Talking General Practice

Emma speaks to GP Dr Aisha Awan who is director of REACHE North West - the Refugee and Asylum Seekers Centre for Healthcare Professionals Education.

REACHE has helped hundreds of healthcare professionals to return to clinical roles in the NHS after being forced to flee their own country.

In this conversation Aisha explains how REACHE supports these clinicians to become registered in the UK, why this work is so important and some of the challenges that healthcare professionals who are refugees or asylum seekers face during this process. She also shares some inspiring stories of some of the doctors REACHE has supported in recent years.

For more information on the programme visit REACHE North West

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This week Emma talks to Jake Beech, from health think tank the Health Foundation. Jake co-authored a report published last month, which analysed the findings of the latest Commonwealth Fund survey of 10,000 GPs in 10 high income countries.

In this conversation Jake explains how general practice in the UK compares with other countries on issues such as job satisfaction, workload, personal wellbeing of GPs, how care is delivered and how general practice works with other services. He also discusses some of the wider implications of the survey’s findings.

Useful links

The Health Foundation’s report Stressed and overworked. What the Commonwealth Fund’s 2022 International Health Policy Survey of Primary Care Physicians in 10 Countries means for the UK can be found here.

Extreme pressure leaves UK GPs among most stressed and least satisfied

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In a special news episode of the podcast the team looks at the findings of an independent review of integrated care systems, which was commissioned by the government and led by former Labour health secretary Patricia Hewitt. 

The final report from the review was published this week and Emma and Nick look at what it had to say about primary care – including some recommendations that could see a major change to GP contracts – and what it could mean for general practice in the future. They also look at some of the wider findings about changes that need to happen to help improve outcomes and patient care.

This episode was presented by GPonline editor Emma Bower and news editor Nick Bostock. It was produced by Czarina Deen.

Useful links

• GP contract 'a barrier to innovation' and needs major overhaul, says Hewitt review
• Struggling GP practices should be 'bought out' and replaced, says Hewitt review
• Companies could 'strong-arm' GPs into selling practices under Hewitt plan, warns BMA
• Hewitt Review: an independent review of integrated care systems

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This week the team looks at whether GPs will be prepared to take industrial action following the imposition of a contract for the second year in a row – and what action the profession could be balloted on taking in the coming months.

They discuss the results of the latest annual British Social Attitudes survey, which assesses public satisfaction with the NHS.

And, as junior doctors step up pressure on the government to improve their pay by announcing a four-day strike, they talk about what this could mean for the NHS, as well as what is happening with the pay offer for other NHS staff.

Finally there’s some good news on COVID vaccination and long COVID.

This episode was presented by GPonline editor Emma Bower, who is joined by our news editor Nick Bostock and senior reporter Eleanor Philpotts. It was produced by Czarina Deen.

Useful links

●     BMA ballot could trigger nationwide shut down of GP practices for 24 hours

●     Treasury set to claw back millions from general practice despite soaring costs

●     Vast majority of GPs ready for industrial action, LMC poll suggests

●     GP Insight workforce tracker

●     'Wake-up call' for government as NHS and GP satisfaction hit all-time low

●     Vaccination halves risk of developing long COVID, study finds

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Warning: This episode contains discussions about death and suicide

In a special episode Emma looks at the issue of assisted dying and asks whether it should be legalised - and if it was, how could it work?

Later this year a bill will be introduced to the Scottish parliament that could see assisted dying legalised. In England the House of Commons health and social care committee is running an inquiry on the issue.

The Scottish bill is being put forward by Lib Dem member of Scottish parliament Liam McArthur. This is the third attempt to legalise assisted dying in Scotland since 1999, so could the law change this time?

Emma speaks to Scottish GPs on both sides of the debate about assisted dying.

She talks to Liam McArthur about why he is introducing the bill and its chances of success - and to GP Dr Sandesh Gulhane, a Conservative member of Scottish parliament who chaired a medical advisory group that produced a report on how assisted dying should work.

She also meets Dr Catherine Forest, a family doctor from California where assisted dying has been legal since 2016. Dr Forest was involved with work that helped pave the way for legalising assisted dying and and now supports patients and their families through the process of assisted dying. She also speaks very movingly about her husband Will, who chose an assisted death in 2021.

And we look at what a change of law could mean from patients’ point of view by talking to Jackie Roberts, who lives in Edinburgh and has incurable breast cancer, and Professor Kevin Yuill, a representative from Not Dead Yet, a group of disability activists that campaigns against assisted dying.

This episode was produced by Czarina Deen.

