London journal of primary care最新文献

{"title":"The buddy group - peer support for the bereaved.","authors":"Susan Gerry Riley,&nbsp;Katherine Irene Pettus,&nbsp;Julian Abel","doi":"10.1080/17571472.2018.1455021","DOIUrl":"https://doi.org/10.1080/17571472.2018.1455021","url":null,"abstract":"<p><p>We describe in this paper the story of the 'Buddy Groups' for bereaved people that were set up at Weston Hospicecare in 2008 and have endured ever since. The group have helped bereaved people to find meaning and value despite their grief. We observed that, through the strength of the relationships formed, people were able to recover well. Group members reported back to us the significant value they placed on being in a Buddy Group.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 3","pages":"68-70"},"PeriodicalIF":0.0,"publicationDate":"2018-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1455021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36339950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting healthcare professionals in a remote rural area of Tanzania.","authors":"Sylvia Berney,&nbsp;Helen Halpern","doi":"10.1080/17571472.2018.1453967","DOIUrl":"https://doi.org/10.1080/17571472.2018.1453967","url":null,"abstract":"<p><p>In October 2017, as two semi-retired NHS doctors, we visited a local hospital and a health centre in Sumbawanga, a rural town in Tanzania. We were curious to find out how the healthcare system worked, to see what support might be helpful to the healthcare professionals themselves and whether and how ideas might be applied in the U.K. We found the health facilities we visited to be well organised and functioning with a small number of multi-skilled clinicians. However, we were aware that there are inadequate numbers of suitably trained healthcare professionals per head of the population in this area and that this could contribute to some of the poorer health outcomes. Our visit left us wondering whether the provision of support in the form of leadership coaching, educational consultancy and friendship with colleagues in the U.K. might enhance job satisfaction and, in turn, whether this might have a beneficial effect on staff recruitment and retention. These are ideas that we are now pursuing with a plan to return to Tanzania in the autumn of 2018.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 4","pages":"89-92"},"PeriodicalIF":0.0,"publicationDate":"2018-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1453967","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36376655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reorganising health and social care in Québec: a journey towards integrating care through mergers.","authors":"Paul Wankah,&nbsp;Maxime Guillette,&nbsp;Sophie Dumas,&nbsp;Yves Couturier,&nbsp;Dominique Gagnon,&nbsp;Louise Belzile,&nbsp;Yahya Mosbah,&nbsp;Mylaine Breton","doi":"10.1080/17571472.2018.1453957","DOIUrl":"https://doi.org/10.1080/17571472.2018.1453957","url":null,"abstract":"<p><strong>Context: </strong>Two reforms (2014, 2015) characterised by the merger of public health care establishments profoundly shaped the current organisation of Quebec's healthcare system. In 2015, 22 megastructures called Integrated Health and Social Services Centres/Integrated University Health and Social Services Centres (IHSSC/IUHSSC), were created and mandated to organise care delivery to their local populations.</p><p><strong>Objective: </strong>To describe the service configuration of the 2015 healthcare system reforms, emphasising on how it shaped the organisation of primary health care (PHC) in Quebec.</p><p><strong>Results: </strong>With the creation of IHSSCs/IUHSSCs, Quebec's healthcare system passed from three to two levels of governance, leading to a centralisation of decision-making powers. Most health services are delivered by the new organisations, while most PHC is delivered by semi-private medical practices, mainly Family Medicine Groups (FMGs). The FMG model is the preferred strategy to develop interdisciplinary team-work and inter-organizational collaborations with other PHC services.</p><p><strong>Conclusion: </strong>mechanisms through which centralised healthcare systems achieve community oriented integrated care (COIC) need to be properly understood in order to improve meaningful clinical outcomes. Mergers may not sufficiently achieve integration of services in all its dimensions. These reforms should be monitored and evaluated on their capacity to mobilise all providers as well as physicians to participate in COIC.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 3","pages":"48-53"},"PeriodicalIF":0.0,"publicationDate":"2018-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1453957","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36340997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A proactive general practice: Integrating public health into primary care.","authors":"Salman Rawaf","doi":"10.1080/17571472.2018.1445946","DOIUrl":"https://doi.org/10.1080/17571472.2018.1445946","url":null,"abstract":"","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 2","pages":"17-18"},"PeriodicalIF":0.0,"publicationDate":"2018-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1445946","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36036302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards a strategic alignment of public health and primary care practices at local levels - the case of severe and enduring mental illness.","authors":"Ricky Banarsee, Cornelius Kelly, Austen El-Osta, Paul Thomas, Chris Brophy","doi":"10.1080/17571472.2018.1437070","DOIUrl":"10.1080/17571472.2018.1437070","url":null,"abstract":"<p><p>The rapidly increasing number of people who have long-term conditions requires a system of coordinated support for self-care throughout the NHS. A system to support self-care needs to be aligned to systems that support shared-care and community development, making it easier for the multidisciplinary teams who provide care to also help patients and populations to help themselves. Public health practitioners need to work closely with clinicians to achieve this. The best place to coordinate this partnership is a community-based coordinating hub, or local health community - a geographic area of about 50,000 population where different contributions to self-care can be aligned. A shared vision for both health and disease management is needed to ensure consistent messaging by all. A three tier system of shared care can help to combine vertical and horizontal integration. This paper uses severe and enduring mental illness as an exemplar to anticipate the design of such a system.