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Emma speaks to Royal College of GPs veterans clinical champion Dr Emily Brookes, about the health needs of military veterans and their families, and what general practice can do to support these groups of patients.
Emily talks about the specific health challenges veterans are more likely to face, from physical conditions like hearing loss and musculoskeletal issues to a higher prevalence of mental health conditions - and the common barriers that prevent veterans from seeking help.
She explains how the RCGP’s Veteran Friendly Accreditation scheme can help practices improve care for these patients and some of the services and support that is available to veterans.
Emily has 20 years of experience as a military GP in both the Army and the RAF and she also talks about what these roles involved and why she followed this career path.
This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.
Useful links
RCGP veterans elearning module
Become a veteran friendly accredited practice
Full list of resources and organisations that support veterans from gov.uk
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Emma and Nick discuss the key news stories affecting general practice. They talk about how the GP contract change that requires practices to keep their online consultation systems on throughout core hours is affecting workload in general practice, as well as the increasingly bitter war of words between the government and the BMA about this issue.
They look ahead to next week’s England LMCs conference, where GP leaders will debate next steps on industrial action as a result of the dispute over online access.
They also discuss the latest NHS planning guidance and what that means for GPs, some good news from Scotland on the GP contract there and Nick’s recent analysis on how GP premises funding is being spent in England.
This week’s good news story is about practices delivering award-winning end of life care.
This episode was presented by GPonline editor Emma Bower and deputy editor Nick Bostock. It was produced by Czarina Deen.
Useful links
● 'No progress' on GP contract reform as BMA frozen out of Carr-Hill review
● Government plans new target for GPs to offer urgent patients same-day appointments
● GPs in Scotland end dispute as £531m funding deal agreed
● Practices forced to hire extra staff to manage online consultation workload
● LMCs to vote on major escalation of GP industrial action
● Most GP practices say £1.1bn contract has not eased financial pressure
● How are ICBs spending the £102m GP premises fund?
● GPs and practices recognised for providing outstanding end-of-life care
● RCGP/Marie Curie Daffodil standards - more details
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Emma speaks to GP Dr Callum Leese about the importance of physical activity and how primary care professionals can promote it to their patients.
Callum is a GP in Aberfeldy, Scotland, and also works at the University of Dundee, where his research focuses on physical activity promotion and implementation in primary care. He is also the Royal College of GPs co-lead for physical activity.
In this conversation, Callum talks about his research, including work with the WHO looking at physical activity promotion in policy across Europe, and RCGP initiatives like the Active Practice Charter and parkrun practices and how these can benefit both patients and staff.
He offers advice for GPs on how to raise the issue of physical activity in consultations and discusses the importance of tailoring exercise advice to patients with specific health conditions.
He also talks about a fantastic initiative he’s involved with, which is aiming for his home town of Aberfeldy to become the healthiest town in Scotland, and his work with the British Society of Lifestyle Medicine, where he leads the physical activity special interest group.
This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.
Useful links
Moving Medicine - website from Faculty of Sports and Exercise Medicine
British Society of Lifestyle Medicine
Callum’s Movement Prescription podcast
Aberfeldy healthiest town website
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This week we look at the rapidly advancing field of genomics, which is becoming increasingly relevant to everyday primary care. Emma speaks to Dr Jude Hayward and Dr Imran Rafi, who are the Royal College of GPs’ joint clinical representatives for genomics. Jude is a GP with an extended role in genomic medicine and Imran is a reader in primary care and genomics at St. George's University in London.
Jude and Imran discuss the most significant changes genomics is set to bring over the next decade, including its potential use in predicting risk for common conditions, rise of pharmacogenomics and whether the government’s 10-year plan’s vision for the role of genomics is realistic.
They also talk about some of the practical challenges facing GPs, such as how to handle patients presenting with results from direct-to-consumer genetic tests, the ethical considerations around data and consent, and the importance of ensuring advances in genomics help to narrow rather than widen health inequalities.
And they also explore the opportunities for GPs to develop an extended role in this fascinating area of medicine.
This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.
Useful links
GeNotes - genomics notes for clinicians
GP with extended role in clinical genetics/genomics - RCGP framework
RCGP eLearning - Genomics toolkit
RCGP position statement on direct to consumer genomics testing
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GPonline is the media partner for the RCGP annual conference and this is the second of two special episodes of Talking General Practice from the event Newport in Wales this week.