Sources

• Proposed Assisted Dying for Terminally Ill Adults (Scotland) Bill
• Medical Advisory Group Report on the assisted dying bill
• Proposed Assisted Dying for Terminally Ill Adults (Scotland) Bill - summary of consultation responses
• YouGov survey on assisted dying
• BMA survey of members on assisted dying from February 2020
• RCGP rejects change in stance on assisted dying - from GPonline
• Regional Euthanasia Review Committee from the Netherlands annual reports - showing the proportion of people who died by euthanasia.
• Dignitas report showing accompanied suicides per year and country of residence
• Third annual report on Medical Assistance in Dying in Canada 2021
• Oregon Death with Dignity Act 2021 data summary
• Dignity in Dying’s Last Resort report
• ONS suicide report
• Are Canadians being driven to assisted suicide by poverty or healthcare crisis? The Guardian
• Cost estimates for Medical Assistance in Dying

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This week Emma and Nick are talking about the GP contract changes in England for 2023/24, which have been imposed on practices for the second year in a row after the government and the BMA failed to reach an agreement. They look at what the changes are, the implications for general practice and what could happen next.

They also discuss this week’s unprecedented junior doctors’ strike, and speak to doctors who were out on the picket lines, and they look at what this week’s Budget means for doctors’ pensions and the NHS as a whole.

This episode was presented by GPonline editor Emma Bower and news editor Nick Bostock. It was produced by Czarina Deen.

Useful links

●     What is changing in the GP contract for 2023/24?

●     Imposed contract threatens 'irreparable' damage to general practice

●     'Whack-a-mole' access targets will force GPs to bring in waiting lists for appointments

●     QOF could be 'streamlined' from 2024 onwards, NHS England says

●     'Industrial action is the only option': GPs urge BMA to move fast

●     'Big win' for retention of doctors as Budget overhauls punitive pension tax rules

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Emma speaks to Ben Gowland, director and founder of think tank and consultancy Ockham Healthcare and host of the General Practice Podcast.

Ben does a lot of work with primary care networks (PCNs) across England and in this conversation we look at what the future holds for PCNs as we enter the final year of the five-year GP contract that led to their introduction in 2019.

Ben explains why he thinks it's so important that practices engage with their PCN and the opportunities he believes PCNs provides practices. We also talk about what integrated care systems and the Fuller report could mean for PCNs and why it's important for general practices to work together to have the biggest possible influence in their local area.

This episode was presented by GPonline editor Emma Bower and produced by Czarina Deen.

Useful links

●     Ockham Healthcare

●     General Practice Podcast

●     ICB draft contract spells out plan to move enhanced services worth millions away from practices

●     GP crisis driving rise in partnership and PCN disputes

●     Top 10 challenges facing PCN clinical directors

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This week the team talks about ongoing GP contract negotiations in England for next year and asks whether the contract for 2023/24 could be imposed.

They discuss a rise in partnership and PCN disputes and what might be behind this trend as well as the latest on this month’s junior doctor strikes.

They also look at the government’s record on the NHS, including how it’s handling the care backlog and discuss GP workforce statistics after they passed a pretty grim milestone last month.

Our good news story this week is about a local patient campaign that’s forced an integrated care board to U-turn on its plans for a large provider to take over a small practice in Lancashire.

Produced by Czarina Deen

Useful links

●     GP contract could overhaul funding frameworks worth £2.5bn a year

●     NHS 'in full-blown crisis' as recovery plan falls short, MPs warn

●     'Grim milestone' passed in steady decline of GP workforce

●     Why GP trainees will join junior doctor strikes in their thousands

●     Victory for campaign to save local GP after ICB U-turn on practice takeover

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Emma speaks to Dr Rowena Christmas, chair of RCGP Wales and a GP in the Wye Valley on the Welsh/English border.

Rowena has been heavily involved in the college’s work over the past couple of years on relationship-based care - or continuity of care - and in this conversation she explains why she feels this is so important and how GPs and practices can embed this in the way that they work.

She also talks about recruitment and retention of GPs and what’s happening in Wales, the impact recent NHS pressures have had on GPs and her priorities over the next two years as chair of the college in Wales.

This episode was presented by GPonline editor Emma Bower and produced by Czarina Deen.

Useful links

·      GP access debate must shift to emphasise quality as well as speed, warns RCGP

·      The RCGP's report on relationship-based care

·      RCGP Wales

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In our fortnightly news review the team looks at what we know about GP contract negotiations in England for 2023/24 after the BMA rejected NHS England’s ‘insulting’ offer.

They discuss an integrated care board’s plans to commission all GP enhanced services via primary care networks and what the wider implications of this could be. And they talk about the findings of the GMC’s latest review on bias in its processes.

The good news story for this week is about a community in Cornwall that is going to extra lengths to find a new GP to join their local practice.

This episode was presented by GPonline editor Emma Bower, news editor Nick Bostock and senior reporter Eleanor Philpotts. It was produced by Czarina Deen.

Useful links

●     GPs reject 'insulting' contract as BMA issues stark warning over 'death of general practice'

●     NHS backs 2.1% salaried GP pay rise from April as contract talks continue

●     ICB draft contract spells out plan to move enhanced services worth millions away from practices

●     GPs don't believe integrated care systems will improve patient care

●     Cornish community creates music video in bid to recruit new GP

●     Link to Ain’t Got No Doctor

●     Lostwithiel Needs A Doctor website

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