Primary Care Knowledge Boost

Doctors Lisa and Sara talk with Consultant Psychiatrist Dr Mark Spurrell about a framework that can be applied to the care of complex patients with multiple problems or difficulties. It is particularly useful at times where we feel stuck, we are struggling to help or move forward and care may be fragmented with lots of care professionals feeling similarly. The idea is to use a value based approach using the whole team to breathe new life into the scenario, create positivity and momentum and build on this to help generate better outcomes for patients that are tailored to their values. 

The idea is originally for the MDT approach of Mental Health work but it has been interesting to discuss the approach for General Practice Patients. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• Spurrell M, Potts L, Shaw A. Framing Value Based Healthcare in Practice: Introducing the Complex Case and Recovery Management Framework (The CCaRM). Int J Integr Care. 2023 Jan 9;23(1):1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9838237/

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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback

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This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to Optometrist Dharmesh Patel to get an understanding of Optometry as part of the Primary Care Team. We discuss how the service is set up, what can be done at the Opticians, different types of patient access and how GP practices can link in with services. We discuss the Community Urgent Eye Care Service (CUES), Minor Eye Conditions Service (MECS) and Community Eye Care Service (CECS).

We take a few examples of cases to illustrate options for accessing services in Greater Manchester. Check out the links in the resources section for more about these services. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• Generic Introduction to Optometry and Opticians in the UK for Patients: https://www.nhs.uk/nhs-services/opticians/visiting-an-optician/

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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara talk to GP Dr Charlotte Bădescu about Ovarian Cancer. We focus on the important learning points about cardinal and other features of presentations to better understand this cancer as an abdominal cancer with symptoms that can and do often present much earlier than the diagnosis is often picked up. She talks us through the value of CA125 tests and the reasons not to be overly reliant on them, though they can be a useful tool in the tool box. The usefulness of ultrasound scans, both pelvic and transvaginal, as well as clinician continuity is discussed.  We go through 2 hypothetical cases based on real examples as well as Charlotte’s own diagnosis. An excellent episode for picking up great learning points to avoid missing this diagnosis in your own patients. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• NICE Guidelines: Suspected Cancer, Recognition and Referral (Dec 2021): https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#gynaecological-cancers

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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara are joined by Community Pharmacist and Director of Pharmacy Transformation for Greater Manchester Luvjit Kandula. We learn all about the Essential Services and Enhanced Services Community Pharmacies are engaged in and get an understanding of the pressures Community Pharmacies are under. We discuss the plans for upcoming transformations and top tips to avoid errors in prescribing and to help take some of the pressure off Pharmacy teams. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• The Kings Fund, Community Pharmacies Explained: https://www.kingsfund.org.uk/publications/community-pharmacy-explained

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara are joined this week by Dominic Anderson (Programme Director of the Health and Wellbeing Programme Greater Manchester), Lorna Laflin (Former Practice Manager who works with the GP Excellence team) and Joanna Bircher (GP and Programme Director for GP Excellence). We discuss the new QOF indicators around Workforce and Wellbeing in General Practice. We learn what the indicators are and get hints and tips about how to achieve them. We come at this slightly sceptical of the workload this might put on practices but are glad of the opportunity to talk thought the underlying principles of trying to support practices, what that support might look like and how to approach this in a quality improvement way that might help all staff, including those charged with collecting this data. This leads us to talk about Compassionate leadership. Please check out our episode resources for links and guides to these things. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

New wellbeing QOF indicator to reduce GP burnout risk, Pulse Article March 2023: https://www.pulsetoday.co.uk/news/clinical-areas/mental-health-and-addiction/new-wellbeing-qof-indicator-to-reduce-gp-burnout-risk/

Quality and Outcomes Framework guidance for 2023/24: https://www.england.nhs.uk/publication/quality-and-outcomes-framework-guidance-for-2023-24/

Greater Manchester Resilience Hub: https://www.penninecare.nhs.uk/gmrh

Greater Manchester Health and Wellbeing Resources: https://gmprimarycare.org.uk/workforce/health-and-wellbeing/

King’s Fund Kind and Compassionate Leadership Online Learning Resource: https://www.kingsfund.org.uk/courses/introduction-kindness-compassion-health-and-social-care

Kindness Leadership Network: https://carnegieuktrust.org.uk/publications/commitment-to-kindness/

Book: West M. Compassionate Leadership; sustaining wisdom, humanity and presence in health and social care. The Swirling Leaf Press. London, 2021:  https://www.amazon.co.uk/gp/product/0995766975/ref=dbs_a_def_rwt_bibl_vppi_i1

Podcast: The Compassionate Leadership Interview with Chris Whitehead: https://www.podbean.com/podcast-detail/cdwzg-b7b51/The-Compassionate-Leadership-Interview-Podcast

Book:  The Leadership Hike: Shaping Primary Care Together. Rughani A, Bircher J. CRC Press 2020:

Staff Risk Assessments with Templates. Health and Safety Executive Website, Managing Risk and Risk Assessments at Work: https://www.hse.gov.uk/simple-health-safety/risk/index.htm

Looking after you too Coaching Support from NHSE: https://www.england.nhs.uk/supporting-our-nhs-people/support-now/looking-after-you-confidential-coaching-and-support-for-the-primary-care-workforce/looking-after-you-too/