In this episode we look at what health minister Stephen Kinnock said about overhauling the Carr-Hill formula and the BMA dispute over online consultations and what delegates thought about this. We also highlight what RCGP chair Professor Kamila Hawthorne had to say in her speech about primary care funding and GP retention.
Emma talks to RCGP vice chairs Professor Margaret Ikpoh and Dr Thomas Patel-Campbell about the results of the college’s latest member survey, the importance of investing in primary care and how the increase in anti-immigration and right-wing rhetoric is affecting GPs.
She also speaks to RCGP Wales chair Dr Rowena Christmas about being the subject of a book that tells the story of rural general practice and the college’s manifesto for next year’s Senedd elections and talks to outgoing RCGP president Dr Richard Vautrey.
Useful links
● Find all of GPonline’s coverage from this week’s conference at gponline.com/rcgp
● Health minister describes online consultation dispute as ‘phoney war’
● Government launches review of 'not fit for purpose' GP funding formula
● GPs face unsafe workload and fear neighbourhoods will make it worse, RCGP warns
Supported by Symprove
This episode of Talking General Practice has been supported by Symprove. Based on an external survey of 432 healthcare professionals, Symprove was the number one probiotic, recommended by gastroenterologists, dietitians and GPs. The unique water-based solution delivers live bacteria to the colon and is proven in randomised controlled trials by leading institutions. 92% of people report a benefit within 12 weeks in real-world.
Healthcare professionals can trial Symprove for free. Visit professionals.symprove.com and sign up for a virtual meeting to hear more about the research behind Symprove and get your free 12-week pack.
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Emma speaks to Royal College of GPs chair Professor Kamila Hawthorne ahead of the RCGP’s annual conference in Newport in Wales, which starts on Thursday this week.
GPonline is the media partner for the annual conference, and this is the first of two episodes that we’ll be producing from the event.
Kamila is nearing the end of her three years as RCGP chair and in this interview, she reflects on the highs and lows of her time in the post. She talks about the experiences of dealing with multiple health secretaries and navigating the contentious issue of physician assistants in general practice.
She also discusses the government's 10-year health plan and what it could mean for general practice, her fears about the future of the partnership model, and what the RCGP wants to see in the new NHS workforce plan. And she explains why she believes there is still a bright future for general practice despite the challenges.
This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.
Read all of GPonline’s coverage from the RCGP annual conference this week at https://www.gpponline.com/rcgp
Supported by Symprove
This episode of Talking General Practice has been supported by Symprove. Based on an external survey of 432 healthcare professionals, Symprove was the number one probiotic, recommended by gastroenterologists, dietitians and GPs. The unique water-based solution delivers live bacteria to the colon and is proven in randomised controlled trials by leading institutions. 92% of people report a benefit within 12 weeks in real-world.
Healthcare professionals can trial Symprove for free. Visit professionals.symprove.com and sign up for a virtual meeting to hear more about the research behind Symprove and get your free 12-week pack.
Hosted on Acast. See acast.com/privacy for more information.
This week Emma and NIck talk about the BMA’s decision to re-enter dispute with the government in England, the online access plans that have led us to this point and what both the BMA and the government have to say about all of this. They also look at what re-entering dispute could mean for the profession.
They talk about the upcoming NHS workforce plan, which is due to be published before the end of the year after the government launched a call for evidence. And they discuss the BMA’s latest survey on the state of GP premises and what’s required to fix the crumbling primary care estate.
Our good news story this week is about a GP who has this week been attempting to break the record for running round the perimeter of Cornwall in an effort to raise money and awareness of early-onset dementia, which has affected her mum.
This episode was presented by GPonline editor Emma Bower and deputy editor Nick Bostock. It was produced by Czarina Deen.
Complete our survey looking at online access and other issues affecting GPs here
Useful links
Dr Elsey Davis fundraising page
GPs are standing up for patient safety by declaring dispute, says BMA
Streeting dismisses GP fears over online access as 'forces of conservatism'
Government 'mystified' over GP stance on online access
Mouldy, cracked and cramped: BMA poll exposes GP premises crisis
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This week Emma speaks to Professor Brendan Delaney, a GP in London and Professor of Medical Informatics and Decision Making at Imperial College London. Brendan’s research work covers artificial intelligence in medical diagnosis and learning health systems and he is a real expert in this field.
