Primary Care Knowledge Boost

Doctors Sara and Lisa speak with Dr John Patterson about Health Inequalities. This is the second of our two talks on Health Inequalities, please check out Dr Laura Neilson’s talk before this one. Dr John Patterson is a GP and Medical Director of Hope Citadel, as well as their Focused Care Lead and the Chief Clinical Officer for Oldham CCG. We discuss the social determinants of health and a working definition of health inequalities. He talks to us about his journey into tackling health inequalities, his projects, and others of interest. He makes a compelling case as to the importance of health inequalities, and how ‘the right thing is always the smart thing to do’.

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

Useful resources: 

Book: Tackling Causes and Consequences of Health Inequalities: A Practical Guide (2020) Edited By James Matheson, John Patterson, Laura Neilson: https://www.routledge.com/Tackling-Causes-and-Consequences-of-Health-Inequalities-A-Practical-Guide/Matheson-Patterson-Neilson/p/book/9781138499867

Hope Citadel Resources: https://hopecitadel.org.uk/

Focused Care (service model to work with the most vulnerable families in communities): https://focusedcare.org.uk/

The Shared Health Foundation: https://sharedhealthfoundation.org.uk/

Greater Manchester Deprivation GP training programme: https://www.docsindepgpst.org.uk/

The Marmot Review 10 Years On: https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on?gclid=Cj0KCQjwkt6aBhDKARIsAAyeLJ28cEVgCnGVUAgk9SflEGZnM-Q0iZ76by6yxw7R-T0CktbmSGIqllkaAg9CEALw_wcB

Doctors John Patterson and Laura Neilson both mention the Eden Project: https://joineden.org/

Maslow’s Hierarchy of Needs (discussed as an approach to Health): https://www.gp-training.net/communication-skills/communication-skills-theory/maslows-hierarchy-of-needs

Professor Steve Fields (Previously NHS England’s Deputy National Medical Director, with the lead responsibility for addressing health inequalities): http://www.homelessnessandhealth.co.uk/events/2017/professor-steve-field/

Interesting Paper Mentioned: North and South: addressing the English health divide, Clare Bambra, Ben Barr, Eugene Milne (2014): https://academic.oup.com/jpubhealth/article/36/2/183/2901779

Related Blog: What can German reunification teach the UK about levelling up? UK policymakers can learn lessons from the German experience to help level up the UK economy Kathrin Enenkel (2021): https://www.centreforcities.org/blog/what-can-german-reunification-teach-the-uk-about-levelling-up/

Common-Wealth health Inequalities Global Research: https://www.common-wealth.co.uk/

David Buck Kings Fund Focused Secondary Prevention in Primary Care is the fastest way to close health inequalities: https://www.kingsfund.org.uk/blog/2011/04/incentivising-public-health-primary-care-learning-qof

The Black Report on Health Inequalities in 1980: https://navigator.health.org.uk/theme/black-report-health-inequalities

NHS Health Inequalities Oversight Group: https://www.england.nhs.uk/about/equality/equality-hub/national-healthcare-inequalities-improvement-programme/our-approach-to-reducing-healthcare-inequalities/strategic-drivers/

Core20PLUS5 A national approach to reducing health inequalities explained: https://www.england.nhs.uk/about/equality/equality-hub/national-healthcare-inequalities-improvement-programme/core20plus5/

Bentley C and Leaman J Health Inequalities: National Support Team Priority actions based upon best practice that could impact inequalities in mortality and life expectancy in the short term  (accessed Oct 2022): https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/215329/dh_130949.pdf

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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 Sara and Lisa talk to Dr Laura Neilson the founder of Hope Citadel who is passionate about tackling Health Inequalities. She talks to us about the importance of addressing them, what the inverse care law is, and skills that people will find useful working in areas of deprivation. We ask her about her projects which include helping create Hope Citadel; a growing group of practices working in areas of deprivation in Manchester, Focused Care; a project that facilitates this, and the Shared Health Foundation. We ask what we in general practice can do to help, and talk about coping with the challenges.

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

Useful resources: 

Book: Tackling Causes and Consequences of Health Inequalities: A Practical Guide (2020) Edited By James Matheson, John Patterson, Laura Neilson: https://www.routledge.com/Tackling-Causes-and-Consequences-of-Health-Inequalities-A-Practical-Guide/Matheson-Patterson-Neilson/p/book/9781138499867

Hope Citadel Resources: https://hopecitadel.org.uk/

Focused Care (service model to work with the most vulnerable families in communities): https://focusedcare.org.uk/

The Shared Health Foundation: https://sharedhealthfoundation.org.uk/

Policy and Advocacy advice from Shared Care Foundation; how to get involved with their projects: https://sharedhealthfoundation.org.uk/policy-and-advocacy/

