British Journal of General Practice最新文献

{"title":"Books: <i>Safe Care in Paediatrics</i>: Safer care for children; sounder sleep for GPs.","authors":"David Misselbrook","doi":"10.3399/bjgp24X740157","DOIUrl":"https://doi.org/10.3399/bjgp24X740157","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"74 749","pages":"564"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrativity and the teaching of consultation skills: Godwin's story.","authors":"Frances Wedgwood","doi":"10.3399/bjgp24X740085","DOIUrl":"https://doi.org/10.3399/bjgp24X740085","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"74 749","pages":"556-557"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Passport to medical freedom? Only for the lucky digitally enabled.","authors":"Alexis Paton","doi":"10.3399/bjgp24X740049","DOIUrl":"https://doi.org/10.3399/bjgp24X740049","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"74 749","pages":"552-553"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Turning the tide on healthy eating.","authors":"Chris Newman","doi":"10.3399/bjgp24X740073","DOIUrl":"https://doi.org/10.3399/bjgp24X740073","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"74 749","pages":"555"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond mental or physical: can critical realism unify medicine's divided self?","authors":"Alistair Appleby","doi":"10.3399/bjgp24X740121","DOIUrl":"https://doi.org/10.3399/bjgp24X740121","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"74 749","pages":"560-561"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Books: <i>King Lear: Shakespeare's Dark Consolations</i>: Teaching differences.","authors":"David Jeffrey","doi":"10.3399/bjgp24X740181","DOIUrl":"https://doi.org/10.3399/bjgp24X740181","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"74 749","pages":"565-566"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician associates have a place in primary care.","authors":"Simon Ellwood","doi":"10.3399/bjgp24X740001","DOIUrl":"https://doi.org/10.3399/bjgp24X740001","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"74 749","pages":"539"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Additional Roles Reimbursement Scheme uptake, patient satisfaction, and QOF achievement: an ecological study from 2020-2023.","authors":"Chris Penfold, Jialan Hong, Peter J Edwards, Mavin Kashyap, Chris Salisbury, Ben Bennett, John Macleod, Maria Theresa Redaniel","doi":"10.3399/BJGP.2024.0083","DOIUrl":"10.3399/BJGP.2024.0083","url":null,"abstract":"<p><strong>Background: </strong>The Additional Roles Reimbursement Scheme (ARRS) was introduced by NHS England in 2019 alongside primary care networks (PCNs), with the aims of increasing the workforce and improving patient outcomes.</p><p><strong>Aim: </strong>To describe the uptake of direct patient care (DPC)-ARRS roles and its impact on patients' experiences.</p><p><strong>Design and setting: </strong>An ecological study using 2020-2023 PCN and practice workforce data, registered patient characteristics, the General Practice Patient Survey, and the Quality and Outcomes Framework (QOF).</p><p><strong>Method: </strong>Descriptive statistics with associations were examined using quantile and linear regression.</p><p><strong>Results: </strong>By March 2023, 17 588 full-time equivalent (FTE) DPC-ARRS roles were commissioned by 1223 PCNs. PCNs with fewer constituent practices had more DPC-ARRS roles per population (<i>P</i><0.001), as did PCNs with more FTE GPs per population (<i>P</i> = 0.005). DPC-ARRS commissioning did not vary with age, sex, or deprivation characteristics of practice populations. DPC-ARRS roles were associated with small increases in patient satisfaction (0.8 percentage points increase in patients satisfied per one DPC-ARRS FTE) and perceptions of access (0.7 percentage points increase in patients reporting 'good' experience of making an appointment per one DPC-ARRS FTE), but not with overall QOF achievement.</p><p><strong>Conclusion: </strong>The commissioning of DPC-ARRS roles was associated with small increases in patient satisfaction and perceptions of access, but not with QOF achievement. DPC-ARRS roles were employed in areas with more GPs rather than compensating for a shortage of doctors. Single-practice PCNs commissioned more roles per registered population, which may be advantageous to single-practice PCNs. Further evaluation of the scheme is warranted.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving personal continuity in general practice: a focus group study.","authors":"Lex Jj Groot, Esther Janssen, Marjan J Westerman, Henk J Schers, Jako S Burgers, Martin Smalbrugge, Annemarie A Uijen, Henriëtte E van der Horst, Otto R Maarsingh","doi":"10.3399/BJGP.2025.0099","DOIUrl":"https://doi.org/10.3399/BJGP.2025.0099","url":null,"abstract":"<p><strong>Background: </strong>Personal continuity is an important dimension of continuity of care in general practice and is associated with many benefits including a higher quality of GP care and lower mortality rate. Over time, changes in society and health care have challenged the provision of personal continuity. Older patients in particular experience more negative consequences from receiving discontinuous care.</p><p><strong>Aim: </strong>To explore the perspectives of GPs, older patients, practice nurses, and assistants on improving personal continuity in general practice, and to identify barriers and facilitators that affect this improvement process.</p><p><strong>Design and setting: </strong>A qualitative study using focus groups was conducted from May to August 2019.</p><p><strong>Method: </strong>We organised four focus groups: two with GPs (<i>n</i> = 17), one with patients (<i>n</i> = 7), and one with practice assistants (<i>n</i> = 4) and practice nurses (<i>n</i> = 2). Focus groups were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Personal continuity was viewed as being provided by the entire general practice team and not just by the patient's own GP. It was suggested that investing in team communication and stability (for example, by efficient use of the electronic health records) and retaining the availability and accessibility of the patient's own GP for patient care, especially for frail older persons, (for example, by delegating tasks) could improve personal continuity. Barriers and facilitators were perceived at the individual (for example, GPs' involvement in tasks), organisation (for example, staff shortages), and societal level (for example, payment system).</p><p><strong>Conclusion: </strong>As general practice moves towards a more team-based approach to ensure personal continuity, efforts to improve personal continuity should focus on supporting team-based provision of continuous care.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between cancer risk assessment tool use and GP consultation duration: an observational study.","authors":"Emily Fletcher, John Campbell, Emma Pitchforth, Luke Timothy Allan Mounce, William Hamilton, Gary A Abel","doi":"10.3399/BJGP.2024.0135","DOIUrl":"https://doi.org/10.3399/BJGP.2024.0135","url":null,"abstract":"<p><strong>Background: </strong>England is short of General Practitioners (GPs). GP consultation rates, consultation duration, and workload are increasing. Electronic clinical decision support (eCDS) tools assist decision-making for screening, diagnosis, and risk-management. Cancer detection is one area where tools are designed to support GPs. Electronic risk assessment tools (eRATs) estimate risk of current cancer based on symptoms. We aimed to explore any association between eRATs impact and GP workload and workflow during consultations.</p><p><strong>Methods: </strong>Thirteen practices participating in a cluster randomised controlled trial of eRATs (ERICA) were recruited to an observational sub-study. We compared the average duration of consulting sessions and consultations where eRATs were or were not activated, using mixed effects regression models.</p><p><strong>Results: </strong>there was no evidence that sessions where an eRAT was activated were, on average, longer than sessions where no eRATs had been activated. However, individual consultations involving an eRAT were longer on average by 3.96 minutes (95% CI: 3.45 to 4.47; p<0.001), when compared with consultations with no eRATs , after adjusting for a range of session and consultation characteristics.</p><p><strong>Conclusions: </strong>There was no evidence to suggest that eRATs should not be used to support GPs in early cancer diagnosis from a workload perspective. eRATs were not associated with increased workload across a session. Definitive findings regarding the clinical effectiveness of eRATs, not the related workload/workflow implications, will ultimately determine whether the use of eRATs should be rolled out more widely.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}