NHS England has outlined a series of practical plans and actions designed to help young carers who may be ‘hidden’, unpaid and under the age of sixteen.
Family doctors across the country can now volunteer to offer a new package of services for children and young adults who perform an informal caring role for a family member. This includes priority appointments for carers, home visits, additional mental health checks, and ‘double appointments’ for the carer and those they provide care for.
Research from Barnardo’s and Carers Trust has highlighted a host of challenges young people face in juggling their caring role with their education and own health, with up to 40% experiencing mental health problems.
The measures, backed by Carers UK, Carers Trust, CQC and the Children’s Society, mean GP practices may offer more tailored services for carers in their community, based on national proposals and assessed against six ‘Quality Markers’, to ensure carers in every community across the country are being offered high quality support by their local practice.
It is estimated that up to one in five secondary school pupils provides some level of care for a parent or sibling.
Royal College of General Practitioners | May 2019 | Fit for the future
Fit for the future presents the Royal College of General Practitioners (RCGP) vision for the future of general practice.
It outlines its vision as:
General practice in the UK will be recognised as a high-status and rewarding profession. It will be the career of choice for growing numbers of ambitious and talented medical students and foundation doctors.
With the right staffing levels, GP workload will be manageable, which in turn,
will reduce stress and burnout. Retention rates and job satisfaction will be higher.
The delivery of relationship-based, whole-person care will be at the heart of general
practice. GPs will have more time to care for those patients with the most complex needs and will work with extended practice teams to provide enhanced continuity of care.
Patients will have more choice over the length, time and method of consultation.
The standard face-to-face consultation length will be at least 15 minutes and more
consultations will be delivered remotely through digital and video channels. GPs will
have access to a wider range of data sources and diagnostic tools, and shared decisionmaking with patients will be the norm.
The skills of the GP as an expert medical generalist will be more highly valued than
ever before. There will be more time and better support for training and professional
development, and GPs will be able to take on extended roles and develop additional
areas of expertise
Fit for the future identifies a number of enablers such as:
Pancreatic Cancer UK | May 2019 | Only one in ten GPs have the tools needed to diagnose pancreatic cancer in time to treat
A little over 1,000 UK GPs were polled by ComRes on behalf of the charity Pancreatic Cancer UK. 3 per cent of GPs polled said they were very confident they could recognise the symptoms of pancreatic cancer in a patient. One in 10 (11 per cent) felt they had the necessary tools to recognise the signs of the cancer.
Around half of GPs (54 per cent) say that they have some of the tools they need, but could do with more. Of even greater concern is that three in ten (28 per cent) say that they do not have the tools that they need to detect pancreatic cancer at a stage where it is possible to treat. The charity’s findings mark the launch of their new campaign Unite-Diagnose-Save Lives to help fund the first-ever simple test for pancreatic cancer by 2024.
A quarter of pancreatic cancer patients die within a month of diagnosis, making it the quickest killing cancer. Currently no screening or early detection tests exist for the disease and half of all patients (53 per cent) are diagnosed at stage 4. Vague symptoms – such as back pain, indigestion and weight-loss – mean pancreatic cancer often goes undetected until after it has spread, leaving patients ineligible for the only potential cure – surgery to remove their tumour.
GPs who suspect the disease can refer patients for ultrasound, CT, or MRI scans. However nearly half of all pancreatic cancer patients are currently diagnosed via an emergency (such as through visiting A&E). The impact is significant: one-year survival for patients diagnosed through a GP referral is three times higher.
Pancreatic Cancer UK is investing an initial £750,000 in the research and is asking for the public’s support to help ensure a desperately needed breakthrough in diagnosis can be made (Source: Pancreatic Cancer UK).
The British Journal of General Practice has published research where physiotherapists have been the first point of contact for musculoskeletal conditions, rather than GPs.
The evaluation of two years’ data suggests that patients with musculoskeletal conditions may be assessed and managed independently and effectively by physiotherapists instead of GPs. Most of patients in the study, were managed within primary care, with low referral rates and highly appropriate referrals to orthopaedics. Patients reported positive views regarding the service.