Greater Manchester Deprivation GP training programme: https://www.docsindepgpst.org.uk/

The Marmot Review 10 Years On: https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on?gclid=Cj0KCQjwkt6aBhDKARIsAAyeLJ28cEVgCnGVUAgk9SflEGZnM-Q0iZ76by6yxw7R-T0CktbmSGIqllkaAg9CEALw_wcB

The Inverse Care Law explained: https://www.kingsfund.org.uk/publications/articles/inverse-care-law

Lives on the Line: Life Expectancy at Birth & Child Poverty as a Tube Map: https://life.mappinglondon.co.uk/

All Party Parliamentary Group for improving the lives of people in Temporary Accommodation across England:  https://householdsintemporaryaccommodation.co.uk/

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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 GP Dr Uma Marthi about Endometriosis; a topic she is passionate about due to the common delay in diagnosis, coupled with the impact this condition has on peoples’ lives.  We talk through a hypothetical case and explore differential diagnoses for dysmenorrhoea, examination tips, investigations and management. We discuss the importance and impact of this condition, fertility and the need to think about and treat this as soon as we can.

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

Useful resources: 

NICE Clinical Knowledge Summaries, Dysmenorrhoea: https://cks.nice.org.uk/topics/dysmenorrhoea/

NICE Clinical Knowledge Summaries, Endometriosis: https://cks.nice.org.uk/topics/endometriosis/

All Parliamentary Group on Endometriosis: https://www.endometriosis-uk.org/all-party-parliamentary-group-endometriosis

Endometriosis UK: https://www.endometriosis-uk.org/

European Society of Human Reproduction and Embryology Endometriosis Guidelines: https://www.eshre.eu/Guideline/Endometriosis

Guardian Article: Endometriosis took my fertility, and part of my self

All Party Parliamentary Group (APPG) on Endometriosis Inquiry Report 2020: https://www.endometriosis-uk.org/sites/default/files/files/Endometriosis%20APPG%20Report%20Oct%202020.pdf

British Society for Gynecological Endoscopy, includes links to Specialist Endometriosis Centres around the UK: https://www.bsge.org.uk/

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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 Dr Avil Danczak to talk about how we can use consultation skills to improve our time management in General Practice. She takes us through first principles and core skills before talking about common pitfalls and how to avoid them. The principles of all we discuss are elaborated on in the ‘Teaching and Learning Consultation Skills’ (TALC) resources that are available for all to access online in the link below. 

Useful resources: 

Teaching and Learning Communication Skills Resources: https://www.gmthub.co.uk/talc

Mapping Uncertainty in Medicine: What to Do When You Don't Know What to Do? Book By Dr Avril Danczak: 

___

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 speak with Consultant Psychiatrist Dr Raja Mukherjee about neurodevelopmental disorders in children. He has an interest in Foetal Alcohol Spectrum Disorder (FASD) and this is the focus of the talk. We cover what neurodevelopmental disorders are, discuss neurodiversity, common disorders such as Autism, ADHD, Dyspraxia aka Developmental Coordination Disorder and Foetal Alcohol Spectrum Disorder. 

Useful resources: 

NICE Foetal Alcohol Spectrum Disorders: https://www.nice.org.uk/guidance/qs204

My FASD and Me (Foetal Alcohol Spectrum Disorder resource): https://fasd.me/

Foetal Alcohol Syndrome Spectrum Disorder (FASD) Awareness Month Resources including information on the Campaign #Drymester: https://www.drymester.org.uk/resource/fasd-awareness-month-assets/

National FASD trust: https://nationalfasd.org.uk/about-us/who-we-are/

National FASD CPD accredited e-Learning and their website provides expert led advice for GPs and other health care professionals: https://nationalfasd.org.uk/learn-more/training/e-learning/

Greater Manchester based support group for FASD: https://fasdgreatermanchester.co.uk/

Prevention, Recognition and Management of Fetal Alcohol Spectrum Disorders Hardcover – 1 Aug. 2021

The National Autistic Society: https://www.autism.org.uk/

FASD Book: Strategies not solutions: https://edmontonfetalalcoholnetwork.org/wp-content/uploads/2019/02/strategies_not_solutions_handbook.pdf

The Time Is Now Book about Foetal Alcohol Spectrum Disorder: https://nationalfasd.org.uk/wp-content/uploads/2022/03/National-FASD-RT-Report-v004-INTERACTIVE-singles-2.pdf

___

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.

*Recorded in June 2020 - Summer Replay*

In this episode Lisa and Sara talk to Dr Avril Danczak, a GP with an interest in managing uncertainty in medicine which led to her co-authoring the RCGP published book called Mapping Uncertainty in Medicine.