Artificial intelligence is likely to have a huge impact across society and its role in healthcare is expected to grow exponentially in the coming years. But what will this mean in practice for GPs on the ground?
In this conversation, Brendan talks about the research he is involved with that is looking at how AI can be used to support diagnosis in primary care. We also discuss whether developments in AI in medicine could de-skill doctors, the vital importance of medical device regulation when using these new tools, and the key issues of clinical liability and data security.
Brendan also shares his thoughts on the government's vision for an AI-enabled NHS and how realistic this vision is as well as his hopes for how this new technology could shape general practice in the coming years. And he has advice for how GPs can prepare for a future where technology will play an even greater role in medicine.
This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.
Useful links
Transformer-based deep learning model for the diagnosis of suspected lung cancer in primary care based on electronic health record data - the study Brendan mentions in the interview
More of Brendan’s research work
IX - Imperial College London’s cross-department AI initiative
AI tools in general practice and liability - advice for GPs
Using AI transcribing software in general practice - medicolegal considerations
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The GPonline team discusses the key news stories affecting general practice.
This week Emma and Nick talk about the BMA special representative meeting on the government’s 10-year plan, which happened last weekend. They look at what health and social care secretary Wes Streeting had to say, some of which enraged many of the GPs in attendance, as well as the key votes on motions about general practice and what BMA representatives had to say about the 10-year plan.
They also discuss the roll out of neighbourhood health in England as the government announced the 43 sites that will form the first wave of its national programme to shift the NHS to this new way of working.
And they look at a piece of work Nick has done over the past couple of weeks looking at the number of GPs the NHS in England needs over the coming years if it is to keep pace with the predicted population rise, including which parts of the country have the furthest to go to reach the levels required.
Meanwhile Kimberley explains our good news story, which this week is about an initiative in Wales that is aiming to support women GPs into senior leadership roles.
This episode was presented by GPonline editor Emma Bower, deputy editor Nick Bostock and senior reporter Kimberley Hackett. It was produced by Czarina Deen.
Useful links
● Streeting dismisses GPs concerned over online access as 'laggards'
● BMA rejects 10-year plan and demands protection of GP model
● Can England double its GP workforce by 2040?
● Map: Which areas face the steepest GP recruitment challenge?
● Third of licensed GPs in England lost to NHS, study reveals
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This week Emma speaks to Dr Helen Thomas, a GP in Hampshire and a member of the group Healthcare Professionals for Safer Screens.
Helen has been involved with developing screening tools and training resources to help clinicians identify problematic smartphone use in young people which might be affecting their mental health.
In this conversation Helen explains the evidence linking excessive screen time to worsening mental health outcomes, poor sleep, and developmental delays, and highlights the harmful content algorithms push to young users.
She explains why it's vital for GPs to ask about device use when consulting with young people presenting with mental health issues and the screening tools and resources that can help clinicians do this.
And she discusses the wider changes needed to tackle this issue, including what the government should be doing.
This conversation includes discussion of self harm and suicide.
This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.
Useful links
Health Professionals for Safer Screens
Health Professionals for Safer Screens resources - including screening tool, health intervention information and training worlds
How TikTok harms boys and girls differently - the Guardian video that Emma mentions in this conversation
Details of Esther Ghey’s campaign to ban smartphones in schools - from BBC
Jonathan Haidt’s Let Grow movement, which Helen mentions in this conversation
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The GPonline team discusses the latest news affecting general practice. This week Emma and Nick look at the latest GP earnings and expenses data and what it tells us about income for both partners and salaried GPs and regional variations across the UK.
There’s also a quick round up of some other data published last week on the GP workforce and practice workload.
They also discuss the BMA’s recent analysis of the 10-year health plan and look at some of the union’s concerns with the plan - and whether some of those issues could lead GPs back into industrial dispute with the government.
Our good news story this week is about the GP workforce in Scotland.
This episode was presented by GPonline editor Emma Bower and deputy editor Nick Bostock. It was produced by Czarina Deen.
Useful links
GP income variation across England blamed on local funding gaps
Experts question data showing double-digit GP partner income rise
General practice facing 'busiest summer ever' as appointments spiral
Neighbourhood contracts must stop hospitals taking over GP patient lists, warns BMA
BMA preparing for return to GP industrial dispute as red lines ignored
Scottish GP workforce reaches six-year high
For GPonline, GP Business, MIMS and MIMS Pharma practice and corporate subscribers
Special report: The 10-year Health Plan
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This week Emma speaks to Adrian Down, who is the managing partner of a practice in Lincolnshire and a director of the Institute of General Practice Management (IGPM).