Background Physiotherapists are currently working in primary care as first contact practitioners (FCP), assessing and managing patients with musculoskeletal conditions instead of GPs. There are no published data on these types of services.
Aim To evaluate a new service presenting the first 2 years of data.
Design and setting Analysis of 2 years’ data of patient outcomes and a patient experience questionnaire from two GP practices in Forth Valley NHS, UK. The service was launched in November 2015 in response to GP shortages.
Method Data were collected from every patient contact in the first 2 years. This included outcomes of appointments, GP support, capacity of the service, referral rates to physiotherapy and orthopaedics, numbers of steroid injections, and outcomes from orthopaedic referrals. A patient experience questionnaire was also conducted.
Results A total of 8417 patient contacts were made, with the majority managed within primary care (n = 7348; 87.3%) and 60.4% (n = 5083) requiring self-management alone. Referrals to orthopaedics were substantially reduced in both practices. Practice A from 1.1 to 0.7 per 1000 patients; practice B from 2.4 to 0.8 per 1000 patients. Of referrals to orthopaedics, 86% were considered ‘appropriate’. Extended scope physiotherapists (ESPs) asked for a GP review in 1% of patients.
Conclusion The results suggest that patients with musculoskeletal conditions may be assessed and managed independently and effectively by physiotherapists instead of GPs. This has the potential to significantly reduce workload for GPs as the service requires minimal GP support. The majority of patients were managed within primary care, with low referral rates and highly appropriate referrals to orthopaedics. Patients reported positive views regarding the service.
Rotherham NHS staff can contact the Library for a copy of this article
Closing the gap: Key areas for action on the health and care workforce | Nuffield Trust | The King’s Fund | The Health Foundation
Staffing is the make-or-break issue for the NHS in England. Workforce shortages are already having a direct impact on patient care and staff experience. This report calls for urgent action to avoid a vicious cycle of growing shortages and declining quality. The workforce implementation plan to be published later this year presents a pivotal opportunity to do this.
In this report, experts from the Nuffield Trust, The King’s Fund and the Health Foundation set out a series of policy actions that, evidence suggests, should be at the heart of the workforce implementation plan. This report focuses on nursing and general practice, where the workforce problems are particularly severe. The authors suggest a number of high-impact policy actions which, if properly funded and well implemented across the NHS would over time create a sustainable model for general practice and help to eliminate nursing shortages. These will require investment of an extra £900 million per year by 2023/24 into the budget of Health Education England.
NHS England | February 2019 | Increasing General Practice Nursing placements for student nurses
A project in Sussex led to the development of General Practice placements for student nurses to experience General Practice Nursing (GPN).
The nurse for Primary Care Workforce Tutor (PCWT) and the Tutor Lead for Advancing Nurse Practice reviewed the GP workforce data across Kent, Surrey and Sussex as collected by Health Education England. They identified an increased anticipated reduction of qualified GPNs across the region due to projected retirement in the next 2 to 5 years.
Collaboration with the university supported the vision of what an excellent placement should look like and the skills which could be achieved in the GP provider settings. The PCWT and the Tutor Lead for Advancing Nurse Practice have formed close working relations with the university colleagues, to support ongoing development of the programme.
The changes made to implement the programme included:
Providing students with opportunity to observe all aspects of the system and facilitating bespoke opportunities;
Developing an induction pack which was adopted by GP providers. This included the expectations of the practice, the student and the skills the student training is delivering, either supervised or unsupervised. This document continues to develop, especially as the team are moving towards hosting multi-disciplinary placements;
Developing a preceptorship programme to support newly qualified nurses awaiting their PIN;
Creating a workforce development conference locally.
Collaboration and co-production with the university supported the vision of what an excellent placement should look like and the skills which could be achieved in the GP provider settings.
The programme aims to bring the right education, training and development to enhance skills, knowledge and understanding to the future nursing and wider workforce (Source: NHS England)