Useful resources: 

Book: Mapping uncertainty in medicine, what to do when you don’t know what to do; Avril Danczak, Alison Lea and Geraldine Murphy (2016): https://www.amazon.co.uk/Mapping-Uncertainty-Medicine-What-When/dp/0850844053

Paper: Varieties of uncertainty in medicine; Paul Han, William Klein and Neeraj Arora (2011): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3146626/

Paper: Dealing with uncertainty in general practice: an essential skill for the general practitioner; Margaret O’Riordan et al: https://pubmed.ncbi.nlm.nih.gov/21781433/

Bradford VTS Resources on decisions, diagnoses and uncertainty: https://www.bradfordvts.co.uk/clinical-skills/decisions-diagnoses-uncertainty/

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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://www.surveymonkey.co.uk/r/YLN6GKT

___

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.

This week’s episode is designed for primary care clinicians wanting an overview of current diabetes management. Doctors Lisa and Sara are joined by Dr Marlon Morais and Nicola Milne to talk first about Type 1 diabetes briefly (from the GP point of view) before going on to discuss the recent changes to the NICE guidelines for management of Type 2 Diabetes Mellitus. We cover useful ways of sifting through the options for medicines and the importance of a holistic approach and the NHS low calorie programmes. The resource list is incredibly useful. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

Visual Summary of NICE Guidelines (Feb 2022): https://www.nice.org.uk/guidance/ng28/resources/visual-summary-full-version-choosing-medicines-for-firstline-and-further-treatment-pdf-10956472093#page=2

Diabetes UK Emotional Wellbeing Module CPD: https://www.diabetes.org.uk/professionals/training--competencies/courses/emotional-wellbeing-module

Diabetes on the Net Six Steps to Insulin Safety Module for Healthcare Professionals (based on key recommendations by NICE in 2017): https://diabetesonthenet.com/diabetes-news/six-steps-to-insulin-safety-e-learning-module/

Trend Diabetes Injection Technique Matters: https://trenddiabetes.online/injection-technique-matters/

NICE Clinical Knowledge Summaries: Type 2 Diabetes Mellitus Management for Adults: https://cks.nice.org.uk/topics/diabetes-type-2/management/management-adults/

Diabetes in Control, When and When Not to use an SGLT2 Inhibitor (traffic light system): http://www.northoftyneapc.nhs.uk/wp-content/uploads/sites/6/2021/12/SGLT-2-Top-Tips-V7.pdf

SGLT2 inhibitors: Indications, doses and licences from Diabetes & Primary Care: https://diabetesonthenet.com/wp-content/uploads/Brown_Need-to-know-SGLT2is.pdf

Diabetes drugs and renal impairment: Updated GPnotebook Shortcuts (Nov 2021): https://diabetesonthenet.com/journal-diabetes-nursing/diabetes-drugs-and-renal-impairment-updated-gpnotebook-shortcuts/

Diabetes on the Net At a Glance Factsheets: https://diabetesonthenet.com/tag/at-a-glance-factsheet/

Diabetes UK: What is a Healthy, Balanced Diet for Diabetes: https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/what-is-a-healthy-balanced-diet

The DiRECT Trial: Weight Management Interventions in Type 2 Diabetes Mellitus (informing the Low Calorie Diet Pilots): https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30068-3/fulltext

Sick Day Rules for Type 1 Diabetes Mellitus Leicester: https://static1.squarespace.com/static/5c2ccb867c93271f5edc9718/t/5ed7a143ee2bfa731b017aac/1591189828264/Sick_Day_Rules_T1_Infographic_V4%5B1438%5D.pdf

Sick Day Rules for Type 2 Diabetes Mellitus Leicester: 

NHS Very Low Calorie Diets: https://www.england.nhs.uk/diabetes/treatment-care/low-calorie-diets/https://preventing-diabetes.co.uk/know-your-risk-dtc/

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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 Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough 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 Diabetes Lead for Manchester CCG GP Dr Marlon Morais and Diabetes Support Lead and Diabetes Specialist Nurse Nicola Milne to discuss diagnosis of Diabetes Mellitus. We go through the types of Diabetes Mellitus, touching on MODY and LADA and get advice on avoiding common pitfalls in making a new diagnosis of Diabetes in General Practice. We talk about the prevalence and importance of this diagnosis, both for patients and the NHS and red flags to look out for. We then cover impaired fasting glucose and the current management options for this including the NHS Diabetes Prevention Programme.  You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

Diabetes UK: types of Diabetes Mellitus explained: https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes

WHO Classification of Diabetes Mellitus (2019): https://www.who.int/publications/i/item/classification-of-diabetes-mellitus

GP Notebook Clinical Classification of Diabetes Mellitus (2021): https://gpnotebook.com/en-gb/simplepage.cfm?ID=-26542064