Adrian discusses the vital role of the practice manager and the work the IGPM is doing to give managers a stronger voice and create clear standards through its accreditation scheme.
He talks about the challenges facing practice managers, including the risk of burnout, and what needs to happen to address these issues, as well as the government’s 10-year health plan and what the move towards neighbourhood working will mean for practices and the pivotal role managers will play in making it a success.
Adrian also explains what the IGPM wants to see from the new GP contract to ensure it provides realistic funding and recognises the contribution of the entire general practice team, including the growing number of non-GP partners.
This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.
Useful links
Institute of General Practice Management
GPonline’s coverage of the 10-year health plan
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This week the GPonline team discusses health and social care secretary Wes Streeting’s letter to the profession and asks whether what he had to say addressed the BMA’s ‘red lines’ to avert further industrial action by the profession. They also look at the latest update to this year’s GP contract and what that means for staff and GP pay.
There’s an update on physician associate roles after their union - United Medical Associate Professionals (UMAPs) launched a legal bid for an injunction to prevent changes to the role following the Leng review.
And they talk about the jobs crisis facing newly-qualified GPs as well as the stresses and pressures facing GPs further along in their career and what this all means for the future of the profession.
Our good news story this week is about patient satisfaction with GP access.
This episode was presented by GPonline’s editor Emma Bower, deputy editor Nick Bostock and senior news reporter Kimberley Hackett. It was produced by Czarina Deen.
Useful links
Streeting sets date for talks to 'retain and reform' practice-based GP contract
PA union loses legal bid for injunction to prevent Leng reforms
GPs 'walking tightrope' as NHS issues advice on changing PA roles
Job crisis 'fragmenting' working lives of newly-qualified GPs
How do you fix general practice? It's the workforce, stupid
How has patients' experience of GP services changed over the past year?
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This week Emma speaks to Dr Richard West, a GP partner in a dispensing practice in Suffolk and chair of the Dispensing Doctors’ Association.
Dispensing practices are a vital lifeline for patients in rural areas, but they are facing a host of challenges that are threatening their viability. In this conversation, Richard explains the crucial role these practices play and the immense pressures they are under.
Richard talks through the complexities of dispensing practice funding, highlighting how out-of-date fee scales and unreimbursed drug costs are affecting practices and what the Dispensing Doctors’ Association is campaigning for to ensure these essential services survive.
He also discusses what needs to change in the GP contract to support dispensing practices, the impact drug shortages have on staff and patients and the need to ensure that ways of working envisaged in the 10 year plan are designed to work for rural populations.
This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.
Useful links
Dispensing Doctors’ Association
Dispensing Doctors’ Association RAMP UP campaign
MIMS - Drug shortages - live tracker
MPs demand major review as UK medicine shortages now 'daily reality'
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This week Emma and Nick talk about how adding GPs to the additional roles reimbursement scheme has impacted on the workforce in different parts of the country. They look at what the government has to say about the ARRS and asking whether it is painting an accurate picture of the current state of the GP workforce in England.
They also discuss what the BMA wants the government to do to avert a jobs crisis for newly qualified GPs this summer. This formed part of a series of red lines that it said the government had to deliver to avoid further industrial dispute by the profession, and Emma and Nick explain what these are and what has led the BMA to make these demands.
Our good news story this week is about some more data from an innovative fruit and veg prescription project that’s running in East London.
This episode was presented by GPonline editor Emma Bower and deputy editor Nick Bostock. It was produced by Czarina Deen.
● Is the ARRS widening GP workforce inequality?
● Opaque GP workforce data spark call for 'honesty'
● BMA sets red lines for government to avert industrial dispute with GPs
● 10-year plan could unlock more GP funding or lead to salaried service, says BMA
● Karin Smyth: ARRS GPs can help turn the tide of pressure on practices
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This week Emma talks to Dr Andy Hilton, a GP partner and chief executive of Primary Care Sheffield a not-for-profit company, owned by the city's GP practices, which was recently highlighted in the 10-year health plan as an example of successful neighbourhood working.