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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara speak with Dr Uma Marthi who is a GP with a Specialist Interest in Gynaecology about red flags for gynaecological cancers. We discuss some cases based on real patients that involve cervical, vaginal and endometrial cancers. We’ll be recording a separate episode around the varied presentations of Ovarian cancer. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

NICE guidelines for Red Flags for Gynaecological Cancers (Updated Dec 2021): https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#gynaecological-cancers

Cancer Research UK: https://www.cancerresearchuk.org/about-cancer/

Jo’s Trust for Cervical Cancer: https://www.jostrust.org.uk/

The Eve Appeal: UK Charity funding research and raising awareness of the five gynaecological cancers – womb, ovarian, cervical, vulval and vaginal: https://eveappeal.org.uk/

Go Girls: UK Charity Supporting Women with Gynaecological Cancers: https://www.gogirlssupport.org/

BMJ Research Article: Prevalence of cervical disease at age 20 after immunisation with bivalent HPV vaccine at age 12-13 in Scotland: retrospective population study (April 2019): https://www.bmj.com/content/365/bmj.l1161

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

**Summer Rewind: This episode was first released on Nov 30th 2022**

Doctors Lisa and Sara talk to Consultant Otolaryngologist Ms Emma Stapleton and Clinical Scientist David Jay about Vertigo. We discuss the definition, differentials, and how to use information around timing and triggers to differentiate between the likely causes of vertigo. We get their take on the important details in the examination that can help identify the diagnosis, and talk options for managing the most common types of peripheral vertigo.

The resources section of the episode description contains excellent resources to help, including examples of how to perform and interpret the Head Impulse test, as well as vestibular rehabilitation resources for patients. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE . Nov 2009, Stroke: https://pubmed.ncbi.nlm.nih.gov/19762709/

A summary of HINTS by David Jay: Developments in diagnostic approaches for acutely dizzy patients: (Feb 2020 ENT & Audiology News): https://www.entandaudiologynews.com/features/audiology-features/post/developments-in-diagnostic-approaches-for-acutely-dizzy-patients

TiTrATE: A Novel Approach to Diagnosing Acute Dizziness and Vertigo. Newman-Toker and Edlow J A. Neurology Clinics (Aug 2015)  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522574/

The Five Deadly D’s of Dizziness (red flags to remember): EM Resident, Unravelling the Mystery of Dizziness in the ED: A Guide for the Student Clerkship, Oct 2018 Wilcox K, Shafer K: https://www.emra.org/emresident/article/dizziness/

BMJ Vertigo: Dix-Hallpike Video: https://www.youtube.com/watch?v=8RYB2QlO1N4

BMJ Vertigo: Epley Manoeuvre Video: https://www.youtube.com/watch?v=jBzID5nVQjk&t=44s

Examples of how to perform the Head Impulse Test for Peripheral Vestibular Dysfunction:

            https://www.youtube.com/watch?v=psyPED6anPo

            https://www.youtube.com/watch?v=XpghlvnrREI

Professor Lucy Yardley: Retraining your Balance: https://www.menieres.org.uk/files/pdfs/balance-retraining-2012.pdf

VeDA Vestibular Disorders Association USA Resources for Clinicians and Patients: 

VeDA Vestibular Disorders Association USA Resources for Clinicians and Patients: 

Meniere’s Society UK: https://www.menieres.org.uk/

The Migraine Trust: https://migrainetrust.org/

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara speak with GP Dr Allison Rees for her advice on how to approach GP Appraisals and Revalidation. We heard her talk about this in a Health Education England First Five talk a few years ago and found it so helpful. We cover why they can be useful, the practicalities of what needs to be done and how to make them work for you. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• RCGP Guide to your Appraisal: https://www.rcgp.org.uk/your-career/revalidation/supporting-information-guidance

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Sara and Lisa talk to Dr Wasim Javed, ST6 in Cardiology, about the diagnosis and management of Angina. Taking a theoretical case we talk through symptoms, differentials, diagnosis, including the guidelines and practicalities of different types of functional and non-functional tests, as well types of angina and their management. It was useful to understand the initial management once diagnosed, and where further investigations or referrals/discussions with cardiology come in. As well as the above, we discuss the difference between medical management and stenting and some of the third line anti-anginal medications. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• NICE guidelines on Stable Angina (updated July 2016): https://www.nice.org.uk/guidance/cg126

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Sara and Lisa talk to talk to Dr Mary Cheshire who is the GP lead on the NHS England Fellowships for Greater Manchester GPs. As she explains, this is a fairly informal fellowship done over 2 years offering different types of courses and support that essentially consists of a paid CPD session a week and a range of CPD events to facilitate this. The course runs a qualification in coaching people can sign up for and are offered Mentors. Completing a quality improvement project is encouraged, whether that is small or large and there are opportunities for support for this along the way. At the moment this is available for newly qualified GPs and those up to 2 years after CCT who are in Salaried or Partnership posts. 

There are other types of Fellowships - we mention the Health Education England GP Fellowships and GP Nurses Fellowships briefly, see details below. 

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

• The Greater Manchester Training Hub GP Fellowship Information: https://www.gmthub.co.uk/our-programmes/gp-fellowship

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our really quick anonymous survey here: https://pckb.org/feedback

___

This podcast has been made with the support of GP Excellence and Wigan CCG. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.