What is MODY Maturity-Onset Diabetes of the Young?: https://www.diabetesgenes.org/what-is-mody/

NICE guidelines: When to suspect Type 2 Diabetes Mellitus (April 2022): https://cks.nice.org.uk/topics/diabetes-type-2/diagnosis/diagnosis-in-adults/

NICE CKS Guidelines Type 1 Diabetes Mellitus (Nov 2020): https://cks.nice.org.uk/topics/diabetes-type-1/

Language Matters in Diabetes: https://www.england.nhs.uk/publication/language-matters-language-and-diabetes/

Diabetes UK Information Prescriptions: https://www.diabetes.org.uk/professionals/resources/resources-to-improve-your-clinical-practice/information-prescriptions-qa

Finish Diabetes Prevention Study (2003): https://diabetesjournals.org/care/article/26/12/3230/21849/The-Finnish-Diabetes-Prevention-Study-DPS

National Diabetes Prevention Programme: https://www.england.nhs.uk/diabetes/diabetes-prevention/

Flatbush Diabetes information on GP Notebook:  https://gpnotebook.com/en-gb/simplepage.cfm?ID=x20160928141517439169

Effects of Diet and Exercise in Preventing NIDDM in People With Impaired Glucose Tolerance: The Da Qing IGT and Diabetes Study (Apr 1997): https://diabetesjournals.org/care/article/20/4/537/22408/Effects-of-Diet-and-Exercise-in-Preventing-NIDDM

The Da Qing IGT and Diabetes Study 30 year follow up: Morbidity and mortality after lifestyle intervention for people with impaired glucose tolerance: 30-year results of the Da Qing Diabetes Prevention Outcome Study. Lancet Diabetes Endocrinol. Jun 2019: https://pubmed.ncbi.nlm.nih.gov/31036503/

NHS Diabetes Prevention Programme: Know Your Risk Patient Calculator: https://preventing-diabetes.co.uk/know-your-risk-dtc/

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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 Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough 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 welcome Consultant Haematologist Dr Chris Gregory back to the podcast to discuss bruising and bleeding issues. We go through history, examination and differentials including patterns of bleeding more associated with different causes. We cover what constitutes excessive/concerning bleeding and blood test values that would lead to on the day/urgent referrals. At the end of the episode, you will hear our learning points. You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources: 

Clinical Knowledge Summaries: Bruising (March 2021) https://cks.nice.org.uk/topics/bruising/

BMJ article Survey, Vitamin C deficiency as a cause of bruising: https://www.bmj.com/content/375/bmj.n2511.full

NICE Suspected Cancer Referrals for Haematological Malignancies (as of Dec 2021): https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#haematological-cancers

Greater Manchester Safeguarding Guidelines for Bruising in Non-mobile Children: https://greatermanchesterscb.proceduresonline.com/chapters/pr_bruising_babies_child.html

British Society for Haematology Guidelines: https://b-s-h.org.uk/guidelines/

Non UK based Information: American Family Physician Feb 2016 ‘Clinical evaluation of bleeding and bruising in primary care’. Includes a helpful breakdown of normal vs excessive bleeding etc: https://www.aafp.org/afp/2016/0215/p279.html

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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 Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough 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.

Drs Lisa and Sara were thrilled to welcome Professor Dame Helen Stokes-Lampard onto the podcast to talk about one of her passions within medicine - social prescribing. They discuss what social prescribing is and why it matters. They talk about the National Academy of Social Prescribing, and its current roles and remit. There are some great examples shared about social prescribing in action, and resources highlighted where people can find out more information about getting involved and having social prescribing link workers in practice.

Useful resources: 

Greater Manchester Primary Care Careers: https://gmprimarycarecareers.org.uk/jobs/

Greater Manchester Training Hub: https://www.gmthub.co.uk

NHS England - Social Prescribing: https://www.england.nhs.uk/personalisedcare/social-prescribing/

Academy of Medical Royal Colleges: https://www.aomrc.org.uk/

National Academy for Social Prescribing: https://socialprescribingacademy.org.uk/

National Academy for Social Prescribing Twitter: https://twitter.com/NASPTweets

Global Social Prescribing Alliance: https://www.gspalliance.com/

Men’s Sheds: https://menssheds.org.uk/

The Money and Pensions Service: https://moneyandpensionsservice.org.uk/

Park Run: https://www.parkrun.org.uk/

English National Opera - Breathe: https://www.eno.org/eno-breathe-3/

Campaign to End Loneliness: https://www.campaigntoendloneliness.org/

Football Association - Walking Football: https://thewfa.co.uk/

___

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 Greater Manchester Health and Social Care Partnership, GP Excellence, Greater Manchester Training Hub and the GP Fellowship Programme, as well as Wigan Borough 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.