In this conversation, Andy explains the origins of Primary Care Sheffield, how it has worked to support practices, and the wide range of services it now provides. He discusses the benefits of working at scale, not just for patients but also for practices and the wider health system, and how this approach can help to tackle health inequalities.
Andy also offers his thoughts on the move towards a neighbourhood NHS, why he general practice will be crucial to its success and the challenges that lie ahead, including estates and the demands of an ageing population. He provides valuable advice on how to work more collaboratively with other practices, PCNs and partners in the healthcare system.
This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.
Useful links
The 10-year health plan at a glance
GPs pioneering neighbourhood model say it has eased workload
Dozens of 'neighbourhood health service' sites to launch from September
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In our news review Emma and Nick talk about the findings of the independent review into the use of physician associates in the NHS and what this means for their role in future.
They look at the results of the latest GP patient survey and what that tells us about how patients feel about general practice. And they discuss what happens next for neighbourhood health as more details emerge about the government plans for 42 sites that are set to push forward this agenda.
This episode was presented by GPonline editor Emma Bower and deputy editor Nick Bostock. It was produced by Czarina Deen.
Useful links
● Could the 10-year health plan derail rising GP patient satisfaction?
● In charts: Which areas have the highest patient satisfaction with general practice?
● Government backs Leng review and warns PAs should 'never replace doctors'
● PAs urged to dispute job changes following Leng review
● NHS won't 'throw money' at neighbourhood health sites, officials warn
● 10-year plan 'risky as hell' for general practice
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This week Emma speaks to Dr Duncan Gooch, a GP in Derbyshire and the chair of the NHS Confederation's Primary Care Network, which represents at-scale primary care organisations. As well as being a GP partner, Duncan also has leadership roles in at-scale primary care organisations in his local area.
In this conversation Duncan shares his thoughts on the what the 10-year health plan could mean for general practice. He discusses new contracts for neighborhood providers, how they could work alongside the GP contract and primary care networks, and why he believes they are not a threat to the partnership model.
Duncan also offers his views on what practices can do to prepare for the move to neighborhood working, the role technology and data will play in how general practice works in the future, and how he believes working at scale can help GPs to have greater influence in their local healthcare systems and how at-scale organisations could evolve to take on some ICB functions in future.
He also talks about addressing problems with GP premises and the importance of having thriving practices if you are to build a successful neighbourhood NHS.
This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.
Useful links
NHS Confederation Primary Care Network
The 10-year health plan at a glance
NHS won't 'throw money' at neighbourhood health sites, officials warn
10-year NHS plan unveils 'alternative' to GP partnership model
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In this week’s podcast the GPonline team looks in detail at the government’s 10-year health plan and what it means for general practice.
They talk about what the plan could mean for the future of the GP contract and the partnership model, the government’s plans for a neighbourhood NHS and what GPs think about the proposals. They also look at how the government plans to shift the NHS from analogue to digital and what this could mean for GPs and their teams.
Meanwhile, our good news story this week is about the national roll out of a programme to train GPs with an extended role in gastroenterology.
This episode was presented by GPonline editor Emma Bower, deputy editor Nick Bostock and senior news reporter Kimberley Hackett. It was produced by Czarina Deen.
Useful links
Find all our coverage of the 10-year health plan
The 10-year health plan at a glance
10-year plan threatens existing GP model and continuity of care, warns BMA
PCNs in talks over taking on neighbourhood GP contracts
Viewpoint: Failure to build 10-year plan around general practice is a serious mistake
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Emma speaks to Lizzy Lloyd, chair of AISMA, the Association of Independent Specialist Medical Accountants, and a partner at the accountancy firm Larking Gowen.
The financial pressures on general practice have been a major theme of the past few years, and in this episode, Lizzy discusses the impact this has had on practices. She talks about cash flow problems and the complexities of the GP contract and funding, as well as challenges around workforce and service charge issues.
Lizzy offers invaluable advice for practices looking to secure their financial future, including the importance of effective budgeting, and maximising income streams. She also discusses ongoing issues with NHS pensions and what GPs can do to navigate this complicated area.
This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.
Read GPonline’s coverage of the 10-year health plan here
Useful links
● Association of Independent Specialist Medical Accountants
● 10-year NHS plan will promise 'major changes' to GP funding formula
● Government begins hunt for private premises investment ahead of 10-year plan
● Extra £100m needed to deliver 4% GP pay rise
● DDRB recommends new GP 'cost index' to help shape contract uplifts
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