK development tool for risk-stratification and ii) matched treatment options for patients at low-, medium- and high-risk of persistent pain. This paper reports on a nested qualitative study exploring the feasibility of delivering stratified care ahead of the main trial., Methods: 'Stimulated-recall' interviews were conducted with patients and GPs in the stratified care arm (n = 10 patients; 10 GPs), prompted by consultation recordings. Data were analysed thematically and mapped onto the COM-B behaviour change model; exploring the Capability, Opportunity and Motivation GPs and patients had to engage with stratified care., Results: Patients reported positive views that stratified care enabled a more 'structured' consultation, and felt tool items were useful in making GPs aware of patients' worries and concerns. However, the closed nature of the tool's items was seen as a barrier to opening up discussion. GPs identified difficulties integrating the tool within consultations (Opportunity), but found this easier as it became more familiar. Whilst both groups felt the tool had added value, they identified 'cumbersome' items which made it more difficult to use (Capability). Most GPs reported that the matched treatment options aided their clinical decision-making (Motivation), but identified some options that were not available to them (e.g. pain management clinics), and other options that were not included in the matched treatments but which were felt appropriate for some patients (e.g. consider imaging)., Conclusion: This nested qualitative study, using the COM-B model, identified amendments required for the main trial including changes to the Keele STarT MSK tool and matched treatment options, targeting the COM-B model constructs, and these have been implemented in the current main trial., Trial Registration: ISRCTN 15366334.
- Published
- 2020
- Full Text
- View/download PDF
45. The migration of UK trained GPs to Australia: Does risk attitude matter?
- Author
-
van der Pol M, Scott A, and Irvine A
- Subjects
- Adult, Australia, Female, General Practitioners supply & distribution, Humans, Job Satisfaction, Longitudinal Studies, Male, Quality of Life, Scotland, Surveys and Questionnaires, United Kingdom ethnology, Attitude of Health Personnel, Career Choice, General Practitioners psychology, Professional Practice Location statistics & numerical data, Risk Assessment statistics & numerical data
- Abstract
Background: Little is known about the drivers of migration of GPs. Risk attitude may play an important role as migration is fundamentally a risky decision that balances the risks of staying with the risks associated with leaving. This paper examines the association between risk attitudes and the migration of UK GPs to Australia., Methods: GPs who qualified in the UK but work in Australia and who responded to the Medicine in Australia: Balancing Employment and Life (MABEL) national longitudinal survey of doctors, were compared with GPs based in Scotland who responded to a survey. Risk attitudes were elicited for financial risks, career and professional risks and clinical risks on a scale from 1 to 5., Results: GPs in Scotland and UK trained GPs in Australia have similar risk attitudes for financial risk. However, UK trained GPs in Australia are less willing to take clinical and career risks., Conclusion: GPs who migrated to Australia after qualifying in the UK were more risk averse about their career and clinical risks. This may suggest that more risk averse GPs migrate to Australia due to pull factors such as less uncertainty around career and clinical outcomes in Australia. The uncertain NHS climate may push more risk averse doctors away from the UK., (Crown Copyright © 2019. Published by Elsevier B.V. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
46. Joint working in community mental health: prospects and challenges.
- Author
-
Hannigan, Ben
- Subjects
COMMUNITY mental health services ,ASSOCIATIONS, institutions, etc. - Abstract
This paper reviews the opportunities for, and the challenges facing, joint working in the provision of community mental health care. At a strategic level the organization of contemporary mental health services is marked by fragmentation, competing priorities, arbitrary divisions of responsibility, inconsistent policy, unpooled resources and unshared boundaries. At the level of localities and teams, these barriers to effective and efficient joint working reverberate within multi-disciplinary and multi-agency community mental health teams (CMHTs). To meet this challenge, CMHT operational policies need to include multiagency agreement on: professional roles and responsibilities; target client groups; eligibility criteria for access to services; client pathways to and from care; unified systems of case management; documentation and use of information technology; and management and accountability arrangements. At the level of practitioners, community mental health care is provided by professional groups who may have limited mutual understanding of differing values, education, roles and responsibilities. The prospect of overcoming these barriers in multidisciplinary CMHTs is afforded by increased opportunities for interprofessional ‘seepage’ and a sharing of complementary perspectives, and for joint education and training. This review suggests that policy-driven solutions to the challenges facing integrated community mental health care may be needed and concludes with an overview of the prospects for change contained in the previous UK government’s Green Paper, ‘Developing Partnerships in Mental Health’. [ABSTRACT FROM AUTHOR]
- Published
- 1999
- Full Text
- View/download PDF
47. GPs scoff at paper's claims about vaccine record fraud.
- Subjects
- *
GENERAL practitioners , *IMMUNIZATION of children , *VACCINES , *PERIODICALS , *MEDICAL care - Abstract
The article reports that general practitioners and immunization experts have dismissed allegations that medical practices massaged records to boost pay. The periodical claimed that children were recorded as having received up to 60% more vaccine than they normally would. The British Department of Health took the allegations by the "Sun" newspaper seriously, but declared that there has been no evidence to support the paper's claims.
- Published
- 2006
48. Paper referrals returned as hospitals battle wait target.
- Subjects
- *
HOSPITALS , *GENERAL practitioners , *PATIENTS , *MEDICAL care - Abstract
The article reports that hospitals in Great Britain are returning paper referrals to practices if they cannot offer patients an appointment within the government's 13-week waiting time target. The block on manual referrals comes in addition to choose and book restrictions which are stopping general practitioners who are referring patients to popular hospitals if they have longer waits.
- Published
- 2006
49. PREPARING FOR THE WRITTEN PAPER IN THE MRCGP.
- Author
-
Goodwin, Daryl
- Subjects
- *
GENERAL practitioners , *EXAMINATIONS , *PROFESSIONAL associations , *WEBSITES - Abstract
The article provides tips on how to prepare for the examination for Membership of the Royal College of General Practitioners (RCGP). It is important to visit the RCGP website to study the exam regulations, syllabus and questions and answers from previous papers. Some source materials which can be beneficial to general practitioners are the Scottish Intercollegiate Guideline Network, Bandolier and the Cochrane Library of systematic reviews.
- Published
- 2006
50. GP boundaries set to be axed in White Paper.
- Author
-
Finch, Rob
- Subjects
- *
GENERAL practitioners , *MEDICAL practice , *LEGISLATORS , *COMMUNITY health services - Abstract
The article reports on the plans of the ministers to abolish general practitioners' (GP)practice boundaries in a move designed to improve services and access by forcing GPs to compete for patients in Great Britain. The scheme is at the top of the government's wish-list as it starts to draft the White Paper on community health services.
- Published
- 2005
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