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 2","pages":"19-23"},"PeriodicalIF":0.0,"publicationDate":"2018-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5901418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36036305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inside general practice ethics: guidelines 'and' 'of' or 'for' good clinical practice.","authors":"Andrew Papanikitas,&nbsp;Carey Lunan","doi":"10.1080/17571472.2018.1437028","DOIUrl":"https://doi.org/10.1080/17571472.2018.1437028","url":null,"abstract":"<p><p>The RCGP conference, like other annual healthcare conferences offers a protected space for reflection on ethical aspects of practice. This paper presents a summary and discussion of a fringe session led by the RCGP Committee On Medical Ethics at the 2017 RCGP annual conference in Liverpool. Well thought-out rules offer a potential solution to the burden of responsibility for making every single decision from first principles. But guidelines can be difficult to follow, too numerous to know, may conflict with each-other and may not be appropriate in all circumstances. Delegates at this meeting discussed barriers to good guideline development and implementation, perceptions of medicolegal risk in non-adherence, aspects of benefit, harm and justice in guideline use and ethical guidelines. Delegates found it easier in the meeting to critique clinical rather than ethical guidelines. There was broad agreement that understanding how to practice in relation to guidelines represented a learning need in general practice education.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 2","pages":"34-38"},"PeriodicalIF":0.0,"publicationDate":"2018-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2018.1437028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36036308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections on integrated care from those working in and leading integrated respiratory teams.","authors":"Nicola J Roberts,&nbsp;Mike Ward,&nbsp;Irem Patel,&nbsp;Janelle Yorke,&nbsp;Martyn R Partridge","doi":"10.1080/17571472.2017.1421020","DOIUrl":"10.1080/17571472.2017.1421020","url":null,"abstract":"<p><p>The concept of integrated care has been advocated for many years to address some of the challenges faced by the NHS. This report examines the experiences of respiratory healthcare specialists working in an integrated role. Twelve qualitative telephone interviews were undertaken with a range of integrated respiratory specialists and their teams working in both hospitals and the community. A descriptive and thematic approach to data analysis was adopted. Participants were very enthusiastic about their roles and saw themselves as ambassadors for this new way of working. Several key themes were identified from the analysis which participants identified as barriers or enablers to the successful undertaking of an integrated respiratory specialist role. These included the participants' previous work experience and background, the range of multi-disciplinary expertise within or needed for the team, the structure of the team leadership and the measurement of outcomes to evaluate the team. Participants identified the need for clear job descriptions and roles, shared training and standards and appropriate outcome evaluation. More research is needed to understand how these new ways of working are developing and how they can be evaluated.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 2","pages":"24-30"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2017.1421020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36036306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards hope.","authors":"Chris Manning","doi":"10.1080/17571472.2017.1415188","DOIUrl":"https://doi.org/10.1080/17571472.2017.1415188","url":null,"abstract":"LJPC is not so much a journal I would say. It is more like a movement that gives hope by championing and supporting a broad vision for health and care. It lifts our eyes beyond the single picture frame to view a whole gallery. It also provides opportunities to think freely and design systems and models of care that derive from the range of people’s needs and meet them, rather than simply describing and assessing focused aspects. Further, LJPC works with many different people’s views and experiences and, having valued them, comes up with comprehensive solutions; the words on its lips being ‘collaboration’ and ‘co-production’. As Gupta et al. enunciate in this issue: ‘Primary care can have an enhanced effect on the good mental health of the population by collaborating with others within local communities for health’. It is affirming to know that such collaboration also benefits the efficiency and health of those doing the collaborating [1]. The enhanced effects of collaborative working on individual practice reminds us that Governments and leaders of all kinds often devise strategy that does the opposite, exemplifying individual actions that can isolate and demotivate others. As John Donne famously wrote in 1624, ‘No man is an island entire of itself’.2 We are all interconnected, even if dividable, and policy should help to achieve strong, healthy inter-connections between people for the sake of the whole of society. Gupta et al. continue: ‘we hope that this paper will help general practice and more broadly, primary care, to take a strong role in developing this (force for whole-society health), in collaboration with public health, local authorities, healthcare and other organisations’. This aligns the paper to the increasing number of initiatives that enable collaboration, such as that being undertaken by The Health Foundation in its (UK Four Nation) Healthy Lives Strategy.3,4 Strategies are nothing without enactment. It is change that matters, beyond the words. LJPC has an important role to play here in supporting those who are committed to making a real difference in their own backyard. In the case of a GP, that means making a real difference to the person in front of them – one of the main duties and rewards of general practice McCartney highlights in this Issue of LJPC, general practices can fail in their duties when we fail to see patients in their full humanity and complexity and instead simply apply guidelines from medical science:","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2017.1415188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35838023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wellbeing in the Republic of Macedonia.","authors":"Nelio Oliveira","doi":"10.1080/17571472.2017.1409955","DOIUrl":"https://doi.org/10.1080/17571472.2017.1409955","url":null,"abstract":"The Republic of Macedonia is the smallest, poorest and most vulnerable country in the Balkans. It is a landlocked country, one of the successor states of the former Yugoslavia, from which it declared independence in 1991. It has borders with Kosovo to the northwest, Serbia to the north, Bulgaria to the east, Greece to the south, and Albania to the west – countries that have some kind of claim to its territory, culture and even its name. It isn’t in the European Union. The Kingdom of Macedonia was established some time during the 7th Century BC. Macedonian dominance of Greece was secured by Philip II and subsequently by his son Alexander ‘The Great’. Alexander was born in 356 BC in Pella, the ancient capital of Macedonia, situated now in the Greek part of Macedonia. From Macedonia he conquered territories all the way to India, including Persia, opening out a corridor for East-West discourse and trade [1]. After several wars against the Macedonians, the Romans defeated them in 146 BC and the country became part of the Roman Empire. Its vast arable land and rich pastures allowed huge fortunes to be amassed by the Roman rulersin a society based on slave labour. The centre of Roman power was transferred to Byzantium in the 4th Century AD and since then various armies have controlled the country, includingBulgarians, Serbs and the Ottoman empire (13th–19th centuries) [2]. The Republic of Macedonia is a pristine land with mountains, lakes and old cities. It has the economic, cultural and physical conditions to offer a good quality of life to its small population of about 2.1 million people. Well-being has decreased since the breakdown of the former Yugoslavia. This is due mostly to the de-industrialization process, and weak political institutions in the country. The climate and land are very favourable to agriculture. Most of the country enjoys a Mediterranean climate as, despite being a landlocked country, it is near to the Mediterranean Sea. This provides high quality land, varied food, excellent wine, good weather, and low pollution. However Skopje, where half of the population lives, has an unhealthy summer because it is situated in a valley that concentrates the pollution created by the vehicles. Despite this, it is worth a visit for the abundance of new gigantic bronze statues of ancient heroes, museums and excellent food and wines. Luckily, it still keeps a strong educational sector and the cultural scene is dynamic with several good museums in the capital. The population strongly and peacefully participates in the difficult political life of the country. The health sector needs improvements, as will be shown further in this article.","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 2","pages":"31-33"},"PeriodicalIF":0.0,"publicationDate":"2017-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2017.1409955","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36036307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How primary care can contribute to good mental health in adults.","authors":"Sunjai Gupta,&nbsp;Rachel Jenkins,&nbsp;John Spicer,&nbsp;Marina Marks,&nbsp;Nigel Mathers,&nbsp;Lise Hertel,&nbsp;Laura Calamos Nasir,&nbsp;Fiona Wright,&nbsp;Baljeet Ruprah-Shah,&nbsp;Brian Fisher,&nbsp;David Morris,&nbsp;Kurt C Stange,&nbsp;Robert White,&nbsp;Gina Giotaki,&nbsp;Tony Burch,&nbsp;Catherine Millington-Sanders,&nbsp;Steve Thomas,&nbsp;Ricky Banarsee,&nbsp;Paul Thomas","doi":"10.1080/17571472.2017.1410043","DOIUrl":"https://doi.org/10.1080/17571472.2017.1410043","url":null,"abstract":"<p><p>The need for support for good mental health is enormous. General support for good mental health is needed for 100% of the population, and at all stages of life, from early childhood to end of life. Focused support is needed for the 17.6% of adults who have a mental disorder at any time, including those who also have a mental health problem amongst the 30% who report having a long-term condition of some kind. All sectors of society and all parts of the NHS need to play their part. Primary care cannot do this on its own. This paper describes how primary care practitioners can help stimulate such a grand alliance for health, by operating at four different levels - as individual practitioners, as organisations, as geographic clusters of organisations and as policy-makers.</p>","PeriodicalId":89823,"journal":{"name":"London journal of primary care","volume":"10 1","pages":"3-7"},"PeriodicalIF":0.0,"publicationDate":"2017-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/17571472.2017.1410043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35838025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}